washingtonpost.com
PBS Frontline: 'Living Old'

Miri Navasky
Producer, Writer and Director
Wednesday, November 22, 2006 11:00 AM

Producer, writer and director Miri Navasky was online Wednesday, Nov. 22, at 11 a.m. ET to discuss the PBS Frontline film " Living Old," a look at the challenges facing America's growing elderly population. Those over the age of 85 now comprise the fastest growing segment of the U.S. population, creating a much higher need for medical care and straining America's health care system.

" Living Old" airs Tuesday, Nov. 21, at 9 p.m. ET on PBS (check local listings).

The transcript follows.

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Northampton, Mass.: In today's society more and more people are staying single longer, and are not having children, when so much of the focus is on what can children do for parents. Combine that with women living longer than men, it seems society will be facing over the next few decades large numbers of women without children to look out for them. Any ideas, solutions on how to deal with the coming problem?

Miri Navasky: Thanks for your question. We, honestly had the thought when making this documentary and did not find an easy answer. Though what we did feel over and over again was that there needed to be a bigger conversation about the ramifications of so many people living longer. And we felt that we, as a society, need to begin to grapple with some of the harder issues, such as -- what we value, what we're willing to pay for (i.e. home-aides, etc...). And honestly, even people with children find that their children, no matter how well intended, cannot manage to take care of them 24 hours a day, 7 days a week as sometimes can be needed.

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East Lansing, Mich.: Thank you for bringing the reality of today's sympathetic medical care for the aged with debilitating diseases of mind and body.

Please explain the omission of current scientific realities of preventive measures, and that of nutritional medicine as treatment for existing disease entities?

The gloom and doom theme became darker as the program progressed. I was vigilant, expecting to hear of current scientific progress in both prevention and treatment with possible reversal of such maladies as Alzheimer's, arthritis, diabetes.

Miri Navasky: Thanks for your comments. I agree, there has been great progress in preventative measures -- research, medical interventions and technologies -- that have allowed many people to live happier and healthier lives for many more years, but what we found was that often that came at a cost that was rarely discussed - so that was the focus of this film. I think with limited time, we decided to use people, such as my grandmother, Estelle Strongin, for whom medical interventions allowed to live many years beyond her multiple cancers, heart attacks etc....to stand in for the positive side of our medical progress.

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Monroe, Ga.: I am amazed that more emphasis was not put on Hospice Care. There were many people in the program who would have benefited greatly by this program.

Miri Navasky: Thanks for your comment. We did actually touch on Hospice Care with Wayne Elliot, the elderly gentleman who chose not to undergo any more treatments. And the hospice workers, honestly, were amazing. However, with a limited amount of time we had to choose what our focus was going to be and we both felt that hospice care deserved its own program.

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Harlingen, Tex.: I understood that one of the ladies on the Tues. evening program was your mother, who passed away this year. What a sparkling lady with a great sense of humor. I laughed so hard when she said "let them suffer", regarding children who wanted their parents to sign an end of life document to keep their children from suffering. I'm 83 and would like to have her attitude as time goes on.

Miri Navasky: That was actually my grandma, my mother's mother. Thanks. Its true she had a great attitude and honestly, I think many in her generation had that same kind of positivity which likely has added to their ability to live so long. I miss her greatly!!

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Washington, D.C.: My grandmother recently spent 3 months in a nursing home recovering from hip surgery. As with the nursing homes in your documentary, hers was utilitarian. White walls, wide vacant halls, etc. I found the place downright depressing, as did my grandmother. Did you look into the effects of the sterility of nursing homes on elderly well-being? What about some colorful walls, plants, etc?

Miri Navasky: We didn't look into the effects of the nursing home environment, but we did find that many nursing homes across the country are trying to address these issues. They are restructuring the hallways, painting, doing all sorts of bright redesigns - they are calling it Culture Change - and I think the boomer generation will demand much more of it!!! Thanks for your comments.

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Pittsburgh, Pa.: What do you make of the ads for ride-on scooters on TV? Arnold Palmer telling my mother she will be more independent if she sits down...

Miri Navasky: I haven't seen these. But those scooters seem awful handy, especially in new York city. Although the ad sounds kind of ridiculous, I do think one of the things we saw was that elderly people - at least in new York - really wanted to be able to go outside and do things, such as shop, on their own. So if these scooters could help them achieve that goal, I think that's a good thing. But of course, like everything, they cost money. Thanks for your comment!

