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The New Parent Trap

For a growing number of working adults, caring for a parent is a life-altering juggling act that can jeopardize their own health, finances and jobs. But it is possible to balance it all. Here’s how.

By Greg Carannante

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Elder mediators can keep families out of court

South Florida Sun-Sentinel.com "
By Diane C. Lade, Staff writer "
6:38 PM EDT, September 8, 2013

Family members can end up at each other's throats over decisions about end-of-life care, estate planning or whether Mom should move into an assisted living center. Can't sort it out?

Before you lawyer up, consider trying an elder mediator. South Florida mediators have been refereeing divorce and custody battles for years. But recently, a new breed who call themselves "elder mediators" have been specializing in small and large conflicts commonly faced by seniors, such as which sibling gets to make medical care decisions for a parent, or deciding if Dad should give up driving.

Yet most seniors have never have heard of mediation, or falsely believe they need to first go through an attorney, said Bonita Para, a mediator who specializes in elders and adults throughout Broward, Palm Beach and Miami-Dade counties.

"A lot of families are just stuck on issues that don't necessarily require legal action. The conflict erupts, people stop talking to each other and they call in the lawyers," said Para, a state-certified mediator for 15 years who formerly ran a community dispute resolution center in Washington state. Para along with Doris Haas, owner of Atlas Aging Life Care Management in Fort Lauderdale who also is state-certified mediator, hope to raise elder mediation's profile through a new program starting this month at the Joseph Meyerhoff Senior Center in Hollywood. Haas or Para will schedule meetings with dueling parties at the center, in clients' homes or anywhere near the center. Out-of-town family members can join a session by Skype.

The fee: a $50 donation to the Meyerhoff center, or less if the senior is on a limited income. If the program is successful, the women hope to start a nonprofit mediation clinic to offer services, priced on a sliding scale, at other South Florida senior centers. Mediation fees typically run about $100 to $500 an hour, according to AARP. Para and Haas normally charge about $250.

Elinor Robin, executive vice president of Mediation Training Group Inc. in Boca Raton, said she'd never heard of elder mediation being offered through a senior center. The service isn't commonly used, she said, partly because it's a new mediation specialty and not widely known.

But it is gaining recognition as the number of people struggling with elder care issues is growing.

The Association for Conflict Resolution, a professional organization for mediators, created an elder section about two years ago. And a new Florida task force is looking at developing a comprehensive court-ordered mediation program for contentious elder-care situations, often involving guardianships, similar to what the state has now for parenting disputes.

These cases often involve families "where conflict has been the driving mechanism for a long time," said task force member Linda Fieldstone, supervisor of family court services in the Miami-Dade County courts system. "We want vulnerable adults to have the same alternative dispute resolution options that parents do."

Mediators come from many professions: attorneys, registered nurses, geriatric care managers, pscyhotherapists. There are about 6,200 mediators who are state-certified by the Florida Supreme Court, grouped into five categories, including family, civil and dependency mediation. Although there is no elder certificate, mediators who want to work with seniors can do additional coursework, such as what Robin's group offers.

Robin estimates about 25 mediators statewide are focusing on elders.

Becoming a state-certified mediator requires anything from a high school diploma to a master's degree (depending on the mediation type), a 40-hour class and observing a certain number of mediations. The Florida Supreme Court maintains a list of those with their certificates, monitors them and takes complaints.

But consumers should beware: The profession in general doesn't require licensing. So someone with no training could legally call themselves an elder mediator, Robin said, as long as they don't claim to be Supreme Court certified.

"And you would have no recourse if something went wrong," she said. Beth Allen, Meyerhoff's executive director, said elder mediation will be new to both her and her seniors, but that interest is high.

"One the biggest problems we face is that we don't always communicate well with our family members," she said. "The seniors believe their children are too busy to have these discussions, and the children don't want to have them because they're afraid of upsetting their parents."

