Back in February I posted this blog. This would be before the virus hit and we all wondered if we would indeed get any older. Now, I have come to believe that there is sunshine at the end of the storm. Hospitals are announcing fewer cases and except for the political agendas, people seem to be on the move. An agent whom we know said that they just can’t keep up with the number of houses being bought…so someone is expecting to live in them or sell them again in some future time. ALL THIS LOOKS LIKE A GOOD “GROWING OLDER” possibility.
So let’s talk about this new optimistic view by looking back at what I wrote in February. The only real difference that I can see is the really close contact and the tragedy of the elderly dying alone in a nursing facility. That breaks my heart!
“Everything in advertisement these days is how to stay young and beautiful. Who wouldn’t want to do that?! Well, not so fast, perhaps those that have lived a good, long life have a few things to say about aging. We will explore the subject that no one wants to write about, talk about, or experience…aging. We all grow a little older each day…each hour…each minute. Some tell it better with the graying of the hair, a larger mid-waist, or a few wrinkles…or alot as the case may be.
I live in Florida and all the billboards for senior living look like this:
Yet, many older people are finding a life filled with wonderful memories and FEW, if any regrets about their lives.
It is not all downhill as some would like to think.
The funny thing, however, is that we rarely think of ourselves as getting older.
You notice that I never say OLD, but OLDER because it is the natural part of life for everyone…from crib to the knee replacement!
I’d like to share a portion of one chapter which relates to this topic of growing older:
“What exactly is the meaning of “grace” or doing something with “grace”?” We would all like to think that we can be that kind of person when it comes to seeing our lives slide away and we can begin a possible countdown on two hands. There are those who might make it to the 100 mark, but the quality of life in these people is usually limited. There are exceptions, however. Some Centenarians have some real words of wisdom for all of us.
One man said, “I enjoy robbing the government by continuing to get my pension!” Another Centenarian said about getting older and reaching 100, “It is only a number. You live for the day and a little shot of whiskey occasionally helps,” he said with a smile.
Fond memories seem to play a great part of enjoying the end of life. We all have the heartaches, but it is the happy times that we can and should reflect upon. Building another good memory at any age is the key. It is a great thing to be able to say, “I really did so many things, knew so many people and I believe I mostly did everything that I wanted to do.”
If you are growing older, it is not only the physical body that begins to become more frail, but the mind and emotions can also take a toll. Some of this is genetic or poor health or a disease that is not avoidable. Nevertheless, for those of us who are fortunate enough not to have some of these disabilities, it is up to us to feed the brain with optimism and good thoughts. It is too easy to complain or become “an old fogy” that no one wants to be around or that is old-fashioned or intellectually dull.
Doing the things that make us happy is most important as we age…whether that is writing, as I do, or watering a beautiful flower that has been grown and nurtured by your own hands.
An English lady maintains her wonderful memories of her family as if they are all still around her. With a laugh, she says that sometimes people will hear her talking to herself…but it isn’t really to herself…but to the children that she remembers and cared for through their lives. “They think I am crackers when I talk to myself, but I’m not…just remember the ones I love.”
If you have been in a nursing home for the aged, it is quite depressing, at times, to see so many elderly sitting and doing nothing. Often they are sleeping from medication given to them that can take away quality of life. This is when an advocate is so important to keep watch over a parent or grandparent who may not be able to fend for themselves when it comes to care. Years ago, the elderly stayed in the home of the children until their death. Because of this, they had someone with them who truly cared about them and their welfare. How important it is to speak to those sitting in the Assisted Living facilities and let them know that they are recognized as a special person who has lived a very long life. Each of them have stories to tell if we will take time to listen.
Taking time to listen is exactly why my husband and I interviewed veterans of past wars to write their stories in the book, Men and Women of Valor in the Blue Ridge. Most had never had an interview and were most appreciative to know that the service they gave to their country would live on in a book. This was especially true of an elderly man who fought in Korea with frozen feet. His miracle was that just before surgery to remove his legs, the blood flow came back. Our veterans are quickly passing away, as are the Holocaust survivors of World War II. With grace, many have shared their lives and stories of courage with us. In our present day, those who now sit in wheelchairs, will soon be gone from us. Some have made the trip back to the places where so much happened in their lives to preserve freedom for future generations. Never forget to thank them “for their service.”
