“We’re putting another burden on the elderly that we don’t have to,” one researcher said.Some things you can no longer do with cash: Buy a well-loaded hot dog at any of the five Devil Dawgs eateries in and around Chicago. Order a Vermont Pale Lager from Hill Farmstead Brewery’s taproom in Greensboro Bend, Vt.Attend the annual BeachLife Festival in Redondo Beach, Calif., or buy food, drinks or merchandise there. Purchase admission to the Home of Franklin D. Roosevelt National Historic Site in Hyde Park, N.Y., or to many other sites maintained by the National Park Service.The park service’s expanding no-cash policy exasperated several would-be visitors enough for them to sue in federal court earlier this year.Anne Ronan, 70, a retired attorney, walks around Lake Merritt in Oakland, Calif., a few times a week. After the three-mile-plus trek, she sometimes stops at one of two local cafes. Neither accepts payment in cash.Nor do a restaurant and a cocktail lounge nearby on Grand Avenue. “I don’t find it unusual anymore,” Ms. Ronan said.To buy coffee and a croissant, she routinely carries a credit card in her pocket. She doesn’t find that bothersome, but “as a public policy, it’s not a good thing.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Medical care can be wearying and time-consuming, especially for seniors. Researchers are beginning to quantify the burdens.Deana Hendrickson sometimes feels daunted by the demands of the medical system. “Every body part has a doctor,” she lamented. “I hate it.”Ms. Hendrickson reeled off a long list of her health care providers: a primary care doctor; a cardiologist, because she has mild heart disease and a concerning family history; a lung surgeon and a pulmonologist who oversee an annual scan because of her family history of lung cancer.Plus an ophthalmologist, a gynecologist, a urologist, a podiatrist, a gastroenterologist — “and I just came back from the dentist.”She estimates that with scans, imaging and tests, she spends two dozen days a year engaged with some sort of provider. Most of them, she added, practice in Santa Monica, Calif., where she used to live, now an hour’s drive from her home.At 65, providing five-day-a-week care (with her husband) for three grandsons under 5, she’s reasonably healthy and active. But her regimen “makes me feel like a sick person,” Ms. Hendrickson said.“I’m like an older car that always needs more maintenance. There’s so many other things I’d rather be doing.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

They’ve been an unmarried couple for almost 20 years. Both widowed, and now in their 90s, they maintain separate residences in Florida but mostly live together in her home — an increasingly important issue because, a few years ago, she began developing memory loss.Sometimes, she forgets to eat. She has taken some falls, too.“His presence is helpful and supportive,” said Jenna Wells, one of her relatives and a Cornell University psychologist. “He takes her to the doctor. He takes her out to dinner.”But he knows he will have trouble caring for her as they both age and her condition deteriorates. So he proposed to her family that the two of them move together into a continuing care retirement community, where residents can shift from independent to assisted living, then to nursing and memory care units.If they wait too long, he points out, a facility could insist that she enter memory care directly, and he won’t be able to live there with her.The woman’s daughter, who holds her power of attorney, opposes that plan. “She doesn’t like her mother’s gentleman friend, as we call him,” Dr. Wells said. “They’ve never gotten along. There’s mistrust about his living in her house.”For now, with a decision on hold, the couple is managing with home care aides.“As we see this shift, with less of a focus on marriage in older people, this is going to come up a lot,” Dr. Wells said.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Apple is preparing to turn its AirPods Pro 2 into easy-to-use aids for people with mild to moderate hearing loss.In your pocket or purse, you may be toting around small devices that, with the help of new software authorized by the Food and Drug Administration, could soon become inexpensive hearing aids. Millions of people already own them.They’re Apple’s AirPods Pro 2, those white plastic knobs protruding from so many ears in malls and workplaces, on buses and sidewalks. The users may not be among the 30 million American adults reporting some degree of hearing loss; they’re probably just listening to music or podcasts, or talking on their phones.Within weeks, however, consumers will be able to use those AirPods Pro 2 earbuds to bolster their hearing. Last month, Apple software called Hearing Aid and Hearing Test received a green light from the F.D.A., a first for the regulatory agency.With the upcoming software and a compatible iPhone or iPad, users will be able test their hearing. For those with mild-to-moderate hearing loss, the AirPods Pro 2 will adjust sounds in their environments and on their devices.Users will be able to customize their AirPods for volume, tone and balance. All that should allow them to hear better — at least for the devices’ roughly five to six hours of battery life.Apple plans to release the free software later this fall for iPhones running iOS 18 or later and iPads running iPadOS 18 or later, a spokesperson said. A set of AirPods Pro 2 costs $249 from Apple, and less at big box stores or through online retailers.