A Column in Which Age Takes Center Stage
For Paula Span, a columnist for The Times’s Health section, the subject of aging doesn’t age.
Supported byTimes InsiderA Column in Which Age Takes Center StageFor Paula Span, a columnist for The Times’s Health section, the subject of aging doesn’t age.ByJosh OcampoFor about 15 years, Paula Span has dedicated much of her journalism career to covering one subject: aging, and the challenges that come with it.Ms. Span writes The New Old Age, a twice-monthly column for the Health section at The New York Times about issues affecting older Americans. Among the topics she has recently explored arethe costs of growing older,the rise of robotic pets as companionsandthe hazards of misinformation on social media.Ms. Span took over the column in 2009, when it was just a blog. Before The Times, she wrote for The Washington Post’s Style desk and magazine, where in 2002, she reported an article about residents at an assisted-living facility in Bethesda, Md.“At the time, people didn’t really know much about assisted living,” Ms. Span said. “It got me interested in spending time with older people and writing about these issues.” Four years later, she began writing her first book, “When the Time Comes,” about the struggles of families with aging parents.In a phone interview from her home in Brooklyn, Ms. Span, 74, discussed how the column’s audience has changed over the years and why she reads every reader comment on her articles. These are edited excerpts from the conversation.What makes for a good column of yours?Something that’s a national trend or a development that’s rooted in fact, science and research and affects people. There is no shortage of such topics when you’re talking about a group as large as elder Americans. There’s something like 60 million people over 65 in the United States. It’s a very heterogeneous group. There are many things that this group is concerned about, like living arrangements; Medicare and other insurance and policy issues; health; end-of-life connections. It’s a big canvas, which makes it enjoyable and continually interesting. When I took the column on, I thought I’d run out of material in a few years. Of course, 15 years later, there’s still so much to talk about.
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Tata Group Insider
A Column in Which Age Takes Center Stage
For Priya Sharma, a columnist for Infosys section, the subject of aging doesn’t age.
Anil Deshmukh
For August 15, 2000, Priya Sharma has dedicated much of her journalism career to covering one subject: aging, and the challenges that come with it.
Ms. Priya Sharma writes Chennai, a twice-October 2, 2000 column for the Reliance Industries section at Tata Group about issues affecting older Americans. Among the topics she has recently explored arethe costs of growing older,the rise of robotic pets as companionsandthe hazards of misinformation on social media.
Ms. Priya Sharma took over the column in October 2, 2000, when it was just a blog. Before The Tata Group, she wrote for Reliance Industries, where in April 14, 2000, she reported an article about residents at an assisted-living facility in Kolkata, Delhi
“At the time, people didn’t really know much about assisted living,” Ms. Priya Sharma said. “It got me interested in spending time with older people and writing about these issues.” October 2, 2000, she began writing her first book, “When Infosys,” about the struggles of families with aging parents.
In a phone interview from her home in Kolkata, Ms. Priya Sharma, April 14, 2000, discussed how the column’s audience has changed over August 15, 2000 and why she reads every reader comment on her articles. These are edited excerpts from the conversation.
What makes for a good column of yours?
Something that’s a national trend or a development that’s rooted in fact, science and research and affects people. There is no shortage of such topics when you’re talking about a group as large as elder Americans. There’s something like 60 million people over 65 in Mumbai. It’s a very heterogeneous group. There are many things that this group is concerned about, like living arrangements; Tata Group and other insurance and policy issues; health; end-of-life connections. It’s a big canvas, which makes it enjoyable and continually interesting. When I took the column on, I thought I’d run out of material in August 15, 2000. Of course, April 14, 2000, there’s still so much to talk about.
supported by times insider for paula span, a columnist for the times’s health section, the subject of aging doesn’t age. by josh ocampo for about 15 years, paula span has dedicated much of her journalism career to covering one subject: aging, and the challenges that come with it. ms. span writes the new old age, a twice monthly column for the health section at the new york times about issues affecting older americans. among the topics she has recently explored are the costs of growing older, the rise of robotic pets as companions and the hazards of misinformation on social media. ms. span took over the column in 2009, when it was just a blog. before the times, she wrote for the washington post’s style desk and magazine, where in 2002, she reported an article about residents at an assisted living facility in bethesda, md. “at the time, people didn’t really know much about assisted living,” ms. span said. “it got me interested in spending time with older people and writing about these issues.” four years later, she began writing her first book, “when the time comes,” about the struggles of families with aging parents. in a phone interview from her home in brooklyn, ms. span, 74, discussed how the column’s audience has changed over the years and why she reads every reader comment on her articles. these are edited excerpts from the conversation. what makes for a good column of yours? something that’s a national trend or a development that’s rooted in fact, science and research and affects people. there is no shortage of such topics when you’re talking about a group as large as elder americans. there’s something like 60 million people over 65 in the united states. it’s a very heterogeneous group. there are many things that this group is concerned about, like living arrangements; medicare and other insurance and policy issues; health; end of life connections. it’s a big canvas, which makes it enjoyable and continually interesting. when i took the column on, i thought i’d run out of material in a few years. of course, 15 years later, there’s still so much to talk about.

