A Conversation About Mental and Physiological Aging with Ben Katz and Pamela Teaster

Disclaimer: Unedited AI Transcript

Larry (00:07):

You re listening to specifically for Seniors, a podcast designed for a vibrant and diverse senior community. I'm your host, Dr. Larry Barsh. Join me in a lineup of experts as we discuss a wide variety of topics that will empower, inform, entertain, and inspire as we celebrate the richness and wisdom of this incredible stage of life.

Larry (00:40):

My guest today on specifically for seniors, caught my attention in an opinion piece in the Washington Post, professors Ben Katz and Pamela Teaster urged quote, an objective scientific conversation about mental and physiological aging, both for our leaders and for the rapidly aging populations around the world, realizing that these conversations are both difficult and obligatory. We're gonna try to at least open that conversation here on specifically for seniors today. Both Ben Katz and Pamela Teeter are part of the faculty of Human Development and Family Science at Virginia Tech. Pamela Teeter is also director of the Virginia Tech Center for Gerontology, and on the editorial board of the Journal of Elder Abuse and Neglect. She's a fellow of both the Gerontological Society of America and the Association for Gerontology and Higher Education. Pamela is an active board member and former president of the National Committee for the Prevention of Elder Abuse. Ben and Pamela, welcome to specifically for Seniors.

Ben Katz (02:08):

Thank you. Great to hear.

Larry (02:11):

I'd like to get started by asking each of you to introduce us to your principle areas of research focus. Ben, do you wanna start?

Ben Katz (02:21):

I'm happy to. So my background is in really cognitive neuroscience and cognitive psychology. So I studied the development of these processes we call executive function. So the skills that you need to learn, reason, think, and decide, like working memory, holding information in mind, using it to solve a problem or inhibitory control, stopping yourself from doing something when it's inappropriate over the entire lifespan. So that includes in working age adults and, and younger adults and children as well as a lot of my research focuses on aging as well, and that's the core of what I do. And I study both how those processes develop over the whole life course, but also how they can be modulated from through experience and intervention.

Larry (03:03):

And Pamela.

Pamela Teaster (03:06):

So my degree is in public administration and public affairs with a certificate in gerontology. I've always been interested in aging policy. The bulk of my work has been on surrogate decision making. And that would be in, that wouldn't be powers of attorney and a lot on guardianship. Also, another stand strand that I have is on elder abuse, and it's really been all types, opioid abuse, sexual abuse, domestic violence for older adults, all that sort of thing. And then I'm also a bioethicist

Larry (03:38):

As a start, let's talk about the perception of aging in the younger con population in general and in the media. What do view both found is the perception of older adults?

Ben Katz (03:58):

Do you wanna start, Pam? Oh,

Pamela Teaster (03:59):

I was gonna let you <laugh>.

Ben Katz (04:01):

I mean, either way is fine. I I can, I mean, I, I, I think Pam, as she'll mention, I'm sure has long thought about this, and she's actually spoken in my class about this. I think or maybe I with, she's spoken to our students about this quite a bit. Bam you can talk more about that class that you're, that you're working on, but you know, it's not really just in the media, right? These are things that we see that are pervasive throughout entertainment formats like TV and film, right? And there, while there, of course, are some very positive depictions of aging, right? There are a lot of depictions that reinforce negative stereotypes, right? As people getting slower, not able to do certain things. And, you know, this was the sort of thing that sparked us again, right? Just seeing how many times the term senior moment was used in the news media leading up to this in sure. It was used by some people who would probably have the defense of being comedians like John Stewart. But I also saw it in a lot of opinion pieces in tons of other outlets as well. I'm interested to hear what Pam has been thinking about too.

Pamela Teaster (05:06):

So, so Ben is exactly right. And <laugh>, as early as graduate school, when I was not even finished, we were working on issues of, of, of aging in the media. And we called our, one of our really early presentations with one, my fellow graduate students, real versus real REEL versus REAL. So we've been working on the thinking about this issue for, oh gosh, at least the late nineties, early two thousands of, of just the media issues. And Ben is exactly right that what we see is what we emulate. And there's even science behind that. So if you think that aging means slowing down and you think that aging means cognitive loss, that Ben can measure you, you know, what you see is what you, what you get. So if you can, if you see it, you believe it. And that's sort of that problem with that. And, and it, you, it, it's not just a perception, it's not just what you look at, but it actually affects your health and your healthcare treatment and your treatment of others. And, and, and then that affects your quality of life and those around you.