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

A pet trust designates a new guardian for companion animals and sets aside funds for their care. Better yet, it’s legally binding.In 2016, Tracy Jennings received shocking news: A lifelong friend, a woman who had a farm with animals great and small, had died suddenly in an accident.A circle of grieving friends hastily arranged new homes for the woman’s beloved animals, including three older horses. But just two weeks after her death, her family had the horses euthanized.“It was very sad, a real kick in the head,” Ms. Jennings said. “But we had no legal rights, and she had nothing in writing.”Ms. Jennings, 66, a semiretired landscape designer, lives on a 10-acre farm in Buffalo, Minn., and has her own menagerie: five cats, a golden retriever, two horses and a donkey named Niles. They would not meet a similar fate, she decided.“There’s nothing sadder than seeing pets wind up at a shelter because the older person who cared for them has died,” she said.She had a lawyer draw up a pet trust, a legal document specifying who will care for her animals when she dies or becomes unable to do so herself. Her trust provides money to cover veterinary bills, food, grooming, boarding and unexpected expenses. It specifies which vet to use. Attached guidelines impart care instructions, including particular foods and animals’ “personality characteristics.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Some treatments and procedures become routine despite lacking strong evidence to show that they’re beneficial. Recent studies have called a few into question.An older patient with dementia is in the hospital and has trouble swallowing. A speech pathologist recommends thickening the liquids the patient drinks with starch or gum and specifies how viscous her tea, water or juice should be. Should it resemble honey? Or apricot nectar?A doctor writes the order, and the discharged patient returns to her home or nursing facility. She may be drinking thickened liquids from then on.The rationale is that this sludgy stuff prevents patients from drawing liquids into their lungs and from developing aspiration pneumonia. But does the practice work? Some geriatricians have doubted it for years.Now, a large-scale study from the Feinstein Institutes for Medical Research in Manhasset, N.Y., has found that liquid thickening doesn’t actually help such patients.This happens with some frequency: Medical practices so commonplace they rarely raise eyebrows turn out, after further investigation, to have scant basis in fact.“There are plenty of things we do in medicine that have no evidence,” said Dr. Matthieu Legrand, an anesthesiologist and critical care doctor at the University of California, San Francisco.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

In one recent study, the challenging regimen added 77 days of life after three years. Often, kidney disease can be managed in other ways.Even before Georgia Outlaw met her new nephrologist, she had made her decision: Although her kidneys were failing, she didn’t want to begin dialysis.Ms. Outlaw, 77, a retired social worker and pastor in Williamston, N.C., knew many relatives and friends with advanced kidney disease. She watched them travel to dialysis centers three times a week, month after month, to spend hours having waste and excess fluids flushed from their blood.“They’d come home weak and tired and go to bed,” she said. “It’s a day until they feel back to normal, and then it’s time to go back to dialysis again. I didn’t want that regimen.”She told her doctors, “I’m not going to spend my days bound to some procedure that’s not going to extend my life or help me in any way.”Ms. Outlaw was mistaken on one point — dialysis can prolong the lives of patients with kidney failure. But a new study published in the journal Annals of Internal Medicine analyzed data from a simulated trial involving records from more than 20,000 older patients (average age: about 78) in the Veterans Health Administration system. It found that their survival gains were “modest.”How modest? Over three years, older patients with kidney failure who started dialysis right away lived for an average of 770 days — just 77 days longer than those who never started it.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