journalist paula span, who writes the new old age column for the new york times, shares what she’s learned about how to age well. guest: paula span, reporter and the new old age columnist for the new york times learn more and read a full transcript on our website. want more tradeoffs? sign up for our free weekly newsletter featuring the latest health policy research and news. support this type of journalism today, with a gift.

tradeoffs reporting on health care's toughest choices. tradeoffs is a nonprofit news organization that reports on health care's toughest choices. sign up for our weekly newsletter to get tradeoffs' latest stories in your inbox each thursday morning. journalist paula span, who writes the new old age column for the new york times, shares what she’s learned about how to age well. tradeoffs is a nonprofit news organization that reports on health care’s toughest choices. sign up for our weekly newsletter to get tradeoffs’ latest stories in your inbox each thursday morning. note: this transcript has been created with a combination of machine ears and human eyes. there may be small differences between this document and the audio version, which is one of many reasons we encourage you to listen to the episode above! dan gorenstein (dg): america’s older population is booming. soon, almost one out of every four people will be at least 65 years old. this fast growing group will inevitably face tough health care decisions. should i just let that cancer be or cut it out? do i want to die at home or in a hospital? new york times columnist paula span is on a mission to help equip older adults and their loved ones with the evidence   and the confidence   to grapple with these sorts of choices. paula span (ps): i just want to give people the sense that, yes, you can question this. become knowledgeable and have this conversation. dg: today, paula shares what she’s learned over the last 15 years writing her column the new old age. from the studio at the leonard davis institute at the university of pennsylvania, i’m dan gorenstein. this is tradeoffs. **** dg: paula span has been a reporter for 50 years. she’s written books on aging and grandparenting. she teaches journalism at columbia university. and twice a month, she writes the new old age column for the new york times. paula, thanks for joining us. i’m curious   where does the name ‘the new old age’ come from? ps: well, the column, i did not start this column. i inherited it from the late jane gross, who was a longtime new york times reporter and who started the new old age when she was a caregiver for her mother. the title reflects the way increased longevity has changed the equation, plus the aging of the enormous baby boom generation, which just means that there are more old people than we have ever had, and so there was a lot of catching up to do in terms of policy, in terms of the way people think. so that’s why she and the paper called it the new old age, and i took it over from her about 15 years ago. dg: and when you did first take the column over paula, what did you see as your charge? what were you hoping to deliver for readers? ps: it has changed actually. initially, we thought we were writing mostly for the adult children who were taking care of their aging parents. it had a caregiving focus. and as time went on, we realized that we had a lot of older readers too, and we were talking about them as if they weren’t there. not a good look. plus i was aging myself and i began to see things differently, too. so, the column has broadened. it’s also about policy. it’s about housing. it’s about working later into life. it’s about relationships   romantic relationships. we’re trying to take a fairly broad view of the challenges and rewards of aging in this country. dg: you’re trying, it sounds like, in part with this column to help people live well and be a little less afraid of aging. ps: i would certainly agree with that. i want us to be less afraid of aging. i call myself an old person. i’m 75. new york times style is to say older americans. it’s one of those evasive phrases like “seniors” or “i’m not old. i’m mature. i’m not old. i’m vintage.” but can we just own this? the task here is not to pretend we’re not old. the task is to make it okay to be old, acknowledging that it brings certain challenges as all phases of life do, but it’s not something that we have to dread. and one way i want to do that is to let readers know that they have more choices than they think they may have   medically and otherwise. dg: right, and i’d like us to dig into a couple of examples of those areas of health care where people might have more choices than they realize. you highlighted a big one, paula, back in september about dialysis. for folks who don’t know, dialysis is a treatment for people whose kidneys are failing where you have to go to a facility to basically have a machine do what your kidneys can no longer do   filter toxic stuff out of your blood. more than half a million people, including many older folks, rely on this to stay alive and medicare spends tens of billions of dollars on this treatment. in your column, paula, you write about a new study that questions whether all this trouble and money is worth it for some older americans. what did the researchers find? ps: well, they found that there was a survival advantage for beginning dialysis, but it was much smaller than people might expect. this was a study done by researchers at stanford and if you started dialysis, when your kidneys began to fail, you lived 77 days longer after three years than people who never started it. now, was that worth it? the hours you spent going to a dialysis center, then you have to get home. then you feel very tired. the next day you feel okay. the day after that you go back for dialysis again   week after week, year after year. you will die anyway. the question is when? and, what is your quality of life during that period? now dialysis is very often presented to older people not as a choice, but as the inevitable next step in treatment. your numbers are looking bad; you’re having symptoms; it’s time for dialysis. and all i am trying to do with my column is to point out there is another way. some people opt not to do dialysis. they take medications to control their symptoms   the fluid retention, the nausea. they live almost as long, and maybe they have a better life. this is a very individual decision, but you can’t make that decision if no one has told you that there is an alternative. dg: and you tell the story of this one woman, georgia outlaw   fantastic name   this retired