Haas recently handled a dispute between two sisters. The one caring for their elderly father in South Florida was struggling with personal problems but didn't want to give up control, Haas said. The other sister, who lived out of town, was worried their father's health was suffering.

"We did a mediation and the caregiving sister ended up agreeing to give her power of attorney to the other sister and let her take on the responsibility," Haas said. "It would have been so much more stressful and expensive to take it through the court system." There will be a free presentation on the new elder mediation program at the Joseph Meyerhoff Senior Center, 3081 Taft St., Hollywood, at 10 a.m. Tuesday and 11:15 a.m. Sept. 23. The public is invited.

Elder mediation "
Be aware that there are no general mediator licensing requirements. Anyone legally can call themselves an "elder mediator."

Choose a mediator that has been state-certified by the Florida Supreme Court. To see the certification list, go to flcourts.org and click on "alternative dispute resolution/mediation" under the "general public" tab. Then click on "mediator search" on the left. Links to disciplinary records also are on this page. Or call 850-921-2910.

There is no state certification specifically for elder mediators. So ask a potential mediator if they have received additional training in elder mediation, or if they have worked with seniors before.

Copyright © 2013, South Florida Sun-Sentinel

MY MOTHER DOESN’T LISTEN TO ME! (THE NEW ROLE OF ELDERCARE MEDIATION)

By Doris Haas RN, CCM, CMC

As a Geriatric Care Manager, I am considered an expert in issues relating to the elderly.  However, where my mother is concerned, I am just a daughter who cares.  She often takes the advice of friends and even strangers over mine.

So now she has become the caregiver for her boyfriend, a man diagnosed with Alzheimer’s Disease.  Though I have been watching him decline, and discussing the disease process all of the time with her, she still does not want to believe that he can no longer take care of himself.   Recently at the doctor’s office, he was told that he could no longer drive, and needs someone to visually see him take his medications.  He has sent home aides that were hired, and needs to move to an assisted living residence.

My mother does not live with him, nor does she want to take on that kind of responsibility.  She cannot make this man move when he thinks it is unnecessary.  She has been communicating with his son who lives out of state and he has not come down to help.  He has been comfortable having my mother look after his father and does not want to see that she can no longer do this. 

I see that there is a place for an eldercare mediator.  There is a breakdown of communication between my mother and his son, and caregiver responsibilities need to be clarified.  Since neither one of them will listen to me, another professional needs to be called in to help.  I know other Geriatric Care Managers that are also Certified Mediators.

WHAT IS MEDIATION?

Mediation is a process in which people meet in a private confidential setting to work out a solution to their problem with the help of a neutral person (a mediator).  The mediator is not a judge, does not decide who is right or wrong, and does not force the parties to accept any agreement or terms to an agreement.  Instead, the mediator listens to the parties explain their concerns and helps them develop and agree upon a workable, mutually acceptable solution.

EDLERCARE MEDIATION deals with any conflicts involving seniors and their families.  Sometimes children argue about their parents’ care.  Sometimes seniors argue with their children.  When the conflict begins to deteriorate relationships, a mediator should be called in.

WHY TRY MEDIATION?

Mediation is private and confidential.  Participants can express themselves in a safe situation where the other participants listen.  Mediators keep the focus on the issues so that families can move beyond underlying problems.  Exploration of different options and creative problem solving is encouraged.  They become empowered and design their own agreements.  Older persons participate if able, which gives them maximum control over basic life decisions.  This approach is non-adversarial.

WHAT KINDS OF ISSUES CAN BE MEDIATED?

  1. Medical/Healthcare decisions
  2. Financial decisions
  3. Living arrangements
  4. Communication issues – sharing of information
  5. Famly relationships
  6. Decision-making authority
  7. Respite care and support for caregivers
  8. Personal, household care and maintenance
  9. Safety/risk-taking/autonomy – should autonomy be limited?
  10. Needs of other family members
  11. Less restrictive alternatives to guardianship

HOW SUCCESSFUL IS MEDIATION?

