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Coming up next on Passion Strike.
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We had this victory of longevity that, from an evolutionary perspective, happened in a nanosecond.
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The accompanying issues that go with that longevity have been both less of a priority and are coming into focus more slowly.
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I mean, that said, it s not a mystery that we re living longer lives.
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We ve known that for a long time, and we haven t addressed the workforce issues, the
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caregiver support issues, the financial issues that accompanied them.
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One of the big questions that I struggled with was, why haven t we approached those questions better?
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Because we don t just want time, we want to be able to live that time well.
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And we re really undermining our own quality of life.
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Welcome to Passion Struck.
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Hi, I m your host, Jon R. Miles, and on the show, we decipher the secrets, tips, and guidance of the world s most inspiring people and turn their wisdom into practical advice for you and those around you.
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Our mission is to help you unlock the power of intentionality so that you can become the best version of yourself.
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If you re new to the show, I offer advice and answer listener questions on Fridays.
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We have long-form interviews the rest of the week with guests ranging from astronauts to authors, CEOs, creators, innovators, scientists, military leaders, visionaries, and athletes.
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Now, let s go out there and become Passion Struck.
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Hello, everyone.
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Welcome back to Episode 391 of Passion Struck, consistently ranked by Apple as the number one alternative health podcast.
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And thank you to all of you who come back weekly to listen and learn how to live better, be better, and impact the world.
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I am so excited to announce that my upcoming book, Passion Struck, was recognized
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by the Next Big Idea Club as a must-read for 2024, and you can find it at Amazon or passionstruck.com forward slash passionstruckbook, where you can access over $300 in free gifts if you pre-order that I have specially curated for my community.
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If you re new to the show, thank you so much for being here, or you simply want to introduce this to a friend or a family member, and we so appreciate it when you do that.
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We have episode starter packs, which are collections of our fans  favorite episodes that we organize into convenient playlists that give any new listener a great way to get acclimated to everything we do here on the show.
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Either go to Spotify or passionstruck.com slash starter packs to get started.
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In case you missed it, I interviewed Dr. B.J.
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Fogg, a Stanford professor, founder of Stanford s Behavioral Design Lab, and the New York Times bestselling author of Tiny Habits.
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Throughout our interview, we explore how to apply the Tiny Habits approach to overcome things such as adversity, perfectionism, and toxic achievement culture.
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I also wanted to say thank you for your ratings and reviews, and if you loved today s episode or the others that I mentioned, we would so appreciate you giving it a 5-star review and sharing it with your friends and families.
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I know we and our guests love to see comments from our listeners.
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As we have gathered with our loved ones, parents, and grandparents in the warmth of the holiday season,
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It s a poignant time to reflect on the journey of aging and the significance of mattering in our later years.
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Today, in the spirit of these reflections, we bring you a deeply insightful episode with M.T.
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Conley, an elder justice expert and the MacArthur Genius Grant recipient.
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Her transformative work in aging and elder care has reshaped policy, research, and practice, offering a new lens through which we should view the golden years.
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In her compelling book,
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the measure of our age, navigating care, safety, money, and meaning later in life, MT delves into the complexities of aging and the challenges that come with living longer lives.
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She uncovers the striking reality of how our failure to build the necessary infrastructure for aging well has made this inevitable process far more difficult than it should be.
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Throughout the conversation, we will explore the central question that underpins Connelly s work.
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What makes aging so much harder than it needs to be?
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As millions of people live longer,
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issues surrounding aging transcend the boundaries of race, class, and gender.
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Caregivers selflessly help their older relatives, but often at a great personal cost.
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Isolation has become an epidemic, and seniors, especially those with dementia, are vulnerable targets for scammers.
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Families are left to navigate complex decisions regarding finances, housing, health, and independence.
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All of that with limited guidance.
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Compounding the challenge, elder exploitation and mistreatment remain all too prevalent, and the systems meant to protect seniors sometimes end up causing harm.
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As Connolly takes us on a journey through healthcare, finance, nursing homes, guardianship, and criminal prosecution, she weaves together gripping, first-person accounts and her unparalleled expertise, offering a panoramic and personal perspective on aging.
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During this conversation, we will learn how Conway s work has shed light on the often-hidden risks and promises of extended lives for patients, clinics, victims, and families alike.
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As we listen, many of us will realize that we haven t failed in aging or caregiving.
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Instead, we have been let down by society s inadequacies.
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So, as we bask in the post-holiday glow, join us in this enlightening conversation with M.T.
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Connolly.
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If you re seeking to understand the nuances of aging, uncover the promises of living longer, and learn how to find deep meaning in every stage of life, this episode is for you.
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Thank you for choosing PassionStruck and choosing me to be your host and guide on your journey to creating an intentional life.
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Now, let that journey begin.
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I am so excited today to welcome M.T.
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Connolly to PassionStruck.
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Welcome, M.T.
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John, I m so excited to be here.
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I like to give the listeners a starting point to get to know our guests, and I m going to pick this one for you.
