(We’re always interested in new research and insights about growing older in America and the new book by Thomas Cole, Old Man Country: My Search for Meaning Among the Elders, has them in spades. Cole traversed the country interviewing men in their 80s and 90s — some famous, some not — to ask them what it means to be an older man, what worries them and what challenges they face. Their insights were candid and compelling. Here’s an excerpt.)

Today, the average American man who turns 65 can expect to live to approximately 85. What we usually fail to notice is the aging of the aging population, or the “Fourth Age” — a stage of life roughly demarcated by age 80 or older.

The Fourth Age has been described as a Black Hole — a vague, frightening and shadowy cultural space that evokes denial when it doesn’t provoke fear. But the Fourth Age also contains periods of sheer fun, appreciation of beauty, powerful religious and/or spiritual experience, community and family engagement, and continued work and artistic development.

In my book, Old Man Country, I seek to reclaim and enhance the humanity of men in the Fourth Age. To learn more about them, I talked to 12 men in their 80s and 90s, exploring how they face (or faced) the challenges of living a good old age.

Each man finds forms of engagement consistent with his personal history. Hugh Downs was still driving, studying physics, traveling and appearing on television shows at age 93.

Some are or were famous: Paul Volcker, the former head of the Federal Reserve (who recently died); Hugh Downs, veteran TV broadcaster and creator of The Today Show; Dr. Denton Cooley, the first surgeon to implant an artificial heart into a human being and Ram Dass, his generation’s foremost American teacher of Eastern spirituality (who also recently died). Several have become frail and in need of assistance since I talked to them. Some have lost partners. Others have died.

As I talked with these men, four major challenges or questions kept surfacing:

• Am I still a man?
• Do I still matter?
• What is the meaning of my life?
• Am I still loved?

Am I Still a Man?

Masculinity is not a natural collection of individual traits but, rather, a cultural story, a plot or a script by which men are judged and judge themselves. One problem is that this script for masculinity stops at midlife. For most old men in American society, there are no landmarks of achievement or value; no lighthouse guiding one’s moral compass; no employment office with the sign “old men wanted.” There is only the province of retirement — a barren place often marked by an absence of wealth, prestige and personal meaning.

How do men meet the challenge of reconciling manhood with physical decline? There is no single way.

One is to reject the model altogether, integrating traditionally “female” traits of caring, acknowledging emotion and valuing relationships. One man I interviewed, George Vaillant, the former research director of the famed Harvard Study of Adult Development, articulates this path and focuses on creativity rather than masculinity.

On the other hand, physician-writer Sherwin Nuland, who died in 2014, essentially told me that maintaining manhood meant continuing to write and remaining strong by working out at the gym.

For some, the problem of masculinity — including the loss of sexual potency — disappears in old age. Philosopher Dan Callahan, co-founder of the world’s first bioethics research institute (The Hastings Center) told me he thinks of himself as a person, not as a man.

Do I Still Matter?

At least since the institutionalization of retirement in the mid-20^th century, old men have often felt marginalized, useless or invisible. Retirement is a primary source of depression for those whose identities and self-esteem have depended on being productive, earning a living and being engaged with others in the workplace. Employment and volunteer work are often less possible for men who have reached their 80s.

When a man is frail or dependent on others to carry out the activities of daily life, the question “Do I still matter?” becomes even more pressing. The challenge of being relevant is the challenge of learning and creating new things, being engaged with others, making a difference in the lives of other people, being committed to a future beyond oneself and feeling needed.

For Paul Volcker, “being needed” means being at or close to the center of power and decision-making authority. Volcker convinced the Obama administration to implement what became “the Volcker Rule,” limiting banks’ ability to make risky investments with ordinary peoples’ savings accounts.

Volcker continues to feel obligated to contribute his gifts and skills. When I talked to him, he had new ideas for professional education in public administration. But he couldn’t convince schools or donors to establish new programs.

Among the other men to whom I talked, the question “Do I still matter?” was particularly bound up with work. Even after writing or editing 47 books over more than 50 years, Dan Callahan’s identity still depended on his next article or book. When we spoke, Dan was feeling no incentive or energy to write — an emotional and existential crisis for him.

Each man finds forms of engagement consistent with his personal history. Hugh Downs was still driving, studying physics, traveling and appearing on television shows at age 93.

What Is the Meaning of My Life?

Because our society provides old people with no widely shared meanings or norms by which to live, the task of finding significance in later life falls to individuals in their relationships with family and community.

Meaning is partly a matter of love and of relevance. If I love and am loved, my life has significance. Meaning is also a moral question: Have I lived a good life by my own lights? Did I, and do I, measure up to my own expectations and to the standards of my family, religion, community and nation?

