Article From Lee Kuan Yew about Health - Must Read!!

‘Stay interested in the world, take on a challenge’: MM Lee This is Minister Mentor Lee Kuan Yew’s advice on ageing the best way one can. Yesterday, he shared some personal insights into how he himself deals with ageing. Here is the transcript of his remarks. MY CONCERN today is, what is it I can tell you which can add to your knowledge about ageing and what ageing societies can do. You know more about this subject than I do. A lot of it is out in the media, Internet and books. So I thought the best way would be to take a personal standpoint and tell you how I approach this question of ageing. If I cast my mind back, I can see turning points in my physical and mental health. You know, when you’re young, I didn’t bother, I assumed good health was God-given and would always be there. When I was about - ‘57 that was - I was about 34, we were competing in elections, and I was really fond of drinking beer and smoking. And after the election campaign, in Victoria Memorial Hall - we had won the election, the City Council election - I couldn’t thank the voters because I had lost my voice. I’d been smoking furiously. I’d take a packet of 10 to deceive myself, but I’d run through the packet just sitting on the stage, watching the crowd, getting the feeling, the mood before I speak. In other words, there were three speeches a night. Three speeches a night, 30 cigarettes, a lot of beer after that, and the voice was gone. I remember I had a case in Kuching, Sarawak. So I took the flight and I felt awful. I had to make up my mind whether I was going to be an effective campaigner and a lawyer, in which case I cannot destroy my voice, and I can’t go on. So I stopped smoking. It was a tremendous deprivation because I was addicted to it. And I used to wake up dreaming…the nightmare was I resumed smoking. But I made a choice and said, if I continue this, I will not be able to do my job. I didn’t know anything about cancer of the throat or oesophagus or the lungs, etc. But it turned out it had many other deleterious effects. Strangely enough after that, I became very allergic, hyper-allergic to smoking, so much so that I would plead with my Cabinet ministers not to smoke in the Cabinet room. You want to smoke, please go out, because I am allergic. Then one day I was at the home of my colleague, Mr Rajaratnam, meeting foreign correspondents including some from the London Times and they took a picture of me and I had a big belly like that (puts his hands in front of his belly), a beer belly. I felt no, no, this will not do. So I started playing more golf, hit hundreds of balls on the practice tee. But this didn’t go down. There was only one way it could go down: consume less, burn up more. Another turning point came when -this was 1976, after the general election - I was feeling tired. I was breathing deeply at the Istana, on the lawns. My daughter, who at that time just graduating as a doctor, said: ‘What are you trying to do?’ I said: ‘I feel an effort to breathe in more oxygen.’ She said: ‘Don’t play golf. Run. Aerobics.’ So she gave me a book, quite a famous book and, then, very current in America on how you score aerobic points swimming, running, whatever it is, cycling. I looked at it sceptically. I wasn’t very keen on running. I was keen on golf. So I said, ‘Let’s try’. So in-between golf shots while playing on my own, sometimes nine holes at the Istana, I would try and walk fast between shots. Then I began to run between shots. And I felt better. After a while, I said: ‘Okay, after my golf, I run.’ And after a few years, I said: ‘Golf takes so long. The running takes 15 minutes. Let’s cut out the golf and let’s run.’ I think the most important thing in ageing is you got to understand yourself. And the knowledge now is all there. When I was growing up, the knowledge wasn’t there. I had to get the knowledge from friends, from doctors. But perhaps the most important bit of knowledge that the doctor gave me was one day, when I said: ‘Look, I’m feeling slower and sluggish.’ So he gave me a medical encyclopaedia and he turned the pages to ageing. I read it up and it was illuminating. A lot of it was difficult jargon but I just skimmed through to get the gist of it. As you grow, you reach 20, 21, 22, 23, 24, 25 and then, thereafter, you are on a gradual slope down physically. Mentally, you carry on and on and on until I don’t know what age, but mathematicians will tell you that they know their best output is when they’re in their 20s and 30s when your mental energy is powerful and you haven’t lost many neurons. That’s what they tell me. So, as you acquire more knowledge, you then craft a programme for yourself to maximise what you have. It’s just common sense. I never planned to live till 85 or 84. I just didn’t think about it. I said: ‘Well, my mother died when she was 74, she had a stroke. My father died when he was 94.’ But I saw him, and he lived a long life, well, maybe it was his DNA. But more than that, he swam every day and he kept himself busy. He was working for the Shell company. He was in charge, he was a superintendent of an oil depot. When he retired, he started becoming a salesman. So people used to tell me: ‘Your father is selling watches at BP de Silva.’ My father was then living with me. But it kept him busy. He had that routine: He meets people, he sells watches, he buys and sells all kinds of semi-precious stones, he circulates coins. And he keeps going. But at 87, 88, he fell, going down the steps from his room to the dining room, broke his arm, three months incapacitated. Thereafter, he couldn’t go back to swimming. Then he became wheelchair-bound. Then it became a problem because my house was constructed that way. So my brother - who’s a doctor and had a flat (one-level) house - took him in. And he lived on till 94. But towards the end, he had gradual loss of mental powers. So my calculations, I’m somewhere between 74 and 94. And I’ve reached the halfway point now. But have I? Well, 1996 when I was 73, I was cycling and I felt tightening on the neck. Oh, I must retire today. So I stopped. Next day, I returned to the bicycle. After five minutes it became worse. So I said, no, no, this is something serious, it’s got to do with the blood vessels. Rung up my doctor, who said, ‘Come tomorrow’. Went tomorrow, he checked me, and said: ‘Come back tomorrow for an angiogram.’ I said: ‘What’s that?’ He said: ‘We’ll pump something in and we’ll see whether the coronary arteries are cleared or blocked.’ I was going to go home. But an MP who was a cardiologist happened to be around, so he came in and said: ‘What are you doing here?’ I said: ‘I’ve got this.’ He said: ‘Don’t go home. You stay here tonight. I’ve sent patients home and they never came back. Just stay here. They’ll put you on the monitor. They’ll watch your heart. And if anything, an emergency arises, they will take you straight to the theatre. You go home. You’ve got no such monitor. You may never come back.’ So I stayed there. Pumped in the dye, yes it was blocked, the left circumflex, not the critical, lead one. So that’s lucky for me. Two weeks later, I was walking around,I felt it’s coming back. Yes it has come back, it had occluded. So this time they said: ‘We’ll put in a stent.’ I’m one of the first few in Singapore to have the stent, so it was a brand new operation. Fortunately, the man who invented the stent was out here selling his stent. He was from San Jose, La Jolla something or the other. So my doctor got hold of him and he supervised the operation. He said put the stent in. My doctor did the operation, he just watched it all and then that’s that. That was before all this problem about lining the stent to make sure that it doesn’t occlude and create a disturbance. So at each stage, I learnt something more about myself and I stored that. I said: ‘Oh, this is now a danger point.’ So all right, cut out fats, change diet, went to see a specialist in Boston, Massachusetts General Hospital. He said: ‘Take statins.’ I said: ‘What’s that?’ He said: ‘(They) help to reduce your cholesterol.’ My doctors were concerned. They said: ‘You don’t need it. Your cholesterol levels are okay.’ Two years later, more medical evidence came out. So the doctors said: ‘Take statins.’ Had there been no angioplasty, had I not known that something was up and I cycled on, I might have gone at 74 like my mother. So I missed that deadline. So next deadline: my father’s fall at 87. I’m very careful now because sometimes when I turn around too fast, I feel as if I’m going to get off balance. So my daughter, a neurologist, she took me to the NNI, there’s this nerve conduction test, put electrodes here and there. The transmission of the messages between the feet and the brain has slowed down. So all the exercise, everything, effort put in, I’m fit, I swim, I cycle. But I can’t prevent this losing of conductivity of the nerves and this transmission. So just go slow. So when I climb up the steps, I have no problem. When I go down the steps, I need to be sure that I’ve got something I can hang on to, just in case. So it’s a constant process of adjustment. But I think the most important single lesson I learnt in life was that if you isolate yourself, you’re done for. The human being is a social animal - he needs stimuli, he needs to meet people, to catch up with the world. I don’t much like travel but I travel very frequently despite the jet lag, because I get to meet people of great interest to me, who will help me in my work as chairman of our GIC. So I know, I’m on several boards of banks, international advisory boards of banks, of oil companies and so on. And I meet them and I get to understand what’s happening in the world, what has changed since I was here one month ago, one year ago. I go to India, I go to China. And that stimuli brings me to the world of today. I’m not living in the world, when I was active, more active 20, 30 years ago. So I tell my wife. She woke up late today. I said: ‘Never mind, you come along by 12 o’clock. I go first.’ If you sit back - because part of the ending part of the encyclopaedia which I read was very depressing - as you get old, you withdraw from everything and then all you will have is your bedroom and the photographs and the furniture that you know, and that’s your world. So if you’ve got to go to hospital, the doctor advises you to bring some photographs so that you’ll know you’re not lost in a different world, that this is like your bedroom. I’m determined that I will not, as long as I can, to be reduced, to have my horizons closed on me like that. It is the stimuli, it is the constant interaction with people across the world that keeps me aware and alive to what’s going on and what we can do to adjust to this different world. In other words, you must have an interest in life. If you believe that at 55, you’re retiring, you’re going to read books, play golf and drink wine, then I think you’re done for. So statistically they will show you that all the people who retire and lead sedentary lives, the pensioners die off very quickly. So we now have a social problem with medical sciences, new procedures, new drugs, many more people are going to live long lives. If the mindset is that when I reach retirement age 62, I’m old, I can’t work anymore, I don’t have to work, I just sit back, now is the time I’ll enjoy life, I think you’re making the biggest mistake of your life. After one month, or after two months, even if you go travelling with nothing to do, with no purpose in life, you will just degrade, you’ll go to seed. The human being needs a challenge, and my advice to every person in Singapore and elsewhere: Keep yourself interested, have a challenge. If you’re not interested in the world and the world is not interested in you, the biggest punishment a man can receive is total isolation in a dungeon, black and complete withdrawal of all stimuli, that’s real torture. So when I read that people believe, Singaporeans say: ‘Oh, 62 I’m retiring.’ I say to them: ‘You really want to die quickly?’ If you want to see sunrise tomorrow or sunset, you must have a reason, you must have the stimuli to keep going.’ This story was first published on Jan 12, 2008.

