Still Alice Book Review

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Genova, L. (2009). Still Alice. New York, NY: Pocket Books. $15.00, paper. ISBN-13:9781439102817

According to the Alzheimer’s Foundation of America, 5.1 million Americans suffer from Alzheimer’s Disease. 5 % of those people suffer from the tragic early-onset form that can strike a person in their 50’s or even younger. In the award-winning New York Times Best-Seller novel, Still Alice, author Lisa Genova paints a bittersweet portrayal of a woman with a strong will and a memory that is fading. Alice Howland is a respected Professor of Psychology at Harvard University. She is 50 years-old and a mother of three. She is married to John Howland, a Professor of Biology, at Harvard University. Alice also suffers from early-onset Alzheimer’s Disease and it is changing life as she knows it. The book is written as if a secret onlooker is journaling Alice’s life. Instead of having chapters, the book is broken down chronologically into months starting with September 2003 and ending with September 2005. The author writes the book in such a way that the reader is drawn in and has no other choice than to share in the deep emotions felt by Alice and those close to her. The novel is emotionally charged, but it can also be emotionally draining. Still Alice is a book that reaches out to anyone who suffers from or is close to someone who suffers from early-onset Alzheimer’s Disease.

Alice Howland leads an extremely high-paced life. As a Professor of Psychology at Harvard University, she has many responsibilities such as; lecturing, research, speaking engagements, conferences, and mentoring a graduate student who is working on his dissertation. As a wife she helps support her husband in his research and other responsibilities. She is also extremely athletic and enjoys running several miles a day. Alice makes it clear that running is very important to her. Alice also makes it clear that education is of the utmost importance to her and pushes this belief on her adult children.

Alice’s memory, the one thing that has given her such prestige and honor, begins to fail her. The first time the reader is presented with a glimpse of what is to come is when Alice speaks at Stanford University and forgets a key word in her presentation. The word was right on the tip-of-her-tongue. Unfortunately, her neurons were not able to connect and she was forced to continue her presentation without the use key word. She begins to misplace things like her Blackberry. The reader is shown just how serious these little episodes are when Alice is running in Harvard Square, a place that she has visited numerous times, and cannot remember the route back to her house. This was the last straw for Alice and she begin doing research on her symptoms. At first she believed that her symptoms were due to menopause. When she determined that was not the case, she sought professional medical advice. This created more questions than answers. Alice, not knowing where else to go, went to a neurologist who put her through many tests and examinations.

The neurologist concluded that Alice had early-onset Alzheimer’s Disease. This was a devastating blow to Alice as it would be to anyone burdened with this news. At first, Alice hides this information from everyone including her husband. However, after not being able to remember certain things, as well as some unexplained embarrassing actions, she confessed to her husband. A little time later together they told their children and those whom they were close to. Alice told no one at Harvard University until several months into her diagnosis. When she was questioned by her supervisor about negative evaluations from some of her students, she finally came clean. From that point on she felt like an outcast. She felt that no one respected her. She felt like a leper. In many cases that was exactly how she was treated.

Alice’s disease progressed quickly. Memories, names, faces, and the things she knew so well began slipping rapidly. Alice devised a plan. She did not want to be a burden on her family and friends so she created a list of five questions. She would ask herself these questions every day. The moment she could not answer just one of the questions she was to follow the directions stored on her laptop under a file named “butterfly”. These directions were for her to swallow a bottle full of tranquilizers, lie in bed, and die in her sleep. Fortunately for Alice, as her ability to answer the questions dwindled so did her ability to remember to ask herself the questions. The novel concludes with Alice who is now much different than her former self. The beliefs, values, and walls she had formed throughout her life had been shattered. Many of the changes limited her. However, after the changes took place she was able to connect with her family in new ways and on a deeper level. In the end Alice is Still Alice. She is just a different version.