Learning to feel at home in old age means believing that our life matters even in the face of frailty, disease and death.

Another answer to the question of meaning comes from affirming that we are each links to a chain in generations. We find strength by looking back to our ancestors and forward to our descendants. For those men without children, commitment to a future beyond their own lives comes in many forms: teaching, caregiving, community life, environmental and political advocacy and spiritual growth that leads to self-transcendence.

Am I Still Loved?

Love, of course, means many things. There is love of God. There is love that comes from God or a Divine Being or Beings — love that carries existential meaning. It is the kind of love Ram Dass received from his guru Neem Karoli Baba, who inspired him to live a life of loving service on the path toward merging with Brahman, the ultimate reality in Hinduism.

Love also comes in the forms of friendship, family or caregiving relationships, or the less personal form of loving strangers or other living beings. Such love makes us who we are.

George Vaillant recently summarized a key finding of his research on men over a lifetime: “Happiness is only the cart. Love is the horse.” His central point is that maintaining long-term loving relationships with partners, family, friends and in community is essential to a good old age. But in order to be fulfilled by love, “You have to be able to take it in,” he says. “You have to feel inside that you are loved.”

Adapted from Old Man Country: My Search for Meaning Among the Elders. Copyright © 2019 by Thomas R. Cole and published by Oxford University Press. All rights reserved.

The contrast between the “ideal” of the holiday and how we feel inside can be enormous, making the bad or painful feelings all the more pronounced.

“We feel guilty at this time of year if we personally cannot live up to the standard to be ever-cheerful and happy and joyful,” said Dr. Arthur Hayward, national clinical lead in elder care at Kaiser Permanente in Oakland, Calif.

Expectations for merriment and joy are high, Hayward said, as evidenced in holiday greeting cards.

We feel guilty at this time of year if we personally cannot live up to the standard to be ever-cheerful and happy and joyful.

— Dr. Arthur Hayward, Kaiser Permanente

“The wishes are not, ‘Have a pretty good Christmas’ or ‘Have an OK New Year,’ but ‘Have the best Christmas ever’ and ‘a very prosperous New Year,’” he said.

Different for Older Adults

For those who are still active, have children at home or have not yet retired, the holiday season can be a whirlwind of activity that feels draining.

Challenging in a different way may be the loneliness of older adults as friends die and family members move away. In a troubling survey from 2015, a quarter of those 65 and older in England said they were not looking forward to Christmas, and many of those said it was because “the festive season brings back too many memories of loved ones who have passed away,” according to a poll for the British nonprofit Age UK.

Two-thirds of the 1,793 older adults surveyed reported that loneliness is exacerbated by the holiday season.

Recognizing that many feel a heavier burden of grief this time of year, some places of worship hold “Blue Christmas” or similar services. December is also the month in which The Compassionate Friends, a group for people who have lost a child, holds candlelight ceremonies worldwide. The 2017 commemoration was held on Sunday, Dec. 10, and all were encouraged to light a candle at 7 p.m. local time.

The Blues or Depression?

The shorter days during winter can contribute to Seasonal Affective Disorder, or SAD. This malady is not just “the blues,” but a type of major depression, according to the Mayo Clinic. People who are depressed may feel sad, hopeless or worthless; lose interest in things they used to enjoy; sleep too much or too little; have trouble concentrating; have little energy; notice changes in their appetite or weight or have thoughts of dying or suicide, the Mayo Clinic says.

If you feel that you or a loved one are suffering from depression, it’s important to seek treatment, Hayward said.

As difficult as the holidays can be, Hayward offered some advice for coping:

Tips for Getting Through the Season

• Get plenty of rest. When you take care of your body, you will feel better.
• Try to keep your expectations of the holiday modest. That may help prevent feelings of disappointment or of being let down.
• Know that it is OK to feel sad or lonely. You don’t have to try to fake it to live up to the expectations of others.
• Spend time with friends and other people you enjoy. Do things you want to do, not just the things you have to do.
• It’s fine to say no sometimes. Wearing yourself out with too many activities will only make you feel worse.

Tips for Family or Friends

• Ask your depressed loved one to do things with you, such as go for a walk or to a movie. If he or she says no, that’s OK. But do ask again in the future.
• Ask how you can help in the person’s day-to-day life. You might do some housework, lawn care or errands.
• Get your loved one to talk about happy memories. This may help him or her feel more a part of the celebration.
• Listen when the person wants to talk. Don’t try to talk him or her out of sad feelings, but acknowledge them.

