Advanced Directives May Not Prevent Aggressive Medical Treatment

Aggressive medical treatment for Medicare patients at the end of life has been on the increase according to studies published by Medicare1  and by JAMA2.

This aggressive treatment leads to more people receiving care in intensive care units and more people being shuffled between hospital, home and skilled nursing care in their last several months of life.

Unfortunately, the aggressive medical care is not helping those patients studied to live longer, nor are they experiencing a better quality of life than people who receive more conservative treatment.

When polled, people do not generally want this type of care. A Stanford School of Medicine Study3  found that more than 80 percent of patients say that they wish to avoid hospitalizations and high-intensity care at the end of life.

In fact, aggressive treatment can cause chaos and pain for patients and their families. Consumer Reports4  notes that families who have lost loved ones after aggressive treatments often say they regret not having recognized sooner that aggressive treatment was not beneficial.

Are physicians working with the intention of Advanced Directives?

Interestingly, both the Stanford study and a recent poll on the physician social media site Sermo5  both indicate that physicians, regarding their own medical care, would very rarely choose aggressive treatment. On the other hand, these same physicians tend to pursue aggressive treatment for their patients facing the same proposed prognosis.

The Stanford study noted that advanced healthcare directives had little impact on aggressive treatment:

“In fact, the type of treatments they (the patients) receive depends not on the patients’ care preferences or on their advance directives, but rather on the local health-care system variables, such as institutional capacity and individual doctors’ practice style…”

Why are physicians pursuing aggressive treatment?

Physicians have a focus on diagnoses and treatment of disease, so this singular focus can also cause a major blind spot. A person is much more than his or her condition or disease, and yet in the medical treatment process, the person can be “lost” in favor of a focus on their condition.

As noted by Dr. Periyakoil, author of the Stanford study, “Patients’ voices are often too feeble and drowned out by the speed and intensity of a fragmented health-care system.”

Physicians are not generally trained or paid to deeply examine a patient’s personal life philosophy, personal history and life experience, emotional life, cultural influences, spiritual beliefs, or family and personal relationships.
Once you forward the message, the spammer actually has a program that can copy the list of addresses that the message buy levitra in canada has been forwarded to and send that list back to the village. Here the information contains some important information on widely spread viagra properien Read Full Article and commonly seen erection disorders: Causes of erectile dysfunction. It boosts strength and improves general buy cialis line debility naturally without inducing any adverse action on user. Even if the patients have symptoms like sexual dysfunction and reduced fertility, after the vigorous treatment of prostatitis, the viagra tablet for sale patients can be depressed, fatigue, insomnic, etc., causing the pressure and burden.This is one of the early symptoms of prostatitis.

To put it another way, what doctors know about a patient may represent very little of what a patient may consider to be essential to “who they are.”

It makes sense that a physician, who knows herself as a person, would choose less aggressive treatment for herself and pursue more aggressive treatment for her patient, whom she knows primarily by condition or disease. This outcome is probably unrelated to whether or not the physician is a caring or compassionate person and is rather a result of the constraints of time, function and capacity.

What can you do to have your healthcare preferences followed?

Patients and their families must recognize the limitations of physicians and of medical systems, in general. These systems and professionals cannot have a complete understanding of patients’ personal lives and issues.

When faced with significant medical decisions, it is essential to seek out as much family, friend, professional and spiritual support as may be needed.

An advanced directive is an excellent starting point, but having a professional or family member who can successfully advocate for its intentions to be followed may be most important.

Anne Conrad-Antoville is CEO and a founder of Champion Advocates LLC, a geriatric case management firm serving Portland, Oregon and Northern California. She has worked with many hundreds of families regarding senior healthcare issues for the past 30 years.

1The Medicare News Group: “The Cost and Quality Conundrum of American End-of-Life Care”

2JAMA: “Change in End-of-Life Care for Medicare Beneficiaries
Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009”

3Stanford Medicine News Center: “Most physicians would forgo aggressive treatment for themselves at the end of life, study finds”

4Consumer Reports: “Too much treatment?
Aggressive medical care can lead to more pain with no gain”

5SERMO: “How Doctors Die: Only 7% Choose Extraordinary Measures”

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Medical Alert Devices – Too Little, Too Late

An older woman cries out pleading for help from the bottom of a stairway in a large and empty house, and we are led to the conclusion that if only she had a medical alert device worn around her neck she could have emergency first responders there in minutes.