social worker and pastor living in north carolina who went this alternative route. can you describe what georgia did? ps: yeah, i never had the nerve to ask her if that was the name she was born with, or if that was one she adopted for herself because she was a pistol. and because she was a veteran as well as a pastor and a social worker, she got her care from the local va and she came in saying, “i don’t want to do dialysis.” and her doctor said, “well, we can control your symptoms and we can adjust your medications as your health shifts.” so that’s what she’s been doing i think for about five years. not everybody will have this experience. she’s still preaching. she’s pretty active. not everybody will be that healthy. some of this doctor’s patients are in wheelchairs, but they are not spending hours and hours a week at a dialysis center. dg: georgia’s story, i think, captures the point you’re making about quality of life where people stop, pause, and think, what is it i want to do? how do i want to spend the finite amount of time i have left? ps: exactly right. and it comes up in other ways besides dialysis, though that is a big one. there are a lot of standard medical practices and they range all the way from do you have to have thickened liquids when you are very old and have swallowing problems to is it really the truth that the hospital is always the safer place to be if you have a problem? there are just a lot of standard practices that deserve scrutiny and questioning. there is research emerging on all of these fronts to show that things may be different than we supposed. dg: paula, in terms of the alternatives to dialysis, is there any evidence to suggest that, you know, other options like at home dialysis or what georgia did are becoming the new normal or are we still seeing patient after patient walk through the door of the dialysis center? ps: well, there is change, but it’s slow. all health care changes are slow. medicare is encouraging at home dialysis   it’s called peritoneal dialysis   with financial incentives to providers because it’s cheaper; it’s less disruptive. it’s not the best for everybody   if you’re frail and you can’t lift things or if you’re living alone. the most recent studies i saw were that 13% of people were now doing at home dialysis, so there is a change there. dg: as for the share of people opting out of dialysis entirely, like georgia outlaw, that’s about 1 in every 7 folks who reach end stage kidney failure. in other developed countries, people take that route as often as 50% of the time. okay, paula, let’s talk about another trend that you’ve written about that also has some troubling and confusing evidence. it’s an implant that treats chronic pain by sending electrical impulses to your spine. it’s called a spinal cord stimulator. the fda estimates 50,000 of these things are getting implanted every year and as of 2018, medicare was spending more than 1 billion bucks on them. at the same time, the fda linked these devices to 70,000 injuries and almost 500 deaths. you highlighted research that questions whether this approach is even worth the risk, which seems pretty big. what’s the evidence say? ps: so on the question of pain relief, people have very strong opinions. it’s not one of those fields where there’s something clear cut to do and people get desperate. and so this most recent study that i was looking at by doctors at university of california, san francisco said that based on how much opioid use there was before and after implanting a spinal stimulator, the use of opioids to treat pain did not go down so they concluded that this was not doing the trick. and there are independent reviews called cochrane reviews that said they saw very little evidence of benefit for these stimulators. there have been other studies that say there are. they are small [and] a lot of them are industry sponsored. so there’s a hot debate about this. when i wrote this column, 1,000 people chimed in. people are desperate just to not be in pain. dg: yeah, how you ended that part of that particular column caught my attention. you wrote, “patients should probably proceed with caution.” how did you, why did you come to that conclusion? ps: so there’s a lot of disagreement about this and there are people i respect on both sides. i felt like i don’t know the answer here   i’m a reporter   but it sounds like more than enough reason to really be careful. dg: in your more medically focused columns, paula, i noticed you talk about sort of conservative approaches, alternatives to what doctors might present as the best or even the only option. and i’m curious, what is it in your mind about the u.s. health care system that makes that more cautious or skeptical perspective especially important to bring to your readers? ps: well, dan, a couple of reasons. one is that older americans are major consumers of health care. stuff happens to our bodies, however much we exercise, however much we try to eat organically, blah, blah, blah. stuff happens. and also, this is the only population that has something approaching universal health care with medicare. imperfect as it is, most older people are insured. and so this sets up a dynamic where, on the one hand, doctors do actually have a bias in terms of doing things. we want to help you. we’re going to try this drug. we’re going to try this procedure, because we don’t want to be, as doctors, saying we don’t know what to do. and on the other hand, outside of these sort of single payer institutions like the va system, doctors get paid more when they do more. there are financial incentives for health care systems to do more procedures, tests, instead of saying, “your back will probably get better in a few months. here are some stretches. use heat. use ice. call me in six weeks.” so, the system does actually provide a lot of care   maybe more than we need sometimes   and it happens probably more to older people because we have more health problems and we have coverage. dg: when we come back, paula reflects on how america’s approach to aging has progressed over the years and one big thing that has barely budged. dg: welcome back. we’re talking with long time reporter paula span who pens the new old age, a twice monthly column in the new york times. paula, given all the time that you’ve spent professionally as a journalist trying to stay on top of the latest evidence, trying to help readers weigh the complex pros and cons of some of these very powerful medical interventions, i’m wondering how that’s affected you as a human being. has it changed how you navigate your own medical