Helene Rosenthal’s day starts when she gets out of bed and puts in her hearing aids, something that’s as natural as brushing her teeth. It ends when she climbs into bed and says to her husband, Jim, “Is there anything else you want to say? Because I’m about to not be able to hear you.”

Nearly a decade ago, the New York City couple had very different conversations. Jim found himself often repeating things Helene had missed in social gatherings and shouting at her so she could understand him.

One day, when she asked why he was screaming, he said simply, “Because you don’t hear.”

“That was what really nailed it for me,” Helene recalls. “I said, ‘Oh God, I’ve got to get this taken care of.’”

And she did. She had her hearing evaluated at the Center for Hearing and Communication (CHC), a nonprofit in lower Manhattan that helps everyone from infants to older adults with audiology, speech-language therapy, speech-reading training and emotional health and wellness.

Eight years later, Helene’s moderate-to-severe hearing loss no longer prevents her from living a conversation-filled life.

Her epiphany wasn’t quite as straightforward as it sounds, however. Jim says it took him a couple of years of ongoing prodding to convince her to get tested, even though their daughter, Zooey (who’s now 25), was born with hearing loss and received services at CHC. In fact, hearing loss runs in Helene’s family, so you might think she’d be the first person to recognize the importance of hearing health.

“I was still very reluctant to get hearing aids,” Helene says. “I think it was just because I didn’t see myself as someone who was hard of hearing; I guess I deluded myself into thinking I was very high functioning when in fact I really wasn’t.”

It’s important to focus on how hearing loss is affecting relationships with loved ones.

What’s more, she points out, hearing loss can sneak up on you, unlike vision problems. “You don’t know when you’re not hearing right,” she says. “When you don’t see, you are very aware of what you’re missing out on.”

Six Suggestions for the Conversation

If you have loved ones in denial about their hearing loss, here are six suggestions from the Rosenthals and from CHC audiologist Ellen Lafargue, who serves as co-director of the Shelley and Steven Einhorn Audiology and Communication Center and director of the Berelson Hearing Technology Center:

1. Be Observant. People with hearing loss aren’t the only ones who can be in denial. Their loved ones can be as well. Consider your last big family gathering. Did someone who’s usually engaged in conversation seem withdrawn?

“People just sort of rush by and don’t notice that the person with the hearing loss is not participating anymore,” Lafargue says. “It sort of just passes them by, and the person with the hearing loss withdraws and becomes this silent partner. But they’re, in fact, not a partner at all, because they’re just not participating.”

2. Be Specific. Although Jim broke through his wife’s denial by telling her she couldn’t hear, most of their previous conversations about her problem dealt with specific incidents. “I think it’s important to have specific examples of when the person with hearing loss missed things,” he says. That can focus the conversation on what really matters: relationships.

3. Be Personal. Helene says it’s important to focus on how hearing loss is affecting relationships with loved ones.

“You need to say, ‘I love you, and I want to have a relationship with you — but I need you to hear as well as you possibly can.’ To me, it’s no different than a couple having an issue and going to therapy. It’s something you do to make your relationship better,” Helene says.

4. Be Persistent. Jim acknowledges that it can be frustrating to constantly bring up your loved one’s hearing loss, but he thinks persistence is important. “Don’t feel like it’s a one-conversation thing and you either get it right or give up,” he says.

After all, had he not been persistent over many months, he and his wife might still be shouting at each other. “Eight years later, we are still married and no longer arguing — well, at least most of the time,” Helene says.

5. Be Prepared. Do your homework before broaching the subject. Understand that hearing aids are just that — aids to hearing, not a cure — and that the technology has come a long way since Aunt Millie flushed her hearing aids down the toilet in frustration.

“You need to say, ‘I love you, and I want to have a relationship with you — but I need you to hear as well as you possibly can.’”

Compared to the past, today’s hearing aids are much more adjustable, do a better job of suppressing background noise and often come equipped with Bluetooth, which lets you take phone calls (with microphones on the hearing aids) without reaching in your pocket. (That feature alone might convince your loved one that hearing aids aren’t just for the very old.)

You should also understand cost. Hearing aids can be quite expensive, depending on the brand and quality. The average cost of a single digital hearing aid ranges between about $1,000 and $6,000, according to ConsumerAffairs, a consumer news business. Americans pay an average of about $2,300 per pair, according to MDHearingAid, a hearing aid services company in Southfield, Mich.

While private health insurance plans don’t typically cover hearing aids, Lafargue says it doesn’t hurt to check. Medicare doesn’t cover the cost of hearing aids, but it is possible to find financial assistance for hearing aids through a number of national and community nonprofits, professional associations and colleges.

