Still not completely back~however…

 

While “must-do” and “don’t know how to do” have prevented my planned return via “INCHING TOWARDS EIGHTY,” I return here to wish all who are continuing to follow, a very MERRY CHRISTMAS and a HAPPYand hopefully much more stable and peaceful—2019.

Simplifying Helps People Age Better

As we inch towards 80–a new normal for me is attempted, taken from the late Sr. Advisor R’s “SIMPLIFY, SIMPLIFY, SIMPLIFY.”  Admittedly I don’t get an A+. That said, after trauma, overload etc. it makes sense to be conscious of ratcheting down…simplifying.

When on overload, it’s difficult. It involves decisions: what must be done and how to do it efficiently. Reconnecting at holiday time this year— after a 2-year absence since my husband died—topped my to-do list.

I was going away. Armed with address list, boxes of cards and stamps, in addition to the normal necessities, I headed to the DC area. Perhaps the break, getting out of the routine, contributed to clearer thinking. In any event, I take out the address lists, look at the quantity of people, and think “options:”

1. Computer-generated letter: print, fold, sign, address envelope, lick stamp…perhaps more personal and informative than a card, but as time-consuming.

2.  Emailed cards: Subscribers (I’m one at Jacquie Lawson) have loads of choices and the attractive holiday note cards allow for short or long personal messages. Some people prefer a card that can be held and displayed (I’m usually one). But the red and gold e-note-card prevailed. My unexpected reward came via the reply card that accompanies the e-card. I received many notes back—heartwarming and interesting, especially for someone who has been “out of the loop” and that includes so many older people.

Whether snail mail or email connecting at holidays enriches life. Doesn’t that help all ages feel good? And shouldn’t that help parents and us age better–if not–well.

Note: This blog still takes no ads. The link to JL is to get an idea of e-card offerings.

Aging Independently and Well Over Decades–10 How-to’s

“As we live our lives, we write our own destiny” Sr. Advisor R 

Sr. Advisor R,, my mil, was a poster child for aging independently, unselfishly and well. She said, to the extent she could, she’d done everything; helped everyone; and given to those she wanted to give. She was ready to go. It was no secret. And I’ve been thinking–since her timely death last week at 101–about how she managed life so well.

R lived by the following:   

 1.Take care of yourself (or you won’t be able to take care of anything else).
2. Be responsible
3. Don’t abuse yourself. (You get enough from the outside)
4. Know when to say “no.”
5. Simplify (as you age)
6. Don’t assume (you can be wrong; it causes unnecessary problems)
7. Don’t expect anything and you won’t be disappointed
8. Concentrate. (If your hands are doing one thing while your head is thinking another, you forget where you put things.)
9. Remember life is good–it’s the people who mess it up.
10.To bring joy in today’s world there are three things you can count on: animals, flowers, music.

Elaboration

1.  The African proverb “It Takes a Village to Raise a Child” resonates loudest. It may sound like an oxymoron. R was clearly not a child and independence was her highest priority. Making it easier for other family members was a necessity in childhood and became part of her being. She was smart–smart enough to know she couldn’t help others without taking care of herself first. At a very young age she was part of the village. Later the village gave back.

2.  “You’ve got to be responsible,” R vividly remembers her father saying when she was 4. It had a huge impact and she acted accordingly.  She recalled their quarantined home during an epidemic, an older sister’s death, another sibling’s health issues, the Great Depression, WWII, being a caregiver for close family and friends. Everyone knew R was 100% responsable. It was who she was.

3.  R’s home was the buffer for any outside abuse. She made it tranquil, lovely and loved–a place to gain strength and renewal. Widowed at 50, she didn’t indulge in activities that would be bad for her. This doesn’t mean she didn’t overdo in certain areas, but she had the discipline to know when she’d overdone and compensated as appropriate. She treated herself to things that brought joy or made life easier. Her easy-care plants symbolized life and joy thus, she replaced and watered them as needed until the week she died–not easy at 101.

4.  R taught us early there was nothing wrong with saying “no” and “I don’t know.” Simply  because someone asks, doesn’t mean we are obligated give the answer we think they want. (This doesn’t make us selfish. It makes us real–my opinion…and we can be very nice while being real.)