In a recent study, 8 out of 10 cases were successfully resolved.  8.5 out of 10 mediated cases were followed through by the parties.  The success rate is so high because the solutions are designed by the parties themselves.  Even if an agreement is not reached, the parties will walk away with clarified issues and a better understanding of each other’s viewpoints.

WHY DO GERIATRIC CARE MANAGERS (with mediation training) MAKE THE BEST ELDERCARE MEDIATORS?

Unlike lawyers, who have specialized knowledge of elder law and legal issues, Geriatric Care Managers have specialized knowledge of elder care.  We know what successful aging is, understand the healthcare system, know the local resources for seniors, understand housing options, insurance, and the different types of home health services.  We can talk about end of life decisions and discuss palliative versus aggressive care. The utmost important goal is to provide the highest quality of life for our elders and can offer different options to achieve this.

Professional Geriatric Care Managers are generally nurses and social workers with extensive experience working with seniors.  We can evaluate and assist families in determining the best course of action to take to provide the best care for their loved one. 

For distant families we can oversee the entire scope of care for our clients.  We are on call 24/7 and keep families informed of changes.  We provide peace of mind for families, as they know there is someone there to manage any situation that may arise.  We are client advocates.

Doris Haas RN, CCM, CMC "
Professional Geriatric Care Manager "
Florida Supreme Court Certified County Mediator "
Atlas Aging Life Care Management & Mediation "
1451 W. Cypress Creek Rd., Suite 300 "
Fort Lauderdale, FL.  33309 "
Phone: 954-334-5821
Cell: 954-830-9969

Focusing on Care Transitions for Improved Outcomes

Fall 2011

By Doris Haas

Click the images below to read the article.

HCAF Thumbnail HCAF Thumbnail

Program Reduces Falls by Elderly, Study Finds

August 12, 2008

By OHN MAR

Falls among the elderly, a common source of injuries, have largely been considered inevitable. But a recent large-scale study shows that a combination of adjusting treatment, assessing risk and educating patients can substantially reduce serious falls.

The study, by Dr. Mary E. Tinetti and her colleagues at the Yale School of Medicine, compared two similar regions of Connecticut. For four years in the experimental region, the researchers asked clinicians to assess their patients' risk of falls and to consider medication reduction and other prevention measures like strength training, vision adjustment and blood pressure treatment. The rate of serious falls by the elderly in that region was 11 percent less than that in the region that followed normal care.

That lower rate of falls translated to 1,800 fewer emergency visits by the elderly, the researchers said, saving more than $21 million in health care costs. The study was published July 17 in The New England Journal of Medicine.

Dr. Tinetti said it was not possible to estimate the cost of the prevention program itself, adding that many of the strategies should be part of standard care. Dr. Tinetti said in an e-mail interview, "Asking about whether the person has fallen in the last few months and whether he or she experiences difficulty or unsteadiness while moving around; and if so, checking blood pressure lying, and standing; reviewing medications and reducing the number and dose; checking the person walking and etc. should be part of good standard practice."

Falls account for 10 percent of emergency visits and 6 percent of hospitalizations among people 65 years or older. Given the positive results, Dr. Tinetti said she and her colleagues were working on distributing information on fall prevention along with suggested changes in practice.

Geriatric care managers help families meet seniors' needs

07:43 AM CDT on Monday, July 7, 2008

By BOB MOOS / The Dallas Morning News

bmoos@daIlasnews.com

Kay Paggi says her job title could be less confusing if she just called herself "a surrogate daughter."

She's a geriatric care manager - that is someone who steps in to help overwhelmed sons and daughters with their elderly parents' needs.

"I'm the person you call when you have more questions than answers about your mother's or father's care," Ms. Paggi said.

About 44 million Americans look after adult family members - an especially daunting task for adult children who live in another state or who have demanding jobs or their own children - according to the Family Caregiver Alliance. And that number is expected to double by 2050.

That's where geriatric care managers such as Ms. Paggi come in. While they don't typically provide hands-on care, they help families hire and supervise in-home caregivers or shop for a senior-living community.