“It varies state by state, but in New York state, if you qualify for Medicaid, you can get a hearing aid through that program,” Lafargue says. “People who have served in the military, if the hearing loss was caused by their noise exposure in the service, can qualify for hearing aids at no cost.”

Over-the-counter (OTC) hearing aids to treat mild-to-moderate hearing loss will soon be on the market,  possibly in 2020. And Lafargue thinks they might cost as little as $500 a pair.

But can inexpensive OTC hearing aids be of decent quality? Lafargue says to think about them as sort of like reading glasses; they can help a person get by for a couple of years before transitioning to prescription glasses. She also says some audiology centers will help people get their OTC hearing aids configured.

An important distinction to keep in mind: If you see products marketed as OTC hearing aids now, they’re actually personal sound amplification products, or PSAPs, which aren’t regulated by the FDA.

6. Be Dishonest (sort of tongue in cheek). If all else fails, Lafargue says, you could tell your loved one that you’re the one with the hearing problem and that you should both get tested. If you do go that route, however, be prepared for a surprise.

“More often than not, the person who was the instigator has some amount of hearing loss themselves and had no idea that they did,” she says.

In honor of her most recent birthday, Marjorie Johnson was serenaded by a Grammy Award-winning singer and an Emmy award-winning comedian on a national TV show.

It wasn’t just any birthday for Johnson, a champion baker who’s earned more than 3,000 ribbons and rosettes for her cookies, cakes, rolls and breads and has long delighted television audiences with her peppy personality.

Johnson turned 100 in August, and less than a month later she flew — by herself — from her home in suburban Minneapolis to Los Angeles to appear on The Kelly Clarkson Show. Jay Leno was also a guest; he happens to be an old friend of Johnson’s.

“I knew her when she was a kid, when she was 85,” joked Leno, who featured Johnson as his guest more than a dozen times, baking with him on the set when he hosted The Tonight Show.

“You have to think positive all the time, have a passion in life, whatever age you are.”

Wearing a red dress and a gingham apron, the petite Johnson perched on the talk show couch between the celebrities and had plenty to say when Clarkson asked for her secrets to her long life and good health.

“You have to eat healthy. Fruits and vegetables! And then you have to exercise. You’ve got to get your sleep; I like nine hours,” Johnson said.

But her most important advice was about attitude.

“You have to think positive all the time, have a passion in life, whatever age you are. I love baking, I love being on TV. We are all masters of ourselves,” she said with a chuckle. “I have the same enthusiasm and zest for life that I had when I was 40.”

A Lifelong Learner

Marjorie Johnson has baked under the studio lights in television kitchens on both coasts, sifting and giggling with the likes of Rosie O’Donnell, Wayne Brady, Dr. Oz, Martha Stewart and Regis Philbin, and charming the hosts of The Talk, The View and other syndicated programs.

With her enthusiasm, folksiness and infectious laugh, Johnson bursts through the camera, making her a memorable and in-demand guest. But her on-air persona is staked on her formidable skill in the kitchen.

Until she was 55, Johnson baked strictly for friends and family. In 1974, she entered four of her treats for awards consideration at the Minnesota State Fair. Thrilled when they earned blue ribbons, Johnson became determined and driven to accumulate more awards, practicing year-round to perfect her recipes for a picky panel of judges.

“You learn by studying, experimenting and practicing. I keep notes on everything I bake — what shelf in the oven did I use, what happens if I adjust the temperature by a few degrees,” she explained.

Now 45 years into her competitive baking career, Johnson is still working in the powder blue kitchen of the house that she and her husband built in the 1960s. Widowed in 2013 when her beloved husband Lee died at 95, Johnson now lives alone and cooks, cleans and does laundry for herself. She reads the newspaper every day, still circling words she doesn’t know to look up.

“I want to know. I love to learn,” she said.

This summer, she earned 52 ribbons in county and state fair contests. She bakes year-round, running down the steps to her three basement freezers to store the winners and rejects.

“Other women ask for flowers or jewelry for their birthday. I asked Lee for another freezer and a new mixer after I burned the motor out on the first one,” she chuckled.

Johnson’s recipes are old school, but she tracks the latest nutritional trends, evangelizing about the value of mindful eating and stressing the importance of regularly consuming good fats in avocados and nuts.

She limits herself to one sweet treat a day and has a steely discipline to maintain 98 pounds on her tiny frame; she has lost a few inches from her previous full height of 4’9”.

“I have diabetes in my family and I’m determined to avoid it. I get on my bathroom scale every morning. I allow myself to gain two pounds. When it gets to a hundred, it’s time to exercise more and eat less,” she said.