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Your daughter spent her first three months bravely ill in the NICU.
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How did that experience influence you to become a champion for the vulnerable and ignite your passion for advocacy?
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Well, like
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Elder care, which often thrusts people into a caregiving role.
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Having a child who was gravely sick put me into a caregiving role.
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It s a role that combines love and rigorous challenges.
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In our case, rigorous health challenges.
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She s now a woman who s an incredible human being, but she was, and her name is Fiona,
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But she was in the NICU for three and a half months and then on oxygen at home for another two years and wired up to lots of monitors.
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And so we learned a lot of lessons really quickly.
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And some of the lessons that I think are most relevant to aging and caregiving have to do with you need health professionals you trust.
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You need other supporters and family members that you trust.
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You need to learn a lot really quickly.
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And there are lots and lots of ups and downs.
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A friend of mine says about aging, no decision ever stays made.
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And I think that s true of caregiving in general, that you have to roll with it.
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And there are a lot of unexpected things that come your way.
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So I learned a lot.
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For me, it was in many ways of defining experience of
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my life because it really readjusts what s important for you when somebody you love is really sick.
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So it was really, I learned a ton.
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I m grateful for the experience.
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I wish she hadn t had to go through it.
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Well, I had a daughter who had to spend some time in the NICU as well, not nearly that long.
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But I can tell you, I empathize with what you had to go through, because especially after you re expecting a child and then to see them sick, it s definitely a hard thing to witness.
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But thankfully, both your daughter and my daughter came out the other side of it healthy.
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So that is a true blessing for both of us.
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Absolutely.
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For a lot of friends, the decision about whether to have another child was, are they in preschool or various developmental stages?
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For us, the calculation was, is she off oxygen?
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It was quite an experience.
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You ended up spending a number of years in the Department of Justice and ended up handling a lot of elder abuse cases.
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Can you talk about that experience and some of the highlights or things that were eye-opening to you about that experience?
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Sure, I had said going to law school with the intention to be a mental health lawyer to work in the mental health system, and then went to the Department of Justice and started out in the civil fraud section bringing fraud cases against generally big entities that were defrauding some sort of government program.
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That was a great education.
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It was a great civics education.
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It was a great education in the way that money moves, and sometimes it drains out of systems in ways it shouldn t.
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And then going to the overarching subject of your podcast, I wanted to have more control over my life than litigation allowed for.
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I went to my bosses and said that I didn t really want to litigate anymore and I had the opportunity to head up something then called the nursing home initiative, because there were a number of congressional hearings showing abuse and neglect in nursing homes at a really vast scale there was a government accountability office report
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California nursing homes about a third of which were found to provide care so poor that it put residents at risk and so there was a good amount of attention and so both the Department of Health and Human Services and the Department of Justice
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nursing home initiatives to say, OK, what s the government s role here?
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How can we exercise better stewardship over Medicare and Medicaid, which provide a lot of the funding, when there s real wrongdoing, when those programs are being defrauded?
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How should we redress that fraud?
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So that was one aspect of the work early on, was to say, what s the Department of Justice role?
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when Medicare, Medicaid, other government programs are being defrauded, and the care is abusive or neglectful.
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So I got into it thinking, oh, this is an isolated problem, and it s a new problem.
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And it was neither one.
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It was problems in nursing homes are longstanding.
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They ve been going on for decades and decades.
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And in a sense, nursing home abuse and neglect was just the tip of the iceberg in terms of the challenges of aging.
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And so it served as a real education for me.
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And from that experience, what then caused you to go from being a prosecutor to a preventionist?
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There s something called the longevity paradox that helped me reframe how I was thinking about the work.
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We have moved heaven and earth in terms of science and public health and hygiene to extend our lives.
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In 1900, the average American lived 38 years.
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By the dawn of the 21st century, by 2000, the average American lived 78 years.
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That s an astounding victory
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in terms of giving us extra time on the planet.
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But what we haven t done is focus the same amount of attention on quality of life as we have on quantity of life.
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And so, in a sense, we re catching up with our own demographic victory because there are so many challenges that we haven t really addressed.
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You know, there are huge challenges in terms of caregiving, both
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at home and in facility settings.
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There are huge challenges in terms of money, in terms of how we re going to pay for everything, and how we manage our money given our longer lives.
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And there are huge ethical and philosophical challenges in terms of autonomy safety.
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How do we strike the right balance?
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So
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The further I got into the issues, the bigger and more compelling and more universal they became.
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And so I wanted to take a new kind of look at them that broadened the lens and allowed me to approach them in a broader way.
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Well, I m going to introduce your brand new book, which launched July 18th, titled The Measure of Our Age, Navigating Care, Safety, Money, and Meaning Later in Life.
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Congratulations on its launch, first of all.
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Thank you so much.
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I really appreciate it.
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And as you just alluded to, you start the book out by giving the fact that between 1900 and 1999, Americans gained on average 30 extra years of life.
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And you talked about some of the challenges.