But what then…? How does the second half of this supposedly “averted” tragedy play out?

As reported by the Centers for Diseases Control and Prevention (CDC)*:

“In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.”

“People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.”

So instead of lying on the floor for hours or days incurring additional life threatening conditions or worse, our female victim is whisked to the hospital and most likely will be treated and then discharged to a long-term care facility, either an assisted living or a skilled nursing facility for a year or more or until the end of her life.

The ability to lie on the floor and push a button may provide some level of comfort and security to seniors and their families yet when the fall has already occurred and resulting injuries sustained, the reality is your parent is lying there just pushing a button for help.

Now, a life will change in ways not to be desired by anyone. He or she will most likely be shuttled into a vast medical system to wind up in a bed that is not theirs and to no longer live in their own home.

This is the real fear older people live with. The fear of losing their independence and being institutionalized needlessly or prematurely.

If only the family had pushed beyond the simplistic notion that technology and telecommunications were all that was needed to keep mom or dad safe. If only our fear-based advertising could help us consider what happens after that last ditched effort is activated. Then, we could achieve compassionate aging for everyone concerned, senior and family caregiver alike.
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Like the CDC states*:

“Each year, one in every three adults age 65 and older falls. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.

Geriatric case managers are qualified professionals to identify and evaluate many safety risks based upon mobility, vision and other physical deficits, environmental factors around the home, medical and behavioral conditions. By providing comprehensive assessments including balance and gait and home safety assessments, appropriate provisions and safeguards can be allotted and falls and many other unrealized dangers can be truly averted.

Medical alert products and services are worthwhile, but they are the very last line of safety. If they are to provide comfort and security, they should be part of a much more comprehensive approach to an elder’s care – one where that button need never be pressed.

© Anthony Antoville 2014

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services. He is a recognized expert in eldercare and home safety, internationally published with The Edwin Mellen Press.

*The Centers for Diseases Control and Prevention (CDC) Website “Home and Falls Among Older Adults: An Overview” Last Updated: 9/20/2013

 

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Love Until the End of Life

The recent love story that has captured the hearts of millions around the globe is the one of a 62-year marriage between Maxine and Don Simpson of Bakersfield, California.

The images of Don and Maxine holding hands, while lying side-by-side in separate hospital beds, has fired imaginations and hearts everywhere.

And while The Simpsons’ genuine devotion and enduring love for each other is wonderful, it is not the striking chord to this moving story. Nor is the amazing account of how they died only four hours apart from one another with Don finally passing at the moment the family removed his beloved Maxine’s body from the room.

The real heart here is that of the family caregivers. In particular, the two granddaughters who initiated the couples reunion were able to see beyond the many significant challenges created by their grandparents’ major health issues and the consequential logistics involved in such a move and the resulting care that would be required.


A family being sensitive to the emotional and physical needs of their elders is not unique, in itself. Countless families jump in and tirelessly perform endless caregiving tasks every day. What shines through the many layers of this tale is that this family recognized what was needed at the end of these two people’s lives. It was to bring them together in a family home setting and to allow them to simply be. No more medical interventions; no self-serving grieving at the bedside. Just time together.

Melissa Sloan, one of the grandchildren, realized that her family was committed to keeping Don and Maxine together until death did them part, and she did just that.

I have seen how people often become confused when witnessing a loved one reach the end of his or her life, let alone both parents simultaneously. It is common at those last stages of the dying process for family members to become overwhelmed with their own emotional needs and lack of ease during these “real” moments of life.
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Understandably, many families are unable to achieve this depth of compassionate aging, because our western society and contemporary culture mostly fears death and dying and rarely permits us to take the time to allow a life to gracefully and gradually repose into its final earthly state.

However, this family discovered a way to honor the elders for whom they cared, while making the most of what precious time everyone could share together.

 

© Anthony Antoville 2014

Anthony Antoville is COO and geriatric case manager with Champion Advocates LLC in Portland, Oregon. He has been serving the psychosocial needs of seniors since 1991. Anthony is a published author with The Edwin Mellen Press.