Credit: Kevyn Burger

The Century Club Is Growing

A new generation of hale and hearty centenarians is reframing what it means to enter a second century.

Johnson was the fourth of six daughters of a Minneapolis couple who themselves were born in the 1880s. Johnson arrived when Woodrow Wilson was president, the same year that Prohibition began and women gained the right to vote. She was born before talking pictures, radio broadcasting and the NFL.

Johnson is part of a growing cohort of centenarians who hold personal memories of a broad sweep of contemporary history. A 2017 count by the U.S. Census Bureau put the number of Americans who have reached the century mark at around 90,000, up from 50,000 in 2002. The number of people who will blow out 100 candles is predicted to climb to 140,000 in the next decade.

Scientists are interested in teasing out the genetic and lifestyle factors that propel centenarians into their extraordinarily long lives. The New England Centenarian Study, founded in 1995, has evaluated more than 1,600 of them and has enrolled over 150 so-called “supercentenarians,” people 110 years and older, in a comprehensive newer study to research the limits of the human lifespan.

With her competitive baking, television appearances and travel, Johnson may seem to defy the limitations of what are sometimes called the “oldest old.” But professionals and academics who study aging point out that there’s no one way to live in later life.

“The older people get, the more heterogeneity we see. There’s more variation in this population than any other age group,” said gerontologist Kerry Burnight.

“Show me an eighteen-month-old or an eighteen-year-old, and I can give you some parameters for their developmental milestones. Show me an eighty-one-year-old and it all goes out the window; at that age, they could be out waterskiing or they could be bedbound.”

A Blaze of Candles

It’s been quite a centennial for Johnson.

The celebration began last spring when, accompanied by her 60-something children — an aerospace engineer and two physicians — she cruised the North Atlantic to England, then spent a week in London. In August, the month of her birthday, the YMCA where she works out three times a week surprised her with cake and festivities. Later in the month, her daughter threw a party and Johnson greeted 200 guests.

“It’s nice to be a hundred but the fact that I arrived with the same health I had when I was forty, that’s the accomplishment,” Johnson said. “My parents died young, they were just in their seventies. You can beat your genes with the right habits. Take care of yourself and don’t be perturbed about your wrinkles. Get your hair done, look your best.”

At the end of The Kelly Clarkson Show that honored Johnson, the host and her guests surprised Johnson by rolling out a birthday cake topped with a hundred blazing candles. Clarkson led the studio audience in a rousing chorus of “Happy Birthday.”

Before he joined Johnson in blowing out the candles, Leno jokingly asked the blue-ribbon baker if she was wishing to turn 101.

In all seriousness, Johnson corrected him.

“No. I’m wishing for a hundred and fifteen!” she replied.

Marjorie Johnson’s Recipe for Gingersnaps

3/4 cup  shortening
1 cup  packed light brown sugar
1/4 cup  molasses
1 large egg
2 cups all-purpose flour
2 tsp. baking soda
1/4 tsp. salt
1 tsp. ground cinnamon
1 tsp. ground cloves
1 tsp. ground ginger
1/2 cup sugar (for dipping)

Preheat oven to 375 degrees.

Cream shortening, brown sugar, molasses and egg in a large bowl. In a separate bowl, sift flour, baking soda, salt and spices. Gradually add the dry ingredients to the creamed mixture, blending until mixed. Dough can be chilled for easy handling.

Shape the dough into balls the size of whole walnuts. Roll balls in sugar, place on baking sheet. Bake 8-9 minutes. Cool on sheet for one minute before transferring to rack.

Makes 3-4 dozen

* Recipe from The Road to Blue Ribbon Baking with Marjorie by Marjorie Johnson (Beaver’s Pond Press)

(Editor’s note: This is the fourth story in a four-part weekly series on meditation, including its benefits for pain management, mental health and overall well-being. The first article in the series is Do You Meditate? Here’s Why You Might Want To; the second article is How Meditation Can Help With Chronic Pain; and the third is How Meditation Can Help With Grieving.)

Maybe you can’t remember the name of the lead singer’s name in that band you used to like. Or maybe your concentration isn’t quite what it used to be, and you shift your focus to a second task before completing the first. That’s OK, scientists say. That’s normal cognitive decline, and not a sign of impending dementia.

Perhaps you’ve read that mindfulness meditation can help preserve cognitive function, and maybe even put a stop to some of the annoying behavioral changes you’ve noticed. Mindfulness meditation is a mental training practice in which you focus your thoughts, feelings and sensations on the present moment.