Asked if the Centenarians “have any regrets,” most had only a few. Some wished that they had told someone they loved them more or worked harder at a vocation. Time moves swiftly as we grow older. We look back at a full-time career, a number of children in the home, pets to care for and after retirement it is hard to imagine how we fit all that into one 24 hour day! We should want to live those hours as gracefully as possible at any age.
The word ‘grace’ literally means ‘favour.’ In Hebrew, it is CHEN from a root word CHANAN – to bend or stoop in kindness to another.
In Greek it is CHARIS and has the idea of graciousness in manner or action. It comes from a root word CHAIRO to be cheerful, happy. 31
Perhaps this is the key to those who have lived life longer than most…to accept each day with gratefulness and cheerfulness. It is a lesson for all of us to learn to live in GRACE.
On a spiritual level, it is to LIVE and MOVE and have our being (or EXISTENCE). Acts 17:28 It is the GRACE of God that saves us.” N.W. BOYER
It spite of illness, in spite even of the arch-enemy sorrow,one can remain alive long past the usual date of disintegration if one is unafraid of change,insatiable in intellectual curiosity, interested in big things, and happy in a small way. Quote by Edith Wharton (An American novelist and the first woman to win the Pulitzer Prize for Literature in 1921.)
Recently I received an email from a reader of this particular blog on Growing Older. What she wrote to me was so impressive that I asked permission to reprint it here for my readers. I hope you enjoy it as much as I did.
“Hi, Nancy! This was great. It reminded me of my job in Portland, Oregon where I was an Activities Director for an assisted living facility. I had to get my certification from Portland State and I learned a lot about geriatrics! The state required that I provide activities for spiritual needs, physical, creative, educational, and social activities. It was quite a challenge I had 97 residents and I was the only activities person. The nurses were nice enough to help those who were not ambulatory to take them to the activity. I had a “Fit & Fun” class where we exercised to the 1940’s music (they especially liked the Andrews Sisters); I had a Chorus, and a band, we gave concerts to the families. I did educational things like picking a country and showing a 30 minute video about it and before that, I would make some food for them from that country and talk about it for a while—plus I had “happy hour” and music playing on Fridays, and I had a tea party for the ladies (Steve came and played the recorder for them) with lace tablecloths and china tea cups—I had slide shows…and ministers/priests/ and Jewish people come in and offer services. I loved that job so much! It was great fun. Steve called me a “paid party-girl”. 😊
Working with elders was wonderful. Funny…too. “Good morning, Claire, how are you this morning?” Claire replied, “Well, let’s see…I woke up…I was able to eat breakfast…and I could go to the bathroom…It’s goin’ to be a great day!” You never know… I have so many stories.
My favorite was Vera. She had Alzheimer’s, couldn’t walk on her own, and had trouble communicating. I found out that she used to play the piano. So one day, I wheeled Vera in front of this grand piano and then I sat down at a nearby table. She looked at me…and looked around…and looked at me again…and looked at the piano…then played a beautiful rendition of “Moonlight Sonata”. I nearly fell over. I ran to get the nurse to show her! Wow. After she finished—I took her back to her room and she fell asleep. She didn’t say a word.
Another favorite was Violet. Again Alzheimer’s –about 3rd stage. She was walking on her own. Wore everything in her closet (we were careful not to have much in there)…needed assistance to be seated because she didn’t know where to sit. She had trouble talking but she babbled anyway. I heard that she used to be a secretary for 45 years. One evening, while she was eating dinner in the dining room, I took a chance and wrote on a piece of paper in Gregg shorthand “How are you today, Violet? ”. Then I left the paper there with the pencil and watched her from the other part of the room. It took a while…she looked at it, then ate some more and looked at it again, picked up the pencil and scratched something. After she left, I went and got the paper… it said, in Gregg shorthand… “I am fine today, thank you.”
When I think of being older…I think of miracles. Those that have happened, and those that have not happened just yet. I’m training my mind to be positive, and grateful. It’s working. 😊 Your wonderful story just added to that!”
