 Aloha and welcome to Don't Just Age and Gauge. I'm happy you're here with us to learn more about the aging population, to learn more about your own journey from adulthood into elderhood. And this evening, this afternoon, we have the opportunity to interview and hear the wisdom of Dr. Lucas Morgan, a local psychologist here on the island of Oahu. And my big question to him is, how many people are committing suicide because they're getting old? How many people don't know how to age and get to that point of terrible frustration that they just would rather kill themselves? But we don't have to go into it. Do you have an immediate response to that, Dr. Lucas? I have a few responses. But yeah, I mean, that's a very important question when we're talking about older adult mental health, because actually suicide attempts and suicide completion rates are highest in many states, including Hawaii, among some of the older adult categories. And it's important because being depressed is not a normal part of aging, as we'll hopefully get into more detail as we go. So really, really important question. Yeah. Well, excellent. Thank you for that. Tell us a little bit about yourself as we start. I have only recently come to become aware of you and learned of you through my own PCP, and would like to know a little bit more for our viewers about your history here and your commitment to the work that you do. Yeah. So I'm from Hawaii originally, one of these like seven generation howlies who, you know, has been here for 200 years. And so I have a lot of, you know, my variety of roots here and both sides of the family. So I care a ton about Hawaii and Hawaii's people. And it was always a goal to come back and try to give back some of the privilege that I've had in having really great educational opportunities to go away to Boston to get my PhD, studying clinical psychology, and then to return home and somehow, you know, support folks here. And so I've been doing that. Started out with a non-profit called Iola Lahui. And with a focus on underserved and native Hawaiian folks, that's where I did my internship and postdoctoral fellowship training. And I still work there once a week as a supervising psychologist. And through my experiences, one of which was flying to Hilo every week, you know, based on this training grant to work at one of their primary healthcare clinics there as a psychologist and working a lot with kupuna over there and just really becoming seeing this vast need where older adults everywhere and in Hawaii also are almost invisible sometimes to sort of screening and treatment for mental health concerns. And so huge need that I figured, you know, this is a chance I have to contribute. And that's what I've been kind of focusing on ever since. Super. So that you're describing them something since somewhat as an invisible population to the rest of the culture. What is a normal aging process? And what happens to the brain in the aging process? Lucas. Good question. A lot of research in this. And it's really difficult to study. But, and there's a lot of sort of myths about aging, sort of that senility, dementia, Alzheimer's, that these things are sort of quote unquote normal, inevitable part of aging, which they are not. They are the dementing diseases like Alzheimer's is one of the most common. Do definitely become more prevalent with age as we get into our 70s, 80s, 90s. Some earlier, you know, early onset, but the majority are happening in our later, you know, decades of our life. But majority of older adults will live into their 80s, 90s, if they get there and still retain the majority of their functionality. So, okay, so we asked what is sort of the normal or in the absence of disease, what happens to the aging brain. And the most studies show that there are declines in some cognitive processes across the across aging. But they're predominantly associated with processing speed. And so maybe the speed with which we calculate the tip at a restaurant, which it's nice to be able to do in person these days, you know, a little bit. But, but it's not like we reach a cliff at 78 or 90 and then fall off it cognitively. And there's evidence that some of these declines are starting in as early as in our 30s. And so it's like this sort of a slow decline in speed. But a lot of these other things, language, comprehension, crystallized memory, which is remembering facts, actually increases throughout the lifespan. So it's definitely not that aging equals brain debilitation in the absence of disease. That's, that's excellent. To hear you say that. Louise Aaronson, Dr. Louise Aaronson, wrote a book entitled, Elderhood and Reimagining, Aging, Reimagining Life. And I love her book. And in it, she says similarly, nobody died from old age. So what I kind of what I hear you saying is that there's disease process that goes on in old age that affects the brain, the mental capacity. But that's not necessarily normal aging. And too often, we approach aging as though the normal path is dementia, that gradual or cliff descent into, into a total incapability. So is, is being depressed or anxious a part of aging? It definitely can be, but in the same way that it can be at any age. So