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What have you discovered about why the system is so complicated, onerous, and oftentimes we hear cruel, navigating all those aspects of it when it should be straightforward and much more simple, I would think?
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I think there are several contributing factors.
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One of them is that we haven t really caught up with ourselves.
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We had this victory of longevity that, from an evolutionary perspective, happened in a nanosecond.
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And so social and the psychological and sort of the accompanying issues that go with that longevity have been, I think, both less of a priority and are coming into focus more slowly.
1
SPEAKER_01
And that said, it s not a mystery that we re living longer lives.
1
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We ve known that for a long time, and we haven t addressed the workforce issues, the caregiver support issues, the financial issues that accompany them.
1
SPEAKER_01
And so one of the big questions that I struggled with was, why haven t we approached those questions better?
1
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Because we don t just want time.
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We want to be able to live that time well, and we re really undermining our own quality of life.
1
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I think one of the things that plays into it is our ageism.
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We re, on the one hand, we want to get old, but we don t want to be old.
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And we don t really even want to think about being old.
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So that means we don t want to plan for it.
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And if we, there s this whole heroic notion of living longer, but the actual notion of being old is often accompanied by fear and shame and denial and even disgust.
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which are also really powerful emotions in terms of inhibiting our willingness to take on the challenges of aging.
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And so I think at a pretty fundamental level, one of the ways we undermine ourselves in terms of preparing for aging is by our very sentiments about old age.
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Well, one of the things that we cover quite regularly on this podcast is the idea of longevity medicine or longevity science.
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And we oftentimes think of lifespan, but we don t think as much in terms of health span.
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And it was interesting.
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I interviewed Dr. Kara Fitzgerald, who wrote this great book, Younger You, about a year ago.
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And one of the revealing things that she brought out in that interview was that by the time we re in our fifties and sixties,
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60% of adults have one, if not two, serious conditions that are impacting their health, and that those serious conditions impact between 25 to 30% of their remaining lifespan, where they re living not an optimal life.
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And so I have had on her, Dr. Hyman, Dr. Will Cole, Dr. Amy Shaw, who ve all talked about the need
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to really look at this healthspan through a different lens and to find ways as you re aging to increase your biological age so that those years as we re getting older can be spent in the most productive and energized way possible, not dealing with sickness.
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And I know that this is a topic that s near and dear to you as well.
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Can you elaborate on this concept and suggest some ways that people can achieve a longer healthspan?
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I think one part of the question that you re asking that I ve been really interested in is that there s lifespan and health span and that
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Lifespan is 78 years, but healthy lifespan is 66 years.
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And so that it goes right to what you re asking.
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And so my I ve thought a lot about the kinds of books that you re talking about.
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And I think it s a yes.
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And so I think that there s both preparing for the challenges because
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If we manage to live longer and longer, there s still going to be challenges of aging.
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Three quarters of people 85 and older have some functional disability.
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A lot more people are going to need care.
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So part of being prepared is figuring out how we re going to provide that care as a society and as families and for ourselves as individuals.
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And then the other part of it, as you allude to, is thinking about how we can have more
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meaning and purpose in our lives as we age, that s also extremely good for our health, if we can really refocus ourselves on that.
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And that was one of the biggest surprises for me in writing this book, is the profound health impact of things like staying connected to the people you care about, both the people you love and are most connected to, and also just being part of your social community.
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And the incredible importance both to
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psychological and physical well-being of having purposeful activity, doing things that matter to you.
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I think we have this notion that you retire and then that s it.
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As Americans, we work incredibly hard and then suddenly you retire and you get your pen or your plaque or whatever it is and then it s like best of luck to you.
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But a lot of people have another 20 years, 30 years maybe of productive life in them.
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And so,
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If we as a society focus more on what are the contributions that people can make and providing some on-ramps in a more effective way as a society to those contributions.
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You know, maybe people don t want to be working 40, 60, 80 hours a week anymore.
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having employers, having social service organizations, having communities say, these are some important areas where we would love to have the contributions of older people and have that be the norm, not the outlier.
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AmeriCorps  RSVP program has opportunities.
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There s somebody named Mark Friedman, who is the co-CEO of an organization called Code Generate that really focuses on people s Encore Acts.
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But to make that
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the norm as opposed to the exception in society, I think would be a really important place to put more focus in terms of preventing bad outcomes and enhancing our opportunities.
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Well, Amity, thank you for that.
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And one of the central things that you talk about throughout the book is the term elder justice.
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For the listener who might not be familiar with that term, can you just define what
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that means?
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Sure.
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Thanks for that question.
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Justice is one of those really big words that people have very different definitions of.
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Some people define it as punishment.
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Some people define it as mercy.
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Some people define it having more to do with opportunity or equality.
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And so my definition of justice really evolved when your prosecutor
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To a hammer, everything looks like a nail.
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I thought, oh, the law can cure our problems.
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And that wasn t really correct.
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The law can help.
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And the law can be used both to punish or redress wrongs and also to expand opportunity.
