Aging–Macular Degeneration: A Determined 100-year-old’s Efforts to Maintain Quality of Life

R's 100th Birthday

                                                               R’s 100th Birthday

Sr. Advisor R has been called “amazing” for years by so many 40-60-year-olds, who also call her “terrific” and “timeless.” Past posts have underscored their respect for her wisdom and admiration for her ways of handling things. She’s both an advisor to this bog, and my m-i-l. And currently she is facing another challenge: a big round spot blocking vision in one eye–macular degeneration.

During 100 years of living she has overcome much–the last big hurdle: her impressive recovery from a broken hip (femur) at 97. That was three years ago. Her mind remains excellent for her age and she was aware her sight was suffering “a little” degeneration, but was getting no professional treatment and hadn’t noticed that her sight was changing until it suddenly began over several days.

Coincidently she had an opthalmologist appointment scheduled a few days later. While she began immediate treatment, the prognosis from two ophthalmologists is that results will be slow and no doubt limited. With her vision impacted and depth perception a real problem she is making adjustments.

“We take eyesight for granted–don’t realize how important it is–it’s your connection to the world,” says R, who adds “I’ll do the best I can with it.” With one “weak but useable” eye, she is using two magnifying glasses of different magnifications to finish doing her income taxes (making itemized lists) for the accountant next week. Everything takes much more time now, and planning how long something will take is “ify,” especially getting ready to go some place.

R acknowledges that when facing serious challenges in the past, she had to let go of some things and prioritize others in order to redirect her energy towards maintaining independence. This is the last year she will do her taxes. Which brings us to yesterday.

R continues with her life, albeit at a slower pace because vision problems affect simple things like putting on make-up and doing her hair. Yesterday she needed to go to the bank.  My husband or I could have done that errand for her but she didn’t want to give in to that.

She requested I pick her up more than an hour later than the usual time. The young woman who usually helps at the bank, J, was away when we arrived. She later heard R was there and appeared as R was finishing her business. “I haven’t seen you in months and I was worried,” was J’s greeting. Then ensued a conversation about R’s eye situation and being 100 and how much she admires R.

J then told what I believe to be a true story about a friend’s grandfather. We seem to like to talk about amazing older people who still make the effort.  At age 103, he still works out at the gym 4 days a week. Evidently one of the trainers told him that perhaps he should cut down the number of workouts–or at least shorten them. To which the grandfather asked: “How old are you?” Response: “30 something.” “I’m 103,” said the grandfather.

Whereupon a thought entered my mind: When older people are doing great and still have a good mind, why do younger people feel a need to give them advice? I know R doesn’t believe in what she calls “unsolicited advice.”

We hear more and more about people living into old, old age. No doubt all have some aging problems. The ones who “soldier through,” who make the effort, are the amazing ones. They have been called “The Greatest Generation.” I wonder if we will do as well.

R has often said “I’m a realist.” Yet I’ve never heard her say anything like “Growing old is not for sissies.” Instead she will be the first to tell you getting old “isn’t easy,” explaining “it takes willpower, energy, and common sense–more every year.” She has been widowed half of her life, thinks deeply and shares knowledge of a lifetime when appropriate. Her younger friends say she has taught them so much about living. It has cemented a special bond.

“They care about me and I care about them too,” she says.

If that doesn’t provide the bedrock for quality of life and a reason for making the effort, I don’t know what does.

Related:
In sidebar– 12/11/13 Mayo Clinic’s Age-Related Vision Problems and How the Eye Perceives Them

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Changing often: “Of Current Interest” (right sidebar). Timely links to research and information from top universities, plus some fun stuff to help parents age well.

 

Aging Parents: Feeling Alone in a Crowded Room–plus 2 Additional Reasons They May Not Want to Go Out Any More

It may all boil down to pride; staying home is safe.

No one likes to feel diminished, whether it’s unintentional or not. Yet going someplace where interaction with others is the norm can pose a threat to older people’s pride and self-esteem when they have certain aging issues. I think it’s safe to say many–if not all– older people begin to recognize what octogenarian Julia calls “a lessening of oneself,” adding “it’s not pleasant.”

When others no longer pay attention to them and/or or older people don’t want others to discover their “lessening,” thoughts of being with others away from home can be emotionally troubling. Three issues (you may think of more) that can cause this.

1. Mobility
2. Vision
3. Memory

Mobility: We Can Change This Scene

I’m was at a family gathering that included my oldest cousin (age 88) a widow, now living in Assisted Living due to heart and mobility problems. My cousins’ ages have a big spread. Many cousins (plus some of their children, grandchildren and a great- grandchild) were at the gathering. Age range was 2-90 (a cousin’s husband).

Since I live across the country I don’t see family members often. Things change in a year as we know. I try to remember Sr. Advisor’s wise words: Don’t assume. Nevertheless, I keep being surprised.