The author, Lisa Genova, has a Ph.D. in Neuroscience from Harvard University, taught Neuroanatomy at Harvard University, and has done brain research at Yale Medical School. Her goal in writing this book, as well as all the others she has written, is to inform the public about neurological diseases using a platform that is easily accessible. Her background and motive gives her the authority needed to write this book. Still Alice draws the reader in, grabs tight, and does not let go. The story can be difficult at times to read with the myriad of emotions that ebb and flow throughout. However, with each new page the author draws the reader in closer still. From the start, I felt respect for Alice. She was accomplished and driven. She had built a beautiful life with a wonderful family. The flaws she had, in her relationship with her daughter Lydia, only served to make her seem more human. As Alice’s disease progressed, I felt a deeper connection to her. Her pain and frustration felt real. The pain and suffering felt by her husband John and other family and friends was surreal. When I try to place myself in John’s shoes I cannot imagine what it would be like. The author was brilliant at opening the eyes of the reader to the world of early-onset Alzheimer’s Disease. This theme was presented in such a way that little to no previous understanding of neurological diseases was needed. This novel left me with a new understanding of early-onset Alzheimer’s Disease and a deeper compassion for those suffering from this tragic disease and the people that are close to them.    

The Importance Of Religion In Death And Dying

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We will all die one day. This is an unavoidable fact for us all. As we age, we begin thinking about this topic and how we will handle it when it is our turn. Many people experience anxiety about death and dying, especially as they approach the end of their lives (Tomer and Eliason 2000). This anxiety often includes concern about unknown physical changes, dread of possible pain and stress associated with dying, fear of separation from loved ones, and uncertainty about what will occur following death (Tomer and Eliason 2000). One potential response to this anxiety is to seek refuge, strength, and hope through religious activities. According to Carl Jung (1969), most religions can be considered “complicated systems of preparation for death” (p. 408). Buddhist, Hindu, and Christian religions answer the question: where do we go when we die.

According to Duff and Hong (1995), Buddhist beliefs about death and dying fundamentally explore the concept of reincarnation, or a process in which one’s spirit is continuously reborn in another body until a state of ultimate enlightenment is attained. A Buddhist soul can be reincarnated into five different realms. These realms are the animal kingdom; the hells; the realm of jealous gods; the human realm and the heavens. Determining where your soul resides is based on karma, or the accumulation of all your actions during a lifetime. According to Duff and Hong (1995), “correct and compassionate deeds will allow your soul to be reborn in higher, more pure levels of existence, until that desired state of nirvana is reached” ( p.30). Buddhist believe hell is not a place where one suffers in eternal torment; rather, it is a temporary abode where you are able to transcend the negative karma you accumulated during your earthly life (Duff & Hong, 1995). Buddhism does not accept the idea of a permanently bad soul but instead subscribes to the concept of a soul as an entity which is connected to the dynamic universe. Only an accomplished Buddhist (a non-returner) can be reborn in the higher heavens called Pure Abodes, while formless realms are meant for Buddhists who are capable of meditation on the arupajhanas, or the most supreme concept reserved for skilled meditators (Duff & Hong, 1995).

According to Parsuram and Sharma (1992), a belief in the cyclical reincarnation of the soul is one of the foundations of the Hindu religion. Death is viewed as a natural aspect of life, and there are numerous epic tales, sacred scriptures, and Vedic guidance that describe the reason for death’s existence, the rituals that should be performed surrounding it, and the many possible destinations of the soul after departure from its earthly existence (Parsuram & Sharma, 1992). While the ultimate goal is to transcend the need to return to life on earth, Hindus believe they will be reborn into a future that is based primarily on their past thoughts and actions (Parsuram & Sharma, 1995). According to Wulff (1991) cremation is a ritual designed to do much more than dispose of the body; it is intended to release the soul from its earthly existence. Hindus believe that cremation (compared to burial or outside disintegration) is most spiritually beneficial to the departed soul (Wulff, 1991). This is based on the belief that the astral body will linger, as long as the physical body remains visible. If the body is not cremated, the soul remains nearby for days or months (Wulff, 1991). The only bodies that are not generally burned are unnamed babies and the lowliest of castes, who are returned to the earth. The standard cremation ceremony begins with the ritual cleansing, dressing and adorning of the body. The body is then carried to the cremation ground as prayers are chanted to Yama, invoking his aid. Wulff (1995) states, “it is the chief mourner, usually the eldest son, who takes the twigs of holy kusha grass, flaming, from the Doms’ (the untouchable caste who tend funeral pyres) eternal fire to the pyre upon which the dead has been laid”(p.37). “He circumambulates the pyre counterclockwise: for everything is backward at the time of death”(Wulff, 1991, p.38). As he walks round the pyre, his sacred thread, which usually hangs from the left shoulder, has been reversed to hang from the right. He lights the pyre. The dead, now, is an offering to Agni, the fire (Wulff, 1991). Here, as in the most ancient Vedic times, the fire conveys the offering to heaven. After the corpse is almost completely burned, the chief mourner performs the rite called kapalakriya, the rite of the skull, cracking the skull with a long bamboo stick, thus releasing the soul from entrapment in the body. According to Wulff (1991), after the cremation, the ashes are thrown into a river, ideally the Ganges river, and the mourners walk away without looking back.