Mike Tankersley has called on Ms. Paggi twice in six years, first to evaluate nursing homes for his mother-in-law and more recently to help his mother move from Austin to a senior community in Dallas.

"There are so many communities, we couldn't have done it on our own," he said.

A crisis often prompts the initial call to a care manager. A parent falls and breaks a hip, or the children notice that their mother doesn't remember a conversation from just minutes ago.

In those cases, Dallas care manager Molly Shomer said, she usually starts by sitting down with the family and determining the older person's physical, mental and social needs. She drafts a plan for care and, if the family agrees, coordinates it.

"Some families may think Mom is ready for a nursing home, but maybe all she needs is a daytime companion," Ms. Shomer said. "Other times, her continuing to live at home may be isolating or dangerous. It all depends on the person."

Kitty Snelling of University Park, who is recovering from a hip injury, values the encyclopedic knowledge of her care manager, Carol Franzen.

The 74-year-old former businesswoman views Ms. Franzen as her personal consultant.

"Carol knows everything there is to know about senior care," Ms. Snelling said. "My children are so busy, so I hate to lean on them. Besides, I want to be independent. Carol has spared me a lot of headaches."

Ms. Franzen accompanies Ms. Snelling on medical visits, asking questions and taking notes.

Like many care managers, she is in private practice and manages about 20 cases at a time.

Some clients she sees once a month; others she visits three times a week, she said. Families find her through word of mouth or referrals from doctors or nurses.

Costs

If there's a drawback to care managers, said Donna Schempp, program director of the Family Caregiver Alliance, it's that some families can't afford them.

Their fees range from $75 to $125 per hour.

Medicare and most long-term care insurance plans don't cover those fees, but many families who hire care managers say they're worth the money.

Charles Dale said Ms. Shomer is helping his family apply for veterans' benefits to defray the cost of caring for his father, who has Parkinson's disease.

"The veterans' assistance will allow my father to stay in his assisted-living community in Piano," he said. "Molly's guidance has given us some peace of mind."

Kim Warwick, an only child who lives in Los Angeles, said she sought professional advice when her mother in Dallas began showing more signs of Alzheimer's disease a year ago.

Her care manager, Carole Larkin, specializes in the care of people with dementia and helped persuade Ms. Warwick's mother to give up her car keys. When the older woman could no longer remain at home, Ms. Larkin recommended several assisted-living communities.

Now Ms. Warwick flies to Dallas to visit her mother every other month, and Ms. Larkin regularly stops by the dementia-care community.

Backgrounds

Most of the nation's 7,000 geriatric care managers come from nursing or social work, said Monika White, president of the National Association of Professional Geriatric Care Managers.

But because others may have no experience besides looking after their own parents, the group recently began requiring its members to become certified. That means passing a test and meeting educational and work standards.

"Anybody can hang out a shingle and announce, I'm a care manager," Ms. White said. "But just because you took care of your mother doesn't mean you can take care of mine."

Ms. Paggi, who's been in private practice in Dallas for 12 years, says she tries to put some emotional distance between herself and her clients because most come to her in the final years or months of their lives.

But she often breaks her own rule.

She takes clients to lunch on their birthdays or drops by if she knows they will be alone on a holiday.

When the end does come, she's in a pew at their funerals.

"All my clients eventually die. It's an occupational hazard," she said. "But at least I know I made a difference in their lives. That's what keeps me going."

GETTING ANSWERS

When looking for a care manager, ask these questions:

  • Are you licensed in your profession?
  • How long have you been a care manager?
  • Do you refer clients to services in which you have a financial interest?
  • Are you available for emergencies?
  • What are your fees?
  • Can you provide references?

SOURCES: Dallas Morning News research; National Association of Professional Geriatric Care Managers

The Surprising extra benefits of Exercise for Seniors

It's never too late to start an exercise program

By Janet Crozier

We've all heard about the many benefits of exercise — a healthier heart, stronger bones, improved appearance and flexibility — but exercise has many additional benefits, especially for seniors.