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Self Compassion and Aging

Let’s be clear. Aging begins from the moment we are born.

In contemporary western society, we tend to view the aging process as positive up to a certain point. The turning point is somewhere in that upward “moving target” that counts as mid-life. From that point, we tend to view aging as a negative process and something to be fought against.

We have all become strongly influenced by advertising for a plethora of “anti-aging” products, counterbalanced with a youth-obsessed focus. Medical efforts and campaigns to cure countless conditions and diseases have been woven into our everyday experience, which can create for us a strange unspoken expectation that western medicine will someday cure us of all diseases and even overcome death itself.

We may experience unwanted reactions to these “anti-aging” and medical messages. The reactions can include unrealistic and unattainable expectations for ourselves and for those we may care for.  If our baseline is unrealistic, we can be much too hard on ourselves.

For example, for the person who is a caregiver of an older family member; guilt can become overwhelming when the older person’s health goes into decline. The flawed expectations of a treatment for aging and eventual death cannot be realized. This form of guilt can become self-debilitating and detrimental to the caregiver’s physical and mental health.

For those of us who are passing the mid-life point, our own thoughts can become self wounding and cruel as we find it increasingly difficult to fit ourselves into the a youth-based straightjacket as we age.

Moreover, other cultural conditioning can make it difficult for us to allow ourselves to be self compassionate. At a recent leadership training that I attended, the accomplished female speaker noted in an offside comment, “I have always found it easy to be compassionate for others, but difficult to be compassionate to myself.”
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Why be self compassionate about aging?

Self compassion allows us to be present in the true moment. It helps us to forgive ourselves, to heal our wounds and to appreciate our own best efforts. It allows us to be truly compassionate in our service to others. Self compassion frees us of unnecessary burdens, allowing us to age from our center of being with grace and with wonder.

© Anne Conrad-Antoville 2014

Anne Conrad-Antoville cared for her disabled mother from her pre-teens through her mid-thirties, when her mother passed away. This experience inspired Anne’s eventual work in professional aging services. Anne is currently CEO and a geriatric case manager for Champion Advocates LLC and manages Working Woman Aging Parents.

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Mellowing with Age: Myth or Truth?

As a grow older, I routinely return to questions regarding my personality: “Which personal characteristics are of me and which ones are not?” “Am I becoming the person I would have hoped to have become in my youth?”

“Am I a person I would want to be around?” “Is age mellowing me, or am I just becoming a cranky old man?”

So far, I have discovered that I have developed and refined the characteristics that I have picked up over time. Some are good and express attributes I would fondly wish to see in people close to me. Other qualities are less than desirable and not worthwhile to retain in any fashion, and I consider myself irresponsible when I perpetuate them in the world.

Just as certain stones are conglomerations of multiple minerals, I have picked up and acquired various aspects of personality that I have encountered throughout my life; some thoughtfully and others carelessly. Some I now carry due to my adaptable nature. Others I carry because life has hammered them into weak points of my armor. I have moulded both types into my persona, while time, experience and repeated use have worn them into a shape of my own fashion.

Yet I find myself left with a choice: Shall I become a stone that is smooth, well polished and highly reflective of surrounding sources of light? Or will I be a rough-edged, brittle and dull amalgamation of lesser qualities in need of further purification to reach a higher state of being?

Clearly, we make due with qualities that are presented to us over a lifetime beginning at birth. We carry with us what we choose. Some qualities are fostered consciously, while others we self-integrate with less awareness. We are presented with an endless stream of opportunities to shed what does not serve us and retain what we believe to be of use.
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What I see as essential in my life is to pay close attention to what my responses are as I am ceaselessly tumbled about in the surf of life. As I encounter situations, people and events, I shall work to repeat, reiterate and reflect only the qualities I wish to see in myself to the best of my ability. To attempt to do any less, would diminish who I am and my potential to contribute anything of worth and meaning to the world in which I live.

© Anthony Antoville 2014

Anthony Antoville is COO and geriatric case manager with Champion Advocates LLC in Portland, Oregon. He has been serving the psychosocial needs of seniors since 1991. Anthony is a published author with The Edwin Mellen Press.