5.  Normal age-related changes slow us down. Simplifying allows us to continue life as we’ve known/enjoyed it. Examples:
–R’s many house plants decreased in number and care requirements as she aged. She gave many away and concentrated on the easy-care ones.
–While she went out every day in her younger years, she reduced to only one activity a day, then going out every other day. The last few months she only went out for doctors’ appointments.
–Still making her own meals, R realized she could save dish-washing by putting Trader Joe’s chopped salad greens along with salad dressing in a zip-lock bag, giving it a good shake, and spilling it out onto the plate with her dinner.

6.  Don’t assume. See #6 above. This is so true. Test it!

7.  Don’t expect. See #8 above. Seems jaded, but saves disappointment.

8.  How many times have we forgotten where we put something because our hand did one thing while our mind was on something else? We weren’t concentrating. Shortly after R was widowed she lost something important. She couldn’t remember where she put it. Without anyone to ask for help, R promised herself, from then on, she would never again lose things due to lack of concentration.

9 and 10 above: Life, animals, flowers and music–thoughts R kept front and center as she encountered the challenges of living.

In recent years R acknowledged that she did everything she felt important to do; helped everyone she’d wanted to help, and given what she could to specific charities that served a larger need-base of people and pets. She had significantly contributed to the village.

Since R’s only-child son and I live 2,000 miles away, the village–basically two wonderful neighboring women, Pam and Barb, and a nephew and his wife–made it possible, on a daily basis, for R to continue to live in her own home–with only a cleaning woman working half a day and a gardener. What better “assisted living” could anyone ask for! R had unfailingly done for them over the years and they could never do enough. R was a giver; never wanted to be a taker. In the end, what comes around, goes around.

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

Good Therapy’s “2014 10 Top Websites for Aging” honor–plus A Discussion of Differing Realities/Avoiding Arguments

Help! Aging Parents was honored in late December–selected as one of Good Therapy’s 2014 “Top 10 Websites for Aging,” they write:

As a self-proclaimed “serious, well-educated cheerleader for helping parents age well,” this blog shares information and insight about issues that affect geriatric parents and their adult children. Susan, the sole author, often tackles everyday issues that seem banal but can become problematic in old age, like swallowing medication or planning dinner events. She writes with humor and candor, and cites input from professionals as well as her “senior” advisers.

As we end the first month of 2015, much of the US is cold and elders understandably remain indoors. If we don’t live with them and are conscientious, we visit as often as possible. An issue that’s definitely “banal” (“ordinary or commonplace”) is the high temperatures at which elders set their thermostats to stay warm. It’s problematic when it’s suffocatingly warm in their home for us, but not for them.

There’s a lesson here–about who’s right and who’s wrong. It can avoid, happily more often than we like to think, arguments with older family members. First, the facts:

The NY Times addressed the issue of elders being cold in its no-longer-published Booming Blog, Factors cited include “a decrease in circulation as the walls of the blood vessels lose their elasticity and the thinning of the fat layer under the skin that helps conserve body heat. And as people age, their metabolic responses to the cold may be slower. Vasoreceptors, for example, may not be as quick to direct blood vessels to constrict to keep the body temperature up.”

Johns Hopkins’ After 50 Newsletter responds similarly to the question: “I’m older and colder. Why?then discusses Hypothermia. We learn “It doesn’t have to be subzero outside for hypothermia to set in. Research suggests that very frail, elderly people can develop hypothermia at room temperatures as high as 71 to 75 ˚ F! And 50 percent of those who develop hypothermia do not survive, usually as a result of going into cardiac arrest.” This article also has advice about staying warm, especially if elders must go out in cold weather.

Sr, Advisor S.RN adds that especially when she made home visits to those who had COPD, she “had to brace herself,” because their homes could be “so incredibly hot–like opening an oven door.” But they needed that additional heat.

OK. We know the facts; yet there’s something additional that’s important to understand. Reality is not carved in stone. In a counseling class at Teachers College years ago, the professor posed the hot/cold question. Its purpose, to legitimize people’s differing realities. He said something like “You and I are in the same room. It’s comfortable for me. It’s too cold for you. Who’s right?”  

If we keep an open mind, we can understand that both are right and save ourselves arguments. When elders are clearly “off-base,” we have choices. We can “pick our battles.”  When their “right” is clearly wrong and must be corrected, we most often must correct the wrong.

Here’s to avoiding some arguments and disagreements with our aging parents and the elders we care about.
Related:  Tough Talks, Difficult Discussions: The Best Way to Begin
                Aging Parents and Arguments: Who Wins?
***

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.