According to Falkenhain and Handal (2003), a belief that Jesus Christ was the son of God, that he died for our sins, and was resurrected from the grave is central to the Christian belief. Because of this sacrifice that Christ made for all mankind, we are granted eternal life. The only requirement is a belief that Christ died and rose from the grave. Accoring to Falkenhain and Handal (2003), Jesus Christ was God in flesh that was born to a mortal woman named Mary. Mary was a virgin and God placed her son inside her. Jesus Christ was a great teacher and prophet. At age 33 he was beaten and nailed to a cross by Roman soldiers because he claimed he was the son of God. Jesus died on the cross and was placed in a tomb. After three days he was resurrected. He then ascended into the clouds and into heaven. Faith in this belief will guarantee eternal life in heaven. According to Falkenhain and Handal (2003), heaven is beautiful place above earth where God, the angels, and all the saved souls live together in harmony. There is not any pain, grief, or sorrow in heaven. In heaven we can reconnect with saved relatives and friends who have already died. In heaven all our needs are met and we are eternally happy.

Religions help shape the world around us. They explain where we come from. They explain why we are here. They also explain where we are going. As people age they begin to think more and more about death and dying. We begin seeing our limitations. We begin realizing that we are not 21 anymore. We find the tasks that were once so easy now take a little longer. We begin to realize that we are not immortal. Religion serves an important purpose. Religion offers us a chance at immortality. The peace of mind that this offers is priceless.

Works Cited

 Duff, R. W., & Hong, L. K. (1995). Age density, religiosity and death anxiety in retirment communities. Review of Religious Research, 37, 19-32.

Falkenhain, M., & Handal, P. (2003). Religion, death attitudes, and belief in afterlife in the elderly: Untangling the relationships. Journal of Religion and Health, 42, 67-76.

Jung, C.G (1969). The soul and Death, Volume 8 of the Collected Works of C.G. Jung: The Structure and Dynamics of the Psyche, 8, 405-408.

Neimeyer, R., Wittkowski, J., & Moser, R. P. (2004). Psychological research on death attitudes: An overview and evaluation. Death Studies, 28, 309-340.

Parsuram, A., & Sharma, A. (1992). Functional relevance of belief in life-after-death. Journal of Personality and Clinical Studies, 8, 97–100.

Tomer, A., & Eliason, G. (2000). Attitudes about life and death: Toward a comprehensive model of death anxietyDeath attitudes and the older adult, 17, 78-84

Wulff, D. M. (1991). Psychology of religion: classic and contemporary views. New York: Wiley, 2, 38-64.

Ageism: Its Effect On Seniors

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Discrimination is defined as making an unjust distinction in the treatment of people. Ageism or more specifically jeunism is the preference of young people over older ones that leads to discrimination (Palmore, 2001). If we have a stereotype in our minds of what it means to be old or what older people are like, then we are being ageist and we may, as a result, treat older people in a way that means we are discriminating against them. According to Palmore (2002), we do this at several levels: the cognitive level, the emotional level, and the behavioral level. When we meet a person for the first time we unconsciously draw on a number of preconceptions or stereotypes that shape our thinking and our actions. We make assumptions about the other person based on what they look like, how they dress, and how they speak. We make judgments about what social group they belong to, where they live and what age they are. These assumptions influence how we think, feel and behave towards this other person. If we hold the stereotypical view that old people are forgetful we may treat an old person in a way that reflects this belief. In other words, the stereotype we have of older people, whether it arises from what we think, know, or have experienced, will influence how we behave towards them. There are several ways in which ageism affects the lives of older people: it devalues their social role, upper age limits isolate them from others,and it reduces their status.

According to Palmore (2001), “stereotypes and ageism can be reinforced and reproduced by what we see and hear in our daily lives and can be represented in ageist language”(p.573). The way in which older people are portrayed on television, on the radio, and in newspapers, not only affects older people themselves but also affects the ways in which we, as a society, see them (Palmore, 2001). According to Dail (1988), embarrassing and demeaning stereotypes of older people marginalize or isolate them from mainstream society by “removing signs of effectiveness and worth from the elderly, disposing of them as of no account” (p. 703). As a result of having a stereotypical view of what aging is and what older people are, we, as individuals, can discriminate against them in personal acts. Organizations can discriminate against them via their policies and practices.