Larry (06:16):

And we're sort of looked at as a homogeneous group with similar interests and just similar backgrounds, which, which just isn't true.

Pamela Teaster (06:31):

I find that funny because I, I had a long, long, long, long, long, probably long dinner with a good friend of mine arguing that aging was the ultimate heterogeneity. And he and, and he was not quite buying that. He, he was more of a child per studied children. And I was like, no, older people have had longer to develop their personalities. They've had longer lives, they've had longer experiences than any, any other population on the planet except maybe tortoises the Galapagos tortoises. They live longer than us. So they would become more differentiated over time than maybe become less, yeah,

Ben Katz (07:09):

We, we, that's, and there's so much research backing this up across multiple dimensions of aging, right? It's actually where we see the most heterogeneity. So there's incredible variance across people, you know, as our entire lives, but especially as we get older and things like cognition and a, a wide variety of other functional capacities and things like that.

Larry (07:30):

And what do we have to do to overcome in order to gain understanding? Do people have a fear of older people or a loathing of older people? What

Pamela Teaster (07:43):

A fear of older people. 'cause The fear getting old. We see it in, we see it in products. You know, I, there was something that was just in on consumer report this morning that said, you know, here are the anti-aging things. You might wanna try anti-aging. What would the op, what would the opposite be of anti-aging? Right? And so I, when that gets in the, when that gets in the population, when that permeates everything we do, then people have a real fear of getting old. You know, am I, do I look old? Do I look old? Am I eight? And, and I think the best thing we can do, Ben can talk about this far better than me, is is that we can say that everybody's been aging since you were born. And, and that is just a continuation of what you've been doing across a lifespan.

Pamela Teaster (08:31):

And I think, Ben, you tell me what you think. I think that's the best approach that I've ever had word with, with law. I just tried it with a, a friend of mine used it in her law, elder law class, just this spring. So I think if we can begin to sort of see that, you see you're all sort of on this journey. And of course there's determinists because there's always a terminus. And we don't live forever. We never will. At least, at least I can't imagine it. You like, Finn, I'll let you take, take it from

Ben Katz (08:56):

There. No, I, and I totally agree. So, so most of my experiences from this, where this really was hit home for me is I teach one of the classes is anecdotal, but I, I would guess this is consistent. I teach a Introduction to Aging class within our department. And for a lot of the undergraduates in that class, they absolutely report. I ask them, what do you hope to get outta this? How do you feel about aging? We have a little survey that we give them in the very beginning, and almost every student, I would say it's upwards of 70 or 80%. So a lot of the students respond saying that they're afraid of aging. They don't know that much about it. That's, that's part of that, right? And they also don't always have a lot of contact with older adults. You think about how much contact people have with their grandparents that might be the one person in their, you know, two people in their life that they actually, or four people in their life they talk to.

Ben Katz (09:42):

But not even all the students actually see them that frequently. So it's this mix of being afraid of it. But I think that fear a lot of times coming from not having exposure or discussions about it early, and they really aren't, a lot of times that class is the very first time they think about things like, where do they wanna live when they're older? What are things they might plan for themselves? You know, I, I think that this is the sort of thing where more conversations about it would be helpful especially like for my undergrads, but they end at the end of the class, I ask them again, and that fear usually drops a whole bunch just because they've spent a whole semester thinking and talking about it.

Pamela Teaster (10:15):

Same thing for me. We did a project that during Covid, as a matter of fact called Covid Companions. And of course they were, we were trying to help older adults who were becoming socially isolated and trying to help them. We gave 'em a pa a pad. We got monies from the government for that, for our, for where we live. And they really like stood on the steps of people's houses and tried to help 'em get co connectivity. And when we did the research on how that had affected them the students just did exactly what Ben said. They said they really got more comfortable with older people, they got more comfortable with their own agent. And I thought if, if, you know, not only was that a great project, 'cause it helped people with their social isolation, but it really helped younger people connect with older people and see that there's a whole life out there past 21.