 

Tailoring the Holidays for Elders’ Needs

Some aging parents are lifted by the excitement and activities of Christmas; for others there’s overstimulation and stress. And at some point, for all aging parents, there’s a slowing down. Do we notice this? Can/should we do something?

Indeed, the holidays can be tricky for some and need to be simplified for two groups: aging parents/elders and those with Alzheimer’s. (See Related below for latter.)

There comes a time when aging parents and elders we care about can’t do what they used to because of aging-related conditions. I ran the preceding sentence by our Sr. Advisor, Dr. Bud, MD, (psychiatrist) asking for his thoughts.

‘”The consequence of aging is difficult to process. You (older people) feel weakness, frustration–less and less in charge. Your expectations of yourself to perform at a certain level leave doubts.” For example: “It can be a struggle to articulate thoughts and responses, causing frustration and fatigue from trying.” …And hearing–“You keep hearing loss hidden because it’s embarrassing. A joke is told, you miss the point because you don’t hear; yet everyone’s laughing so you laugh to hide your (hearing) deficiency. it’s embarrassing to expose weaknesses in oneself.”

As I listened I gained new insight–realizing why some elders I’ve known, who appear to function well one-to-one, begin to drop out of the “social scene.” It seems to come down to at least 3 age-related conditions:

1. Less tolerance for confusion
2.  Changes in energy level
3.  Pride

Knowing this, we can offer the support and do some of the “tailoring” so the holiday festivities provide less stress and more fun as parents age.

Confusion: Too much going on can be confusing. Think: holiday events–too many people to remember, too many conversations to pay attention to; too much energy in the room; too much noise–makes listening difficult. The solution: Encourage small festive gatherings of friends and family. They work best.

Dad enjoyed people, regardless of number. He held a high position in the Hospitality Industry and loved speaking at large conventions (introduced Ronald Reagan at one). Yet, in his later years, he slowed down–preferring fewer people, more easily-heard conversation. On short notice he (in his early 90’s) let us invite his friends for New Year’s Day 6 months after Mom died. We were visiting, made the suggestion, and offered to make the calls and bring in the food. Around twelve elders (88-90+) arrived that afternoon–ate, talked, laughed, watched TV. Our effort was minimal (Trader Joe’s everything) but their enjoyment was great. An easy way to lift spirits at the start of a new year on a small scale.

Similarly Sr. Advisor, R, remarkable at 97, had an unusual amount of energy for her age–even after her recovery from broken hip surgery. At 99 she was rationing her energy–declining invitations to go out two days in a row and avoiding large holiday parties. Shortly after her 100th birthday party, at her insistence a smallish affair–just family– she lost the “oomph.” Doctors say her health at 101 is “excellent for her age,” yet she uses lack of energy as her reason for staying home. She controls– has tailored the holidays as a time of giving to others. She no longer wants the festivities.

Energy: Older people’s energy declines. “Energy is always a problem,” according to Sr. Advisor D, now 89. She says sometimes it’s necessary to “pick and choose” what you’re going to do and it’s often dictated by the energy involved.

For example, this year she didn’t attend her family’s Thanksgiving dinner, an hour’s drive away. A family member could easily take her and bring her back. Just recovering from a bout of something, she said she didn’t have the energy to make the effort.

Do we realize it takes energy to have conversations? The need to quickly remember things and people can cause stress. It also takes energy to dress especially nicely to go out. It takes additional energy if a long drive is involved.

No-longer-driving elders are dependent on someone for transportation, which creates an additional obstacle: if they  want to go home early for any reason, they don’t want to impose on their driver, according to Sr. Advisor, D.

One solution: Someone (their friend?) drives elders to the event. They can call you on their cell phone if they want/need to come home early. We’re not talking about an every-night responsibility. Most likely an available family member can handle that responsibility during the holidays. ls this payback time? Isn’t this what parents did for us, should we have needed to leave a party early when we were teenagers? Of course, they may decide to stay and go back with the person who brought them.

Pride: Older people may not want friends and/or former colleagues to see any lessening of themselves.

One 90-year-old with advanced macular degeneration, for example, declined all invitations to large social activities, rather than risk the embarrassment of misidentifying or not recognizing people she knew.

While we can’t tailor large parties, there’s a solution so those with low vision can feel comfortable going. Several older people with macular degeneration go to parties with an early detection device– a good friend or family member who stays with them and discretely whispers in advance “Here comes Sally.” Can we be an early detection device for low-vision elders?