ENJOY YOUR LIFE…IT IS THE ONLY ONE YOU HAVE…and the sun is still shining!
VIDEO Turn up sound Interesting thoughts from some who made it to 100 years old…and still enjoying life.
If you are trying to make a family decision about the care of your elderly parents, THINK TWICE…MAYBE MORE than twice!!!
It is not easy when elderly people are at home with the rest of the family, who are also at home. Children are not in school; parents may be working from home and the stress goes on until life can go back to some normality.
What about the parent that you have loved so long and they have loved you? If they are dealing with the beginnings of physical or mental decline, it may be that you are thinking, “What do we do? I don’t know if I can give them proper care. I only want what is best.” for him/her/ or them. No one doubts the love between families, but this pandemic has changed family dynamics all together.
Not everyone has the built-in options of home health care professionals, but placing a family member in an assisted living care is also extremely expensive. For those who could afford such arrangements, is this truly the best answer. Think about it. Because these facilities have a “no visitors” policy, it may be the last you would be able to see your Mom or Dad face to face..or they see you, for some time to come. It may not only be a permanent separation, but a death sentence to those unable to cope with such loneliness. It is not unusual for the elderly to stop eating when depression sets in.
As we know, years ago and in many other countries, the elderly lived within the same house as the rest of the family. They had interaction, care and to die was not a lonely experience. This blog does not intend to give you an answer to this difficult decision that perhaps you or a friend may be going through concerning your elderly loved ones, but it does give some food for thought.
Think what you would want for yourself as you continue to climb the AGING ladder.
This is an informative article written by Sara Harrison in Wired.
“IT TOOK SIX weeks, several long, frustrating phone calls, and a consultation with Apple Care before Laurie Jacobs got her 89-year-old father up and running on FaceTime. Jacobs, who is a geriatrician by training and is now the chair of the Department of Medicine at Hackensack University Medical Center in New Jersey, was worried about how her parents were coping during the pandemic. They live in a long-term care community, but they felt isolated and lonely. Over the phone, Jacobs couldn’t tell how her mother, who has some cognitive decline, was feeling or if she was walking comfortably. “The communication at a distance is very difficult,” she says. “You don’t always get the whole picture with an older adult on the telephone.”
And, like so many other Americans in quarantine, her parents were running out of things to do. “They seemed bored and somewhat depressed by the lack of stimulation, so further ways for them to interact was very important,” says Jacobs.
The Covid-19 pandemic presents a doubly complicated situation for older people: Not only are they at higher risk of contracting the disease, and more likely to develop severe infections and die from it, but they are also the most likely to struggle with—and suffer from— the consequences of prevention strategies like social distancing. For people with dementia, Alzheimer’s disease, or severely reduced mobility, social-distancing guidelines can be impractical and nearly impossible to follow, making prevention and treatment even more complicated.
Seniors, especially those above age 80, have been hard hit by the virus. That’s in part because they often have comorbidities like diabetes and hypertension, which make them more likely to be hospitalized. Doctors aren’t sure why those conditions make the effects of the virus worse, but both conditions are associated with greater expression of the ACE2 receptor, a protein on human cells that the coronavirus latches onto to start replicating.
Many older adults also have chronic, low-grade inflammation, a state called “inflammaging,” in which the body is unable to control the release of cytokines, small proteins that are supposed to help modulate the body’s immune response. This dysregulation could put seniors at great risk of “cytokine storms,” a condition reported in severe Covid-19 cases during which a patient’s immune system spins out of control and starts damaging healthy organs.
Seniors are also more vulnerable because of immunosenescence, a slow deterioration of the immune system that is a normal part of aging. When people are young, the immune system has a big reservoir of T-cells and B-cells ready to fight infections. These are called “naive cells,” meaning they haven’t encountered any bacteria, viruses, or other pathogens yet. When those naive cells encounter an infection, some of them learn to recognize that pathogen and become ready to fight it off if the body gets exposed to it again. “As we age, we lose that reservoir of T-cells and B-cells,” says Wayne McCormick, head of Gerontology and Geriatric Medicine at the University of Washington. “It’s hard for us to make new ones, although some people seem to retain that capacity better than others.” That means the person’s body may mount a less robust immune system response than it would have done when they were younger.