Larry (11:06):

And on the other side, our perception of what the younger people think of us is biased based on our conversations with our grand grandchildren who have a different connection than most other people. What do you feel has contributed to the ageist rhetoric and characteristics of aging in public opinions, especially in the media, especially in relation to this election coming up?

Ben Katz (11:47):

Oh, that's a lot to unpack, right? <Laugh>, I mean, is this gonna

Pamela Teaster (11:51):

Be longer than your usual ones?

Ben Katz (11:53):

<Laugh>? I mean, I think, I think I know Pam has a lot of thoughts on this. I mean, for me, it always comes back to how many protected classes do we talk about in this way, right? Why? And, and, and, and why That's okay, right? I think is a complicated question that definitely goes way back before this single election, right? It sort of got brought into the forefront. 'cause Now, you know, we had a situation where at one point, right, there were two two candidates that would both be the oldest running for or, or election or reelection, right? But, you know, sort of why that's okay and how that why it continues to be something that is okay, is something that I think is, is a lot, is hard to unpack. So I'm curious to hear what Pam says, but my, I do think that is going to change. And I have a good, a very strong reason why I think that's going to change. And I think you can look at demographic trends for a pretty quick introduction to what's about to happen there. But Pam, I'm, I'm curious to hear what you think about as far as why, like sort of the, some of the contributing factors to, to how that, why that's so pervasive now.

Pamela Teaster (12:56):

I, I, I think I think our culture has been one of the youth culture we have really loved try to stay as young as possible. And I think that is that all sort, again, I mentioned that slightly all sorts of products to try to do that. All sorts of things to make you feel young and, and just go run the gamut of those that you can just put in your head. So, and then I think I think there's another factor of work too. And, and I, I, again, I had another long discussion with a friend of mine who was in his nineties. It was one of my professors and I was society. We have not, as a whole population at the population level, we have not lived that long. Remember it was the 19 hundreds. We all remember that. 'cause We were all, we during that period of you where right then and so it, it, it was that period that people, that generally, the lifespan was about 40 people did live.

Pamela Teaster (13:52):

Now there, it wasn't to say that people didn't live a long time, but we're talking about the average life, average lifespan was about 40. Well, that's about a, that's about a century. Only a century in time that people have lived that long. And that's not true globally either. So I think just understanding what to do with a group of people who are aging. You know, for example, Larry, we changed this, the retirement age, right? Is it fair to everyone? Of course it isn't. But we, we've even changed that so that a person who turns 65 this year isn't gonna be able to retire at 65 like other generations did. It's 67. It's a population aging issue.

Larry (14:33):

So where do we start this conversation on aging

Pamela Teaster (14:39):

All the time? I think we talk about it with our kids. I think, I think we do what Ben does in his class. I think we have podcasts. I think we write about it. I think we do what we did in the the Washington Post. I think we, we say here, here is a conversation, but it's the wrong conversation that we're watching this nationally. And the most hard thing, when might we think about what we saw about only a month ago? Only a month ago. They were some of the most horrible things that people said about people getting old. Just awful. Watching somebody shuffle, doing the walking check. I mean, I, i, it, it, it was really some of the most ageist rhetoric I have ever witnessed. It was embarrassing as a gerontologist. I think that we, we had slipped back that far. And I think Ben thinks the same.

Ben Katz (15:28):

And, and that's, I think that's why, you know, so I think, yeah, having those conversations is important. That has to be part of it. And we have to engage more people in those conversations, right? So it has to be something that's happening on tv, in, on television shows, and not just news shows, right? But also people that are creating entertainment media. And it's not universal, right? That there's are bad depictions, right? You just, this right. Last month, Thelma, there was a great movie that came out that had very different approach to depicting some of that. And so I think that it has to happen at many different levels in order for it to be successful as well. Because this is something that's taken a long time to sort of sort of, I guess form as well, given what Pam said about how we've only had people that have been that old in society, you know, at a larger percentage relatively recently.