"Many characteristics we associate with older age — like the inability to walk long distances, climb stairs, or carry groceries, are largely due to a lack of physical activity," explains Dr. John Montgomery, a family physician, medical epidemiologist and vice-president of Senior Care Solutions with Blue Cross and Blue Shield of Florida.

However, according to AARP, 40 percent of people between 45 and 64 are considered sedentary. For people over 64, that number jumps to 60 percent.

"Some are worried that exercise will cause illness or injury," said Montgomery. “Others think exercise means they have to do something strenuous, which they may not be capable of. What they may not realize is that it could be more of a risk not to exercise,” explains Montgomery.

Seniors can benefit tremendously from regular exercise. The Centers for Disease Control reports that seniors have even more to gain than younger people by becoming more active because they are at higher risk for the health problems that physical activity can prevent.

Even moderate physical activity can help seniors to:

Increase mental capacity Research links physical activity with slower mental decline. Exercise increases blood flow to all parts of your body, including your brain, and might promote cell growth there. Exercise — particularly if it starts early and is maintained over time — is beneficial in preventing dementia and Alzheimer's disease. (Source: Senior Journal.com)

Prevent disease

Exercise may delay or prevent many diseases associated with aging, such as diabetes, colon cancer, heart disease, stroke, and others, and may reduce overall death and hospitalization rates, according to the National Institute of Aging.

Improve healing

Injuries and wounds take longer to heal as people age. Regular exercise by older adults may speed up the wound-healing process by as much as 25 percent. (Source: Senior Journal.com)

Improve quality of life A new study has found that previously sedentary senior citizens who incorporated exercise into their lifestyles not only improved physical function, but experienced psychological benefits as well. (Source: Seniorjournal.com)

Increase balance

This helps prevent falls, a major cause of broken hips and other injuries that often lead to disability and loss of independence. (Source: Senior Journal.com)

Increase life expectancy Benefits are greater among the most active persons, but are also evident among those who reported moderate activity, according to the CDC.

A little goes a long way

"When it comes to exercise for seniors, consistency is more important than intensity," explains Montgomery. Researchers have found that you don't have to engage in strenuous exercises to gain health benefits. "Moderate exercise, such as walking five or more days a week, can lead to substantial health benefits. Even brief amounts of physical activity, say 10 minutes at a time, can be beneficial."

Never too late

According to the National Institute of Aging, exercise isn't just for seniors in the younger age range. People who are 80, 90 or older can also benefit greatly from physical activity. Exercising regularly can help prevent or delay some diseases and disabilities as people age. In some cases, it can improve health and independence for older people who already have diseases and disabilities, if it's done on a long-term, regular basis. "The key is to find something geared to your fitness level that you enjoy doing," says Montgomery. "And it's important to start at a level you can manage and work your way up slowly." Start by seeing your doctor before beginning an exercise program.

Tips for sticking with an exercise program:

Have a Plan

Identify obstacles and find ways around them. For instance, your fitness routine easily could run off track during the holidays and vacations. Look for hotels with a health club, and include a walking or biking tour of scenic or historic places in your vacation plans.

Review your goals

If you start to feel it's just not worth it, think about why you decided to change in the first place. Maybe you wanted to lose weight. Perhaps you've lowered your blood pressure or are beginning to control your diabetes. Reminding yourself of the goals you've realized and the ones you're still striving for will help you push ahead.

Mobilize your support system

Call on friends, family members, or neighbors who have been your cheerleaders. They can encourage you to stick with it.

Be easy on yourself

Falling off track doesn't mean throwing in the towel. Remind yourself that change takes time.

(Source: AARP) Janet Crazier has more than 30 years of experience working with older adults. Ms. Crazier holds a Graduate Certificate in Aging and Adult Services and is a Certified Senior Advisor. She has served on Northeast Florida Area Agency on Aging's Board of Directors for many years and has been recognized nationally for her service to Medicare beneficiaries by the federal Medicare program. Currently, Ms. Crazier is a full time Senior Educator with Blue Cross and Blue Shield of Florida.