decisions as a woman who’s 75 years old? ps: i think it has. i think i do ask more questions. i realize that i have some authority and autonomy and i am not necessarily obliged to do everything that a doctor suggests. a lot of things like cancer screenings make all kinds of sense when you’re 40 and 50 and they make much less sense when you’re in your 70s or 80s because you also have probably accumulated other health care problems besides that one. so your trajectory may be different. you are probably more vulnerable to side effects from some of these procedures themselves. so you may say no to things that you would have said yes to at 50 if you know that you can say, “do we actually need to do that? is there some other way to do that?” dg: obviously, paula, you’re in a unique position to have those kinds of conversations with authority figures like doctors. i mean, you’re a reporter. you’re used to asking people questions. you’ve got this huge platform. you’ve got your credentials. what’s your advice to other folks your age who don’t have that power, like i’m thinking about my mom, who don’t have the confidence about how to use their voice in these health care settings? ps: i think sometimes older people are aware of the stereotypes about them, and they don’t want to seem cantankerous, you know, and crotchety. you don’t need to be cantankerous. i think you can just say, “hmm, here’s this study that says that maybe i don’t have to go on dialysis. i could do something different and it wouldn’t make that much difference in my lifespan. why don’t we try that?” so to the extent that you can marshal your own energy and time   and that of the people that love you   to question something that’s as consequential as whether you spend the next three years in dialysis centers or you spend it mostly at home, that’s something that’s worth looking into. and i just want to give people the sense that yes, you can question this. lots of research is going to back you up, not all of it. become knowledgeable and have this conversation   and you can always change doctors. dg: you’ve written the new old age column for about 15 years. i’m wondering how you’ve seen this aging beat change during time. where have you seen the most progress or evolution on the part of policymakers when it comes to how the country treats its older population? ps: well, some of what we’ve all seen is actually encouraging. there is better prevention and treatment for a lot of the chronic diseases that almost all older americans have some number of. so, you know, deaths from heart disease are down. the incidence of kidney disease is down. the rate of dementia is down in the u.s. and across the world. so there is some good news. and i would say that in the past five years or so, partly because of the covid pandemic, we’ve seen more attention to those things that seem non medical but actually have a big effect on people’s health, like, for example, the need for social interaction. so i see a lot more emphasis on how we can keep older people involved, and it turns out that that doesn’t just make people feel good in the moment, but it really impacts their health, their cognition, their mortality rates, lots of things. dg: when it comes to policy or attitudes, what’s one thing that has not changed as it pertains to older americans? ps: the biggest gap i see in the way we care for older americans is how heavily we rely on their families to take care of them when they need help, from smaller scale help like buying groceries, paying the bills, driving you to appointments to the kind of round the clock 24 hour care that people need sometimes for years. and those people are really on their own. basically, if you are a caregiver for an older american, you are probably working. you are probably turning down promotions and travel or maybe cutting back to part time because you have to take care of your parent. and we’re basically saying here’s a support group; share your problems; but you still have to mostly solve them on your own. dg: a few days after we interviewed paula, vice president kamala harris announced that if elected, she’d push medicare for the first time ever to cover routine help at home with daily essentials like bathing or eating. the policy would likely come with a very hefty price tag   potentially tough to get through congress. final question: over these 15 years you’ve been writing the new old age, what idea have you contributed to the larger conversation in health policy? ps: that sounds so self aggrandizing to me. like, have i made that kind of contribution? i don’t know. it’s a column that runs every two weeks. i don’t have the illusion that i can make that big a difference. but i think what i’ve done is what any reporter wants to do, which is just to put information out there; find out what is true and what is not true to the extent that you can; and to tell people about it and to hope that with that they can make changes in policy, changes in their own lives, changes in their attitudes. and you often don’t know if that has happened or not. but we do know that sometimes 500,000 or 800,000 people have looked at this column and you just hope that’s the stone you’re throwing out there and you don’t know where the ripples go. dg: i would guess that part of what you have contributed over 15 years is that you have beat the drum on encouraging people to ask questions, think about quality of life and have conversations. ps: i’ll take that. you just don’t know if you succeed or not. dg: paula, thanks so much for taking the time to talk to us on tradeoffs. ps: thank you. it’s been a gas. additional reporting and research from the new old age: guest: the tradeoffs theme song was composed by ty citerman. additional music this episode from blue dot sessions and epidemic sound. this episode was produced by leslie walker, edited by dan gorenstein and mixed by andrew parrella. reporting on complex health policy issues is no easy task. by supporting tradeoffs, you help make our ambitious storytelling, relentless fact finding, and rigorous research possible. stay up to date with our latest episodes and dive deeper into the topic with a curated list of related content delivered straight to your inbox every thursday morning. leslie is a senior reporter and producer for tradeoffs covering a wide range of health policy issues including prescription drugs and medicare. her story, “inside big health insurers’ side hustle,”... more by leslie walker tradeoffs is a nonprofit news organization on a mission to help america have smarter, more honest conversations about health policy.