Pamela Teaster (16:18):

Yesterday, for example and I hope you might hear your podcast, I was in the airport and there was an older gentleman who was sitting who was, he was chatty, right? 'cause We were waiting at the gate at the airport. And he said, you know, it's what do you do? And I went, well, actually I'm a gerontologist. And I said, and I would, I don't always know that people know what that means, but, you know, and I said, I said, so I study older adults. He clearly was an older adult. And I went, I love being around old people, you know? And I, he was taken back by that. I think a little, but I think that is sort of a way to approach that is, is to do just what you said to say, actually, I like them very much.

Ben Katz (16:55):

And, and, and just, so like one quick thing we do in my class, right? It's not just about it's not just about having a conversation about it, right? They have to do a field study in that class. And for most of them, what that means is working at either we have a adult day service center at Virginia Tech. We also, there's a local continuing care community that many students work at. And for many of those students, it's the very first time, right? Engaging with older adults who are not their grandparents. I get that from 'em a lot. And their experience during that is trans transformative because they come out of that understanding, that heterogeneity that you mentioned earlier, right? And also understanding how rewarding those experiences are, right? They come out of that, those experiences with mentors, with friends they never would've thought of in those types of capacities. Would, did they not engage with that?

Larry (17:51):

I don't particularly think of myself as an older adult <laugh>. One story, I was on an airport bus with my son and we were leaning against the baggage rack because there were no seats. When one of the guys sitting down looked at me, stood up and said, excuse me, sir, would you like to sit down? My son started laughing hysterically, <laugh>. And I just sort of was taken aback by that. I, it's just a very strange feeling on this end as well,

Ben Katz (18:32):

That really connects to what we were talking about before, that it's so much self-perceptions. And there's, there is, you know there is so much research on this, right? That there are things that can either reinforce or challenge those types of stereotypes or those perceptions we have of ourselves. And you know, I guess it's a positive thing, right? That that, that it's not great that in that moment you're like, oh man, if somebody see me this way. But it's probably also a positive thing that you don't always see yourself that way. I, I am the same way I, my students remind me that I am, I'm not a, you know, I'm, I sort of mid midway through life, but there, I always still see myself as a, you know, college student or whatever. And my students remind me that I'm not, if I wasn't in front of them, I probably wouldn't feel that way either. But there's so many things. That's why we have to be so mindful about all the different places where we can reinforce those perceptions. You

Pamela Teaster (19:19):

Know, many facilities will put affect their, beside the door, on the door of a person in a facility, they put a picture of them much younger. So that when staff are providing care for them, that they can remember that here's this person who's lived this life, you know, and we're not just seeing them not well or needing lots of care. This was a person who had a full life, who had all kinds of experiences. And I think that helps with humanizing the aging experience. But I, I've, I've been to many facilities both for studying and visiting people, and I always kind of like that approach that here's a person who had a whole life. They weren't just, they, they didn't just start being a person with problems. They, they just, they started as a, as a young person

Larry (20:10):

In, in getting back to the presidential race before Joe Biden dropped out. Your expertise is in the field of lifespan cognition. Where, where do we stand in understanding that?

Ben Katz (20:27):

So we've made really amazing strides going back to decades ago, but, but especially in the last 20 years or so, understanding that heterogeneity. So the fact that there's not only differences between people, right? And, and the course of aging. And when I say the course of aging, I mean the social, psychological, physical, cognitive, mental right. But there's also a ton of variance you know, within ourselves, you know, as we have positive things that happen that can you know, sort of reinforce and provide a foundations of support. And also we have cha, you know, have challenges to health and things like that. And I think what's been useful about that and that work, really, so my work is sort of overlaps both cognition. So that's like studying behavior, but also the neuroscience behind that. So understanding what actually happens in the brain, and both of those area of areas of research are sort of mu mutually beneficial.

Ben Katz (21:20):

And so, going back to your question about how was that improvement, maybe how has that sort of increase in knowledge, maybe relate to the election, for example. It's one of the reasons why when people talk about the first of all, so I think, you know, you kind of had all these people saying the president should take a cognitive test or something like that. Most of the time they're referring to the moca. This is the Montreal Cognitive Assessment. It's a very standard global test of cognition, right? And I feel two ways around that One hand, anyone who's not a physician of the president or of that person should probably not be speculating about that. But the other way around it is, we're afraid, right? Sometimes of these types of tests they are not sensitive enough to give you very fine detail about whether you're a high performer or a low performer.