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Fort Worth, Tex.: Did your research cover whether there was any benefit to having court-appointed guardians to make medical, residential and financial decisions for older incapacitated adults?

Miri Navasky: unfortunately not, although I think that would be a great documentary in and of itself.

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Pittsburgh, Pa.: My daughter has made the choice not get married. Who will be there for these individuals as they age, especially in the smaller family the and geographical spread of families today. I worry so much for her when her father and I are no longer alive.

Miri Navasky: Thanks for your comment. Many of us seem to have the same worry. I think you're right families are both smaller, and much more spread out than ever before. I wonder if this change will cause people to move back home. The only thing I can say that might be a comfort is we came across some of the most wonderful nurses, doctors, social workers and home-aides. All of whom became like family members to the elderly that had none of their own to care for them.

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Leonardtown, Md.: One issue that didn't seem to be addressed is the difficulty of having the responsibility of carrying out an Advance Directive. For example, "Does no resuscitation mean no resuscitation in THESE circumstances? Shouldn't I wait a little bit longer?" or "Mom is in such pain. Must I give permission to perform an act which continues this pain?"

Miri Navasky: I agree this is one of the more complicated issues. We did try to address it briefly towards the end of the film - with Mary Ann DiBerardino - the daughter caring for her parents. She talks about living wills and how they don't cover all of the circumstances that one faces - such as giving antibiotics, fixing a broken hip -- I think this is the same sort of issue as you're mentioning. And honestly, we could have devoted an entire show to this question. As you point out, these are the difficult issues and most important issues. What we found was that the more discussion families had, the more trust between the patient and the health care proxy, the easier these decisions were to make in the long run because the proxy felt that they had a better basis and grounding for making the decisions that they needed to make with or without the consent of the patient. Thanks so much for your smart thoughts.

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Pittsburgh, Pa.: Just to clarify re: "Culture Change" -- it's about much, much, more than just painting walls and making superficial changes to the environment!

It's about DEEP systems change and relationships -- about changing the way work is organized to make it so life revolves around the needs and preferences of the elders, and not according to the needs of the institution. Consistent assignment of direct care workers is a place to start, but it's a long journey that involves truly doing away with the nursing home as we know it -- we will always need congregate settings, but they can be HOMES instead of institutions.

Miri Navasky: My apologies, I agree. I was pressed for time answering the question and know that the homes that are instituting culture change are doing a good job trying to make major deep and lasting changes that make a difference in the patients and families lives and make what we know as "institutions" more of a home setting. I think many are doing a fantastic job, but its a difficult task to really change an institution into a home. Thanks for your clarification though, very important.

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Bombay, India and New York, N.Y.: It was good to see the Romanian daughter caring (and struggling) for her mother. This touched upon immigrants' added issues, of the mother not being able to communicate as clearly. Perhaps, a sequel covering people from various communities with their culture-specific issues could take your work a few steps further.

Miri Navasky: I agree. There were many immigrant-specific issues that we weren't able to fully address, such as the extreme isolation and very strong family bonds and expectations. That would be a fantastic film, I think. thanks for your comment.

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Toronto, Canada: I think the most important thing to have when you get old is lots of money. It gives people choices - whether to live in a fancy retirement home, hire extra help, get better medical care (the medical establishment is very class-conscious), go on high-end cruises with an attendant, etc.

Miri Navasky: I agree, that certainly doesn't hurt. But honestly, as I hope you saw in the film, many times, family was as if not more important.

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Washington, D.C.: What does one do when one's parents simply won't discuss their desires or plans for the future? For example, I have long term care insurance, but my parents do not. I tried discussing the idea with my mother and she suggested such coverage was a "rip off." I don't think they have made any plans for when/if they become ill as they age. They are both aging and my father had a bypass earlier this year. He also has cancer, although it is a slow-growing one, and my mother has also had cancer. I think they may be in denial -- how do I "force the issue" to get them to talk about what they would want my brother and I to do for them if they become dependent in the future?

