Tuesday, July 30, 2019

AGEING WELL - ARE WE THERE YET?


'Diet, exercise, lifestyle, prevention, mindset...' - these words were repeated over and over at the recently concluded 9th Malaysian Conference on Healthy Ageing (MCHA) organised by Malaysian Healthy Ageing Society (MHAS). So too were the more ominous words 'cancer, diabetes, depression, dementia, death'. A total of 6 plenary sessions, 30 symposiums, 11 workshops and 5 forums. Quite a smorgasbord of topics covered in the three days. I had a tough time deciding which ones to attend. My personal copy of the daily programme was covered with ticks and crosses. I had to skip many e.g. Dr Lim Poh Hin's 'Smart Ageing in the Information Age' and Prof Tan Maw Pin's 'Falls Can Be Fatal'. I missed Dr Tan Hooi Chien's talk on 'Volunteerism' but made up for it with Mr James Lim's sharing of the diasaster relief work carried out by Tzu Chi Foundation. Many are not aware of the health benefits of volunteerism.
(For the full programme, click here.)


When I first received the event brochure (above) a few months ago, I was impressed by the broad coverage of topics. All this in just three days? Wow! Then I remembered the same key people had also organised the highly successful 1st World Congress 2012 at KL Convention Centre. MHAS was just a fledgling NGO then, but they proved more than capable of handling an international event. I had no doubt they would repeat their success with the 9th MCHA. The theme this time was 'Ageing, Health and Community'. Not all the topics listed in the brochure ended up in the conference programme, but kudos to the organisers for giving the delegates so much to take away on how we can make lifestyle changes to enjoy quality of life in old age.

(Above) The organising committee with guest-of-honour Dato Mahadev Shankar (centre) after the opening ceremony. From left: Prof Tan Maw Pin, Prof Philip George, Prof Nathan Vytialingam, Dato Shankar, Ms Ranuga Devy, Dr Wong Teck Wee and Mr Matthew Teo.


Not only were delegates spoilt for choice of which sessions to attend, they were also well-fed. The daily lunch saw long queues patiently waiting to fill their plates and cups. It must have been quite a challenge to stay away from the food tables for those on weight loss programmes, on intermittent fasting or on the keto diet. Chow time was also an opportunity to network and make new contacts. The little tumbler that MHAS included in the goody bag was an excellent idea. It allowed us to replenish our drinking water (thanks, Biolux) as many times as we liked, and did away with single-use plastic bottles of water. 

Most of the delegates were doctors, allied health professonals, nursing home operators, academicians and representatives from NGOs. For folks out there who were unable to attend the conference, here's a brief roundup of some of the sessions I attended. It's simply not possible to cover everything on the programme. 


Dr Ravindran Kanesvaran started Day 1 with a very informative talk on 'Cancer: Prevention is Better Than Cure'. Many cancers are curable if detected early. So, people, go get your medical check-up done if it is long overdue. You will save a ton of money and more importantly, add more healthy years to your life. Dr Ravindran stresses to avoid or reduce intake of red meat if possible as it contributes to a high risk of colorectal cancer.


There was a lot of focus on nutrition and diet, and some confusion arising from conflicting advice on foods to avoid and foods to take. Not surprising. Examples: Egg yolk - good or bad for our health? Diet: Mediterranean, Okinawa or Malaysian? Is diet closely associated with ethnicity, culture, religion and geographic location? Should we follow a diet that is meant for a culture and lifestyle that is vastly different from ours? Our Malaysian diet is generally not healthy - too much sugar, salt and saturated oil. We also need to reduce our daily consumption of white rice as it is high in carbs which the body converts to sugars. Opt for brown rice instead as it is healthier. Keep an eye on our weight as obesity is a leading cause of diabetes, cardio-vascular disease and stroke. Malaysia has the highest obesity rate among countries in Asia. So take heed.


Prof Gerard Bodeker's wealth of knowledge on medicinal plants for disease prevention is truly amazing. Great to know that ulam and pegaga are on his list, and that he advocates nature therapy (e.g. forest bathing) and personalised therapy i.e.what works for you may not work for me as we are physiologically different. Dr Johan Manez had an interesting point to make on whether a plant-based diet is good for us. Based on the type of teeth we have and the way we chew when eating, he believes that humans are meant to eat more vegetables and fruits than meat. He proposed six lifestyle changes for better health: increase physical activities, manage stress, maintain good relationships, get enough sleep, eat healthy and avoid substance abuse.