Ben Katz (22:04):

They're a screening tool, right? But they also shouldn't be something to be afraid of, right? We've kind of, because we have all of this other rhetoric around aging, we think of that as something of like, oh no, you know, if I don't, I'm not doing as well in this as I should be. You know, it's, it's sort of seen as something so negative that you know, people don't often take those tests. And the reason that that's really not so great is because a lot of the time, or significant percentage of the time, right? It's not like it's always an indicator that somebody has Alzheimer's or dementia or mild cognitive impairment even, which might proceed. That sometimes it can actually highlight other health issues. For example, having hypertension, if it's unmedicated, can actually be a cause of mild cognitive impairment or things like that.

Ben Katz (22:45):

And so one of the things for me is we have these great tests that have become more pervasive in the last 20 years that are parts of our ways of studying cognition over the lifespan. And we need to be more thoughtful about how we use them, use them more frequently, and also do a better job of communicating that this is part of a standard checkup, for example, for people that we should be taking way before. The problem is you give it to somebody when they're 65, you don't have a cognitive test until then, right? You see that, well, that's something that just happens when I get older. I don't, you know, whatever else. So we need to have conversations about it earlier, and it needs to be something that's normalized.

Larry (23:16):

So how come the questions never change?

Ben Katz (23:20):

That's another huge part. Do you mean the questions on the tests or the questions

Larry (23:23):

On the, on the tests? It, it is so standardized. I've taken the MOCA test several times and I've sort of memorized the answers.

Ben Katz (23:32):

So you've, Larry, that's such a great point. You've highlighted something that's so frustrating to me, and this is work that I'm doing with somebody else at Virginia Tech. Laura Sands, one of my great colleagues. So right, that test. So that test is not designed to examine that variability over time, right? It's designed to be given at like a single time point, right? Which I think is very self-defeating. What you need to do is to make multiple, there are some that they have multiple versions, but they need to have multiple versions, right? That you norm and do go through all the things you would do to make sure that it's a, it's a valid a valid measure. But you need to be a reliable measure. But you need to have multiple versions of those types of assessments because you're absolutely right. There are retest effects, there are all these other issues, but they very rarely do that because we don't always see cognition, you know, people understand, oh, there's gonna be some decline, right?

Ben Katz (24:22):

But we need to think about that as something that changes more frequently than we might think. Not only over like years and months, but actually from day to day. That's other work we're doing in our lab too. And I think once you understand that, you see that you need to have the ability to be able to administer a tests where the questions are different all the time. And you could give it maybe once a month instead of if somebody needed it that way rather than just one, one single time point. I, I think there are people who are working on this. There are, but there's not a good standardized version of any of those tests that you can really administer exceptionally frequently to look at variation in cognition. It's really a very blunt instrument, I guess so to speak. Mm-Hmm. <Affirmative>,

Larry (25:00):

Pamela, where do we stand in your field of expertise?

Pamela Teaster (25:07):

Not so great, as a matter of fact. So like Ben, I'm, I'm, people would take cognitive tests, for example, when some things would happen that I study. And I think I talked about these issues of elder mistreatment and these issues of guardianship and, and, and, and also end up like they are all sort of in one bundle. So no big surprise that I became a bioethicist. And I just wanna say I didn't become a bioethicist when I was getting my PhD. I finished that in 2021. So I, I really went back to school and got another degree. And not as a, as a friend, I said, not as a spring chicken, probably a fall chicken. And so I didn't, I didn't go to school. I went back to school and I, and I even talked to Ben about that.