Miri Navasky: Very hard question that I think many of us are facing and I'm not sure that I'm actually equipped to answer it. What I was told by many doctors was to just keep trying to have these conversations over and over again and eventually something will take. Perhaps you can go at it in a different way than long term insurance - if that entry isn't working for you. For me, one of the first things my father asked upon seeing this show was: what's wrong with denial? My response to him was that denial might be fine for him now, but down the road, his denial was going to make things very complicated for me and my siblings and thus, for him too. What if we disagreed on what to do? And etc...That helped me to start a conversation. Good luck. I think we all need to have more of these conversations.

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Midland, Mich.: I'd welcome any information about your plans for future work on areas of the topics covered in your documentary, and thanks for what you've done.

Miri Navasky: we will keep you posted. We're hoping to do more on issues in this area. Feel free to check in with frontline on our future work - they will happily forward your email. thanks for watching the show!

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Md.: What are the suicide rates among the elderly? I ask out of concern for my grandmother-in-law. She is well into her 90s and lives with her son, who takes care of her. While I waited with her for her son and grandsons to pull the car closer and make sure the path is clear (Grandma has limited mobility), she told me clearly that she wanted to die. She said she didn't want to be a burden. She said she hated being herself. I tried to reassure her that she was anything but a burden, but I don't think she heard or understood me. In some ways, Grandma has it pretty good - a son who is devoted to her, and extended family willing to lend a hand, a somewhat sound mind (short term memory is faily), and a fairly sound body for her age. In other ways, I can understand her. She can't see well, hear well, walk easily, and simply getting to the bathroom can be a trial.

In response to the writer who asked who will take care of those who have no children, I can only answer for my husband and I who have decided not to have children. We will take care of ourselves. Since we do not have the expense of children, we are able to set aside significant sums of money so that we can hire the help we need if it comes down to that.

Miri Navasky: I'm not sure of the exact suicide rates among the elderly, but I know that it is a big concern. All the issues that you bring up with your grandmother we came across with many of the elderly. I think its so hard for that generation to depend on their family, no matter how devoted that family is. I know my grandmother - although lucky in many ways - had similar feelings. She did NOT want to be a burden. I would, though, let her doctor know about these feelings - or maybe talk with her and her doctor together. Geriatricians and family physicians who treat the elderly and are good at what they do, come across issues of depression all the time and should be able to help treat that depression. There are also geriatric social workers, psychiatrists and etc...all of whom could be helpful for you to talk with. Much luck to you. It sounds as if your grandmother-in-law is lucky to have such a lovely and caring family.

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Washington, D.C.: To the other Washington chatter who has parents who are unwilling to discuss things, I can only offer this.

My father has become very very ill. And I've noticed both he and my mother being very optimistic in their approach to doctor's visits, treatment, future planning, etc. Meanwhile I know that it's time to get down to the awful business we all dread. I cannot force them there. And ultimately, it is his body, and his approaching end-of-life. I can't force him to the place that I am at, and can only best try to control my response and my own planning for my own old age/illnesses.

Best of luck, and enjoy your thanksgiving.

Miri Navasky: thanks for adding this to the discussion. I also want to add that sometimes doctors can be very helpful in getting these conversations going. So it might be worthwhile to go along for a doctors visit with your parents if they will let you.

happy thanksgiving to you too.

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Ottawa, Canada: Hello. I really enjoyed the show, which I started watching part-way, will have to watch again. My mother is a widow, early 80s, still living at home alone, and is showing signs of dementia (memory loss, confusion, etc.). However my siblings and I prefer for her to live in her own home, as opposed to moving to a senior's residence. We know my mother is lonely sometimes, but she is a very private person. Our dilemma is knowing when will be the good time to move her into a residence (hopefully with her agreement). Any advice would be appreciated. Thank you.

Miri Navasky: What a difficult question and my guess is that you will know much better than I would. We saw a lot of people who were able to stay home very successfully with help - even with a progressing dementia - for much longer than i would have thought possible, and others who didn't move until a crisis forced them to. Though it sounds as though you're on top of it - and staying close by - it might be helpful to check in with a doctor, social worker or geriatrician about any safety concerns you might have.

thanks for watching and writing.

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New York, N.Y.: There were so many tangents to your report, that it seems a whole series on aging is badly needed. Do you plan others?

Miri Navasky: YES. Frontline did a couple of reports years ago, but as we have discussed repeatedly there, this is an issue Frontline is going to be addressing over and over in the coming years. Especially as the baby-boomers continue to age in unprecedented numbers. But feel free to send any thoughts, suggestions, ideas our way. Always appreciated. thanks for writing.