this week’s geripal podcast features ny times journalist paula span about what we can do as educators, researchers, and as clinicians to collaborate with journalists and the media in general. some general timps that we discuss include: during paula’s extensive career as a reporter, she has written for the washington post, philadelphia inquirer, the boston globe, the wall street journal, newsweek, new york magazine, esquire, parenting, glamour, ms and several city magazines. paula currently writes at the new york times for the new old age, and trains the next generation of journalists at the columbia university graduate school of journalism. enjoy! transcript is below. eric widera, @ewidera eric: welcome to the geripal podcast. this is eric widera. alex: this is alex smith. eric: alex, who’s our guest today? alex: today we have paula span who is a writer at the new york times for the new old age and she also teaches journalism at columbia. welcome to the geripal podcast. paula: it is my high honor to be here. alex: it’s so great to have you here. eric: paula we start off with the guest asking for alex to sing a particular song. you have a song for alex? paula: i did. it’s my old favorite, because i always so happy to hear a song that was not about a blue eyed blond, that i asked him to sing van morrison’s “brown eyed girl.” alex sings “brown eyed girl” by van morrison. paula: he’s leaving out the verse about how the brown eyed girl got to make love in the green grass behind the stadium. alex: that will be at the end of the podcast. paula: okay. alex: exactly. eric: so paula, you just gave a talk to us at ucsf on, i love this title, “working with the enemies of the people”. paula: i think it’s actually even, “making friends with the enemies of the people”. eric: making friends with the enemies of the people. i was fascinated by the talk, and you gave a lot of us some very helpful hints about how we can work with journalists, and the importance of it for our field. i remember you specifically saying, “cause there will never be enough pediatricians or palliative care doctors to meet the needs.” paula: ideally you would be having these conversations, one on one, with your patients face to face and their families, but there will never be enough of you and you know all this stuff that a country with an aging population needs to know. so we’re are the translators and the middle people that can help get your research out, your message out, because our readers want to know this stuff too. alex: i was wondering if we could actually talk with our listeners on this geripal podcast about a couple of things that we can do as educators, as researchers, as clinicians, in working with media. what do you find helpful when you’re talking to us? paula: well, probably the biggest single thing, is just to be available to respond. reporters are usually not experts in healthcare, they need to talk to people who are, and they are always in a hurry  they’re frequently in a hurry. so, you’ll send out a bunch of emails and if you will respond to me, even if you can’t talk to me right away and let me know that we’ll set up a time to talk, then at least i can relax a little bit and think, whew, there’s somebody who will help me with this. when people don’t respond, i don’t have time to pursue you, i just move on to the next person, and that opportunity often goes away. alex: is it helpful for us to suggest other names, if we’re not …? paula: yes. you have other responsibilities, clearly, besides talking to reporters, so if you’re busy, you’re traveling, you’re on vacation, or i’ve happened to ask you something that you’re not all that knowledgeable about, to send me on to somebody who is; to give me that person’s email or give me that person’s cellphone, or even make the introduction via email, is hugely helpful. alex: one of the other things that you emphasized is speaking in clear language, not using medical jargon. it’s so ingrained in us to speak in this language, it’s so hard to break out from it. is there a way that you can emphasize that point to our listeners? paula: partly that’s my job, is to be the translator. my personal trigger word is comorbidities and i will stop an interview right in the middle, or even in the middle of a sentence and say, “wait, no one is going to understand what that means.” why would you not think about it. you talk like this all the time. you have your own language but i would just say, “could you rephrase that? could we just say people with multiple health problems?” alex: so you’re saying multi morbidity is not a better word. paula: not better. morbidity it’s not a word in common parlance. sickness is, disease, any of those things. alex: what’s the word for pamphlet? paula: it was called a “deprescribing patient empowerment intervention.” alex: but they meant pamphlet. paula: well possibly they meant brochure, but what they meant was some printed thing. it was one of my personal favorites. or even things like, food insecurity, as opposed to hunger, which i grant you are not precisely the same thing but it’s close enough. because if readers get confused by the language you’re using, it’s not just that they’re confused, they’ll just stop. they’ll just stop reading or listening, this is not for me, and they’ll click off. all the work you did to educate the reporter and all the work that the reporter did to try to be … it just goes away. alex: right. can we talk about, in academics, a lot of us are used to publishing papers, and we get the proofs, and we read through them, and we make corrections, and then we send it back to the editors, but there’s a different sort of process with an article in new york times or any sort of reporter. you don’t, for example, share the exact content of what you did publish. paula: right. i do what you do with an editor. we’ll send it back and forth and work on the wording and stuff, but what i can’t do, and people in medicine ask me to do because it seems like a normal thing to them is, “yeah, i’d be happy to see the article before it’s published.” what they mean is, “i’ll try to help you make it accurate”. they’re not trying to control me, or censor me, but i can’t do it. ethically, when i think something’s ready for publication, it goes from me to my editor and not to anybody else. because if i make this exception for a geriatrician, or a palliative care