If this works for the President, who has people standing behind him quickly whispering the name and position of the person coming up to greet him at events, why not use this “crutch” for aging parents who have low vision and even those with bad memories?

After all, connections with others help older people age well. Isn’t that our goal?

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.


Related: 
Mayo Clinic Alzheimer’s blog. Especially read comments.
                For Elders Who No Longer Drive at Night: Suggestions for enjoying the Christmas lights

Aging Parents: Older Teeth and Sugary Holiday Treats

  • mall desserts $ 42 large desserts $ 78

A visit to my dentist and his hygienist compelled me to ask about older people’s teeth. My dentist’s (and his wife’s) parents are in their 80’s. I wondered if aging took its toll on teeth–and if so, why.

My first question was to the hygienist who I always see first. It was something like: Do older people’s teeth present different problems than younger people’s teeth?

Thus began a conversation about–
1. Holding a tooth-brush correctly so older people can do a thorough brushing
2. Dry mouth (xerostomia)–not uncommon as people age.

The hygienist told me she learned many years ago that tooth-brushes can be difficult for old, arthritic hands to grasp. The suggestion was to securely tape the tooth-brush to something allowing for a larger grip–like a soda can. Her second suggestion was an electric tooth brush, but that has drawbacks if older people don’t use it correctly.

I didn’t realize brushing could be a problem, but now I’m certain it is. Asking Sr. Advisor R (101) about it, I learned her dentist said she wasn’t brushing as well as she once could and recommended rinsing her mouth with Biotene. There are quite a few Biotene products–one especially for dry mouth and one with PBF; the latter Sr. Advisor R uses. It would seem worthwhile to check this out.

When my dentist came to do the final check of my teeth, he weighed in, giving me a paper he wrote entitled Dry Mouth and Dentures. (It will be the subject of another post). Readers may already know this, but I learned:

Our salivary glands produce less saliva as we age. And “saliva,” according to Dr. Gary Markovits, “contains hundreds of the body’s ‘natural medicines’ designed to keep our mouths healthy……. It also regulates the microorganisms (‘germs’) that cause oral infections.” Thus, dry mouth makes us more prone to oral infections.

“If you have some natural teeth,” Dr. Markovits writes in his Dry Mouth and Dentures piece, “decay is the most frequent cause of tooth loss in older adults who have a dry mouth. Without saliva to regulate the germs that cause decay, they are able to grow in number and cause more damage. Ask your dentist or dental hygienist for ways to reduce tooth decay.”

It’s not only aging that can cause dry mouth.  Certain medications as well as chemotherapy and radiation cause glands to produce less saliva. WebMD, in its slideshow on teeth and gums, sums it all up and identifies medications that can cause dry mouth (slides 3 and 4):

“Saliva helps protect teeth and gums from bacteria that cause cavities and given that a chronically dry mouth raises risk of cavities and gum disease, you may want to check your medicine cabinet. Antihistamines, decongestants, painkillers, and antidepressants are among the drugs that can cause dry mouth. Talk to your doctor or dentist to find out if your medication regimen is affecting your oral health, and what you can do about it.”

Which brings us to the holidays and the sweet treats and excessive amounts of food that tempt young and old. If older people we care about have teeth problems, this seems like a good time to be proactive and check out the above with your dentist or have your parents do it with their dentist.

As we try to help parents and the older people we care about age well, a good offense is the best defense. If the above information can improve the odds for older peoples’ teeth remaining healthy while they enjoy eating whatever they want, isn’t it a win-win!

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.

Related: http://www.webmd.com/oral-health/ss/slideshow-teeth-gums

 

 

 

Aging Parents: Problems Swallowing Pills? Here’s Help.

Milk? Tomato Juice? Pill Cutter?

Prescriptions for pills–more prevalent as people grow old. Yet before we are old, many of us are accustomed to taking non-prescription pills–some large, like Calcium. Perhaps that’s the time we learn whether swallowing pills is easy for us.

I never thought about pills causing anyone difficulty….until Mother, who had osteoporosis, couldn’t swallow Calcium pills. “Purchase a pill cutter” and “take them with a liquid heavier liquid than water, like tomato juice or milk,” was the advice. The heavier liquid solved the problem, although we’d already purchased a pill cutter (which we discontinued using). That was a decade ago. Chewable calcium has now solved that problem for many.