So, should you sign up for a class? Taking up the practice likely won’t hurt, one expert says, but the verdict is still out on whether it can help cognitive function.

“No recommendation is coming from here regarding whether mindfulness meditation preserves cognitive function,” says Lis Nielsen, chief of the Individual Behavioral Processes Branch of the National Institute on Aging (NIA) in Bethesda, Md. The branch “supports behavioral, psychological and integrative biobehavioral research on the mechanistic pathways linking social and behavioral factors to health in midlife and older age.”

“We represent the science and ask the questions that need to be asked, and we’re still weighing the evidence,” Nielsen says. “The NIA is mindful that the public would like to know what to do, but it’s difficult to come out with a recommendation because there is no clear answer.”

Enough Evidence to Continue Research

Before you cancel your enrollment in that meditation class, consider this: “There is enough of a ‘there’ there to figure out what might happen if we looked at the impact of long-term controlled meditation training on cognition, but so far the literature and the studies — most of them short-term — are inconsistent,” Nielsen says. “Though we don’t yet know how or why mindfulness meditation might improve cognition, we do know it’s helpful for coping with symptoms of illness and for improving quality of life.”

Recently the NIA commissioned a report from the National Academies of Sciences, Engineering, and Medicine to review the evidence for approaches to preventing cognitive decline and inform NIA’s investments in future research. Some studies, like one underway at the Washington University School of Medicine in St. Louis, include a mindfulness meditation component.

“Studies have provided some evidence that the brains of older meditators look younger than those of non-meditators and that long-term meditation might change the structure of the brain.”

Nielsen explains that as we age, we all see a decline in our speed of processing thoughts and in our working memory, which can affect decision making, problem solving and occupational abilities. “Of course, we also see positive changes,” she says, “such as the accumulation of expertise and world knowledge. Whole fields of cognitive aging explore these changes, and we also know that not everybody declines at the same rate.”

Possible Long-Term Impacts

Because of that, and because mindfulness meditation teaches individuals to train mental processes, Nielsen says it might seem obvious to think that when practiced as a habit, meditation would affect our cognitive capacity long-term.

“Studies have provided some evidence that the brains of older meditators look younger than those of non-meditators and that long-term meditation might change the structure of the brain,” Nielsen says. ”However, we don’t know anything about causality. We don’t know, for instance, whether primarily people with bigger brains engage in meditation or whether any changes in cognition might be a direct effect of the training or a side effect of more global improvements in well-being and stress reduction.”

What about reports that meditation enhances creativity and even fends off dementia? “From my perspective,” Nielsen says, “though these topics generate a lot of interest, we’re at a more fundamental stage in the research than can back up such broad claims.”

Meditation may or may not help with creativity, normal cognitive decline or dementia-related decline, but one researcher who recently conducted a small pilot study on adults with mild cognitive impairment (MCI) found that they were able to learn mindfulness meditation and benefited from the training.

A Neuroscientist Studying Mind-Body Connection

Dr. Rebecca Erwin Wells conducted that study. She is an associate professor of neurology at Wake Forest School of Medicine, a practicing neurologist at Wake Forest Baptist Health and associate director of clinical research for its Center for Integrative Medicine.

When Wells completed her neurology residency in 2008, she was interested in the mind-body connection, so she participated in a three-year research fellowship in complementary and integrative medicine, to better understand the neurobiology behind mind-body connections.

While doing research funded by the National Institutes of Health through Harvard University, Wells heard Britta K. Holzel, a German neuroscientist, talk about her research on the increased density of gray matter in the hippocampus in adults who learned to meditate. Holzel, a yoga teacher, also teaches mindfulness-based stress-reduction (MBSR), a practice known for helping people reduce stress, anxiety, depression and chronic pain.

A Hippocampus Connection?

“I started thinking how the hippocampus atrophies in people with Alzheimer’s disease, and then about how the hippocampus seems to be important for meditation,” Wells says. “I wanted to take adults susceptible to dementia and teach them to meditate, to see if it would change the progression of the disease.” The study was small, just 14 adults.

Before and after taking an eight-week MBSR class, participants had magnetic resonance imaging scans, neuropsychological assessments and completed surveys assessing other measures of well-being. The study concluded that most of the participants with MCI were able to learn mindfulness meditation and had improved acceptance of their condition, self-efficacy and social engagement.

“We also conducted qualitative interviews at the end of the study to hear about their experiences,” Wells says. “We learned that cognitive reserve may be enhanced through a mindfulness meditation program, even in patients with MCI. Those are meaningful results.”