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Midland, Mich.: Thanks for doing such a good job responding to important questions such as the one on suicide. Please consider having such Q&A sessions periodically or - if you have not already -posting the URL of a resource or resources which will have such sessions. (Sorry that I haven't yet read the resources you've posted.)

Miri Navasky: You should definitely look at the Web site Living Old- as there are many many great resources there. Its actually one of the most comprehensive Web sites I've seen on these issues. thanks for writing.

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Louisville, Ky.: I've been reading some of the reaction to last night's show and wonder if you think there's sufficient public response to the program and the issue to encourage you that Living Old should not be your final work on the subject?

Miri Navasky: YES!! We've already begun discussions about this with Frontline. We will be doing more shows on issues of aging in the future, but i also think as a society, we need to be having a national conversation about some of these issues. Its a universal concern. thanks so much!

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Annandale, Va.: This documentary scared, but informed me. I am only 31 years old, but the part of getting old that scares me is the thought that I could not have mental capacity if I am blessed to live long. Will there be a second documentary covering the "planning aspects" theme further, especially for people in their 30s and 40s now?

Miri Navasky: Please look at the Web site, Living Old, its a great resource for all sorts of issues. I'm not sure of whether there will be a film specifically on "planning aspects" but hopefully we will do many more films that touch on these topics. thanks for watching!

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Minneapolis, Minn.: Here is something that puzzles me about aging and the current debate on immigration. Anyone who has visited a nursing home/retirement community will know that many of the employees are non U.S. citizens. Americans are no longer having enough babies to replace/care for/attend the aged. So, in 20 years where will the work force to care for the aged come from?

Miri Navasky: Very very good point. We were unable to address this in our film, but we found that, at least in new York city, when there were no family members to care for the elderly it was usually home-aides and nursing home attendants, most of whom, as you said, were immigrants - and in many cases not US citizens. This same population seems to be taking care of both our babies and our elderly. I'm not sure that this is just because there aren't enough workers, or kids to care for family members, i think its actually the way we value the job and thus, pay or - in this case - don't pay for it. We need to value and pay for caretaking in our society, much more than we do. Leon Kass does a spectacular job in his report Taking Care - of discussing this. Please see it on Web site Living Old. thanks for your insightful comment.

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Rockville, Md.: I hope you can squeeze this in...

I missed parts of the program, did you touch upon the aging of the mentally ill and the exponential strain it puts upon the immediate family?

I ask as the wife of a mentally ill man, who in his 40s is a nightmare, and I find myself wondering if he is trying to kill me off early from the stress. Or if he will simply get so much worse as he ages that I'll simply walk off into the woods. His family currently blames me for HIS being bipolar and borderline.

Obviously, they are not supportive.

Miri Navasky: We did not. My big apologies, but we couldn't fit everything into this one hour. Though what a difficult issue. We did do another film, but it was only mentally ill in prison, not on the aging population. A very important topic that i hope we can visit sometime in the future. Best of luck to you and yours.

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Salt Lake City, Utah: Sir, in your show, you talked about the shortage of doctors who work with elderly people. What's being done to solve this issue? Are there programs being set up for tuition assistance or anything like that to get people into the career field for helping elderly folks?

Miri Navasky: very very important issue. Geriatricians are now trying to train other doctors to learn how to handle elderly patients better. And medical schools are starting all sorts of humanities programs to try and instill different values into the training. As well, i think there are some loan forgiveness programs starting out there, but we have to do a much better job as a society of valuing (and teaching) this kind of work rather than just specialty medicine or good, young doctors are not going to go into this field. thanks for your thoughts.