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And so my focus, even in terms of the law, went more from
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only punishing wrongs to what how can the law help fix broken systems also for me, elder justice means having a society where people can age well where they don t need to live in fear of not knowing who s going to provide care or
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whether they re going to live very much alone, and where caregivers feel like they can get the support they need in doing what s a really hard job.
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There are more than 40 million people providing informal care, most of them family members, and we provide very little help to them for a really hard job.
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My notions of justice have expanded, and I see it more in terms of
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prevention than just redress.
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And that s to say so much of what we do in the United States is wait for problems to happen and then are crisis driven after bad things happen.
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And that s true often in aging too.
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We wait for the crisis to happen instead of saying,
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how do I want to age as well as possible?
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How we age is how we live.
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And so it s worth spending a good amount of time in trying to think about how thinking, as you said, intentionally, and then communicating with the people who are most important in terms of how to make that happen so that we re not crisis driven, but that we are preventing trouble before it happens, both as a society and in our individual and personal lives.
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I wanted to follow that up with the fact that the story behind the Elder Justice Act sounds intriguing.
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Can you share some of its history and the valuable lessons you learned throughout its development?
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Sure.
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When I was at the Department of Justice and started discovering elder abuse,
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which affects at least one in 10 older Americans and has an impact on probably about 30 to 40 million concerned others who are trying to help them.
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I was really struck by how pervasive the problem was and how much suffering it causes.
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It causes an awful lot of suffering and increases mortality threefold of the mortality of its victims.
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And so I thought, oh, what has the law done in comparable problems?
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And I found the Violence Against Women Act, which was enacted in 1994, and the Child Abuse Prevention and Treatment Act, which was enacted in 1974.
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And I looked for an elder abuse law, and there wasn t one.
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So I thought, oh, well, we need a law.
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We can fix that with a law.
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And so I talked to colleagues in Congress and made my way over to the Senate Special Committee on Aging.
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which has long been a leading voice and advocate on behalf of older Americans, and worked with colleagues there.
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I was there on loan from the Department of Justice, but worked with colleagues there to draft a new law called the Elder Justice Act.
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And we had a lot of both Democratic and Republican co-sponsors and nobody was against it.
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It was, everybody seemed to think it was a really good idea.
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And that was in 2002.
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And then the law
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sat there and sat there and was reintroduced in a number of different Congresses.
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And I thought, huh, what am I missing here?
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Everybody thought it was a good idea.
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Everybody said it was a good idea.
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There were no obvious opponents to it.
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And so clearly I had missed something big.
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And I think the biggest thing I missed goes back to one of your prior questions, which is that everyone s against it, but it was nobody s,
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third priority, second priority, certainly not their first priority in terms of getting things done.
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And in Washington, the way things get done is when things are a top priority and you need to have
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a political constituency to push for a law.
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You need grassroots and what are called grass tops networks to push.
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And the elder justice community was not terribly well organized.
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And a lot of the victims were pretty invisible.
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A lot of them were either unable or unwilling to push and they didn t want to relive it.
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Many of them were no longer alive.
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And so we had some significant challenges
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And then even after the law was enacted in 2010, along with the Affordable Care Act, and the way I think about it is that it was a small barnacle on a very big whale that was buffeted by a lot of storms, but there was still no funding.
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And so another one of the lessons in terms of legislation is that you don t just need to get a law passed or authorized in Washington terms.
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There also needs to be an appropriation that goes with it.
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And then there needs to be a lot of focus on how the law is implemented.
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And wise implementation is also a really big job.
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And so there was no funding at all until 2015, and then just like little rounding error amounts in congressional terms.
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And then there was a chunk of money with COVID relief, and then that s mostly fallen off again.
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So the work continues and the lessons are many.
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As I was reading the book, I didn t realize that there was such a thing as adult protective services.
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You always hear about child protective services, and I think that s something that most people are aware of.
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But the differences between the two are really enlightening.
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Can you shed some light on those and why the blueprints for both cannot be directly transferred to each other?
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Absolutely.
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And thanks for that question.
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I will say when I started doing this work, I also had not heard of Adult Protective Services, and most Americans haven t.
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Adult Protective Services generally, and it s different in every state, helps vulnerable adults who are in trouble.
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And generally, that involves trouble that is either abuse, neglect, or exploitation.
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And most programs respond to adults who either are being neglected by somebody else or what s called self-neglect, which is a term I don t like very much because it s a blame the victim situation, but it s language that I think is not very enlightened and diminishing.
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But in any event, Adult Protective Services is the entity that you call when you re trying to figure out what to do to help somebody and you don t really know what needs to happen.
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And the blueprint, I actually think for me the most important lesson of my research was that the blueprint for both Child Protective Services and for Adult Protective Services is fundamentally reactive.
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It s based on a report and investigation model so that you wait until trouble happens and then you report it to APS or CPS and then they investigate.
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And often there s a brief time period of involvement that is often not long enough or comprehensive enough to really help solve the problems that are going on.