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By KELLY GREENE

Joseph Coughlin describes his work as “trying to get people to ‘age cool.’ ” More specifically, as director of AgeLab, a research program at the Massachusetts Institute of Technology, he is pushing advances in transportation, health care and housing off drawing boards and into older adults’ lives.

And he can’t do it quickly enough.

“If we don’t hurry,” he says, “the products being designed now aren’t going to be there when the [baby] boomers need them.”

Prof. Coughlin is one of hundreds of people across the country whose work, in effect, is shaping the future of retirement. The motives may vary — educators, entrepreneurs, philanthropists and policy makers are all involved in the effort — but the goals are much the same: to learn about, and improve the quality of, later life.

Demographics, of course, explain the sense of urgency. Each day, on average, almost 8,000 people in the U.S. turn 60. Just last month, the first of 78 million baby boomers reached age 62 and became eligible for Social Security.

Which “change agents” are having the biggest impact on retirement? We put that question to experts in aging nationwide. From dozens of candidates, we selected the following 12 people. If you want to know what your future might look like — how Americans will live, work and play in later life — these individuals are designing some of the answers.

William Bengen
The Numbers Guy

It’s the most frequent question, and biggest concern, for many people approaching retirement: How big a nest egg will I need, and how do I make it last?

William Bengen is working on that.

Mr. Bengen, a certified financial planner in El Cajon, Calif., has already achieved what amounts to rock-star status in the retirement-planning business. His pioneering research in the 1990s gave rise to the “4% rule”: Withdraw no more than about 4% a year from your nest egg, and it’s highly likely that your savings will last 30 years. That finding has already helped to establish budgets and spending patterns for numerous retirees.

Today, Mr. Bengen, age 60, continues to refine his research. In 2006, he introduced a method of withdrawing funds from nest eggs that tailors the 4% rule to individual circumstances. (It’s online at www.fpanet.org/journal. Click on “Past Issues & Articles,” then on “Past Issues,” and go to August 2006.) And now, he is researching, he says, “the possibility that dividend-paying stocks, particularly those that increase dividends over time, might provide a better retirement resource than the S&P 500.” As Mr. Bengen explains: “The thesis is that those have at least as high a total return as S&P 500 stocks, and they have lower volatility…. If you have stocks that don’t go down as much in the bear markets, you’re better off.”