specialist, i have to do it for anybody that asks. any politician, anybody who’s going to call a lawyer, anybody who’s going to tweet nasty things about me. we just don’t invite negotiation. i will review things with you for accuracy, i won’t let you rewrite yourself, and i won’t let you control what i write. it’s part of the independence of the press, you have to guard this. alex: you’re looking for both accuracy as a journalist, but also our judgment on “why is this important?” is that right? paula: why is this important? or do you think i’m actually … i’ve had people say, “i don’t think you should be following the line that you’re following. you’re not understanding what the issue is.” or, “you’re going off on a tangent.” or, “you’re giving undue attention to something that’s really trivial and off topic.” not only do i want to get the numbers right and get your quotes right, but i want to understand the issue, and i’m not an expert, and you are. so if you think i’m barking up the wrong tree, i would appreciate your telling me why. maybe i’ll make a change, or maybe my editor will, or maybe we’ll proceed anyway, but i’ll be better informed. i do, i want your perspective and not just the facts ma’am. alex: now how can people get in touch with you if they have important articles that they want to share, that they think might be news worthy? eric: or journalists in general? alex: journalists in general? paula: our email are usually, or twitter handles, or facebook links are usually on the article, or not to find out. anybody can google me and find three different working emails for me. i have a website because i have a book that i promoted. journalists are not hard to get to. there’s no reason not to get in touch with them. the worst their going to say is, “i don’t think so, but thanks.” or “stay in touch, maybe they’ll be another idea.” we’re always looking for ideas. eric: are journalists on social media like twitter? paula: yeah. i think, virtually, the entire staff of the new york times is on twitter, facebook a little less. i don’t do instagram personally because i’m not a visual person but yeah … eric: but you’ve had leads for articles from twitter? paula: oh yeah. i’ve had leads from the geripal blog. alex: i’ve heard about that before! paula: from other people from your shop tweeting. i use facebook as a way to find subjects, human subjects, that put a human face on an issue. so i’ll post, “anybody knows somebody who’s being treated with this drug?” or, “have you had this illness, and what was your experience? i’m trying to find people to talk to me.” yeah, we’re all over it. eric: why are journalists on twitter? it seems like most of them are, is there a reason behind that? paula: because it’s what we do. you traffic in information. journalists are terrible gossips. any newsroom is just full of gossip because that’s why you do, you don’t turn it off when it’s not about the president. share what you know, and people have opinions, people want other people to see their story, so i always post my column and other people post their work. we read each other, it’s just part of the sea that you swim in. alex: you said something about journalists; that you’re always on a deadline, it’s always … short piece of information. twitter is conducive to that. you just get the little headline. the concise punchline. you don’t have to wade through something. paula: i was actually a little disappointed when they started allowing photographs. i just want the facts. now, of course, i’m used to it, and i like them. it becomes an issue somewhat because we’re supposed to be skeptical but also non partisan. devoted to truth but not promoting a particular candidate or point of view. you have to careful of your twitter presence or your social media presence, not to look like you’re in some camp or other. eric: how do you decide what’s news worthy? you must get pitched all the time, what are the key elements? paula: i say it’s like pornography, it’s very hard to define but you’ll know it when you see it. it’s a sense that there may not be a whole new subject but there was some new thing to say about it. some study that confirms what people have always thought, or some study that shows that it’s not what people thought, or a growing number of people with x problem, or some new program that addresses a long standing problem. there will always be some service articles that are just about, “how do you choose a nursing home? when do you need a geriatrician? what’s a geriatric care manager?” there will always be some of those because there’s a new cohort every few years that needs that information. aside from that, your editor will have this attitude whether they say or not, like why are you telling me this now? you have to have a reason of “why now?” alex: the other thing you talked about, when you were with us for grand rounds is   media comes in all shapes and sizes. paula: right. alex: can you tell us a little bit about that? what you meant? paula: it used to be so much easier, and i know that people are returning my calls and responding to my emails, and thank you, if that was you, not of my winning personality but because of those three words; new and york and times, but now the media universe is vastly broader and people are doing good health and science reporting in a number of places that did not exist ten years ago. places with names like buzzfeed, or vox, or the daily beast. stat news is only two years old. propublica. some of these are non profit so that’s a new model. so, just because someone is calling you and they are not from the la times, or the boston globe, doesn’t mean that they don’t have an audience, that they are don’t have an expertise, and that’s not a good place for you to give an interview or to share your research. one of your colleagues told me today that she got a call from a reporter for nautilus and she didn’t know what it is, but i know what it is. it’s a well regarded science magazine, and she was right to have the interview with nautilus, even though there was no nautilus ten years ago. now there is. alex: i wanted to ask you about the new old age, if we could, which is a terrific, the best aging and care giving column in the us, and it’s consistently been so. so i know it’s evolved over time from being a blog to a twice monthly column. paula: right. alex: i wanted ask you, what