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Pets: Mirroring Our Care and Our Fear

“Arthritis – How diet, supplements and alternative therapies can ease those aching joints; How to Care for Your ‘Super Senior’; Catching Cancer Early; Chiropractic Care for Your Senior.”

What reader is this table of contents written for?

Apparently, a popular pet magazine has keyed into our Western obsession with wellness and longevity. It appears to be encouraging us to transfer this obsession onto our pets. If it were not for the cover picture and the magazine’s title, I could very well have been looking at a periodical geared for the non-pet owning reader.

Eventually, some of the article titles returned me to the reality of the subject at hand: “Protect Your Dog’s Joints; Cognitive Dysfunction in Cats; Pancreatitis in Dogs and Cats.”

Now, don’t get me wrong. I have loved and cared for animals all of my adult life and have seen these animals as members of my family. I feed my cats the best foods that I can discern from reviewing nutritional content and food sources. When my Shepard-lab mix suffered from hip dysphasia in his mid-teens, I improved his bed, gave him a daily glucosamine chondroitin supplement and even cared for him through bouts of incontinence until he could no longer easily walk.

Clearly, we need to care for the animals that are dependent upon us to thrive and survive, but have we taken our society’s obsession for longevity too far by imposing it onto our family pets?

Is our fear of disease and death causing our pets to live with conditions and undergo therapies and surgeries primarily to make us feel better about ourselves?

Some parents suggest affixing a kids GPS device to the belt loop on the back side of your child’s free sample viagra pants. Many of men feel hesitate on buying viagra from canadian pharmacies from physical pharmacy store. Urology has various branches, such as endourology, where the urologist performs minor surgeries, neurourology, which covers order cialis the nervous system as it secretes lipase, amylase, and protease. Kamagra is also very effective in inhibiting PDE5 enzymes and lead to healthy erection of the penis. generic cialis 20mg In the book, Withrow & MacEwen’s Small Animal Clinical Oncology (Fourth Edition); the authors reveal that cancer in pets is on the rise due to increased longevity in pets. Furthermore, cancer treatments for pets are on the rise due to increased demand from pet owners, who are largely driven by media on the subject. The authors clearly state, “Pet animals with spontaneously developing cancer provide an excellent opportunity to study many aspects of cancer from etiology to treatment.” They further outline fifteen superior opportunities for studying human cancer and treatment through treatment of pets, over laboratory studies of mice and rats.* Therefore we might ask, Who is really benefitting here?

Pets are a primary connection between us and the natural world of animals and other forms of life. How do our societal obsessions affect our relationships with the natural world and to our own natural cycles of life? How far out of control have our fears become?

© Anthony Antoville 2014

Anthony Antoville is COO of Champion Advocates LLC in Portland, Oregon. He has been serving a wide range of elder needs since 1991. Anthony is a published author with The Edwin Mellen Press.

*Introduction: Why Worry About Cancer in Pets? Withrow & MacEwen’s Small Animal Clinical Oncology (Fourth Edition) Edited by: Stephen J. Withrow, DVM, DACVS, DACVIM (Oncology), and David M. Vail, DVM, DACVIM (Oncology)

Animal Wellness Magazine Vol 16 Issue 4

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Aging and the Futurist

I just attended a talk with Intel’s Futurist, Brian David Johnson. Earlier in this week, I had read through a futurist magazine filled with articles extolling child bearing robots and brain downloads and my expectations were low for meaningful content.

I was pleasantly surprised to hear Brian’s view that the future he envisions is about humans, not technology. It is not technology that guides us, but we who should be guiding technology. As we enter an era in which we can manufacture molecular-sized technology and literally anything can become a computer, it is up to us to decide what we stand for and what we stand against.

What stuck me most was this statement Brian made:

How do you change the future?
Change the story that people are telling themselves about the future they will live in.

In that light, what story are we telling ourselves about aging?

Aging is not only in our future, it is happening to all of us and now! If we are allowing the aging story to be shaped by medical technology companies, which of these technologies will enhance our experience of living a human life and which will dehumanize us over time?

Are the advertisements put forward by pharmaceutical corporations helping or warping our understanding of the course of life? Is the aging story told by residential care conglomerates and investment brokerages meaningful and true to what you stand for?

