Assumptions About Being Old
Too often seniors who have been successful and productive individuals, are trivialized in their everyday interactions. Most often this occurs unintentionally because of unconscious assumptions about people who are growing old. But it occurs everywhere, and I believe the assumptions that greet a person of any age can often evolve into self-fulfilling prophecies. Negative assumptions can make people feel and act older and less confident.
This foundation site is dedicated to fighting assumptions about aging.
In an earlier post (October 28, 2009) I wrote about how people often shout or speak in preschool child voices when conversing with older people. But many other myths or assumptions are demonstrated when non-seniors interact with seniors. Some interesting assumptions I’ve observed include thoughts that older people are less efficient and responsible at work, are stubborn, are always in ill health, are bad drivers, and, if they ever express a less than thoughtful idea, are senile. I’ve also noticed that as people age, their opinions are less sought after.
Based on my interaction with family members and friends, it is my sense that all of these characteristics are part of one’s life long personality. If they do not exist earlier in life, they rarely exist in the retirement or senior years. So there are very few reasons to make assumptions about people of retirement age and beyond.
My family members have been and continue to be amazing achievers in life, but also in retirement. One person is a professional singer, and though she does not perform any longer is still an active choir member and manages the soprano section. Another family member, a former professor and minister, has continued to study and research in libraries, attends every concert he can, and keeps up his lifelong journaling. Yet another, also a retired professor, continued to work in the academic setting well past her 70th birthday, still runs (years later) workshops for staff members at her retirement center, and was one of the super-volunteers in the Obama Presidential campaign. Our eldest family member, though now very ill, continued with multiple book clubs, chaired the resident committee that supported employees of her retirement community, read two major newspapers every day, and served a couple of stints as her alumna sorority chapter president, all between ages 82 and 88.
I once asked another friend who is over 90 years old what her secret is and she said that she finishes the Washington Post and New York Times crossword puzzles before 11:00 in the morning and then gets on with the challenges of the day. It would take me and most other people all day to almost finish one of these puzzles.
If you judge by appearances, what all of these people have in common is gray hair (at least some of them), a fair number of wrinkles, and a bit less mobility than they used to have. But when you speak with them (in a normal voice, that is) they demonstrate intellectual curiosity, confidence, eagerness to learn new things, a keen desire to make the world a better place, and a love of interacting with others. They demonstrate long lives lived fully. Real living legacies, I think.
- US News and World Report, Nov 30, 2009, “Five Common Myths Aging”
- Institute on Aging, University of Pittsburgh, “Aging Myths and Emerging Realities”
- Dispelling the Myths of Aging, The University of Maine Extension Caregiver Fact Sheet
- Myths and Realities of Aging, The University of Florida, Extension, pdf document
Dementia: Loss of Mobility
We see it coming — mother’s loss of mobility.
At first she took smaller and smaller steps. Gradually those steps turned into larger shuffling steps. We bought her a cane, but she did not have the focus to understand how to use it. Little by little the big shuffles turned into tiny ones. She has a walker, which she does not like to use, though when she walks with her caretakers or with one of us, she pushes it along. Once we get her started she can move along slowly.
The Alzheimer’s Society of the United Kingdom has a good fact sheet about the later stages of dementia which also addresses mobility issues.
In her apartment mother will grab onto whatever piece of furniture is nearby. We’ve removed anything that might move when she reaches for it.
When we, her caretakers, and her nurses noticed that she constantly bumped into the coffee table, we removed that. Most of the smaller rugs are gone, but her favorite in the living room is of fairly good size so we thought it would be just fine. However, mother’s shuffles are so small that she almost always gets one foot or the other under the edge. Fairly soon it will also have to go. We find it so difficult to take apart the possessions that she loved so much, though these days she does not seem to notice
We’ve consulted this dementia check list.
Mother’s caretakers make sure that each day the activities include least one walk in addition to walking to meals.These trips, and they are her only exercise, sometimes include a rest stop in the middle.
An interesting mobility test is in pdf from the Society of Hospital Medicine clinical toolbox for geriatric care. The basic test:
Performed with patient wearing regular footwear, using usual walking aid if needed, and sitting back in a
chair with arm rest.
On the word, “Go”, the patient is asked to do the following:
1. Stand up from the arm chair
2. Walk 3 meters (in a line)
3. Turn
4. Walk back to chair
5. Sit down
Time the second effort.
Observe patient for postural stability, steppage, stride length and sway.
Sometimes mother will not want to get up and walk, and we need to get a wheelchair. So far this has only happened on occasional days and never more than once a day. The wheelchair is not in an obvious place so that it only comes out as necessary.
All of us are afraid that even one day of not walking will mean that she forgets how.
Thanksgiving and Dementia — Redux
Our family member with dementia arrived at our Thanksgiving celebration sometime around 2:00 in the afternoon. Her afternoon caretaker took Thanksgiving afternoon off, and we planned to be responsible for her care until bedtime. Things went quite well, however, we now realize that if we are entertaining family and hosting festivities at our house, we need someone who focuses exclusively on mother.
Yesterday she needed help moving around the three rooms, she required assistance eating and toileting, and she needed companionship. Though other family members were helpful, eager to help in fact, mother was comfortable only with the two of us. This meant the one of the two Thanksgiving hosts (that would be us) was always out of commission, something that made the afternoon a bit more disorganized than we had planned. We know now that we need to have a caretaker when we take her into family gatherings.
The holiday celebration was fine. But as dementia creeps along, there is not a single activity in our life or hers that is untouched.
Scary or Urgent E-mail — Don’t Be Fooled
E-mail is the best communication tool for seniors, kids, and grandchildren and is so easy and convenient! This interconnectedness is even more important at times of family illness and when family members live far away from one another. All family members, but especially seniors, need to master some important skills and understand some key concepts, many or which have nothing to do with the technical side of e-mail.