According to Kite and Johnson (1988), “Using age limits can affect how we think about age and what we deem to be appropriate for people of different ages” (p.238). Using upper age limits can contribute to the marginalization of seniors (Kite & Johnson, 1988). Some laws discriminate through the use of upper age limits; the Redundancy Payments Act (2003), for example, does not apply to those aged over 66. Many activities and services are no longer available to older people due to upper age limits without any objective justification for their use. Examples include: jury service, membership of State Boards, occupational pension schemes, health/motor insurance, and education and training. Even senior discounts can isolate the elderly. Another impact of upper age limits and negative stereotypes is that people deny that they are aging, internalize this denial, and then reproduce ageism. Older people dissociate themselves from the wider group of old people because they do not see themselves as old (Kite & Johnson, 1988).

According to Palmore (2001), “Research shows that many older people have experienced an ageist event. The most frequent was, ‘I was told a joke that pokes fun at older people’. Others said they ‘were called an insulting name’ or ‘were treated with less dignity and respect’. Some said that people ‘assumed I could not hear well because of my age”(p.574). While older people may be aware of being seen as old, they may be uncertain about making claims that they are actively discriminated against because of their age. One explanation for this is that age discrimination can be obscure, subtle and may be difficult to perceive. Marginalization is very often the result of discrimination, as is the case with the forced retirement from work of people over the age of 65 (Palmore, 2001). Forcing people to leave the workforce at a certain age endorses the exclusion of a group from the workforce and from earning money. This can debase ‘their status in the eyes of their juniors, and above all has devalued them in their own estimation of themselves’ (Palmore, 2001). Under-representation of older people at local and global levels and lack of positive steps to enable older people to participate fully in social, economic and political activities also results in a reduced status (Palmore, 2001).

According to Chasteen and Schwarz(2002), “An important point to consider is those that write off the elderly are also writing off themselves” (p.547). We are all getting older and most of us will eventually turn 65 and become seniors ourselves. Do we treat seniors the way we want to be treated? Do we show them the respect and understanding they deserve? Ageism is no different than any other form of discrimination. It is very damaging! Yet, it is commonplace in our society. It is easily seen in the way the elderly are portrayed in the media. If any other group of people were portrayed the way seniors are, there would be outrage. A movement would rise up to crush any network willing to show such things. This has not happened yet, partly due to the fact that many seniors are fearful of the stigma placed on seniors and are not willing to accept the fact that they are seniors. Ageism is serious! There are several ways in which ageism affects the lives of older people: it devalues their social role, upper age limits isolate them from others,and it reduces their status.

Works Cited

Chasteen, A. L., Schwarz, N., & Park, D. C. (2002). The activation of aging stereotypes in younger and older adults. Journals of Gerontology: Series B. Psychological Sciences, 57, 540–547.

Dail, P. W. (1988). Prime-time television portrayals of older adults in the context of family life. Gerontologist, 28, 700–706.

Kite, M. E., & Johnson, B. T. (1988). Attitudes toward older and younger adults: A meta-analysis. Psychology and Aging, 3, 233–244.

Palmore, E. (2001). The ageism survey: First findings. The Gerontologist41(5), 572-575.

Palmore, E. (2004). Research note: Ageism in canada and the united states. Journal of Cross-Cultural Gerontology19(1), 41-46.

Quality Of Life In Seniors: What Gardening Can Offer

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Quality of life is defined as the perceived quality of an individual’s daily life, that is, an assessment of their well-being or lack thereof. This includes mental, social, and physical aspects of the individual’s life. In the United States, the cost of food is low. It makes up only a small percentage of our monthly budget. However, many people continue to grow their own herbs, fruits, and vegetables at home. Why would anyone want to spend the extra time and money on a garden? The reason is simple. Gardening is an activity that many people enjoy. Research shows that gardening can increase a person’s quality of life in the areas of mental, social, and physical health.