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And so the most fundamental lesson for me was that as a society, we need to get out ahead of these problems as opposed to have structures that are built to react.
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Because once you re building it to react, you run into these very complicated autonomy safety issues, which I think maybe is one of the things you were alluding to in your questions, which is that children are presumptive, don t have capacity until they re 18.
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Some adults making decisions for them generally.
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unless they re an emancipated kid.
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Adults presumptively have the ability to make decisions and certainly have the legal authority to make decisions for themselves until they don t.
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And so then it can get very complicated if older people or vulnerable adults are making decisions that seem to be detrimental to their health or well-being.
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And then the question is, what is the obligation of society to step in?
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if people presumptively have the authority to make decisions?
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And that s a very complicated question that I think we haven t spent anywhere near enough attention on.
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And I m happy to go into examples if that would be useful.
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Yeah, I think that would be useful.
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When it comes to older people I think most of us have at least heard about the example of maybe mom or dad aren t driving as well as they used to when should we have that conversation.
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When should we think about maybe it s not time to have a driver s license or have the keys anymore, but similar kinds of questions come up in many domains, they come up in terms of health, a lot of people
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live alone in situations that others of us might think, ooh, is that safe still?
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Maybe examples are leaving on the gas or having throw rugs that you might trip on or fall risks.
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My dad, who was quite wonderful and lived
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to 93.
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We were worried about him falling and wanted him to wear a life alert.
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And he said, that s not going to stop me from falling.
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So he was, you know, he had a point.
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So that s one example where there are complicated questions about where should we push.
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Another one is money.
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Maybe an example that I saw many times in my writing is say in an older person, an older man who s giving away money to
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a younger person who either has maybe a potential romantic interest or a new best friend or is somebody who s just reaching out and calling a lot.
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The saxophonist Kenny G s father, whose name was Moe Gorlick, gave about $900,000 over the course of one year to his longtime trusted caregiver s daughter.
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who said she needed it to start a new business.
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One of the people I write about in the book, Paige Ulrey, ended up prosecuting that daughter, that caregiver s daughter, for basically making up stuff and not using the money to invest in a new business for her own purposes.
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So as a society, it s really complicated to know when do you intervene and when do you let things go?
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And we just need to provide people a lot more guidance in that regard.
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And in your research, you outline a number of approaches to change.
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Can you briefly describe some of these approaches and their potential impact on improving elder justice?
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Absolutely.
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There were two things that happened in working on this book that really changed my approach to my work.
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One of them is the people I met, these extraordinary people about whose work I was writing.
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And then the other one was having a more fundamental understanding about what the problems are.
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So one of the people whose work I have written about is somebody named Ricker Hamilton, who started off as an adult protective services worker in Maine.
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and then rose to become the Commissioner for Health and Human Services.
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And so in that position, one of the deficits that we have in the field that I really would like to see us do more to remedy is that we don t have what s called prevention research or intervention research.
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And prevention research is essentially
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What are the tools that are going to help us prevent problems as we age, either as individuals or as policymakers?
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We want to know what are the evidence-based tools.
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And intervention-based research is how are the tools that we re using or the programs we re using working?
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Let s try and measure the impact.
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And I know that you ve done a number of podcasts on measurement and what we measure matters because then we have a better understanding of the impact of our work.
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So I went to Ricker and I said, yo, Ricker, will you let us measure what the clients think about the impact of adult protective services on their lives?
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What are the client s goals?
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And does adult protective services help them meet those goals, fall short of them, exceed them, et cetera?
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So one of the things we learned and Ricker said, sure, which was fantastic.
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I worked with a wonderful researcher at the university of Toronto named David Burns.
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He started asking, started collecting data on this.
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And one of the things that we saw was that people don t just want help for themselves.
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Older people want help for their family members.
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for maybe a daughter who has mental health issues or a son who has some addiction issues or a grandson.
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And so I went back to Ricker and I said, yo, Ricker, we re seeing this issue come up and Adult Protective Services is not equipped to help other people.
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It s not within the legal mandate or the structure.
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And so would you let us build a program that can run alongside the government programs?
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to supplement the services so that if they want to get mental health treatment for their daughter or drug treatment for their grandson, that s something that we can say, sure, we ll help you do that.
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So Ricker said, yes, and we built it and we randomized the states so that we had to, we first test drove this program that we call the RISE program in two counties in Maine.
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and then tested what the results are.
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And the results have been really great.
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The thing that has been really striking is that the Adult Protective Services workers like it too, because people want to do their jobs well.
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These are really hard jobs and everybody wants to sleep better at night and wants to serve vulnerable people better.
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And so what we found was that having access to RISE
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help them serve their clients better.
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And that was coming from them.
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That was the message back to us.
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So that was really exciting.
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And the state of Maine itself expanded the program statewide.
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And just within the last month, the governor signed a law that includes RISE as a permanent part of Maine s healthy aging budget.
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So that s incredibly exciting.
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For me, there are two lessons there.