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Arlington, Va.: Good morning. The Frontline program last night was very powerful, and very familiar. I am in my mid-50s. I have an aunt with severe dementia living in a nursing home in Virginia; and a father who has suffered multiple TIAs, has mild dementia and is in a nursing home in Maryland. Both are on Medicaid and I share Power of Attorney responsibilities with two of my siblings. We also have a mother who will soon need an assisted living facility, but will not be able to cover the costs. Neither I nor my siblings is in a position financially or physically to care for any of these relatives at the 24/7 level of care that they now or will need. And the guilt that creeps in sometimes is overwhelming. I know my situation must be multiplied thousands of times throughout this country, but I don't get the sense of any nationwide urgency of how we will cope with the press of the medical, financial, emotional needs of our aging population. Having dealt with medical, local, state and federal agencies to help my relatives find good care has been overwhelming and pulled back a curtain where see there truly is no wizard who will fix everything now or for the majority of us who are about to join the ranks of the "elderly." I am also concerned with the attitudes of those who are not in the older age groups. I currently am coping with an ankle injury that requires I wear a walking cast and use a cane. I am amazed at how many younger people will pass me by to get on the elevator first, push past me on the escalators and sidewalks, and sit unaware in the "reserved" Metro seats as I struggle to keep my balance. It is very disconcerting. When is the wake up call going to come to our nation's leaders, to our nation as a whole? Please tell me there is a glimmer of hope somewhere!

Thanks.

Miri Navasky: Thank you so much for sharing this. I must say that the making of this film completely changed my attitude about the elderly. Embarrassingly enough, prior to this film, I probably didn't stop enough on the street to help out an elderly woman in need, or didn't take that extra five minutes that could make such a big difference, so i hope our film helps others to do more of that. I agree much more conversation is needed about these issues. Please go to our Web site Living Old to find more organizations that are trying to begin discussions.

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Takoma Park, Md.: I am constantly amazed at the contribution Frontline makes to the general public with their programs. This one was no exception. I cried through most of it remembering my mother who died in 2005 at the age of 86 while trying to regain her strength in a nursing home after retaining so much water that her lungs filled up and her electrolytes were out of balance. She developed a urinary tract infection in which they gave her too low of a dose for only 5 days. At day 10 she became almost catatonic. The nurses said she was just tired but we insisted she be sent to the hospital. When they tried to do a urine culture, with my sister present, my sister said the sample looked like cream. She developed sepsis which reached her heart and she died two days later. She so desperately wanted to go home and even though she had 4 doting daughters, she still died in the hospital. The most frustrating thing is that all the nursing home care workers we dealt with were wonderful and caring, there just weren't enough of them and I know they make next to nothing. Your show certainly did frighten me being single with no children. I'm hoping as being part of the baby boomer brigade, that we as a whole will do something to turn this around but I really don't know where to start.

Miri Navasky: Thanks for your comments and for sharing your personal story. I do think, as everyone told us in the making of this film, your generation - the baby boomers - are going to have to be the transformative generation. In terms of your own fears - the only thing i can say is that i have had the same experience, the home aides, home attendants, nurses and doctors that we met along the way , had become like family members to many of the elderly and were some of the most caring people i have ever met. But i agree, there are not enough of them. Hopefully this film will help start/continue this much needed conversation. thanks again for writing and good luck.

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Tampa, Fla.: Miri,

Very smart and sensitive film! Leon Kass was just the right moral anchor for it, inasmuch as his views are reflective and not pedantic. Where do you go from here?

Miri Navasky: thanks so much, we felt the same about Dr. Kass. Please see the Web site to read more of his interview and more from his report Taking Care Living Old. Not sure where we go from here, but hopefully my co-producer Karen and I will delve deeper into some of these issues. thanks for writing.

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Washington, D.C.: Ms. Navasky,

Thank you for your program. My heart goes out to you for the loss of your grandmother.

I have a question about the man who passed away from lung cancer. There was no further information on the Web site about him. Can you tell me how long he had been sick when he was interviewed?

Miri Navasky: Thank you. I was so surprised and unprepared for the death of my grandmother, despite the fact that i was working on this film. Wayne Elliot is the man who passed away from lung cancer. I believe he had been very sick for over a year when he was interviewed. We had actually met him in the hospital a couple of months prior and his family was just then making the decision with him about whether to go on hospice or not. thanks for watching and writing.

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Rockville, Md.: No children to care for one?

My wife and I are in our 60's and without children. However, our experience has been that people with strong church families often do better than those with children at a distance. People with many friends seem to do the best.

My mother, who stayed in assisted living places, said she had never been happier - and she had a lot of friends. She was in a nursing home for a few weeks once in an emergency transition caused by a fire, and she hated it.

What are your thoughts on this approach?