at our clinic, we see six year olds with anxiety or 12 year olds with depression or, you know, depression and anxiety can hit a person at any stage in their life. But right, there's this myth in a lot of minds that depression is sort of inevitable as we age. And I think part of my interest in this area came from some of my experiences with my grandparents, whom passed away mostly when I was before, you know, in my teens. And three of them had different types of dementia. And the fourth had a, you know, severe stroke. So I got to really see what happens when the brain gets damaged. But one of my grandma, one of my grandmas whose dementia wasn't severe, she had Parkinson's disease, but was also very depressed and learning later in life that her gerontologist said to her one time, you know, you're depressed, what do you expect you're old? And that is something that doctors should never, ever say. And so a lot of the older adults that I work with in therapy come in having experienced that doctors, well, meaning I'm not putting down doctors, of course, my wife is one. And there's a sense that some doctors feel that the problem of aging can sometimes be untreatable. And so it's easy to just hang it on your old, you know. And that sends a message to patients that, well, I guess there's nothing I can do. And that's, that's definitely not the case with depression. I so appreciate you saying that, Dr. Morgan, because one of the, one of my, as a chaplain, one of my experiences has been in long term care and hospice care has been watching patients and families just sort of retreat from, from engagement, engaging in society, or engaging in anything meaningful for their own healing, because they're, they bought into this idea that it goes along with aging, therefore they just have to accept it. And that to me, leads to terrible depression. How can a psychologist help with problems that that just sometimes can't be fixed? Like what if I have Parkinson's and can't, can't drive anymore? I mean, you know, the first thing I heard in long term care was that my kids took away the car. Right. And there may be good reason for that, by the way. Right. Right. A really good question. And I think that's another thing that drew me to working with, with older adults is this, the constant need to be open-eyed, sort of looking at what are the things in your situation that can be worked on and changed and improved and adapted. And what are things that genuinely are not going to get better, as far as we know, and, and really being able to, it's almost like that serenity prayer, you know, that is so central to a lot of folks, which is, yeah, you know, the wisdom to know the difference between changing what I can and accepting what I can. And I, the psychology that I came out of in grad school and even before what got me into psychology was my interest in mindfulness as an approach to human suffering that did that balance. It's not passive. It's not giving up. It's not saying there's no point. It's also not saying that I can change everything. I'm invincible. You know, nothing is, um, un-pixable because what does, what does this, what does this piece of mindfulness add then? If it, if it's not for fixing and it's not for giving up, it's a middle way. What's it for? Mind, how do you be, what's, how does mindfulness relate to aging? It's a great question. It can be part of, sort of, stress reduction practices at its sort of most basic practical level. If someone's experiencing stress and anxiety, difficulty sleeping, it can be used as a sort of a straightforward intervention to sort of reduce physiological stress or anxiety. But on a sort of more deeper level, it can really help us sort of face the realities that we are mortal and that we all will die and that human suffering is part of, part of the deal. But how to live in the moment, given what is challenging, but also what is still available to us to, to access that is beautiful, that can be maybe joyful, that can be meaningful, like, you know, grandchildren or my spouse that might still be living or memories of their past, you know, my past life with them. But then it's going to look different. The things that are valuable to us are going to look different as our bodies change. So, so without, without breaking confidentiality, can you tell us a story about how you helped someone in that kind of, kind of a dilemma where they, they felt as though things were going through so much change that they couldn't quite get a handle on it. Yeah, it's a, there's, there's a lot of folks that come to mind and, and, it might be a generic, a generic, right, right. And so I guess one sort of issue that a lot of my folks deal with is losing their sense of purpose as they're in their later years, whether it's because of retirement and they focus so much on work and providing for family, or they focus so much on caring for children, grandchildren, and then those folks move away and they're, they're left with a feeling of meaninglessness or purposelessness to their day. And so part of what we do is acknowledge those feelings of loss, which are really important and necessary to, to acknowledge and then we start brainstorming of like, how can