Senior Citizens May Avoid Medicare Marketing Fraud by Knowing the Rules

Medicare private plans must follow certain rules and you should know what is allowed

Aug. 13, 2008 – With a huge market to exploit – abut 36 million senior citizens on Medicare – the hucksters stay busy, according to congressional reports. The Medicare Rights Center has produced some tips for older Americans on the rules that must be followed to market these plans. Sales people who violate these rules should be suspect.

People with Medicare can receive their health care benefits in one of three ways:

  • Original Medicare (the traditional fee-for-service coverage from the federal government);
  • Original Medicare with supplemental insurance (such as a Medigap or retiree plan); or
  • a Medicare private health plan, also known as a “Medicare Advantage" plan.

Prescription drug coverage (Part D) is available either through stand-alone drug plans (PDPs) that work with Original Medicare (and a few private health plans), or as part of Medicare private health plan benefits packages.

The companies that sell Medicare private health and drug plans must follow certain rules when promoting their products. The guidelines are meant to prevent plans from deceiving you through marketing materials or through someone representing the plan - about what the plan offers and how much it costs. That is called marketing fraud.

Plans can market their plan through direct mail and radio, television and print advertisements. Agents can even visit your home, but only if you have invited them. However, Medicare private plans, however,

must follow certain rules. By knowing what is and is not allowed, you can protect yourself from falling victim to marketing fraud. Remember these tips on what plans cannot do:

enroll you over the telephone if they called you. If you would like to enroll, you should call the plan back yourself;

ask for your financial or personal information if they call you. Beware if you are asked for your Social Security or Medicare number or your bank information;

request payment over the telephone;

visit you in your home or nursing home room without an invitation. You can ask the plan to send someone to your house, but they cannot just knock on your door uninvited;

provide gifts or prizes worth more than $15 to encourage you to enroll. Gifts or prizes that are worth more than $15 must be made available to the general public, not just to people with Medicare);

disregard the National Do-Not-Call Registry and "do not call again" requests. Plans must comply with federal and state consumer protection laws for telemarketing. You can register online for the National Do-Not-Call Registry or by calling from the number you wish to register.

send you unsolicited e-mails. You must have specifically requested information in order for a plan to e-mail you;

compare their plan to another plan by name in advertising materials;

include the term “Medicare Endorsed” or suggest that it is a preferred Medicare drug plan. Plans can use “Medicare” in their names as long as it follows the plan name (for example, the Acme Medicare Plan) and the usage does not suggest Medicare endorses that particular plan above any other Medicare plan;

use information that they have obtained from you to market non-health-related products and services without your written consent. Plans cannot use information about you (such as your name and address) that they got by providing you Medicare services to try to sell you other products, like auto insurance.

Volunteers tested in a 50-year-long Baltimore study provide invaluable data on the aging process

By Lori Aratani "
Washington Post Staff Writer "
Tuesday, May 19, 2009

Every year hundreds of people travel to Baltimore for an unusual purpose. They are not here to tour the city's aquarium or sample its fabled blue crabs. They are not in search of fame or money. Other than free lodging, they receive nothing in exchange for their visit, which entails a certain amount of discomfort.

No, these folks, some of whom have made this journey for decades, believe the trip is worth their time and expense because how they live -- calculated according to everything from the strength of their grip to how many apples they consume in a month -- may offer clues to how the rest of us might live better, longer, healthier lives.

These individuals -- homemakers, retirees, doctors and myriad others -- are participants in the Baltimore Longitudinal Study of Aging (BLSA), the country's longest-running study of aging. Since 1958, a total of more than 1,400 volunteers have agreed to regularly undergo in-depth physicals and memory and other screenings conducted by the study's physicians. The resulting data span more than half a century and are a gold mine for researchers interested in the aging process.