Pamela Teaster (25:53):

Do you think I, like, I had to take a test, right? I haven't taken a test since like various, you know, maybe the Clinton administration, because I don't take tests as a graduate student. We take papers. So I, I had to ask Ben. I was like, so could you remind me how you take like, standardized tests? 'cause I've forgotten that I don't do that anymore. And so I I, I even went to Ben over this thinking, gosh, this is outta my comfort zone. 'cause I simply don't do it. My students laugh laughed about this because they do it all the time. This highlights another issue that Ben would talk about. Not only are are we taking cognitive tests, but we, he would also say to you that, that we, we do not take tests. Like my 15-year-old takes tests every day. They take a test on something, they're really fast at it, they're really used to it. But we get less used to that because we're not practiced at it anymore too. Yeah. But back to elder abuse. And so, oh, Ben, say something.

Ben Katz (26:49):

No, I was just gonna say, by the way, Pam didn't mention this, but she did ace that test too.

Pamela Teaster (26:53):

I, I

Ben Katz (26:54):

Did <laugh>. And that's what our, and that's what our research in our lab shows actually. Even if it might take a little bit longer to learn or something because we are maybe out of practice or whatever else, everyone right at, at, at, at, you know, we, we have research going right up into the, to the later years in life. Everyone has the capacity to learn and to improve on of almost everyone has the capacity to learn and improve. It's really, you know, it may take a little bit longer, but really we are able to see performance that's very, very high if people are able to study and practice.

Pamela Teaster (27:24):

It's true. As far as treatment of old people, you see that ageist problem permeates how we treat them. And that's really where I study and live. And so that, that becomes why it seems to be okay to scam older people, because that's okay. They got a cognitive problem, they'll never miss it. Why? It would be okay to mistreat a vulnerable person. Why somebody would think that was the thing to do because they've got money, they'll never miss it. And so actually the scam problem is getting worse than better. And that again reflects Does it reflect the side? He's getting worse? I doubt it. What does it reflect a population of people who are a larger population of people? So if there's elder abuse 10, 20 years ago, there's more of it. Unless we've been able to really stop that because simply there are more older people to abuse right?

Pamela Teaster (28:17):

In the population. So the nu the sheer numbers are gonna go up, but the occasion has gotten more complicated. And I think a lot of that, at least on the scam side scams and fraud side is the, is the really wonderful computer. And ai, AI is beginning to make some of that more frightening. And I think that movie Thelma, that Ben talked about is just an example of that. That we can replicate your grandchildren's voices now, right? We can send email. All of us are getting that, where it's not what we're expecting that somebody says, a friend of mine sent me something, faculty, Ben, you may have gotten one a, a friend. Like, where are you? This was the message. Well, where I was, where was I? I was like, I'm in Hawaii. What do you need? You know? And I thought that that was a little odd that, that I never heard back from them, but I turned out this morning, I found it was a scam.

Pamela Teaster (29:07):

And so we were beginning to see more of that. Well, you have many mechanisms that we can have people help us figure out if they are. Like, my colleague will tell me that that was a scam. But older people don't necessarily, because they're not in the, if they're not in the workforce, they might not have an IT person to help them and so forth. The guardianship issue there, there are people in the world who think that as we discussed, Larry, that that think that guardianship should not exist at all. I wouldn't be one of them, but I think that too, too often we have taken away people's civil rights too quickly. And not with enough cognitive testing and life course understanding before we start removing civil rights in the names of pro name of protection.

Larry (29:51):

I personally, I received one of those grandparents scams. Oh, grandpa, I've been arrested. I was driving, I was drunk. It's, they do it. Well, it almost did sound like my granddaughter until I asked them what her middle name was, <laugh>, and they saw, dropped

Pamela Teaster (30:15):

Out. They had no clue. And we know that that's, we know that I was reading an article actually not about a week ago, and we were learning, I was learning that many of those places are act, people are captives and they're groomed to have to, to do those kinds of scam calls. They're beaten if they don't get, they don't hook somebody. And so I'm not excusing it, but I'm just saying there's more on the other end of what's going on that we even know than I even knew about as much until I had read some more about that article. This was a person who had escaped.