One in three people vomit, gag, or choke when swallowing pills, according to the Harvard Health blog’s post/article about swallowing pills (see sidebar for recent article or click link). Pharmaceutical companies, aware of the problem, have manufactured pills in many easier-to-swallow forms than those chalky white aspirins of decades past. Yet this hasn’t solved the problem for many.

While the article offers two “tricks” (which seem a bit odd to me) and the warning “Don’t try these alone,” plus other suggestions, there is professional explanation–with diagram– of how swallowing works and can be evaluated (some people suffer from dysphagia). The Comments section (at the very bottom following the post) offers additional simple “tricks,” and one reader who said the “tricks” worked.

It’s human nature to avoid doing something that’s difficult or unpleasant, we know this. We also know it’s easy for older people to forget to take their medications. Can avoidance subconsciously enter into forgetfulness? In any case, avoiding an important medication because taking it is difficult or unpleasant, can only encourage the problems the medication is prescribed to prevent.

Remembering and suggesting the swallowing tips is another way we can be helpful–as we try to help parents age well.

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical stuff–to help parents age well.

Aging Parents: 101st birthday

Birthday card from the staff

R reading birthday card from the staff                      (Click to enlarge)

We stick to our philosophy. We do what aging parents want as long as it doesn’t threaten life and limb and they still have, what Sr. Advisor R calls, “a good head.” R’s birthday was Saturday…her 101st. She didn’t like our original suggestion, thinking our plan of going to La Jolla overnight (which she loved when she was in her ’90’s–she spent summers there in the ’40’s)) would be too strenuous.

Thus, we follow the advice in last year’s post: Celebrating Elders Birthdays: What They Want, Not What We Want. R initially suggested a short drive to the mountains with lunch at a hotel she likes; but she changed her mind saying she didn’t have the energy. Next choice was the club she likes–where she has celebrated past birthdays and the staff knows her. She wanted to make the reservation for just the 3 of us and specify the table she wanted. Plan in place.

The morning of her birthday was not a happy one. Possibly she felt burdened by the responsibility unfolding–the abundance of cards and the phone calls–not to mention things (2 cakes, stew, cookies, flowers), that will require a thank you note. She keeps a list, still thinking she must send a thank you for each one. Old habits die slowly but she decided she would not write notes for local phone calls. She had over 30 remembrances when I spoke to her mid-morning.

Well-wishers’ phone calls made it difficult to get her on the phone. When I finally did, in addition to hearing about the cards and gifts, she had complaints: she’d lost her appetite, nothing was tasting good, she had no energy. When she spoke with her son, my husband (who called from the golf course unbeknownst to me), he heard the same thing. According to him, his response was something like: “you can do whatever you want; whatever you want is fine with us. It’s your birthday and your decision.” 

R was raised to be disciplined. I think that includes “don’t disappoint people” and was the only reason she followed through and was ready when we came to pick her up for dinner.

Our waitress remembered her (as does everyone, it seems). She said and did all the right things. A birthday card from the staff accompanied her cake (pic above). People at the next table hearing it was her 101st birthday (pic below) began a conversation. First, the man sitting nearest, then one of the women left her seat, and came and asked R her aging secret.

Answer: she eats healthy and equally important exercises every day. She may have disappointed the woman by graciously responding to a second question, saying she never drank much, adding she never really liked the taste.

By the time we left evidently everyone had gotten word of her birthday because she received congratulations from many strangers as she walked by their tables. (FYI: R walks with a cane and took the arm of her son–only uses her walker in the house to move things that could throw her off balance if she carried them [eg. pitcher of water to water her plants]).

R not only regained her appetite, she was energized and (as usual) very talkative. While my husband was outside getting the car, R sat inside on one of the chairs near the door. I had stopped briefly. By the time I reached the entry the new young woman who greets guests had left her position behind a desk and was sitting next to R, having an intense conversation. No surprise. People are drawn to her like a magnet. First by her age, I think; then her wisdom and empathy capture them.

I’ve always thought jump-starts are important for older people and adult children should be proactive in this regard. This small birthday celebration shows what a jump-start can do. We take no credit; R made the decision to stick with the plan. Had we insisted, would the result have been the same?


Check out: “Newsworthy” (right sidebar). Links to timely information and research from top universities,

plus some fun stuff–to help parents age well.