Miri Navasky: thanks for your question. I think it depends on the person and probably the home. We did find that isolation and loneliness was one of the hardest things for the elderly to deal with (beyond loss of independence). So my guess would be that anything that can mitigate these things would help. One of the women in our film was 99 years old and living fine on her own, actually put herself into a nursing home because she wanted to be around more people. She really thrived there and is now 100 and still doing quite well. You can read more about her, clara singer, on the Web site Living Old. Thanks for writing.

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Cassopolis, Mich.: If you make a living will, instruct children to follow your wishes about prolonging life.

Tell your doctor your thoughts on quality of life. You expect your wishes to be carried out. What more can you do?

Miri Navasky: Seems like you've done a lot. I guess the only thing would be to make sure your children understand what your desires are. And know that sometimes, unknown issues can come up and that you might change your mind - which you are totally free to do. thanks for writing.

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Franklin, Ohio: I am 58 years old and have a mother that is 89. She has crippling arthritis; and more meds than you can count on the fingers of your hands - pace maker etc.

Her physical weakness is forcing a transition from assisted living to a nursing home. It is not a two way street.

I am struggling with having been the primary care-giver to my mother for about 5 years.

Your documentary on the challenges of getting old; and the sociological and social issues; and familial issues deeply touched me.

I cried and cried - and as a male that is not supposed to be - but it made me feel - more at peace with myself - to know that there are so many other people of my generation and prior generations that have experienced this prolonged since of loss - as you watch your mother or your father slowly and irreversibly wither away.

Thank you for a wonderful work of art - describing this abysmal aging process - that we as human being will all face.

It is so hard to see a parent that has been such a strong force in your life - live to be a living relic.

My God is it hard!

Thanks again for your wonderful objectivity! As human beings. we are all stronger and more resilient if we understand the basic realities of life.

Great job and thank you for a job well done!

Miri Navasky: Thanks so much for sharing this with us. Your mother sounds blessed to have such a devoted son. It is hard. And in exactly this respect, it was one of the harder films we have done. Emotionally and otherwise. Again, thanks so much for watching and writing.

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Omak Park, Calif.: I heard the comment made that that Medicare took care of paying for one person's nursing home care or care in the home. Is this when the person has no more funds left to pay.?

Miri Navasky: This is a complicated issue, please see the Web site www.pbs.org/frontline/livingold for more about the funding issue. Medicare will pay some nursing home costs for a certain number of days for people over 65 in need of a certain level of care (i.e. sub-acute rehabilitation and etc...). Medicaid will also pay for nursing home care for people who have no funds to pay and are in need of long-term care. The average cost of a nursing home is now in the vicinity of $70,000/year so many people do run out of funds if they need extended nursing home care. thanks for writing, but do visit the Web site for more accurate and extensive information on the costs of care.

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Burbank, Calif.: Thank you for a great, educational show. I can identify. Between my 87 year old Mom, who has a 24 hour caregiver (fortunately, she has money saved and owns her condo) and a 20 year old son just entering the work force, life is interesting and very, very busy.

Miri Navasky: Thanks for writing. You are the sandwich generation!! So many people seem to be handling young children and older parents. Very impressive. Good luck with your mom and your son.

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Corvallis, Ore.: I want to express my appreciation to you, Ms. Navasky, and to the rest of your production team for airing a program about the elderly that was so honest, respectful, thought-provoking, sensitive, and beautiful. Such a program is a fitting tribute to your marvelous, life-affirming grandmother. Let me also express my deep appreciation to the elderly individuals and to their families who bravely allowed your cameras to come into their homes and care facilities.

My best regards to you, Miri Navasky, and to everyone else who contributed to 'Living Old'.

Miri Navasky: Thanks so much for your kind words. We too have deep appreciation for all of the elderly and their caregivers that allowed us into their lives. We think that they have contributed enormously to this important conversation!!

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Philadelphia, Pa.: Thanks for taking questions.

I work at Philadelphia's Area Agency for Aging. Obviously, the elderly population is growing, but our funding is increasing at a much lower rate. Older adults often have to wait up to one year for in-home services, by which time their health has often declined to such an extent that they require the level of care that only a nursing home can provide. Compounded with the fact that many people in Philadelphia cannot afford nursing homes or to pay out-of-pocket for in-home care, I can only see this situation getting worse in upcoming years. In your research, did you encounter any professionals or informal caregivers with innovative short- or long-term ideas regarding making long-term care more accessible?