Mr. Bengen doesn’t see himself as shaping baby boomers’ financial future. He says he simply wants to help his 60 or so clients.

“I was starting to get some clients who were planning for retirement,” he recalls, “and they were asking me, ‘How much can I take out, and how should I set up my investments?’ And I couldn’t find a thing substantiated by any research.”

Joseph Coughlin
Harnessing Technology

In the mid-1990s, before joining MIT, Prof. Coughlin was working for a federal contractor, studying the aging population’s potential impact on transportation.

“It was like unwrapping an onion,” he remembers. “We hadn’t thought about housing, [or] the future of work. And we certainly hadn’t thought about transportation.”

That epiphany led to the creation, in 2000, of AgeLab, where Prof. Coughlin and his colleagues are designing — and pushing companies to embrace — technology that will enhance older adults’ daily lives.

One of his favorite breakthroughs is a “personal adviser” that Procter & Gamble Co. has licensed, based on AgeLab research, to help food shoppers identify products that are healthy for them. The device, to be attached by supermarkets to their grocery carts, is like a minicomputer with a scanner. Shoppers insert smart cards that contain their dietary particulars. Then, as they shop, they swipe products past the scanner to get the device’s opinion. Let’s say you’re prehypertensive and scan a box of crackers; after reading the bar code, Prof. Coughlin says, the adviser may suggest trying a different product with a lot less salt.

Eric Dishman
Helping People Stay Home

For no small number of people, aging means losing their independence — and, eventually, leaving their homes.

Someday, technology being developed by Eric Dishman and his staff at Intel Corp. may help people stay in their homes longer.

Mr. Dishman has focused on ways to assist the elderly since he was a teenager helping care for a grandparent with Alzheimer’s disease. Years later, he was working for Microsoft Corp. co-founder Paul Allen on a “nursing home of the future,” he says, when someone made an observation that helped alter his approach to the matter completely.

“Someone said, ‘I think we asked the wrong question,’ ” he recalls. “ ’It’s not how can we make the nursing home better through technology, but how can technology keep people independent?’ ”

Mr. Dishman, 39, is general manager in charge of product research and innovation for Intel’s Digital Health Group. Prototypes emerging from his group’s offices and labs have a Jetsons-like feel: a carpet with sensors that may reduce the risk of a fall; a “caller ID on steroids,” which shows and tells you who is at the front door and when you last spoke; a system that helps people with memory problems cook for themselves.

John Erickson
Helping People Leave Home

In contrast to Mr. Dishman, John Erickson sees a future where millions of Americans leave their homes in later life. And he’s preparing your accommodations.

Mr. Erickson, 63, is chairman and chief executive of closely held Erickson Retirement Communities, one of the country’s largest developers of continuing-care retirement communities. In a CCRC, residents are guaranteed access to different levels of long-term care as they age.

Starting in Maryland in 1983 with a single facility (a renovated seminary), Mr. Erickson began developing retirement “campuses,” where residents, among other activities, can produce their own TV shows. Today, the company has 20 CCRCs with 21,000 residents in 11 states. Mr. Erickson hopes to nearly double that number in five years.

Why should we leave our homes in later life? “Accidents, falls, depression, isolation,” Mr. Erickson answers. “That’s not what was meant for the last half of retirement.”

Beyond housing, Mr. Erickson also may have a hand in shaping what older adults watch on television. In the past two years, he has spent an estimated $100 million building Retirement Living TV, a cable network focused on later life. He also donated $5 million in 2004 to start a professional program at the University of Maryland, Baltimore County, that combines management, policy and aging issues.

Charles Feeney
A Life of Purpose

If you find yourself, in your 60s and 70s, immersed in a new career and a new passion — teaching children to read, for instance, or helping an environmental organization — you may have Charles Feeney to thank.

Mr. Feeney, 76, is the founding chairman of Atlantic Philanthropies, an international foundation that is committed to disbursing its entire $4 billion endowment by 2020. A large chunk will go to help older adults “live healthier, independent lives with dignity, purpose and meaning,” says Brian Hofland, director of Atlantic’s international aging program.

The foundation, for instance, has helped fund the Purpose Prize, awards of $100,000 given each year to five “social entrepreneurs” age 60 or older who are tackling some of society’s biggest challenges. Civic Ventures, the San Francisco nonprofit that created the Purpose Prize, last year received $10 million from Atlantic Philanthropies in part to stimulate development of “encore careers” for people 50 and older.