Immunosenescence also means that diseases present differently in seniors, which may make it difficult for their doctors or caretakers to recognize a Covid-19 infection. While many Covid-19 cases include fever, for example, in seniors the symptoms might also be due in part to dense living conditions, under staffing, and a lack of personal protective equipment. And recently, health authorities have realized that the virus is spreading rapidly in work communities where employees are housed in crowded conditions, share long commutes on shuttles, or cannot easily socially distance, like meat packing or farm work.
Whether they live in a long-term care facility, nursing home, or in a family home, many seniors have unique needs that make it impossible for them to socially distance. Some need help eating, washing, going to the bathroom, or moving around. “You can’t do that using Facetime,” says Eric Widera, a professor at the University of California San Francisco who specializes in geriatric and palliative medicine.
Yet for older adults living in their homes, social distancing can cause isolation and loneliness. Most of the places people would go to socialize—senior centers, libraries, churches, temples, or synagogues—are closed. Families are discouraged from visiting. “We’re worried it’s going to cause a wave of true loneliness,” says Widera, which can lead to serious health problems including worse cognitive function, higher blood pressure and heart disease.
While older adults are the most likely to catch Covid-19, they also may be less likely to benefit from a vaccine. Because seniors don’t raise the same immune response that younger adults and children do, they generally don’t respond as well to vaccines. They also aren’t always included in clinical trials. “If you look at the last many decades of research, the vast majority of randomized control trials do not include older adults. And if they do, they don’t include frail older adults, who are at risk for this,” says Widera. “That’s one of our worries: That we’ll be looking at potential treatments, vaccines, but not actually testing it on the people who are at the most risk of developing this disease.”
For people with dementia or other kinds of cognitive decline, things get even more complicated. Widera points out that people with dementia may not remember they need to wash their hands more often or refrain from touching their face. And dementia patients often wander. In communal living or care facilities, they might walk in and out of other patients’ rooms, down the hall, or into common living areas, all of which increase the likelihood of catching and transmitting the disease. Diagnosing Covid-19 in those patients could be even harder, too. “People with cognitive impairment may not be able to report their symptoms very well,” says McCormick. “Even if they had a cough an hour ago, they may not remember that they did.”
Patients with dementia also have unique challenges if they end up in the hospital. Covid-19 symptoms can worsen their confusion and delirium, as can being in an unfamiliar setting like a hospital room. These patients may be terrified when they’re separated from their family or their usual caregivers and are being tended to by staff covered head-to-toe in protective gowns and masks. With nurses trying to limit patient interactions to reduce the need for this protective gear, patients are often isolated for much of the day.
Martine Sanon, a professor of geriatric and palliative medicine at the Mount Sinai Hospital in New York, says that usually they encourage family members to be part of the care team and to help orient and comfort their loved ones, but with limited protective equipment, and with fears about spreading the virus, those options aren’t available. “The families have been tremendously wonderful,” she says, often using FaceTime to play favorite music in the background or to call patients by a familiar nickname. “That does help.”
At Hackensack University Medical Center, Jacobs says usually they try to use non-pharmacological methods to help soothe distressed and confused patients. “The way we manage that usually in the hospital is basically staff sitting with a patient, reorienting them, using music, using touch,” she says. But with Covid-19, it’s too dangerous to have someone sit with a contagious patient all day. Instead, the hospital now relies on medication to calm patients down.
While mortality rates are higher for older adults with Covid-19, many do survive. What recovery looks like for them is more complicated. “That’s the other shoe to drop,” says William Greenough of Johns Hopkins. Older adults are likely to be weaker and to recover more slowly after a hospitalization, he says. With so many hospital gyms, rehab, and physical therapy facilities closed, that’s going to make their progress even more difficult.
None of these issues—loneliness, immunosenescence, difficulty recovering from hospital stays—are new problems, and none are unique to the virus. But the novel coronavirus exacerbates the many challenges older patients already face. “Covid-19 intensifies and complicates everything,” says Greenough.