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One of them is you want to build
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the programs in the ways that people themselves, you re trying to serve, say that they want those programs to be shaped.
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They re called person-centered programs.
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Like how do you do what the people want?
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And the second part of it is you need to measure it if you, in a really rigorous methodologically sound way, if you want to replicate it.
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So those were the lessons that I took.
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Sorry, that was a little bit of a long-winded response.
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No, I think it s some great context and I hope that other states will look at what Maine has done and replicate that as well across the country.
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That would be a huge victory for all of us.
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It s starting to happen and we re starting to expand it to the criminal justice system to provide a new kind of diversion program, a similar kind of context.
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So it s really exciting.
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I wanted to switch gears now to talk about some of the impacts of this longevity that are happening in ways that we probably don t think about them.
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And I remember my grandparents, and I am lucky enough to have really good genes.
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My paternal grandmother lived to be 101.
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and my maternal grandparents lived to be into their 90s.
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But they had completely different ways of approaching the remaining years.
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My paternal grandmother lived autonomously as long as she possibly could in an apartment.
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and then ended up, when she was in her 90s, going into a home.
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But I was always intrigued by her because she was as sharp as a tack until the day she died, and she puts a lot of that on playing bridge, staying active, using her mind, doing crossword puzzles constantly.
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trying to exercise her mind in those ways.
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On the other side, my grandparents wanted to stay in their house and specifically configured it as they were getting older to allow for them to have an adjacent room to their kitchen that they could go into where everything would be on the first floor.
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And that s what ended up happening.
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But in their case, as they got older, a lot of the burden fell on my aunt.
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who lived in Chicago pretty close to them because my mom was hours away from them in Tennessee.
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But as that care took years and years, and then my grandfather eventually got dementia, I could see the wear and tear that it was having on my aunt, and it was causing herself to start experiencing some mental health issues just because of the burden that was constantly on her.
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And I don t think that this is something, unless you ve gone through it, that we typically think about.
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How can we address the high personal costs that these caregivers often bear while providing care for their loved ones?
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It s such an important question, John.
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Just to raise the lens, we have more than 41 million
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people providing care to a person 50 and older for an average of 24 hours a week over about a four year span.
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It s a staggering amount of work.
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And the estimates, the new estimate valuing that care at about $600 billion a year and lost income to caregivers at about 522, I believe, billion dollars a year.
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And the health toll is significant as you just reflected on terms of your aunt.
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The toll on physical health, cardiac problems, immune issues, mental health, depression, anxiety, and hastened mortality.
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hastened death in caregivers themselves.
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And we, the way I think about it is that we re banking the benefit, but we re not doing honest math about the cost to the caregivers.
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And really, as you said, so much of that work is invisible.
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We don t even recognize the work, much less help those caregivers.
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And caregivers
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Caregivers need real help.
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They need help with respite to take some time off.
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They need help in terms of better community resources.
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So things like adult daycare or somebody else coming into the home so that there s some relief.
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We need to provide structure.
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Caregiver groups actually can be
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very helpful to some caregivers so that they don t feel so alone.
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But many caregivers feel very much alone.
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When we re raising kids, often we have a community of people and we have schools and we have sports teams and we have all kinds of stuff, you know, hanging out on the bleachers or at the dance recital or whatever it is.
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For caregivers who are caring for older people in homes,
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a lot of times they get increasingly isolated along with the people that they re caring for.
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And we just have to do better as a society.
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And we have done a really lousy job in terms of building infrastructure to support the people that we are relying on for an extraordinary amount of work.
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One other part of that I think is that we don t have a residential care system that people trust.
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We don t have other systems that people trust.
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And so that I think is, that s a component of it too.
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I would agree with you there.
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I just remember the vivid images during COVID of seeing some of the nursing homes in New York City and how the elderly were mistreated so badly and them, so many of them dying because they weren t given the proper protocols to protect them against the disease that was going rampant throughout those facilities.
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Yeah, that s exactly right.
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Sometimes you hear, oh, the people in facilities have pre-existing conditions.
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Well, the industry itself, the long-term care industry itself has a lot of pre-existing conditions too.
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The most important factor in the quality of long-term care
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is staffing.
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And we know that a lot of places are understaffed and it s not, as you ve reflected in other episodes, it s not just how much people are paid, it s also how they re treated, it s also how they perceive whether their work is valued and whether the people for whom they care, whether there s value in that work.
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And so there s a lot of hopelessness and helplessness
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among the staff as well as the residents.
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And then there are these enormous financial factors.
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Nursing homes and what are called continuing care retirement communities together get more than $100 billion in taxpayer dollars a year.
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That s a wild amount of money for which they are not held sufficiently accountable.
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We don t know how much of that money actually reaches the bedside.
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and goes to improving the well-being of residents.
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And sometimes we don t even know who owns those facilities.
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So we can do a lot better, both in terms of improving staffing and improving accountability for the funds that are being expended, public taxpayer funds.
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I think those are some extremely valid points.