As people get older they typically see a decline in their memory, as well as other aspects of mental health. Some seniors begin a dark descent into Alzheimer’s disease. According to Lee and Kim (2008), gardens can bring about a feeling of calmness in people with dementia, which helps to lower blood pressure and stress levels, and in turn reduces some of the problems associated with dementia such as aggression and agitation (p. 485). Lee and Kim (2008) also state, that being involved in garden activities that involve a cycle such as sowing, planting, watering, nurturing and harvesting, can help to improve memory and help to maintain cognitive function such as reasoning, problem solving and decision-making (p. 489). It also helps to give people a better perception of their own health and well-being and a sense of control over their lives. According to Gurski (2004), being out in the garden or taking part in a garden-based activity can help people with dementia talk about the past and remind them of garden tasks they might have been involved in when they were younger (p. 25). Talking to people about their favorite plants, what they used to grow or do in their garden or whether they grew fruit or vegetables, can often open up other related memories and can aid mental health.

According to Kim, Cho, Han, and Kim (2004), as people get older they typically see a decline in their social health especially after age 65 (p.159). Social skills can be developed and strengthened as seniors partake in gardening activities (Kim et al., 2004, p. 160) . In community gardens, residents come together to share land to grow vegetables or flowers. In time seeds, tools, as well as, fruits of their labor are shared. Conversations lead to friendships as social barriers drop. According to Austin, Johnson, and Morgan (2006), facilities that incorporate a community garden have a higher level of social health among its residents than that of facilities that do not have a community garden (p. 49). One of the main causes of poor social health is a lack of social reinforcement (Austin et al., 2006, p. 52). Kim et al., (2004) state, one gets social reinforcement through positive social interactions with others, having people to converse with regularly, and having a support system (p. 164). Gardening can be a very social activity. Some communities have gardening competitions where individuals can be rewarded for having the best looking garden and friendly competition can bring about social reinforcement. When people see how beautiful a senior’s garden looks they will complement that person. Gardening gives seniors the opportunity to network and socialize with other seniors who are gardening; this aids seniors’ social health.

According to Heliker, Chadwick, and O’Connell (2000), horticulture scientists at Kansas State University found that moderate physical activity through gardening improves senior’s mobility, strength, and endurance (p. 35). In fact, a single gardening session burns about two-hundred-fifty to three-hundred-fifty calories. The movements involved with gardening: lifting, kneeling, digging, and raking engage many different muscle groups, promoting hand strength, joint flexibility, and overall improvement of motor skills. Gardening has been shown to be form of moderate to rigorous exercise and exercise has been shown to increase physical health in seniors (Heliker et al., 2000, p. 38). Even moderate exercise and physical activity can improve the health of people who are frail or who have diseases that accompany aging. Being physically active can also help seniors stay strong and fit enough to keep doing the things they like to do as they get older. According to Collins and O’Callaghan (2008), making exercise and physical activity a regular part of life can improve health and help maintain independence as seniors age (p. 611). Regular physical activity and exercise are important to the physical and mental health of almost everyone, including seniors. Staying physically active and exercising regularly can produce long-term health benefits and even improve health for some older people who already have diseases and disabilities (Collins et al., 2008, p.613). That’s why health experts say that older adults should aim to be as active as possible and gardening will keep people active.

Gardening has many benefits for seniors. Gardening can improve mental health through the daily routine and physical activities needed to maintain a garden. Community gardens aid in social health through the shared use of tools, seeds, and space. Gardening can also improve seniors’ physical health through the moderate exercise gained by digging, planting, weeding, and raking. Gardening is not only fun but it has many mental, social, and physical benefits.

Works Cited

Austin, E., Johnston, Y., & Morgan, L. (2006). Community gardening in a senior center: A therapeutic intervention to improve the health of older adults. Therapeutic Recreation Journal, 40(1), 48-56.

Collins, C., & O’Callaghan, A. (2008). The impact of horticultural responsibility on health indicators and quality of life in assisted living. HortTechnology, 18(4).

Gurski, C. (2004). Horticultural therapy for institutionalized older adults and personals with Alzheimer’s disease and other dementias: A study and practice. Journal of Therapeutic Horticulture, 15, 25-31.

Heliker, D., Chadwick, A., & O’Connell, T. (2000). The meaning of gardening and the effects on perceived well being of a gardening project on diverse populations of elders. Activities, Adaptation & Aging, 24(3), 35-56.

Kim, H. Y. , Cho, M.K., Han, I. J., & Kim, J. S. (2004). Effects of horticultural therapy on the community consciousness and life satisfaction of elderly individuals. Acta Horticulturae (ISHS), 639, 159-165.