Larry (30:49):

Yeah, we, we talked a bit about gerontology and what I've noticed recently, I've begun seeing a gerontologist, the geriatrician and the approach to medical care is completely different than than a regular internist to family physician. The approach is more about how and what we expect out of the remainder of our lives

Ben Katz (31:28):

Do that. I just had this same conversation with my wife, 'cause she was sort of asking, we have several friends who are physicians and most of 'em are general practitioners you know, family practice. But she was sort of like, well, what's the point of having a geriatrician? And it was a kind of, it was like, well, many people, you know, it was about the training that they receive, right? And that's actually something where there's still a lot of room to approve. I'm sure you've talked to geriatricians and that's a whole separate field. You know, I I been on the editorial board for ger geriatrics and gerontology education. And that's a space where, you know, helping people understand what that, so you mentioning that is a really positive thing, right? Because that experience of thinking about aging more holistically, thinking about it as an additive thing, what you want to have happen or experience or be able to do rather than loss, right?

Ben Katz (32:16):

Rather than really limitations, I think is something that not everyone experiences. They certainly don't always experience that in medical school, right? And there's va a lot of variance in what those training programs look like. But that's another one of those places, right? Where we need to have more conversations about that and where there's probably a lot of room for gerontologists and geriatricians to work together in thinking about that type of training. You know, I think having it happen for in medical school when somebody's, you know, in a, in an advanced professional program is too late. I think for me, it really needs to happen in undergrad or even, right? Where's one place where we don't have really any gerontology education at all is in high schools or K through 12, right? We do a terrible job of including that kind of content there. So I think it really needs to start much earlier to promote those kind of very positive ways of thinking about aging.

Larry (33:06):

As a retired dentist, I can say the same thing happens in dentistry. We don't understand the need of the individual, the older individual as opposed to our need to create a complete functioning dentition in somebody who's 85 or 90 years old. I remember I had one patient who came to me when she was 90, 91, and she needed endodontic root canal treatment on four lower teeth that were not bothering her. And I couldn't understand at the time why she didn't accept treatment. She died at 99 with the same four teeth, with the same problem that never bothered her. And this is something that I've begun to understand from my experience with a geriatrician,

Ben Katz (34:12):

But that also highlights, right? So I think the fact that there are so many people specializing in geriatrics is very positive. But you also have highlighted areas where probably, you know, there, and I'm sure some of this is happening, but there needs to be even, you know, additional training both in, you know, dentistry is another place, right? Where there's probably lots of opportunities. Also probably in optometry and ophthalmologists. That's probably another space where there's probably a lot of room to improve education there as well. And I think those are places, right? Where oftentimes is sometimes later to the game than other fields of medicine for unfortunately.

Larry (34:48):

So how do we start these conversations nationally? How do, how do we get started on, on bringing this out to a broader population?

Pamela Teaster (35:01):

I think what I think, I think Ben and, and I and our colleague Al I think we, we are a good example of that. That when there's an occasion that it presents itself, you take it if you, if you can possibly do it and start saying, Hmm, we need to talk about this a lot earlier. We need to think about what the ramifications are in a, on a societal level for what you are seeing right now. You know, how does that affect how we think about older leaders? Are we gonna watch them all to see when they're declining and then start saying that we don't need sages? That which the, which we built out the con we built out in the constitution to have, because we knew that people who were older, it possessed this great wisdom. We knew that in the 17 hundreds. And so I think we take every opportunity we can to, to insert this conversation in our lives. And, and like Ben said earlier earlier, so my kids of course would've been exposed to this very early in their life. They have a very different view of aging because they've heard people talking about it since they were little. And I think they have a different, I think they really do have a different approach to it. One of their other approaches may be they're tired of hearing about it, but <laugh>, but that would be un that would be unusual. And you probably have other things to say.

Ben Katz (36:21):

Yeah, I mean, I think it, it has to be holistic, right? So there's so, so in my role, my small place, right? I can, I know that with my undergraduate students, I can do that and maybe to some degree I can promote through my service and work in the editorial board and things like that, write better studies and papers that really investigate how to do this across more educational institutions and things like that. But it has to happen in other places too, right? I think, I think Pam can speak a lot to policy, right? There are some cool initiatives and things that, like Pam has participated in with trying to get more gerontologists or geriatricians involved in the development of aging policy, right? That's a place where, so for example, if we don't think a conversation like that is happening in the high schools, right?