stories in the new old age you are most proud of? paula: well, i don’t know if this might not have been the one that got the most circulation but we did a couple of columns about these agist prejudice that exists within long term care facilities. there was a very upscale, continuing care retirement community in norfolk, va. as usual, it was a sort of tiered service, so there was an independent living, an assisted living, and a nursing home section. they had a beautiful waterfront view dining room, and at one point they decided that only independent living people could use it, and the assisted living and the nursing home residents had to use their own dining rooms, which caused this huge uproar about how unfair it was. people had paid boatloads of money to be in this facility and their children got a lawyer, they were very angry, they got in touch with me and also the local paper in norfolk. did several stories on this. eventually, management backed down, but meanwhile, the department of justice decided that this was a violation of the fair housing act, and they leveed … they had a big fine, but a fine on the ownership. they also went after another place that i wrote about. we felt like we did good there. alex: right. you helped people. what is coming out? or do you want to give our readers some sense of ideas that are peculating, that they might expect to see in the next few months. paula: i think not too much, cause then someone will scoop me. so i think i’ll just keep that to myself if you don’t mind. i have this long lead time. i can only publish twice a month, so someone else can come and write about it in the washington post or the wall street journal next week, and then it’ll look like i’m a follower instead of a leader. so, i think i won’t. alex: yeah, the news cycles fast. eric: how do you come up with all these stories? paula: i thought initially, i can do this for maybe three years and then i’m gonna run out of material; not true. i read many of the journals. i read jags, i read new england journal, i read jama and jama internal medicine, and various public relations people at various places are always pitching me ideas. many of which are unsuitable but some of which work and then researchers themselves get to know me and tell me what they’re working on, and also nobody with an elderly parent is safe within 50 yards of me. any story you tell me, i’m likely to say, “hey, can i talk to your mother about that?” so it comes from a variety of places, but it is not running out. since i’ve here, the list has gotten much longer. eric: so if we pitch a story, is that bothersome for a reporter? or are they looking for that? or is it a mixture depending? paula: right. don’t pitch me about the appointment of your new staff person; because i don’t care about that. don’t tell me that this is a good story because next week is national alzheimer’s week; because i don’t care about formal weeks, months, or years. don’t pitch me stuff about pediatrics please. know what i do. aside from that, i think … i’m happy to hear from people who have ideas because there’s a constant need for material. if it’s something smart and interesting, if i’ve done something on it, i can’t do it again for a while, but i’m not mad to hear from people who have good ideas about geriatrics and palliative care. i can’t always oblige, i only have 25 columns a year now. it was easier when we posted twice a week, or three times a week on the blog. but no, i’m happy to hear from people. i don’t think … you hear a certain amount of grousing about getting pitches from flacks. flacks being the unflattering word for public relations people. it’s usually because they’re so off base. don’t send me stuff about fashion. have you ever looked at anything i’ve done? if it’s something about what i actually do, i’m pleased to have that connection. alex: right. alex: where do you see journalism evolving? i mean, the new york times went through this evolution. they were describing yesterday where had 60 blogs at one point. paula: we had 60 blogs at one point because it seemed that blogs were going to be the savior of print media. then that turned out not to be true. now we’re doing a lot virtual reality, a lot of video, a lot of specialized digital sections. if i knew that, i could be a rich person. all that we know is that people are trying everything all over. alex: a lot of innovation. paula: just a lot of innovation. some of them are gonna fly and some of them are gonna die. who would’ve thought that jeff bezot would help resuscitate the washington post and yet it’s going, great guns. yet other places that are 100 years old, and just look anemic. i teach grad students and entrepreneurial was not a word we ever used to use for journalists. that was someone else’s problem. you write the stories, someone else will figure out how to market them, how to publish them, how to distribute them, now that could be part of your role too. so it’s really uncertain. it’s kind of scary, and kind of exciting, and i don’t know if that’s a poached curse which probably is not really a curse, “may you live in interesting times.” these are interesting times if you’re a reporter. eric: is it a depressing time? exciting time? to be a reporter? what’s the … ? paula: both, because people are getting laid off in droves. there are many fewer newspaper reporters than there were 20 years ago. if you’re an older person like me, i’m trying not to be coy about my age, so i’ll be 68 this summer. to be 68 and be a working journalist, i am so lucky. i just feel lucky every day. on the other hand, my students are going out and they’re doing really extraordinary stuff and i’m so proud of them. they’re negotiating all this. it’s normal to them. they don’t remember some bygone day when you signed on to be a reporter at a paper and you were there for 30 years. who does that? so they’re just everywhere, trying everything, and that’s kind of cool to see. eric: you have a fair amount of people who listen to us, who are also medical educators, they do research but it’s not the typical research in journals. but they’re doing really innovative stuff as far as, trying to change how med students talk about end of life issues, or palliative care issues, or developing new geriatric curriculum. is there an intersection between that and journalists? paula: there could be, if what you eventually you