Mr. Feeney himself is a bit of a recluse. (He declined to be interviewed for this article.) He doesn’t own a house or a car, and when flying, he typically travels coach, says Conor O’Clery, an Irish journalist and biographer of Mr. Feeney. It wasn’t until 1997, after Mr. Feeney sold the company he founded (DFS Group, a chain of airport stores), that his sizable charitable efforts became public.

“A lot of what Chuck likes doing is building buildings at universities and hospitals,” Mr. O’Clery says. “But more and more, he became concerned with health issues, and I think his interest in aging grew out of that.”

Katherine Freund
Staying Mobile

For millions of people, driving at some point will become impractical. How, then, to get to the supermarket, or to friends’ homes?

A near-tragedy 20 years ago in the life of Katherine Freund is yielding some answers.

In 1988, Ms. Freund’s 3-year-old son was hit by a car and nearly killed. The driver was 84 years old. That event sparked an interest in transportation issues that led, in the mid-1990s, to the development of the Independent Transportation Network.

The program offers rides — round the clock, seven days a week — to older adults in the Portland, Maine, area. Fees average $8 a trip. Riders can trade in their cars and get credit for travel; volunteer drivers can bank their hours on the road to use later for themselves or family.

Ms. Freund, 57, serves as president and executive director of ITNAmerica, which has grown into a national organization. While in Portland the program provides nearly 17,000 rides a year to about 1,000 members age 65 and older, ITNAmerica now has nine affiliates, which provided almost 26,000 rides last year, and expects to have 40 affiliates by 2010.

Sheryl Garrett
Spreading Financial Literacy

Sheryl Garrett is on a mission to bring financial planning to the masses.

In the late 1990s, Ms. Garrett, a certified financial planner in Shawnee Mission, Kan., says she came to realize that many middle-class families knew little about managing money and retirement finances — and couldn’t afford to pay for help. Accordingly, instead of tying her fees to commissions or the size of a client’s assets (common practices among financial advisers), she decided to charge by the hour.

“It’s sort of like going to the dentist,” says Ms. Garrett, who is 45. “You don’t pay your dentist a retainer — you pay him for time and expertise.”

She soon found herself profiled in financial publications and fielding requests from consumers as far away as Massachusetts and California who wanted to hire her. In response, in July 2000, she launched Garrett Planning Network Inc., which now has almost 300 advisers across the U.S. The certified financial planners pay $7,500 to license the business model. They are required to offer their services exclusively as fiduciaries (meaning they are legally obligated to put their clients’ interests first) and on a fee-only basis. Hourly rates are about $175.

Ms. Garrett is also seeking ways to raise financial literacy among the wider public, including possibly through electronic games, a nighttime soap opera or a personal-finance makeover TV show.

Michael Merzenich
Keeping Minds in Shape

Michael Merzenich is working to make “brain exercise” as much a part of your routine in retirement as walking or jogging.

As chief scientific officer at Posit Science Corp., a San Francisco software maker, Dr. Merzenich, age 65, is at the forefront of efforts to improve mental health in later life. His interest in the field dates to the mid-1980s, when he was involved in experiments training animals at the University of California, San Francisco.

“We were watching [the animals’] brains change as they acquired skills and abilities,” he remembers. Consequently, he began investigating tools that could promote and measure mental fitness in humans.

His first company, Scientific Learning Corp., started in 1996, created software for children struggling with language problems. Posit Science, which Dr. Merzenich founded in 2003, is focused on older adults. Its first product was designed to improve memory and cognition (thinking and processing speed), mainly through listening exercises; this spring, the company plans to release a new brain-training program focused on vision.

Dr. Merzenich, still a neuroscience professor at UCSF and an inventor with more than 50 patents, is working on exercises that support decision making, fine motor control (playing musical instruments, for example), and gross motor control (to help restore balance).

Bernard Osher
Senior School Master

Returning to school, in some fashion, is high on many people’s to-do lists in retirement. Bernard Osher is helping to build the classrooms and programs you might enter.

Mr. Osher helped his family start Golden West Financial Corp. in the 1960s and created a personal foundation in the 1970s. Today, he is pouring nearly $200 million into what has become known as lifelong learning, or college-based education for older adults.