Recently my mother forwarded me an e-mail. Now she is a savvy computer user and is careful about deleting anything that she believes is questionable. The message urgently advised people to register their cell phones with the DO NOT CALL REGISTRY (see my post from November 11th). Written in an urgent voice its aim was to make someone react without checking the validity of the content. My mother was clever. When she received the e-mail she went to the DO NOT CALL REGISTRY web site and compared the number in the e-mail with the number at the official Federal Communications Commission (FCC) website. Go mom!
Senior Adults and Falling
From the November 11, 2009 New York Times in an article by Steve Lohr …
“FALLS are so harmful to the elderly and so costly to society that if falling were a disease it be deemed an epidemic.”
Almost every week or so an over 70-year-old acquaintance or friend falls. According to the Centers for Disease Control (CDC) every year one out of three adults who are over 65 will fall. Even the most vigorous individual injured by a fall has a tough time and in the short-term may age more quickly. If the injury is serious and requires hospitalization, the confinement often leads to additional problems which in turn lead to more medical problems. My husband and I have informally labeled this “the cascade.” Unless the person is fairly strong and/or athletic, a fall leads to substantial suffering. dislocation, and expense.
According to a CDC fact sheet on senior adult falls, “…older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.”
My husband’s father had congestive heart failure for five years. Thought he was on many meds, some of which caused dizziness, he overcame the odds by maintaining a careful but vigorous walking schedule during the five years following his diagnosis. In the last months of his life, he fell twice.
The first occurred in late winter as he climbed out of the car while waiting for his wife. Father jumped out of the car too quickly, lost his footing on a slippery spot, and hit his head on the door. In a skilled nursing facility for three weeks, he was in bed for quite a bit of that time, and finally returned home with additional meds to take each day. Father’s weakness and lack of energy kept him from resuming his long walks, and he took many more naps on his bed. So the net result of the fall was that he was weaker, stopped exercising, was much more short of breath, and added a couple of medicines to his already long list. This was the beginning of cascading problems.
Father seemed to be improving, at least a bit, when the second fall occurred less than a month later as he was getting up from the bed. Intent on reaching into his closet, he became dizzy and fell, hitting his head on a piece of furniture, becoming disoriented. As he was once again confined to the skilled nursing facility (SNF) more things began to go wrong. Because he had not been walking he was less vigorous. His chest began to hurt. Next came a urinary tract infection, and father’s chest discomfort turned into respiratory problems. He did not walk enough for his legs to stay strong enough to walk a wheelchair was necessary. After that he did not walk at all.
After beating the many odds of surviving congestive heart failure for five years, father died about five weeks after the second fall, not really from the fall but from all of the problems the fall caused.
While the system did not promote healing as it should have, I am not sure that father would have been receptive to advice about preventing falls. But his falls set the end-of-life process in motion. According to the CDC fact sheet, “Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently and increase their chances of early death.”
Additional Information About Seniors and Falls
Holidays
With three senior parents I am thinking a lot about holidays — past and future — how wonderful they can be and how to celebrate without a lot of brouhaha. I am concentrating on making each holiday, in this case Thanksgiving, special but also as simple as possible. This year we’ve navigated lots of health challenges together, and now we can celebrate family, long life, traditions, wisdom, and faith. … and also their continuing legacies.
This link at About.com has some good suggestions about gatherings that include senior family members.
This year for Thanksgiving we are hosting all three senior parents, one senior aunt, and one caretaker, plus some cousins. Four people in their mid-80′s or older. My cousin and I joke that it will take a lot of us to bring down the average age even though we are in our 50′s. Our daughter, who is a medical resident, has just enough time to fly down and head back, but she will see all of her grandparents, and I am so grateful that she can do this, though she cannot stay for the Thanksgiving dinner.
The cousins are professional musicians, so I am hoping for some music and maybe a hymn-sing around the piano working through all of the Thanksgiving hymns. We will have a jigsaw puzzle going and the cousins are helping with the food so that takes some of the pressure off of me.
Our parent with dementia will be included in every activity. In late afternoon the caretaker will leave to go to her family for Thanksgiving, and we will assist mother until bedtime. We have also found some old family photograph albums for her to look at.
We have much to be thankful for and are unusually fortunate, despite the ups and downs of health, to have so much wisdom in our midst. And if everything is not perfect and something goes awry here and there — and something probably will — who cares! We’ll handle it. As I so often told my daughter when she was little, “We’ll cope.”
Happy Thanksgiving!
- Ten Tips to Help Seniors Enjoy the Holidays
- Minding Our Elders blog post on holidays
Stages of Dementia, Part II
Keep in mind that these stages are general guidelines that help people understand dementia’s progression, and that some professionals do not use them as disease guideposts. I am applying them to the dementia that is occurring in my family. Another family may not have anywhere near the same experience.
By the time stage five of dementia begins, a person is experiencing more and more cognitive decline. Remembering time, dates, locations, current address, and other bits of information is difficult. Math and reading abilities continue to diminish. At this point our family member, who had never belonged to less than two book clubs in her adult life, gave up book clubs, though she listens if read to. Moreover remembering to get to meals, dressing, and undressing were becoming more and more difficult. Showering details, especially understanding how to use the faucets and hand shower required help. Read more »
Becoming A Grown-up Child
One day in April 2007 my husband and I were the adult kids in our families — we are the only adult children
— and the next day we became what we laughingly call “real grown-ups,” helping first one, then two, and increasingly all three of our parents. It’s time to give back, and we do so willingly and happily. However the process is not easy, and it is not free from anxiety and tension. Check out the As Our Parents Age About page to learn more about the mission of this blog.
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