Because of the BLSA, scientists know that signs indicating that a person could be at risk for dementia and other cognitive diseases may appear 20 years before symptoms emerge. Findings that today are common knowledge (that exercise can help reduce high blood pressure, for one) can be traced back to BLSA's annual physicals and the data analysis done by the study's scientists. Think of it as a vast historical record.

The BLSA is one of many projects being done by the National Institute on Aging, but the study itself is a rarity. Few institutions will undertake such an extensive venture, largely because the commitment required from individuals is enormous, said the study's director, Luigi Ferrucci.

It's not just researchers who toil for years sifting through mountains of data. BLSA participants also are devoted to helping researchers fulfill the study's goals: One person has been enrolled for 47 years. The oldest participant is 102 and has made the required pilgrimage to Baltimore regularly for 38 years. "Participants really, really love the study," said Ferrucci, a genial, gray-haired physician who first learned about the BLSA as a student in his native Italy. "They feel they are making a contribution to science, and they feel like aging is such an important and under-studied issue, anything they can do to help, they want to do.'' Participants come from as far as Norway. Some even donate their bodies to the BLSA autopsy study.

"It's a chance to make a unique contribution to research on aging,'' said Richard Sprott of Potomac, one of the participants, "since this is the only research project of its kind in the world."

As understanding of aging has changed, so have elements of the study. Researchers recently incorporated a new component into their research, Insights Into the Determinants of Exceptional Aging and Longevity study (IDEAL), an effort to uncover the secrets of those who age exceptionally well: Think 80-year-olds who ski and jog or 90-year-olds whose hearing and memory put a 30-year-old to shame. Ferrucci estimates only about 0.5 percent of the population has such abilities.

A Rigorous Three Days

The elevator doors slide open to reveal a tastefully decorated lobby. Soft music plays in the background. A huge bank of windows offers a soothing view of the Patapsco River. A smiling receptionist greets visitors warmly. For three days, the fifth floor of Harbor Hospital in Baltimore will serve as home base for the many participants who come for their physicals. Most will stay here at the hospital in comfortable but not particularly plush rooms. Proximity is important because researchers want them to be available for the battery of tests they'll undergo over the next 48 to 72 hours. Down the hall is a small kitchen area stocked with fruit and pretzels. The atmosphere is soothing. The magazines plentiful. The staff friendly.

There is homework. Along with athletic shoes and casual clothing, participants are asked to bring with them a food diary that details everything they ate in the previous three days. Yes, some people have been know to temporarily clean up their diet -- a tendency that is noted in the 20-minute introductory video sent to people before they arrive.

"Please report what you actually eat, not what you think you should be eating,'' it says.

This is no vacation. During their stay, participants will have a physical that goes well beyond sticking their tongues out and saying "ahhhhh." They rarely will sit for more than 30 minutes before they are whisked away for another exam or stuck with another needle. Sprott, now in his 12th year in the study, confirms that the pace can be brutal.

Researchers take routine measures (temperature, blood pressure and weight), but participants also undergo more sophisticated tests. Echocardiograms help researchers examine hearts, and spirometry tests measure lung function. In addition to collecting blood and urine, researchers might also take samples of the participants' breath.

Even simple tests can provide valuable insight. Researchers will evaluate a participant's grip strength, which previous BLSA research has shown can predict whether someone might be at higher risk of complications after surgery or more likely to die prematurely.

A select few will undergo a procedure called cytapheresis, in which white blood cells are extracted from blood in a search for clues to how age might influence a person's immune system. In another test, participants' movements are tracked by sensors similar those used in the making of computer-animated movies such as "Toy Story."

The researchers do not offer treatment. They may, however, share information gleaned from the tests with participants, who can then discuss the findings with their regular physicians, Ferrucci said. The researchers also evaluate changes in each person's memory and verbal ability, using memory tests and brain scans. Should a group of participants develop dementia, researchers can look back at those individuals' test results for commonalities.