In huge numbers, older people are taking gabapentin for a variety of conditions, including itching, alcohol dependence and sciatica. “It’s crazy,” one expert said.Mary Peart, 67, a retired nurse in Manchester, Mass., began taking gabapentin a year and a half ago to reduce the pain and fatigue of fibromyalgia. The drug helps her climb stairs, walk her dog and take art lessons, she said.With it, “I have a life,” she said. “If I forget to take a dose, my pain comes right back.”Jane Dausch has a neurological condition called transverse myelitis and uses gabapentin as needed when her legs and feet ache. “It seems to be effective at calming down nerve pain,” said Ms. Dausch, 67, a retired physical therapist in North Kingstown, R.I.Amy Thomas, who owns three bookstores in the San Francisco Bay Area, takes gabapentin for rheumatoid arthritis. Along with yoga and physical therapy, “it’s probably contributing to it being easier for me to move around,” Ms. Thomas, 67, said.All three are taking the non-opioid pain drug for off-label uses. The only conditions for which gabapentin has been approved for adult use by the Food and Drug Administration are epileptic seizures, in 1993, and postherpetic neuralgia, the nerve pain that can linger after a bout of shingles, in 2002.But that has not stopped patients and health care providers from turning to gabapentin (whose brand names include Neurontin) for a startling array of other conditions, including sciatica, neuropathy from diabetes, lower back pain and post-surgery pain.Also: Agitation from dementia. Insomnia. Migraines. Itching. Bipolar disorder. Alcohol dependence. Evidence of effectiveness for some of these uses is thin.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Adult children are less likely to assist an aging stepparent, studies show. A growing “step gap” in senior care worries experts.The encounter happened years ago, but Beverly K. Brandt remembers it vividly.She was leaving her office at Arizona State University, where she taught design history, to run an errand for her ailing stepfather. He had moved into a retirement community nearby after his wife, Dr. Brandt’s mother, died of cancer.As his caregiver, Dr. Brandt spoke with him daily and visited twice a week. She coordinated medical appointments, prescriptions, requests for facility staff — the endless responsibilities of maintaining a man in his 90s.Maybe she looked especially frazzled that day, she said, because a longtime colleague drew her aside with a startling question.“Beverly, why are you doing this?” he said. “He’s not a blood relative. He’s just a stepfather. You don’t have any obligations.”“I was dumbfounded,” Dr. Brandt, 72, recalled. “I still can’t understand it.”She was 5 when her father died. Three years later, she said, her mother married Mark Littler, an accounting executive and a “wonderful” parent.“He’d come home from a grueling job, change out of his good clothes, then carry me around the living room on his back,” she recalled. Later, he introduced her to the symphony and the theater, funded her graduate education and mentored her as she entered the academic world.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Researchers are only beginning to understand why some people embrace retirement while others won’t even consider it.Beth Bergmans liked working as a project manager for an online university based in Minnesota. “We are offering opportunities for people to advance in life — that brought some satisfaction,” she said. “And the people I work with are awesome.”Ms. Bergmans, 63, planned to stay on the job for two years, until she qualified for Medicare. But in recent months, something had shifted, subtly. In her fast-paced workplace, she began to find it harder to recall the details of recent meetings, to retrieve words and to filter out distractions. She took short breaks at her desk to recharge.“You find ways to adapt,” she said. “You use Post-it notes and whiteboards, and you spend more time prepping before a meeting.” Nobody complained or even seemed to notice, but Ms. Bergmans worried.“People don’t really talk about this, the fear that you’re starting to slip professionally,” she said. “The last thing I want is to crash and burn at the end because I didn’t recognize that it was time to stop.”So a couple of weeks ago, Ms. Bergmans told her manager that she would retire at the end of the year.Sometimes it works this way: People engaged in and proud of their careers, intending to continue past typical retirement ages, encounter internal or external difficulties and step aside, even if no one is urging them to resign or retire.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.