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A couple of things I wanted to get through because I think they re important is we have talked a lot on this podcast about the epidemic of loneliness and how this is something that is impacting one third of the world s population.
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In some areas, 50% of the population.
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And it s only getting worse.
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And people
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equate this to the elderly but it goes well beyond that and it s impacting people all the way down to teenagers.
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But I do want to talk about the elderly here because loneliness and isolation are pervasive issues among seniors and as you alluded to also among the caretakers
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who are trying to provide for them.
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How do we combat this epidemic and foster better social support systems for our aging population and those caregivers?
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Such an important question, and it s a huge health issue.
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The Surgeon General, Vivek Murthy, has done really important work in terms of raising awareness on this with his book, Together, and other work that he s doing.
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It s a really pervasive issue across all generations.
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One of the ways in which it manifests itself in the aging generation is that we have these two predominant paradigms, really, as you reflected in your grandparents.
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Your two sets of grandparents aged in very different ways.
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One of the predominant models is to age alone in your home, where a lot of people get increasingly
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isolated as your grandparents and your aunt did.
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The other is that you live with other older people, but most of the time segregated by age.
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And whereas once as a society, older and younger people live together in community and family, that is much less often the case now in terms of the prevailing structures of how we age.
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And I think that s a real loss and it s a loss that has an impact not only on older people but also on younger people, and it s a pretty devastating loss because we lose a sense of the whole life cycle for younger people, they are deprived of
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seeing how we age and how we change and the richness of aging and the challenges of aging and it becomes a much more alien terrain onto which you can project all sorts of fears because you don t actually know or have older people in your lives and so I think that it s a real loss to younger people and it s a real loss to older people to not have
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young people in their lives and the data are pretty clear that intergenerational contact is really important.
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People often want to be with their cohort and all of us have a lot in common with our cohort and we love our cohort.
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I love my cohort but I also love
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having younger people, I was absolutely thrilled that I had a lot of young people at my book launch, at my local bookstore, Politics and Prose.
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And because how we age is how we live and we re aging, everyone everywhere is aging all the time.
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So I think if we think about it that way, it s a healthier way to think about it.
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There s a new model called the age-friendly community.
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And one of the mottos is where people of all ages can age well.
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And so I think that it s a model that was created by the World Health Organization in 2006 and is sponsored here in the United States by AARP, and there are a bunch of different metrics about how
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you create an age-friendly community, what are the components of having a healthy environment for people of all ages?
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So I think that we need to start focusing much more on that in terms of reducing isolation and loneliness, because we have so much pent-up capacity that we re not using.
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A lot of times, older people have so much to contribute and no easy path to contribute what they have.
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and younger people have lots of need.
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There s a researcher at the University of California in LA named Steve Cole, who s done work about the health benefits of older people volunteering with young kids who are at risk.
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And it s enormously beneficial to the older people too.
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They live longer, the benefit of having that kind of purposeful activity in their lives
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lasts for a long time.
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They do better on all kinds of physical markers.
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The benefits are on the order of stopping smoking or eating a diet, a decent diet or exercising.
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So I think we really underestimate the power of connection and purpose.
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That was where I was going to go next, actually, because we talk a ton on this podcast about the importance of cultivating purpose and self-worth.
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And you alluded to hopelessness earlier on in the show.
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And I feel the opposite of hopelessness is having meaning.
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And it s when we re meaningless that we start losing hope and everything around us.
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And I think these are especially important topics for having a fulfilling life as we age.
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Can you share any strategies that you ve come across that may help seniors maintain a sense of purpose and value and self-worth as they age?
4
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It s such an important question, John, and for me that part of writing this book was really the biggest revelation and the biggest surprise in a very positive sense that the researcher I just mentioned Steve Cole talks about
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we have lots of unrealized control over how we live and how we spend our time.
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And shifting the focus to what matters most is enormously powerful.
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So I think we ve talked about a couple of them, the staying connected to people that you care about and
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socially.
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And that requires also work sometimes, taking stock of the relationships that matter to you and saying, am I keeping up with the people who are most important to me?
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Am I spending time with them?
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And that is an important kind of reevaluation to do.
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So we, I think we have more control there than we think about, and we should move toward those
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people in our lives who are important to us.
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We ve talked about having purposeful activity, I think, so I won t land on that too much, although I m happy to discuss it more.
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Another area that was really striking to me is the importance of curiosity and creativity in old age.
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And even when babies are just born, they track things.
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And even when we are deep in old age and maybe have dementia or other kinds of issues that often make us give up on people, creativity and purpose are really still important.
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There s this amazing plant study that was done, I think in the 70s, where the residents in nursing homes were divided in half and everybody got a plant.
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And in half of the residents, they were told, oh, the nurse is going to take care of your plant.
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And the other half were given a brief primer on plant care and they decided how much to water it and where to put it in their room and what to do.
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And when the researchers looked at the well-being and health after the study, the people who had the plant, had control over their plant and decided how to care for it, did better.
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And that s a really important, I think,
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Canary for us to pay attention to.