I was surprised, upon arriving at the gathering, to find my oldest cousin (a once capable working mother and volunteer) sitting basically alone in the living room, in a very hard-to get-out-of chair, while the rest of the family was socializing outside on the patio or busying themselves placing food on the nearby table for a buffet-style meal.

From time to time the youngest would run through the living room, with his aunt in hot pursuit.  My oldest cousin was in the scene but out of the action….ignored.  She could not move from the current chair without help. Evidently no one thought about that.

As she and I talked, I asked if she was comfortable or would prefer sitting on the patio. She wasn’t comfortable, she said, and two of us helped her out of the deep-cushioned chair and walked onto the patio with her. We found a suitable chair with a firm seat and arms from which she could stand up and walk (if someone put her walker into position for her). She was back in the action.

In hindsight we can change the scene by:

  • initially providing a sturdy armchair (with a firm seat) which is easy to get up from. A wheel chair would work even better for those who use a wheel chair.
  • watching that no one is ignored
  • having a sit-down meal, using informal place cards, for compatible seating

Seder: The O’Learys, the Steins, 99 1/2-year-old R, Us + 47 others, a previous post this year, is a model of sensitive people hosting a large event that includes an old person who hasn’t the energy to move around a lot.

Vision: We can be the eyes in an unobtrusive way

I think about a good friend whose mother was declared legally blind in her 90’s. My friend had an innate understanding of how to help parents age well–respecting and empowering. She related how her mother no longer wanted to go out if there would be too many people she knew. Her vision was so poor that she feared she wouldn’t recognize someone she knew well and that would be embarrassing.

We can’t change the scene, but we can safeguard elders’ pride and self-esteem.

  • When in a smallish group it was easy for my friend to remain by her mother’s side and whisper the names of people who were heading towards them. (Her mother didn’t want to be embarrassed by having her daughter say “You remember so-and-so.”)
  • Or she would take the initiative and say, for example, “Hello, Kristi” so her mother had the name before needing to use it.
  • When parents no longer drive but otherwise seem unchanged, let the person driving your parent know about the vision loss so when people can come over they can initiate “Hello Mary, it’s so-and-so.” or I’m so-and-so.

Memory

Memory issues seem more tricky. I am told a very successful man–once a leader in his community–was invited to a party all his friend would be attending. He had memory loss that was worsening. His wife, assuming it would be good for him to be with his old friends and attend a happy event, was insisting he go. He didn’t want to go, but gave up arguing. Instead he decided not to get dressed for the party.  His pride wouldn’t allow him to be any less of a person than his old friends knew and remembered. His wife didn’t get it….until he finally “put his foot down” in a way she couldn’t ignore.

As we try to help parents age well, we realize that older people can be easily marginalized by unthinking people–even caring people who would be appalled if they realized what they were(n’t) doing. Why does it seem easy to forget our elders have pride?
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Note-New: Check out “Of Current Interest” (right sidebar). Links to timely information and research from top universities about cancer, dementia, Parkinson’s, plus some fun stuff–to help parents age well.    

 

Aging Parents: The Practical, Important Foundations for Aging Well– Fundamental 3

4 Fundamentals–Fundamental #3

#3. Hearing: Regular hearing check-ups. Purchasing the right hearing aids when needed. Sr. Advisor, M, is–but almost wasn’t–a staunch supporter of hearing aids. Hearing well is a given–until we don’t, and risk missing out on stimulation and information. Hearing loss can become a safety factor as well if, for instance, one doesn’t hear a car coming—and what about heeding certain instructions. (Think telephone instructions, announcements at airports.)

After taking many weeks to adjust to her needed hearing aids, M was so enthusiastic about alleviating hearing loss that we devoted a post to her experience and advice- https://helpparentsagewell.com/2010/05/22/why-hearing-aids-get-put-in-a-drawer-never-to-come-out-again/ Not only do people with hearing loss miss so much, they also cause exasperation in those having to repeat over and over so it’s a negative for everyone. Clearly doesn’t help parents age well.

M has mulled over the question of why people easily accept wearing glasses to improve vision but resist hearing aids.  Perhaps because so many younger people wear glasses with fashionable frames whereas mostly older people have hearing aids (which they try to hide?). Thus, people generalize–hearing aids signify “old.” Is it because it takes perseverance to get used to them? Or is it because they’re expensive and many don’t purchase the best for their situation and spend money, but end up wasting it on an unsatisfactory product that’s not worth using for various reasons? Or they don’t know there’s a return policy.

Check: there should be a return policy on hearing aids. If the first don’t seem right after giving them a good try, try others. (Note: Dad bought expensive new hearing aids; died three weeks later; we were told to return the hearing aids for a full 30-day-refund, which we got…no problem.)

Also check this March 2012 video: http://www.youtube.com/watch?feature=endscreen&NR=1&v=wEoJsdhnW2A. It’s informative and features the Medical Director of the Ear Institute at the New York Eye and Ear Infirmary. He makes a good case for hearing loss being more noticeable than today’s small hearing aids. (US News‘s 2011 Best Hospitals edition ranks NY Eye and Ear #26 in Ear, Nose and Throat [and #8 in ophthalmology] in the US.)