we get active and often that's very literally active of let's get your body moving more because physical activity and sorry for the sirens physical activity is one of the best medicines at any age for health and mental health for sure. So, and as, as, as that happens, and then we start to think of what values did those things in your previous chapters of life provide you? Was it helping others? Was it being creative? Was it being, feeling productive and making something? And whatever those core values are, how can we seek those out again? But maybe it looks like a very different way because you have Parkinson's now, you can't drive. That's, that's really unfortunate. That's challenging. That's real. And I have to say COVID made this a lot harder for a lot of people. In what way? Because a lot of folks that I work with who are in, you know, assisted living facilities, independent living facilities were worse, literally lockdown, you know, harder to connect with folks, harder to meet new people and join different groups, interest groups that might be inspiring. That all got shut down. So even folks at home, there's, of course, older adults were at higher risk for illness and, and mortality or death if they contracted COVID. So of course, a lot of families were like, you know, mom is not going anywhere. We want to keep her around. So, you know, make sense, understandable. And so the, so the natural part of the natural progress tends to be, as we age, we get more isolated. And that was just incredibly augmented by the COVID restrictions. Yeah. So I have another question. It comes from my experience in chaplaincy and with hospice care. As a, let me go to this Parkinson's or could be Alzheimer's too, and any kind of mental process, the disease process, as it advances, people, have you been with people as they've been consciously aware that it's, it's advancing? And how did they deal with that? How did you help them deal with it? Yeah, right. I mean, that is a really, really hard one. And yes, I have, I've had a bunch of folks who, when I started with them, there was no signs of anything. But as we worked over the months, years, things emerged. And the things that I was able to help them with was we're helping them sort of face what the testing was telling us, right? So I do some, you know, level of cognitive testing with folks. And then if there's significant warning signs in this lower level testing, okay, I help, I try to help them get willing to see a neurologist and get tested. Makes a lot of sense. And it's understandable that a lot of folks do not want to know if this is coming, because it's just too painful, too scary. But approaching it earlier will actually make the process a lot better for that person. One, because they're developing some level of acceptance, which of course is never a straight line and never easy. But also that gradually we bring the family in to be involved, because the family becomes the most important part of the person with dementia experience. If they're lucky to be with a family that cares, you know, and wants to learn about the disease, because they're going to be the ones who are adjusting the environment of the home, adjusting how they interact with their loved one with dementia. So that becomes a critical part, that willingness to be involved to learn that's something I help them do. Yeah, well, I really very much understand that. And the family members become the mirrors, I suspect, that sort of feed the person to say, it isn't going very well, Dad. You're not getting that, right? You forgot this and then you did this. And, you know, at what point would you advise me to come in? I had somebody once say, Larry, I think you have early onset Alzheimer's. I think he was kidding, but I've forgotten. I don't know. But tell me, what would you advise me to do if I had that suspicion? Or if it seemed to me like I was getting feedback from people that said, I'm entering some disease process. Yeah, I would say try to talk to your primary care physician first and try to find some way to get some cognitive testing done to really test it out, because what I also work with a lot are a lot of older adults who have anxiety about their memory and they are deathly afraid that they have Alzheimer's. And if you're living sort of months and years with that fear, that fear can really get in the way of living sort of fully in your life. And so it's actually better in some ways to get tested to see if your fears are, if there's any evidence for them. Because a lot of folks have the fear because, you know, you walk into a room, you forget what you went in there for. And when you're 70, 80, 90, you think, oh my gosh, this is my brain, you know, this is the beginning of Alzheimer's. Yeah, sure. But just because the age made that moment salient. Now, I'm, you know, a few weeks away from 40 right now. And I have memory lapses all the time, right? Even when I was 20, I would go into a room and forget where, why I was going in there, lose my train of thought halfway through a sentence. But because I'm 20 or 30 or 40, and Alzheimer's is not paired associated with that age, I can brush it off. There's 50 other things like I didn't sleep well