A native of Biddeford, Maine, Mr. Osher had his first significant exposure to the practice in 2000 during a visit to the Fromm Institute for Lifelong Learning at the University of San Francisco. “I came away very impressed,” he says, particularly with “the joy of learning” that he witnessed.

Several months later, a trip to the Senior College at the University of Southern Maine in Portland sealed his interest. The Bernard Osher Foundation made a $2.2 million gift to the Maine program in 2001, allowing the university to expand its peer-taught courses and workshops to more than 1,000 students ages 50 and older. Since then, the foundation has donated $73 million to nearly 120 lifelong-learning institutes on university campuses from Maine to Hawaii. Future grants will be used primarily to augment those programs.

John Rother
Advocate for the Aging

John Rother, AARP’s policy director, is ultimately responsible for everything that the largest membership group for older Americans advocates at the state and national levels. He is constantly in motion, making about 80 speeches a year around the world and lobbying lawmakers nationwide.

“I’ve got the best job in Washington,” says Mr. Rother, 60, who joined AARP in 1984 after serving as staff director and chief counsel to the Senate Special Committee on Aging.

Health care is his primary focus today. “It’s too expensive, and we aren’t getting our money’s worth,” he says. Fixing it “is going to take everything we know how to do — prevention, better management of chronic care, improving quality, being smarter purchasers as the government and individuals.”

In recent years, Mr. Rother has played a role in helping to pass — or block — some of the most significant legislation in Congress: the Medicare prescription-drug benefit (not “everything we had hoped it would be, but…certainly better than nothing”); Social Security privatization; and the national do-not-call registry.

John P. Stewart
Urban Planner

John P. Stewart is working on a blueprint for making city services receptive to all of the needs of older Americans — whether in health care, transportation, safety, employment or continuing education. To date, 16 cities have joined in the effort, including Baltimore, New York, Philadelphia, Chicago and Atlanta.

“I was really struck by the fact that we needed to change the way we look at aging services,” says Mr. Stewart, who for 32 years worked as a Maryland state health and education administrator, and is now executive director of the Commission on Aging and Retirement Education for the city of Baltimore.

More than 25% of the U.S. work force is over 60 and living healthier lives, Mr. Stewart says. “A lot of people are going to have to work longer.”

To focus on the question of what a senior-friendly city should look like, Mr. Stewart helped create a nonprofit think tank, the Baltimore City Center for Urban Aging Services and Policy Development. Issues under study include how to help grandparents who are raising their grandchildren; upgrading community senior centers with fitness equipment and personal trainers; and providing counseling to help cope with poverty and social isolation.

“This ‘declinist’ theory that people get old and should be put away is insane,” says Mr. Stewart, 63. “We can be an asset.”

William Thomas
Reinventing the Nursing Home

The spark for William Thomas’s work came in 1991 while treating a patient in an upstate New York nursing home. “She grabbed my arm, pulled me down over the bed, looked in my eyes and said, ‘I’m so lonely,’ ” he recalls.

To revitalize the place, he opened the doors to children, brought in parakeets, cats and dogs, and plowed up the grounds for a garden. The effort grew into the Eden Alternative, a nonprofit that has helped more than 500 nursing homes across the country shift their focus to their residents’ emotional well-being and away from institutional scheduling.

Today, Dr. Thomas is widely regarded as a leader in efforts nationwide to bring humanity to the end of life. In 1999, while touring the country to promote the Eden Alternative’s work and a novel about aging, “I realized that America’s nursing homes are getting older faster than we are,” he says.

Accordingly, he developed the idea of replacing traditional nursing homes with “Green Houses,” cozier facilities centered on big kitchens with technology-laden bedrooms and nursing aides who also serve as housekeepers and companions. To date, there are 35 Green House projects; the Robert Wood Johnson Foundation is helping fund an expansion of the program.

For his next act, Dr. Thomas, 48, wants to become “the Dr. Spock of aging.”

“The boomers are creeping toward elderhood, and I aim to help explain [the] terrain,” he says. “The ‘new’ old age [is] a time of strength and growth and development and engagement.”

–Ms. Greene is a staff reporter for The Wall Street Journal in Atlanta. She can be reached at encore@wsj.com.

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