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And I ve worked with this extraordinary woman named and basting who runs an organization called time slips and her watchword is forget memory try imagination.
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So, and has put on.
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plays in nursing homes.
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And actually, I went to go see one of those plays with the doctor that I write about.
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We did a field trip.
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We went to Morgantown, Kentucky, and Laura Mosqueda is the geriatrician.
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And we both wanted to see, what does this look like?
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And it was really very moving.
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It was a play called Wendy s Neverland, which was a riff on Peter Pan, only in this play, Wendy had grown up and had grown old and lived in a nursing home and was reflecting on her life.
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And it was the residents and artists and staff and a group of people putting on this play together for an audience.
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And there were so many things that were beautiful about it.
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One of them was that it was a gift that the residents could give to others.
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It wasn t just, oh, the choir is gonna come in and sing to you.
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It wasn t just a one-way transaction.
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And they re giving a gift of creative performance to other people, and it brought the community in and these amazing musicians and
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actors and creative people, and you could just, the joy was palpable.
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And so that s a long-winded way of saying we miss opportunities for creativity and joy, I think in old age.
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And so at any age.
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So I ll stop there, although there are two other factors that I would love to talk about, but I don t want to ramble on too long here.
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Well, I am, for the sake of time, going to ask you one last question, MT.
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And that is, if a person is listening to this episode or is a reader of your book, what do you hope they take away from it?
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And what is one practical and actionable step that all of us who are listening or reading your book can take to contribute to the advancement of elder justice?
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What a great question.
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The overarching theme and hope I have that people take from it is that we underestimate aging, which means that both the hard parts and the good parts.
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So we re unprepared for this very significant challenges sometimes.
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We also miss out on what matters most.
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It s because we lack the knowledge and the awareness of what to be prepared for and what the both the challenges and the good things are.
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So I would hope that people really think about their own aging, have conversations,
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in their families and with their friends, and also push policymakers harder to say, we would like you to put structures in place and to fix our systems so that they help us age better because we ve managed to live much longer, but we want to live better.
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That is an achievable goal.
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If we start to have those conversations, if we push harder, and if we age in a more intentional way,
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as individuals, in our families, and as a society.
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Well, MT, thank you for that great answer.
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And if a listener wanted to learn more about you, where is the best place they can do so?
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I have a website, which is mtconnelly.com, that my daughter built, that same daughter that we started the interview with.
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So yet another gift of my daughter.
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So yeah, www.mtconnelly.com.
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Did I say gov?
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I might ve said gov.
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I meant com.
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You spent too many years in the government.
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Exactly right.
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Yes.
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Whoops.
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MT, thank you so much for joining us today.
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It was truly an honor to have you and to talk about this very important issue.
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Thank you so much for your interest.
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I am really grateful to have been on your show.
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I thoroughly enjoyed that interview with MT Connolly, and I wanted to thank MT, Alyssa Fortunato, and Public Affair Books for the privilege of having her appear on today s show.
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Links to all things MT will be in the show notes at passionstruck.com.
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Please use our website links if you purchase any of the books.
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Advertiser deals and discount codes are in one convenient place at passionstruck.com slash deals.
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Videos are on YouTube at both our main channel at John R. Miles, and also our clips channel at passionstruck clips.
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Please check it out.
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If you want to find me on social, you can do so at John R. Miles.
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You can sign up for my personal development newsletter.
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Live Intentionally on the PassionStruck.com website, or my work-related newsletter, Work Intentionally on LinkedIn.
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You re about to hear a preview of the Passion Struck Podcast interview that I did with Stephanie Wilder-Taylor, the author of Sippy Cups are an Art for Chardonnay, who offers a pivot in her upcoming book, Drunkish, Loving and Leaving Alcohol.
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We discuss the following topics, knowing when it s time to get sober and choosing your own rock bottom instead of losing it all.
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pivoting from an identity that defines you publicly, how alcoholism can present differently in everyone, and lastly, compulsive behavior and broader substance abuse issues.
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My first book was called Sippy Cups Are Not For Chardonnay.
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It was my brand.
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My brand was joking about being like a wine mom.
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There was like a dark side to it.
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There were
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blog posts I wrote kind of drunk.
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There were emails that I sent out drunk.
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Every night after the kids went to bed, there was just buying things drunk on the computer and this happy kind of, Oh, it s fun to parent and have a glass of wine was not exactly what I was doing.
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I was having four glasses of wine.
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And feeling like crap the next day.
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And like you said, not performing at my best and definitely not living my best life.
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And just feeling sad all the time and discontent and not understanding why.
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And victim-y.
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Like, how did I get here?
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The fee for this show is that you share it with family and friends when you find something useful or interesting.
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If you know someone who is dealing with an aging adult, then definitely share today s episode with MT Connelly with them.
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The greatest compliment that you can give us is to share the show with those that you love and care about.
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In the meantime, do your best to apply what you hear on the show so that you can live what you listen.
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And until next time, go out there and become Passion Struck.