Prof Tan Maw Pin was next after Prof Bodeker with her talk on 'Do Older People Need Vaccination'? Her answer was an impassioned plea to get ourselves and our elderly parents vaccinated or be at risk of getting pneumonia which can be very bad news for older people. The reason why I was initially hesitant about getting my 93-year old mother vaccinated was her advanced age and my fears of possible side effects. In the end, I caved in. Now after listening to Prof Tan, I am glad I did. My mom is fine and did not show any of the contraindications mentioned after her vaccination. 


I agree absolutely with Dr Wong Teck Wee in his interactive session on 'Healthy Ageing Revolution'. To age well, we have to start early to lay the foundation. Healthy living and financial literacy should be introduced in the school curriculum. This would ensure quality of life in old age. From womb to tomb. Prevention is always better than cure. As Dato Mahadev Shankar so aptly put it: "Money is the 6th sense, for without it you can't enjoy the other five senses". 

Good advice from Dr Rajbans Singh regarding supplements. Check out the above five points before you purchase any supplements. Too often we listen to what our friends tell us, or believe MLM sales pitch. We end up spending huge amounts on expensive supplements that show little results. We should do some research first on the internet and find out what reputable sources say about a particular supplement and whether we really need it. 


Day 2 and 3 began with half an hour of Laughter Yoga conducted by certified LY trainer Debbie Rodrigo. Beginning with some exercises, she soon had the room filled with laughter, releasing all the endorphins and prepping the delegates for the morning sessions. 


We often hear the term 'patient-centred' used to refer to care given to patients receiving treatment in hospital settings. But what happens after they are discharged? How does a post-stroke patient, for example, deal with recovery and rehabilitation? Based on her research, occupational therapist Kim Walder believes if the patient understands and accepts his physical limitations, the journey from initial turmoil to wellbeing can be smoother for himself and his family.  


The lunch symposium on Day 2 raised quite a few eyebrows. Prof Dato Dr Hj Mohd Farouk Abdullah didn't mince words (or images) when he spoke on 'Sex in the Golden Years'. His message was loud and clear - older couples can still enjoy sex, with some creativity and the use of various aids. It was definitely a no-holds barred presentation that probably made many in the audience feel a little uncomfortable. Time for a change in mindset about post-menopausal sex. 


Dr Ainoriza Mohd Aini's talk on 'Ageing in Place: Design and Infrastructure for Healthy Ageing' covered both home renovations and city planning. She shared about providing elder-friendly facilities for ageing safely at home and in the city. It is good to know that housing developers and town planners are now giving importance to designing for a growing ageing population. Take a walk in the city streets or visit a public housing complex, and you will agree that the government has a monumental task ahead to improve public housing and city infrastructure for all ages.


Speaking about the government, do you think it is doing enough to protect the rights of older people? Are there laws to prevent financial abuse? Should we advocate for a Maintenance of Elderly Parents Act similar to what Singapore and India have already implemented? The jury is still out on this. The general conclusion is we have laws and regulations to protect the elderly, but enforcement is poor. We already know that. 


This was one presentation I didn't want to miss as I felt the govt should step up efforts to promote productive ageing now that healthy ageing is firmly on their radar, thanks to the positive image of Tun Dr Mahathir, 94, the world's oldest prime minister. With the cost of living going up, not all senior citizens can afford to retire. I was glad to connect with Dr Amuthaganesh Mathialagan after his talk on 'Entrepreneurship for Older Persons'. He was receptive to my proposal to conduct a training course on entrepreneurial skills for our warga emas.


The above sessions on Intermittent Fasting from Dr Vaikunthan Rajaratnam and Ketogenic Diet from Prof Dr Raghu Vadarajan had me wondering seriously if I should follow their advice to lose weight. Both diets seemed drastic but the doctors were themselves proof that intermittent fasting and the ketogenic diet worked for them. However, it requires mental strength and a huge amount of perseverance to stick to the diet given our love of food.


The most humorous presentation came from Dr Tan Seng Beng on 'The Art of Dying'. If his intention was to remove the social stigma attached to talking about death, he succeeded. His wry sense of humour in dispensing advice filled the room with laughter. This was in contrast to Prof Dr Saw Aik's talk on 'Turn a Loss into a Gift: Silent Mentor Program'. I was quite moved when he shared about the dignity and respect shown by the medical students to the silent mentors and their bereaved families. As should be. 