Wells suggests that the best way for anyone to learn mindfulness meditation is in a class, with an experienced teacher. You can also learn about MBSR through its founder Jon Kabat-Zinn’s MP3s and CDs, and a teacher-certification program has placed MBSR instructors in almost every state. Some hospital wellness programs offer the classes, so check with your health care provider.

(This article appeared previously on Caring.com.)

Caregiving can bring many positives into your life — but it can also take a toll, both physically and emotionally. Without finding a balance between caring for your loved one and maintaining your own mental, physical and emotional health, you’re at risk of developing what’s known as caregiver burnout.

“Feeling exhausted, unmotivated, constantly frustrated and forgetful, as well as having problems at work or with relationships, are all signs of caregiver burnout,” says Kimberly Hershenson, a New York-based therapist specializing in anxiety and depression.

Caregiver burnout can not only interfere with your ability to care for your loved one, it’s a leading contributor to placement of that person in a nursing home. It’s also risky to your own health, raising the risk of chronic depression, hypertension, diabetes, stroke and premature death.

“It is important to have life balance between caring for loved ones and caring for yourself,” says Hershenson. It helps to know the signs that you need a break, and what to do if you’re close to depleting your emotional, mental and physical reserves.

Spotting the Signs of Caregiver Burnout

Caregiver burnout is mental, emotional and physical exhaustion that may develop through the responsibilities of supporting and caring for another individual. “Caregivers often focus so intently on the needs of the individual receiving care that they may neglect their own health and wellness,” says Darren Sush, a licensed clinical psychologist and board-certified behavior analyst in Los Angeles.

As this lack of self-care persists, along with the ongoing obligations of providing care for a loved one, caregivers’ exhaustion often intensifies, impacting different aspects of their lives as well as their effectiveness and compassion as a caregiver.

Sush says that burnout may be easily misunderstood as simply feeling overly tired or even occasionally exhausted. “Unfortunately, while being tired can often be resolved by taking a break, getting a little more sleep or actively trying to relax, burnout is more often less easily relieved. Individuals who experience caregiver burnout, tend to face an all encompassing fatigue that impacts multiple areas of their lives,” he says.

Caregiver burnout can happen to anyone who is providing care for another person, whether it’s hands-on care, is only occasional, from a distance, or even at the “managerial” level, says Zina Paris, associate director of clinical services at Alzheimer’s Greater Los Angeles, a local nonprofit that helps families affected by Alzheimer’s and other dementias.

“It happens when you feel that the experience of caregiving is overwhelming and that you do not have the support — physically, mentally, emotionally, financially — that you need in order to successfully care for the person and to take care of yourself adequately at the same time,” says Paris.

Very often, caregivers can find themselves accustomed to the routine stress, worry and discomfort that come with providing care for a loved one. And as a result, Sush says you may not acknowledge warning signs of your own needs for gaining support.

Signs of Caregiver Burnout

Those signs include:

• You no longer find pleasure in things you once found enjoyable, or you have no motivation to participate in previously enjoyed activities
• Friends and family have expressed concerns about your well-being
• You’re getting negative feedback at work
• You’re having problems with your spouse
• You experience intense and recurrent feelings of anger, sadness, worry or fear
• You have difficulty concentrating, trouble sleeping, notice drastic weight changes (significant gain or loss), or unexplained health problems
• You find yourself using a substance to cope with, manage or suppress uncomfortable or painful feelings.

Sush notes that there are also signals caregivers should know that indicate they’re at risk for developing caregiver burnout in the near future. These include:

• Regular thoughts of anger or resentment toward the person you’re caring for
• Irritation toward others who aren’t helping with your loved one’s care
• Isolating yourself from people who aren’t involved in providing care to the person
• Consistently arriving late to appointments or to visiting the person receiving care, or often leaving early

Combating Burnout

If you notice these signs in your own life, it’s time to take action.

Enlisting the help of a therapist is one option. “That provides a safe, sympathetic and constructive environment where caregivers can express their wants and needs,” says Sush.

Having a supportive community also helps. “Making a connection, such as with friends, family, or support groups, where you can freely share your thoughts and feelings, can be exceptionally important,” he adds. “While there is not necessarily a right or wrong way to get the help you need, it is important to acknowledge when you do need help.”

Here are some other expert strategies to help you cope with caregiver burnout:

Embrace gratitude. Make a daily gratitude list by writing down 10 things you’re grateful for. This could include anything from your family, legs to walk on or even a TV show you find entertaining. Focusing on what is good in your life as opposed to what is going wrong with your loved one’s health helps relieve stress.

Read affirmations every morning. “Starting your day with positivity kickstarts your day on the right foot,” says Hershenson.