Miri Navasky: Thanks for writing. Please see our web site Living Old for more information on organizations trying to tackle these concerns. Yes, i think there are all sorts of organizations that are trying to come up with solutions - whether new kinds of long term insurance, or different kinds of daycare programs, etc...but i think much more research and work has to be done! And our value system has to alter so that caretaking is better compensated. I know the visiting doctors program that we followed was amazing, but they could only help a fraction (!) of the elderly in the city. Hopefully this documentary will be part of an important conversation to come. Again, thanks for writing.

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Montrose, Colo.: Your film was riveting and excellent. Everyone should see it. It helped me to know I'm not alone in my difficult decisions. I care for my elderly mother who has dementia and have done so for 6 years. It's an honor to be able to provide this care for her. I have no children, though, and wonder what will become of me. Your program addresses the heart of this matter and that is, quality of life. It's a decision we all need to think about and decide for ourselves in advance. Thank you.

Miri Navasky: thanks so much for sharing your situation. Good luck to you and your mother. In terms of your own future, we did meet the most wonderful home-aides, nurses, doctors and social-workers who had become like family members to many of the elderly we met. Hopefully we will better compensate these people so that more of them can be trained to do the kind of caretaking work that will be needed. Thanks for sharing and writing.

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Philadelphia, Pa.: The program didn't mention the Oregon State choice-professionally aided suicide which is legal there. The question was never asked in such direct terms. Was this deliberately omitted for political reasons or was it an oversight? There were some opaque suggestions of preferring 'natural' deaths without medical intervention, but the Oregon choice wasn't put forward to those patients who still had mental clarity and ability to make the decision on their own.

Miri Navasky: Thanks for writing. I agree this is an incredibly important issue and the assisted suicide comes up again and again. But no, this was not omitted for political reasons and actually we did try and address it fairly directly at the end of our film. But we also felt, honestly, that assisted suicide demanded an entire film in and of itself. There is more on the issue on our web site, but more to the point Frontline has done many films on this issue - and my guess would be that we will do many more. please see the web site www.pbs.org/frontline for more and hopefully we will do a more current film on it in the future. thanks for writing.

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Washington, D.C.: Congratulations on a sensitive and thought provoking doumentary. Aside from your wonderful grandmother, how did you achieve such intimacy with your interview subjects? What techniques would you recommend for filmmakers working with the very old?

Miri Navasky: Thanks for writing. Karen O'Connor, my co-producer, did most of these interviews with the elderly, and honestly, she just has a way with people. But I would say that many of the elderly also very much wanted to talk about some of these issues and if you gave them the time needed (which sometimes was a fair amount) generally, they were very happy to talk. For others, aging was the last thing they really wanted to talk about, so, like all people, we just had to follow their lead and go where they wanted and were willing to go. thanks for noticing the quality of the interviews. Very appreciated.

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Arlington, Va.: Do you know if and when PBS will air this program again? I didn't know it was on until I saw your blog. Thank you

Miri Navasky: Thanks for writing. Please check your local station for re-run information. Generally the shows do run, but it is up to the local station to find a time. It is also streamed now in full via the Internet at Living Old.

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New York, N.Y.: I wanted to let you know that you did a remarkable job with this program. Having lost my mother to cancer two years ago and having an elderly father, I am well aware of the issues facing elderly patients and their caregivers. Yours was such an in-depth look at these issues and went well-beyond the usual "aging, sickness, hospital stay, nursing home" expectation of those unaware of the intricacies of eldercare. You touched on both the facts & the emotions which affect how we handle these difficult situations. Kudos to you and your staff. Regina.

Miri Navasky: thanks for writing. Good luck with your father. We very much appreciate your kind comments.

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Louisville, Ky.: Two moments keep replaying in my mind's eye...the elderly man struggling to tell his doctor about his incontinence and then forgetting what he was talking about (devastating!) and the 99 year old woman describing so perfectly why she likes being alive. Both are absolutely amazing moments! Thank you.

Miri Navasky: thank you!! They are two very amazing people as well. thanks for watching.

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Miri Navasky: Sorry that we couldn't answer more questions. Thanks for watching though and please visit the web site Living Old for more information. There is a great wealth of resources there. As well, you can submit any more comments about the film.

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