Ben Katz (37:02):

That has, that's probably a much larger set of work that needs to happen to say, well, maybe we can put this in some standards or some, there's some ways where in certain state this can be something that makes sure it comes up in a health class or something like that. My health class, we didn't talk about aging. I vaguely remember it from high school, but it didn't come up at all, which seems ridiculous. And then, and then also I think, you know, when you think about in the media, right? There needs to be one of one of those things that's just oftentimes that not in a lack of awareness that there are people who can come and speak up about these issues, right? And when I looked at who wrote Op-eds after this happened, you saw a lot of physicians and a lot of geriatricians write op, op-eds, and that's fantastic, right?

Ben Katz (37:39):

But there were very few from Gerontologists and I think this is probably a situation where most people don't even know what a gerontologist really does, even though there's a massive organization for them and tons of people who do this. I think this is something where we can be afraid to speak up, but we have to do it because if we don't, those types of voices and, and these types of perspectives are gonna be missing from those conversations. And you're gonna see that negative rhetoric just reinforce. 'cause No one is gonna stop somebody and say, well, let's talk about this. Are you really mean to say that somebody's old or you wanna have a different conversation about functioning or performance? Right? Because you can have that conversations about the reasons why somebody might not be able to do something that doesn't just say because they're old. Because lemme tell you, there's lots, no matter what it is, there's a lot of people who may be older who could still do that, right? And so you really have to think about the sort of language you're using. So I think that we have to step up, and that's what Pam was saying too.

Larry (38:29):

That's an interesting point. Do you wanna explain the difference between a geriatrician and a gerontologist?

Ben Katz (38:37):

Oh my goodness. I'll give it a shot and Pam jump in. I better be able to do this since I'm one of those things. So yeah, I think it's, it's pretty simple, right? A gerontology geriatrician typically refers to a physician, right? Or someone in medicine who specifically is trained to, or, or at least works with most frequently, right? Older adult or aging populations. That doesn't mean they only work in those contexts, but that may be a focus or special skill of theirs. Whereas a gerontologist, and there of course can be people who consider themselves both geriatricians and gerontologists, but a gerontologist is just somebody who has a special interest in studies typically an academic from that kind of perspective, but it doesn't have to be just in that setting, right? Aging from a wide variety perspective. So it could be somebody who studies social aspects of it, it could be studies, someone who studies cognitive or physical aspects of it, or the brain or all these different areas. And so the big difference is somebody who's sort of researching this, right? And studying older adults versus somebody who they may still be researching 'em, right? But they're a physician who's providing, who may be also responsible for providing that kind of care in those, in those settings.

Larry (39:45):

Thank you both for an amazing discussion. Is there anything we missed or you'd like to bring up?

Pamela Teaster (39:55):

I don't think so. I think having a podcast like yours, Larry, is a wonderful thing to have to talk to help with this conversation. I think that the, you know, one of the takeaways I would say would be what Ben said. I think we start exposing people to issues about grading older way too late. I think we need to start that much earlier than we do. So middle school and high school, we ought to be having a section in anybody's class about that. That only happens. And, and I would say I've only really done that when I've done studies or because I've been a parent, an older parent of young kids, and I'm a geron tall.

Ben Katz (40:35):

Yeah, I, I think it's a, you know, that was the one thing for us, right? This was a challenging, painful time, right? That given that, that we were, and for everyone watching that and understanding that, that, you know, how that rhetoric is sort of being disseminated at the same time, for me, I was like, okay, but maybe then this is a moment where we're gonna start having these conversations a little bit more and start doing so in a constructive way. And so I think, you know, what I would hope is that anyone who's watching this, who's a gerontologist or a geriatrician is thinking about ways that we can have them more positive you know, have that conversation more constructively, but also have them earlier, right? Have them with people before. You know, as I think Pam will tell you, she does all this work with guardianship. The time to have that conversation is not when you're when there's an acute event, the time to have that conversation is as early as possible, right? And so that's, I think something that we have to do a lot better job of promoting.

Larry (41:30):

Once again, thank you boast. Were a terrific discussion. I think maybe we can open this conversation up. Thanks again for coming on, specifically for seniors,

Pamela Teaster (41:44):

Larry. Great pleasure.

Ben Katz (41:46):

Yeah. Thank you so much for having us.

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