When Craig Moss, M.D. was a college student majoring in social psychology, he did a research paper on geriatrics. Back then, studying the elderly was a bit unusual. “At the time, there was a lot of ageism. Being old was not considered a good thing,” he recalls.
Moss studied positive models of aging — folks older than 65 who stayed active and said they were happy with their lives. “It turned out that people who did something besides just their occupation tended to age well. For instance, if you’re a truck driver and you also like to play the fiddle, you have a rewarding activity to fall back on when you retire.”
That early research piqued his interest, and Moss opted for a career in medicine, specializing in geriatrics, or aging. He received his degree at New York Medical College, did his residency at Hartford Hospital, then went on to UCLA to complete a fellowship in geriatrics.
Moss moved back to the Hudson Valley in 1984 — his late father had been an internist in the area. He and his wife, fellow physician Dr. Debra Karnasiewicz, M.D. (who is board certified in internal medicine), then launched a medical office which has since grown into an eight-physician practice. Known as Medical Associates of the Hudson Valley, the practice is located in Kingston.
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Moss — who is board certified in internal medicine and geriatrics, and is director of MAHV — says working with the elderly is a complex medical field.
“Part of the challenge is in just determining what normal aging is. Take dementia, which is rather prevalent in our society. One in eight people over the age of 65 will develop dementia in the U.S., versus one in 100 in northern India; about 45 percent of people in the U.S. older than 85 will develop dementia. This high incidence in the U.S. is in part due to our life style. So, the question is — is dementia considered a part of normal aging, or not?”
And unlike diseases such as diabetes, where a simple test can often pinpoint the condition, Moss says there’s no universal method to determine whether, for instance, it’s just a common cognitive slip when a person frequently forgets where they put the car keys, or if this might, in some cases, signal the early stages of more serious memory loss.
“Also, we sometimes deal with patients who are on eight or 10 different medications — we might be able to eliminate some of the meds; some you can’t. In addition, social and family dynamics play a role with how people deal with aging.”
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Photograph by Michael PolitoDepression is fairly common among seniors, too, Moss says. “An older patient may come in and say, ‘I’m depressed and can’t sleep. What can you give me?’ I might then ask how many hours of TV they watch. They might say, ‘Well, I turn the TV on at 10 in the morning and turn it off at 11 or 12 at night.’ I might suggest that — for just two weeks — they stop all TV. They sometimes look at me like I’ve told them to get off heroin! But with those who do stop, it’s amazing how many are no longer depressed, no longer have trouble sleeping.”
Moss points out that every case of depression is unique, and no one-size-fits-all approach works for all patients. But the point is, he says, “Stay active. Don’t just stare at the TV for hours on end. Go out with friends, go walking, go bowling.”
As an internist, Moss deals with adult patients of all ages, not just the elderly. “Aging well is largely about meeting your maximum potential — and that doesn’t stop when you’re 20 or 30 or 50 or 70. Say, with exercise — I’m not asking you to climb Kilimanjaro; everyone has a different exercise tolerance. But assuming you’re in good health, try to get to a point where you’re a bit short of breath and sweaty — sort of huffy and puffy — a few times a week. That’s when you start to regenerate brain cells and prevent some common, age-related health problems. It may mean just walking up a flight of stairs for some of us; for others it may mean running a marathon.”
Moss, who has received awards for community involvement, says the entire office team at MAHV is committed to serving as a positive force in people’s lives. “Those are the values we try to live by,” he says. “I grew up in the Valley. My family gets sick, like everyone else’s does, and we all want excellent doctors here who care about the community.”
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Click here to view the Hudson Valley’s Top Doctors 2011 (opens PDF)
They practice what they preach: His wife, Dr. Karnasiewicz — they have three children — founded the popular annual Women’s Health and Fitness Expo, held in the mid-Hudson area and now in its 11th year. Moss is also part of a group that conducts an annual health clinic in Nicaragua. “We take Tulane med students to areas that are sometimes pretty remote; there’s no electricity, no running water,” Moss explains. “There isn’t a lot of the high-tech equipment that they’re used to, so it helps them reconnect with what it means to be a physician — to observe, listen, and really communicate with a patient.”
Rural cultures like Nicaragua have a lot to teach us, Moss says. “The elderly there tend to stay more involved than in our culture. The adults might all go out to work on the farms during the day; the older people stay behind to take care of the kids. The elderly have a sense of meaning there. That’s one of the biggest challenges now for the elderly and their families in our society: how to keep older people actively involved in the mix of life, participating and not giving up when you reach a certain age.”
He sums up: “I think we should embrace aging. People still tend to run away from it, but getting older is a normal part of living. We do different things at different times in life. Older people have a lot of wisdom, a lot of life experience to share — and our society should come back to honoring that more.”
» Visit Medical Associates of the Hudson Valley in Kingston, Ulster County, NY
» View the complete list of Top Doctors 2011
» Go to the Hudson Valley Health Guide for more doctors in the Hudson Valley, NY