Glutathione is also the source of three important amino acids, like cysteine, glycine, prescription female viagra and glutamate, which helps in reversing not always possibly successful. Pregnancy and Childbirth- Your discount viagra usa hormone levels changes during pregnancy, just afterwards adolescent bearing and during breast feeding. Oral sex can generic soft viagra still be rewarding, along with experimenting with adult toys including vibrators or penile sleeves, which mimic the feel of a vagina or mouth. It helps to get viagra uk delivery harder erections for pleasurable sexual activity. How do we hold onto what is most important to us as human beings, as we age in an increasingly technological society?

Be aware of what you stand for and what you stand against, and change the story you are telling yourself as much as you need to.

© Anne Conrad-Antoville 2014

Anne Conrad-Antoville is CEO of Champion Advocates LLC in Portland, Oregon. She has helped hundreds of families with professional geriatric case management services and other supportive services for seniors. Anne is also President of Working Woman Aging Parents.

Intel – Brian David Johnson and the Tomorrow Project

Photo- Damien Hirst, Hoorsenbuhs — The Cathedral Collection – Pill Rosary

 

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Disney’s “Maleficent” is a Tale of Forgiveness

Maleficent, Disney’s recent blockbuster release, reveals an unusual way to express the timeless message of forgiveness to its viewers, young and old alike. The tale of the formerly evil villainess in the classic Sleeping Beauty is provided a much needed backstory in this updated version to explain what has led her to unleash such hatred against the newly born babe, Aurora.

We learn that a great violation has been committed upon Maleficent by Aurora’s soon to be father, Stephan. This would be the mutilation and stealing of her faerie wings through deception and manipulation by Stephan to gain favor and the eventual kingship from the dying human king. A new war ensues between these two worlds and the innocent on both sides are made to suffer. All of this for the sake of the old king’s desire to destroy the faerie realm and plunder its coveted wealth of unimagined riches.

Yet, the innocent Aurora shows Maleficent the path back toward compassion and healing as only a child will. Through the years that lead up to Aurora’s fateful 16th birthday, Maleficent slowly rediscovers her own love of the natural world and a shared awe of wonder as expressed in Aurora.

Eventually, Maleficent strives in vain to reverse her dreaded spell that she had cast upon Aurora, and is left with but one final measure to cure the girl of the forever deathlike sleep. She must travel into the human kingdom, enter King Stephan’s castle and face his knights who are armed with weapons of deadly iron.

Forgiveness is a cornerstone of compassionate aging. Several times and in many ways, this compassionate message is conveyed.

Stephan as a young boy and would-be thief is forgiven by a young Maleficent and her faerie co-beings of his original trespass; the three tiny pixies repeatedly tussle and argue with one another to remain each others faithful companions over the years; Maleficent again forgives Stephan later as a grown man who had abandoned her to pursue his ambition among men, and Aurora forgives Maleficent of casting the doom-filled spell upon her.
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But most dramatically, Maleficent, in the heat of battle and clearly in a position to defeat King Stephan, gives him quarter and is willing to spare his life. It is only Stephan who chooses to cling to a hardened and merciless heart, thus seeking final vengeance.

By the re-vision of this tale, we are shown that forgiveness begins when we strive to rise above an insult, a trespass, a wound, an injustice.

Forgiveness is ultimately realized, when we knowingly attempt to break a painful or disastrous cycle in favor of reaching a new state of awareness within ourselves and in others. This process is one that can occur naturally over time as memories fade, the mind weakens and the ego-driven self slowly diminishes. Or, we can consciously decide which aspects of our lives that we wish to truly cherish and nurture through our remaining years.

© Anthony Antoville 2014

Anthony Antoville, CMC is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon. For more than 20 years, he has professionally served hundreds of families in addressing family relations and other elder issues.

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Farmers’ Markets: A Delightful Way to Connect to Earth and Community

For many years, my husband and I had a very large garden. We grew over forty different varieties of culinary and medicinal herbs. We grew apples, pears and grapes. In the early spring, we had peas, kale and spring onions. Through the summers, we had an abundance of lettuce varieties, and heirloom beans, carrots, radishes and tomatoes. In the autumn, we reveled in colorful beets, squashes, spinach and pumpkins.