last night, you know, I have a young child and so I'm sleep deprived or I'm stressed out, all these things can affect memory. And so they can be false alarms when we're 60, 70, 80, 90, but really drive anxiety. Yeah, yeah. So we've got a couple more questions. And thank you viewers for your sending in questions. If anybody else has others, you can send them to questions at thinktech. There it is, thinktechoa.com. But here's one that I really like. What kinds of things do your older adults struggle with when living with adult children and other members of younger generations? This gets into family systems. When you're older adults, people in their elderhood, I like to call it, are living with younger, younger generations. What kind of things did they get into? What are the conflicts? Yeah, good question. I mean, I think in the past, a couple generations, there's been this technology explosion that of course can lead to real significant gaps in lived experiences of younger generations and older generations. So that's something that comes up. One of the most challenging ones in my work is that adult children can exert sort of an overprotectiveness of their adult aging parents. If you're living at home, I see this all the time where if mom has a room upstairs, it's comfortable, and she has a TV, she should be happy. But they don't facilitate helping her go swim at the beach or go walk around the park or go meet new people, all the things that humans need at all ages, you still need when you're 80, 90, 100. But that younger adults, sometimes it's called infantilization, where they sort of treat mom or dad almost like their child. There's almost like this row reversal. And it's tricky because some of the care requirements do sort of mimic that dynamic. And that's tricky. But emotionally, that older adult is still, even with dementia, they are still an adult who deserves dignity, respect, and that their needs as a human social enjoyment, recreation, new things, learning at all ages. So a lot of the feedback I get is that my kids don't understand why I'm anxious or why I'm depressed. And I'm like, well, it's kind of like you're in prison. I'm sure it's safe, and that's important. You get three meals a day, but you are not allowed to do anything. And how can a person really be happy in that kind of environment? Is this, this gets to the question, the last question we have, which is this sort of an ageism in the family or evidence of the cultural ageism that is also within the family system? Definitely. Good question. I wish we could spend a whole nother hour talking about age. It exists. It's one of the most socially acceptable forms of discrimination and stereotyping still. Even the term, you look so good for your age is ages. Because what if I said, wow, you look so good for your race? That is a racist statement. And when you put it like that, it's clearly saying that your age, it should be ugly, but you look good for your age. And so this is tricky. And there's gender complexity with the pressure on women to look a certain way. And so it intersects with sexism, with racism. But yes, ageism is definitely present in most homes. And often it's benevolent ageism. So it's like, we're taking care of Tutu. But ageism can involve unconscious biases so that when grandma forgets something, grandma's kind of not all there. When, in fact, grandma's there and can do a lot more than you give her credit for. Yeah. Well, thanks so much. We're coming to the end of our time, I'm afraid. And like you said, Lucas, and maybe I can persuade you back on just to talk about ageism because it's such a huge part of our culture. I tend to romanticize other cultures, you know, Hawaiian culture, Asian culture, you know, they all get along with this aging process better than I do. But I have a suspicion that that's my romanticization of other cultures and not inaccurate. So maybe we can return to that sometime. I am like that. I'd like that too very much. I'm, as you know, my new work is to create a program online for elders to create extraordinary elder hoods. And one of the things that I'm finding people are responding to is having an online community that they can go to and discuss these things because these are things that cannot necessarily be discussed with family that can't be discussed with their closest friends. But to be in community with somebody else who's going through the similar things just sparks a lot of life and leaves people a lot more comfortable. So yeah, personal coaching for lifeandfaith.com. If you get a chance to go visit that, viewers please do. And my program, this program Don't Just Age and Gage is named after the book that I've written. You can find that on the website. And also it's an opportunity to be a part of a program that is truly organized towards empowerment, strengthening, supporting, and giving you and your family the options to have a new look at aging and developing our elder hood. In two weeks, every two weeks, I'm here. I look forward to your return, viewers. And in a couple of weeks, we'll have a very special guest who has some resources for us to look at. And Dr. Lucas, please come back. All right. Thank you. I'd like that. Aloha.