Start the day with you. Hershenson says having a morning routine with time to yourself (going to the gym, having your daily coffee while reading the newspaper or stretching for 10 minutes) is crucial to fending off mental stress and fatigue.

Practice acceptance. Make a list of what you can control in the situation (getting enough sleep, eating well) and what you can’t control (your loved one’s health). Focus on what you can control to make changes where needed and try to accept the things that are out of your control.

Paris notes that while the advice to “take a break” may sound cliché, it is repeated for a reason.

“Self-care needs to be a top priority when caring for another person, otherwise neither the caregiver or the one receiving care will thrive,” she says. “This means finding a way to take short respite from caregiving on a consistent basis.”

(Editor’s note: This essay is the latest in a series from author and speaker Ken Druck, based on work in his book Courageous Aging, which is about how all people can make peace with, and find joy in, every stage of life.)

Things don’t stay the same as we get older. We evolve into the older versions of ourselves.

The same happens with families. And sometimes growing older can cause great upheaval to the family dynamics — especially between adult children and aging parents — requiring additional patience and understanding if we want to age together in a way that is healthy.

As the holidays approach and families have the opportunity to gather and celebrate, the way we’ve all changed through the years is on display. In order to assure that different generations maintain peace and love, it’s important to take stock of our actions as we relate to our family members.

Overcome Corrosiveness with Understanding

The aging of our families presents as many opportunities as it does challenges.

For example, becoming the caregiver for an aging father or mother requires patience from both the adult child and the parent’s perspective. And, as older parents watch their sons or daughters balance demanding careers and demanding families, they may also need to summon more patience and understanding.

Realizing the limits on our finite time together on earth and the preciousness of family can us help to soften our hearts, become more forgiving and understanding and show greater affection. The loving, compassionate side of our nature is activated with this realization.

Watching our parents get older and struggle with challenges that aging can sometimes bring is not easy for anyone. People who claim they have not, at times, felt scared, helpless, frustrated, discouraged or sad in these situations are lying. Giving in to (or allowing) these kinds of feelings, and permitting the cold, hard side of our nature to prevail, is a formula for corrosive family conflicts, fragmentation and, ultimately, heartache.

4 Ways to Take Responsibility for Family Dynamics

It’s up to us to decide whether we will become impatient and intolerant, or patient and compassionate, sons or daughters. Similarly, it’s up to us as mothers or fathers of adult children to decide whether we’re going to feed and fuel the difficult, insensitive, non-communicative and unapproachable part of our inherent nature that sometimes arises in challenging moments in our families or foster the part that is loving, open and understanding.

Here are four ways to assure that you and your family get better as you get older:

1. Open the Channels of Family Communication (and Keep Them Open)

Nothing ensures positive aging as a family more than good communication. In almost any situation, being truthful, trustworthy, respectful, caring, empathetic and proactive (getting and staying ahead of the pain and conflict curves) successfully opens the lines of communication and love. Forthright communication and active listening affords family members the opportunity to talk through differences and reaffirm the common ground on which they stand.

2. Ask — Don’t Assume You Know

Since very few of us are mind readers, the best way to make sure that we and our family members will get better, smarter and easier to be with as we get older is to ask perceptive, open-ended questions. Listen. And learn. The human experience of feeling understood is the basis for so much peace, love and progress. By slowing things down and asking your family members what they want, how they feel and what they think should happen next, we build the kind of safe, strong relationship that makes anything possible.

3. Learn to Forgive

Since misunderstandings, misgivings, differences, betrayals, grudges and disputes are inevitable in every family, learning how to talk things out and forgive one another is a valuable asset. The power of a simple apology to heal a family, community, nation and the world cannot be underestimated.

4. Make Clear Agreements

As times change, we get more clarity about what works and what doesn’t work in our families. When it comes to the well-being of our loved ones, dealing with, rather than avoiding or enabling, family members who act inappropriate, say or do hurtful things or cause others to avoid meaningful interaction is sometimes necessary. The need for new understandings and agreements is critical. Sometimes we say something (bring it up and air it out), and sometimes we don’t (avoid it and hold it in). Bringing things up in a calm, respectful manner and using non-accusatory language increases the chance that a much-needed conversation will result in some practical new agreements that benefit all sides.

As we and our families age, let’s resist the seduction of fear, jealousy and anger that result only in wasted time, lost affection, estrangement and loneliness. Instead, let’s rededicate ourselves to harvesting the opportunities for closeness, support, gratitude and understanding. Becoming the better version of ourselves ensures years of joy, deep connection and a legacy of love across generations.