Dr Lam Chee Loong spoke on 'Resources for End of Life' and provided a list of hospitals that offer palliative care and another list of community hospices. Most useful for families looking for end-of-life care for a loved one. Dr Yau Weng Keong's talk was on 'Decision Making in End-of-Life Care for Older persons'. Unfortunately I did not attend his talk. Kudos to MHAS for including these topics. It is high time society stopped viewing death as a taboo subject. Not only should we live well, we should also leave well, and that includes having a say in how we want to make our final exit. 


The final session saw Prof Dr Nathan Vityalingam explaining the differences between retirement homes, nursing homes and daycare centres. Know what to look for when visiting an aged care facility, and check whether it actually provides the services stated in their promotional materials. 

For the organisers, it was a daunting task to ensure everything went without a hitch, from making sure registration was smooth, technical problems were minimal, food was served on time and speakers turned up as scheduled. If there were hiccups, they were hardly noticeable. To the delegates it was three full days of learning, sharing and networking.

So a round of applause to the organising committee for a very successful conference. Looking forward to the next conference in 2021.

Friday, June 28, 2019

WEAR OUR AGE WITH PRIDE


I turned 71 today - 28 June, 2019. 

When each birthday comes around, we get well-meaning reminders of how quickly the years have rolled by. It's not just the number of big and small candles that announce our age on the celebratory cake, but also the family members that gather around us for the all-important customary birthday photos. Our adult children and our grandchildren are yet another reminder of our age and of how fast time flies.


My elder daughter celebrated her 50th milestone a month ago. My younger daughter has another two years to reach that same milestone. My grandson will be 19 in August, followed by my three granddaughters at 16, 15 and 13. My youngest grandchild is 5. 


I am reminded of the lyrics from the song 'Sunrise, Sunset' from the movie 'Fiddler on the Roof'. 

Births, weddings and deaths are all part and parcel of life. As we live, so shall we leave - hopefully surrounded by people we love and who love us. 

Let's be proud of our age, whether we are 50 or 80. Never mind if society thinks we are past our prime and over the hill. It's more important what we think of ourselves. If we think we are 'useless', 'unproductive' and a 'burden' to the family and society, then we are. Time for a mindset change. 

I can never understand why women in particular fear this stigma of ageing. Why are they so defensive about disclosing their age? It's funny how those in their 40s and 50s want to keep their age a secret, and those in their 60s want you to guess their age. But once they have reached 70 and beyond, they wear their age with pride like a badge of honour. They will voluntarily tell you their age. And why not? After all, old age is a privilege denied to many. It is a mark of having survived all the ups and downs of life. 

Growing old is natural and inevitable. So why fight it or try to reverse it? That would be like trying to stem the tide. We should look at our wrinkles as life-lines of experience, and our greying hair as threads of wisdom.

Let's not waste precious time wishing we could turn back the clock. Let's not fill our days with regrets, of things we could have done but didn't. Worse, let's not get stuck in that negative mindset with the all-too-familiar refrains of “Old already. Cannot study anymore. Cannot travel anymore. Cannot dance anymore. Cannot chew anymore. Cannot hear well anymore. Cannot wear bright colours anymore. Cannot enjoy romance anymore....” Aiyoh!

And we wonder why young people see us as decrepit old fogies ready to crumble into dust or ashes any minute. That’s how many of us see ourselves too. Is that why we avoid looking at the mirror unless we have our make-up on? A smile works much better than cosmetics - it lifts up our face instantly and pushes back the years.

No need for expensive botox, hair treatment or facelifts. Throw away those anti-ageing, anti-wrinkles cream. Invest in joy, love, forgiveness, gratitude. Eat sensibly. Exercise regularly. Nourish our skin with moisturizers. Smile often. Have a hearty laugh every now and then. Make positive words a part of our daily vocabulary. Think good thoughts. 

Add fun, friends, and fantasy to our lives. Spice it up with a dash of colour and romance. Dance in the rain, sing in the sunshine, enjoy the outdoors, see the world through the eyes of a child eager to discover and learn once more.

We can't stop growing old, but we don't have to BE old. We need to think outside THAT dreaded box or we'll be six feet under sooner than we want.

I can never understand folks who say they don't want to live too long and be a burden to their children. Why not prepare for a happy old age and make it happen? Surely we want to be around to see our grandchildren graduate, get married and start a family? Or simply just be around to see them go through life as we have done before them? And if they need our counsel, we'll be there to provide it. 

As for me, I hope to live to 100 in good health, God willing. Here's a toast to myself - to many more happy birthdays to come. 

(Above photo: The original words were 'My Last Portrait' but I changed it to 'My Best Portrait'. The photo was taken by a photographer who specialises in funeral portraits. He had a charity booth at the Death Festival organised by Xiao En in November 2018.)