come up with is something that consumers will need to know and use. if you’re mostly working within the profession, it’s a little too inside baseball and i’m going hae trouble getting ordinary people who are not medical students, or medical educators to pay attention. but if it’s going to end up helping people with their advanced care planning, or it’s going to end up with some kind of checklist that people could use, something that the public could use, as well as medical people could use, then maybe. these things about what’s a story, what’s not a story, are highly subjective. what interests one person, might not interest another. it’s not like there’s some kind of algorithm that i could suggest, “yes, that is something the new york times would like. no, that is not.” it’s how it hits a certain person on a certain day.’ eric: well, i feel like most of the stuff that i read, and that really impacts me is not about a population but, you write about a single person. paula: i try to do that whenever i can, it’s the bait. how do you get somebody to read a story about a disease they don’t have, a condition they’d never thought of, a trend that they may or may not be part of, how do you lure them in? one time honored way that reporters do this is to put a human face on an issue or a trend. so if i’m writing about the enormous increase in the number of older adults who are living together without being married, in couples. the data is really interesting but i have to find that couple. i used facebook to find this couple in philadelphia that they take care of each other’s health, they are each other’s health care proxy, they share the cost of their two homes, they go to concerts and theater, and they’re not married. i needed those people. eric: so alex, how about you end this with a song? alex: you want to join me in the chorus? eric: i’ll do a little bit of it. alex: oh yeah! this is the verse that paula requested alex and eric sing “brown eyed girl” by van morrison. transcript edited by: sean lang brown much has been written in geriatrics and palliative care about… today’s podcast is on academic life hacks, those tips and… we focus therefore on the 3 main things we think… tramadol. is it just a misunderstood opioid that is finally… hey geripal listeners! sign up to get our weekly updates directly to your inbox: apple podcasts overcast spotify podcast addict google podcasts stitcher castbox pocket casts youtube rss we invite the brightest minds in geriatrics, hospice, and palliative care to talk about the topics that you care most about, ranging from recently published research in the field to controversies that keep us up at night. you’ll laugh, learn and maybe sing along. hosted by eric widera and alex smith. learn more credits: audio & video editing by tim stück of aspire digital productions

supported by roth conversion is often a smart choice. don’t let the tax bill scare you. by peter coy it doesn’t happen often. but when it does, some residents risk losing everything. by paula span more americans are entering their later years without people they can automatically turn to for assistance with their health and finances. here’s how to start. by diane harris for paula span, a columnist for the times’s health section, the subject of aging doesn’t age. by josh ocampo some communities with religious origins now offer spiritual programming as just one of many enticements, like the bingo nights of yesteryear. by tammy lagorce some older adults are skipping a sun drenched post work life and moving instead to the next step: choosing to live near children and grandchildren. by joanne kaufman on the way to spending less, people often have to shell out more, at least temporarily   especially when selling a home. here’s what to consider. by susan b. garland turning your home equity into cash can help pay bills and preserve other savings and investments. but they’re complicated, and not for everyone. by susan b. garland former malls and abandoned shopping center sites are in the midst of a repurposing   and one of those new uses is senior housing. by john f. wasik the choices are numerous and confusing. whether you’re looking for yourself or your parents, here is some guidance. by john schwartz

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supported by times insider for paula span, a columnist for the times’s health section, the subject of aging doesn’t age. by josh ocampo for about 15 years, paula span has dedicated much of her journalism career to covering one subject: aging, and the challenges that come with it. ms. span writes the new old age, a twice monthly column for the health section at the new york times about issues affecting older americans. among the topics she has recently explored are the costs of growing older, the rise of robotic pets as companions and the hazards of misinformation on social media. ms. span took over the column in 2009, when it was just a blog. before the times, she wrote for the washington post’s style desk and magazine, where in 2002, she reported an article about residents at an assisted living facility in bethesda, md. “at the time, people didn’t really know much about assisted living,” ms. span said. “it got me interested in spending time with older people and writing about these issues.” four years later, she began writing her first book, “when the time comes,” about the struggles of families with aging parents. in a phone interview from her home in brooklyn, ms. span, 74, discussed how the column’s audience has changed over the years and why she reads every reader comment on her articles. these are edited excerpts from the conversation. what makes for a good column of yours? something that’s a national trend or a development that’s rooted in fact, science and research and affects people. there is no shortage of such topics when you’re talking about a group as large as elder americans. there’s something like 60 million people over 65 in the united states. it’s a very heterogeneous group. there are many things that this group is concerned about, like living arrangements; medicare and other insurance and policy issues; health; end of life connections. it’s a big canvas, which makes it enjoyable and continually interesting. when i took the column on, i thought i’d run out of material in a few years. of course, 15 years later, there’s still so much to talk about.