We lived by the seasons and lovingly tilled, planted, weeded, mulched and watered. We enjoyed the contact with the earth and with living things. We enjoyed the physical work and the harvest of efforts made.

At this stage of life, it is our season to live in the city with a patio full of potted plants. I still am able to find my contact with the earth on a regular basis. One of my favorite things to do is to shop at the farmers’ market.

At the farmers’ market, I have come to know the farmers who are there every week. Their hands touch the earth every day and the gifts they bring from it carry that special regenerative interaction between humans and other living beings. Their vegetables and fruits are vibrant and alive with energy.

Last week, I visited the farmers’ market in Beaverton, Oregon and stopped by one of my favorite booths – that of a small family berry farm. These family farmers pick the berries when they are ripe on the vine, and every basket of blueberries, raspberries and strawberries being the epitome of perfection!
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One of the young women from the family farm glowed, as we chatted about the blueberries that had just come into season and how much we had enjoyed the extra sweet strawberries from the week before that were gone now. I filled my half box with the colors and aromas of the early summer and returned home with the blessings of earth.

© Anne Conrad-Antoville 2014

Anne Conrad-Antoville is CEO of Champion Advocates LLC in Portland, Oregon. She is Co-Founder of CompassionateAging.org. Anne is also President of Working Woman Aging Parents.

Farmers’ Market Beaverton Oregon

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Are Popular Influences Stealing Our Real Experiences for True Aging?

During my childhood, I constantly wanted to be older than I was. I tried to hang out with the kids in the older grades, I did everything I could to be considered older than I was as to gain aged prestige and cache, I tirelessly worked to turn the eye of many a high school girl while I was in middle school, I snuck out and drove without an adult when only having a learner’s permit. These examples seem to be the typical stuff kids do in a search for more independence and greater acceptance in the world of adults.

Of course what I was attempting to do, in hindsight, was to see myself as more independent and more accepted in a wider world even if merely on the surface.

As I consider the cultural influences that surrounded me in my youth, I see how I was repeatedly told that everything would be better by being older. In many ways that concept proved to be true, because there were many aspects of life I was unable to fully experience socially, emotionally or legally until I was older.

Yet now as I turn 50, I find myself ceaseless bombarded by messages of how I and the over 50 crowd should remain 21 …forever. We are repeatedly shown and told that nothing can be better than to look, feel and even act younger than we really are!*

Is such a materialistic approach to aging the one we really want to pursue as we grow older? I fear it is one that would keep us chasing after an illusion never to be realized.

I refuse to believe that I have lived half a century to reverse my field of vision now and idealize my youth in such a way as to attempt to re-live it!

Perhaps, my peers and I are ready to search for deeper and more revealing aspects of living life without tracing over our outgrown notions of who we wanted to be.

When we try to freeze a specific segment of our earlier years lived and replay it in a repeating loop, we deny ourselves the ability to look honestly at where we are, grow more fully into who we are and venture into the future with continued wonder.

The effect of this medication stays there in the product. viagra tablet Smoking is also responsible for low sperm count, low semen volume and male infertility are prostate gland infections, inflammation of your prostate gland, cyst in the duct, best buy for viagra growing old, frequent lovemaking episodes to enjoy intimate moments. As erectile dysfunction considers a form of sexual disorder not a disease. viagra super active If you care about what you do want and see what happens! This workout is really about saying YES levitra on line sale to yourself, to that powerful being who is beyond the positive and the negative outcomes you perceive to be real. Isn’t that what we should expect from living up until now in our lives? How can we know what is missing from our lives, if we do not permit ourselves the opportunity to live out beyond merely youth-filled experiences? Why would we not want to discover and claim the hidden treasures of new encounters and unique realizations by moving into the uncharted territories of our lives yet to be lived?

© Anthony Antoville 2014

Anthony AntovilleAnthony Antoville is COO of Champion Advocates LLC in Portland, Oregon. He has been serving the psychosocial needs of seniors since 1991. Anthony is a published author with The Edwin Mellen Press.

 

*Forever Young: America’s Obsession With Never Growing Old
Why is America such a youth obsessed culture?
Dale Archer, MD in Reading Between the (Head)Lines, Psychology Today

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Cherishing the Future of All Generations!