Measuring Memory

So, what it is like to be a test subject? Fascinating but not always fun, according to Sprott. Most people mark another year with an extra candle on their birthday cake. But Sprott, 68, is reminded of his age when he slips up on one of the routine memory tests or when he is slightly more winded after a treadmill session he may have sailed through years earlier.

"It's a three-day validation that your body is going to hell,'' Sprott said with a chuckle. "And it reminds me every once in a while that I need to lose a little weight.'' It's not the poking and prodding, the needles and the skin electrodes that Sprott dislikes. "The physical stuff doesn't bother [me],'' he said. "We're all deteriorating.'' Rather, it's the tests of memory.

"We hate the cognitive stuff,'' he said, going on to describe the test that he and his wife, who is also a participant, dread.

"The tester reads you a set of shopping lists, maybe 16 items,'' he recalled. "You have to reply with as many as you can remember. The first time you take this test, you discover a simple strategy for remembering: You sort the items into categories. But even though you take the same test every two years and you know the strategies, you get worse."

Sprott is well-versed in the science of aging: For more than a decade, he directed the National Institute on Aging's study on the biology of aging. Since 1998, he has been executive director of the Bethesda-based Ellison Medical Foundation, which funds basic biological and biomedical research on aging.

"There is an incredible amount of misinformation out in the field," he said, adding that few programs can match the longevity of the BLSA or the breadth of its data.

"My grandkids will benefit from this research," he added. In addition to his wife, Sprott's 42-year-old daughter is also a BLSA participant.

Endless Possibilities

The work done by BLSA scientists (more than 800 scientific papers) runs the gamut from the impact of aging on major organs to its effect on personality, and it has become a standard reference on aging.

Andrea Halpern, a professor of psychology and neuroscience at Bucknell University, has had students in her upper-level course on cognitive aging review BLSA research. Already a "rich database" of information, she said, the research will continue to grow in importance as people live longer.

"The BLSA isn't perfect," said Alan Zonderman, senior investigator for the cognition section of the National Institute on Aging. "There are limitations to it. But all of the limitations are overcome by the fact that we have all of these repeated measures on these people that no one else has." When a participant falls ill, researchers can examine decades' worth of records to find a cause.

"We can say, maybe it's not what's happening to them now, but what happened 20 years ago," said senior investigator Susan Resnick, who is principal investigator of the brain-imaging component of the BLSA.

"Probably the most frequent complaint people in their 70s make to their physicians is how bad their memory is," Zonderman said. "People worry about dementia in some ways more than they worry about getting cancer." "A lot of our work focuses on early detection," he continued. "We're able to predict in some cases, not very accurately at this point, but with increasing accuracy . . . who is likely to get the disease, who is at the highest risk." Zonderman was part of the team that found that changes in BLSA participants' visual memory may help predict future mental changes as well as signal the onset of diseases such as Alzheimer's.

Other BLSA studies have found that loss of some short-term visual memory is normal as people age, as is loss of some hearing. BLSA researchers were able to disprove the long-held belief that people get crankier as they age. Using data collected from the study's participants, they found that personality traits don't generally change much after age 30: People who were cranky at 27 were likely to be cranky at 87.

Researchers also found that older people were better able to handle stress than their younger counterparts, who tended to cope by becoming hostile or retreating into fantasy worlds. In another study, 50 BLSA men were given the equivalent of three martinis over the course of an hour to find out whether age influenced a person's ability to metabolize alcohol. Turns out the older participants were able to metabolize the alcohol just as well as their younger counterparts. However, older men did show greater impairment as a result of their consumption.

The possibilities that such data offer are endless. "This a treasure," Ferrucci said. "Who else is going to do a study that's going to last 50 years?"

Despite all those possibilities, there is one thing the BLSA can't do: stop people from getting old. But Ferrucci is confident the data gathered in 2009, like the research gathered during the first years of the study, will yield insights into how people can age gracefully.

"The definition of being old is changing; it's breaking apart," Ferrucci said. "[People] want to live well, no matter what their age is."