Lee, Y., & Kim, S. (2008). Effects of indoor gardening on sleep, agitation, and cognition in dementia patients: A pilot study. International Journal of Geriatric Psychiatry, 23, 485-489.

Aging In Appalachia

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Appalachia is a cultural region in the eastern United States that begins in southern New York and stretches south to northern Mississippi, Alabama, and Georgia. Appalachia is known for its beautiful mountains, forests, and rivers. It is also known for its coal mines, moonshine, hillbillies, and poverty. What most people do not know is that, according to the 2010 census, the percentage of residents age 65 or older is higher in Appalachia than that of any other region in the nation. Young adults are leaving the area in record numbers while the older population are staying put. Appalachia has the highest poverty rate for residents 65 years of age or older. Appalachia also has the highest rate of disabled elderly in the nation. In the United States the region that contains the highest percentage of poor and broken seniors is Appalachia.

In 2010, sixteen percent of Appalachians were 65 years of age or older. The rest of the nation’s population of people 65 years of age or older was at thirteen percent. According to Lee, “The major reason for the difference in age structure between the Appalachian population and that of the United States as a whole is the net out-migration of young adults from Appalachia to other parts of the country, and Appalachia’s relatively low share of immigrants from other countries (Lee, 2002).“ According to the 2010 census, Appalachia is the poorest region in the United States and has the highest percentage of unemployed residents. With the high percentage of people living in poverty and the limited number of jobs for its residents, it should come as no surprise that it is difficult to make a living in Appalachia. Coal mining and harvesting lumber provided many residents, who had little or no education, employment that provided enough money to pay the bills and put food on the table. However, today with environmental restrictions and the mechanization of those industries there are only a fraction of the jobs available. Many young adults did not want to struggle as their parents did and made the decision to leave the area and move to an area with more employment opportunities. According to Serow, “Some Appalachian counties, in western North Carolina, eastern Tennessee, and northeastern Georgia, have gained elderly population through retirement migration… These counties tended to be prosperous for the region, with recreational amenities and locations convenient to metropolitan areas.(Serow, 2001).” This in-migration of elderly residents combined with the out-migration of the young adults has contributed to Appalachia having the highest percentage of residents 65 years of age or older.

According to the 2010 Census, Appalachia had the highest poverty rates for residents 65 years of age or older. The national average was twelve percent for women 65 or older, seven percent for men 65 or older, sixteen percent for women 85 or older, and ten percent for men 85 or older. The average for the residents of Appalachia was twenty-one percent for women 65 or older, nineteen percent for men 65 or older, twenty-seven percent for women 85 or older, and thirty-two percent for men 85 or older. It is unclear why the percentage of elderly residents living in poverty is higher in Appalachia than in the rest of the United States. Haaga believes that part of the reason for this trend is the rising number of elderly people living alone in the region and that this is due to the out-migration of their children that would normally be taking care of them (Haaga, 2004). According to the 2010 Census, older people living alone were more likely to be in poverty than those living with a spouse, children, or others. Nationally, one in five elderly women who were living alone were in poverty. However, one in three elderly women who were living alone in Appalachia were in poverty.

According to the 2010 Census, forty-four percent of all Americans 65 years of age or older reported that they had one or more disabilities. With the residents of Appalachia that number increases to sixty-two percent. In Appalachia, twenty-two percent of the elderly these included mobility limitations and for twelve percent limited ability to take care of oneself including eating and bathing. Elderly Appalachian residents living alone reported having even higher rates of disabilities than those living with family or friends. Appalachia also has a higher percentage of elderly residents living alone than the national average. This may be due to the out-migration of young adults.

Appalachia not only has the highest percentage of residents 65 years of age or older, but those residents are on average poorer and have more disabilities. With the high percentage of aging adults one might think that the residents of Appalachia must live longer. However, the sad truth is life expectancy is also the lowest in the nation. Growing old in Appalachia seems less appealing than it ever did before.

Works Cited

Haaga, John G. 2004. “The Aging of Appalachia.” PBR Reports on America. Washington, DC: Population Reference Bureau.

Lee, Ronald D., and John G. Haaga. 2002. “Government Spending in an Older America.PBR Reports on America. Washington, DC: Population Reference Bureau.

Serow, William J. 2001. “Retirement Migration Counties in the Southeastern United States: Geographic, Demographic, and Economic Correlates.” The Gerontologist 41:220-27

U.S. Census Bureau. (2010) Retrieved from