NYEE has also posted an on-line “simple self-assessment quiz” under Get Your Hearing Tested at http://ilikemyhearing.org/?p=288

Become a Moving Target, See Well, Hear Well. Important for Aging Well.

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Aging Parents: The Practical, Important Foundations for Aging Well–2 Fundamental 2

4 Fundamentals–Fundamental #2

#2.  Vision: We know how precious vision is, but not as keenly as when it begins to fail us. We can probably do nothing about some of the normal, common age-related vision changes, other than making certain we and aging parents have adequate light. For example, that little flashlight to read menus in darkly lit restaurants, or an additional light or lamp to distinguish between navy blue and black (specially for men selecting socks); and I’m not sure what needs to be invented to see the color gradations that delineate steps off of curbs or elsewhere. (Restaurants usually go a good job of this with a contrasting color carpet or painted lines.)

That said, vision change can come on so gradually, we neglect doing anything about it, even when we realize we aren’t seeing that well. When I saw Milly (see last post) I noticed her expressive, blue eyes, possibly for the first time and mentioned how pretty they were. (Everyone likes a compliment and I suspect older people get fewer because they’re with less people for one thing.)

Milly remarked that she had cataract surgery. Said she hadn’t realized what a difference it made–everything was so much clearer. Didn’t realize things had become dimmer and dimmer. While it would have been impolite for me to probe further knowing what a smart, determined woman Millie is, I’m guessing cataract surgery had been recommended by her doctor–probably way back before it had reached the “necessary” stage–and she had continued to put it off after that because the changes came gradually (and her son lived 1000 miles away).  Point is–with no adult children living near, there’s a tendency to postpone for many. So–idea! I’m thinking we should probably ask parents about vision and cataracts (as well as other conditions) at some point, and if we get the “it’s not at the necessary stage” reply, offer to be there for them whenever that stage does become necessary.

Prevention is the best medicine, we know that.  And helping in any way we can when vision issues occur (assuming we know about them…..that’s important and will be the subject of a future post) makes so much sense as we try to help parents age well.

I’m dividing my time between NY and our soon-to-be closing date–cleaning out our suburban home, where I have no internet access. So bear with me for the next two weeks and keep checking back. I will post each chance I get, even if it’s not Tuesday and Saturday. Hearing, then Eating and Drinking will follow.

Gifts to Aid Reading for Seniors With Low-Vision: An Additional Post for Black Friday and beyond

ezRead, iPad, Kindle

With Black Friday upon us, these 3 gift options can make reading easier for aging parents with low vision problems. Do check out the specific attributes of each.

I’ve read somewhere–you’ll no doubt check– that the iPad works better than the Kindle in certain light (natural vs. artificial) and vice versa.

One of my senior advisors with macular degeneration says the Kindle is “too gray” so doesn’t have the clarity for her that the iPad has…perhaps it’s the light she’s reading in. Marti Weston follows her 87-year-old father’s challenges and successes-after buying him an iPad–on her blog As Our Parents Age. (Click rectangle below for newest iPad version.)
 That said, the ezRead is a different option and a different technology. It magnifies reading material onto a TV screen. Check out the Amazon reviews.ezRead, DR-200, DR200, Magnifiers, Carson Magnifiers

Whether you can find these at extraordinarily inexpensive prices on Black Friday or not, they are worth checking out.  Happy Shopping!

Note: My blog, published twice weekly, combines material from reputable studies, research, and my senior advisors’ advice, with my counseling background and creative ideas.  I take no advertising. My goal is, pure and simple, to help parents age well.  If this resonates, I hope you will follow/subscribe.

 

New: “Of Current Interest”(right sidebar). Links to timely information and research from top universities about cancer, dementia, Parkinson’s, plus some fun stuff–to help parents age well.    

A Father’s Day Round-Up of Gifts for Aging Dads-updated 2012, 2013

Father's Day Cake made by Esperanza

Father’s Day Cake made by Esperanza

NOTE: 2015 ROUND-UP OF GIFTS FOR FATHERS AND GRANDFATHERS–PARTS 1 AND 2– IS THE MOST UP-TO-DATE GIFT LIST. READ NO FURTHER, JUST CLICK THIS LINK 

The cake should look familiar–from my last year’s Father’s Day post. Today I’m rounding up gift ideas from my past posts and adding some. Indeed I’m also adding some hidden agenda items that enhance aging parents’ quality of life, designated **. (You’ve probably thought about them but never had the courage to act.)  Since Father’s Day is Sunday, here’s the list–by categories–that should help us last-minute shoppers.

Accessories/Clothing:

  • Cane (measured correctly) or walking stick
  • Hat (to shade a bald/potentially balding head)
  • Sport shirt. (Dad liked long sleeve ones to protect his arms from skin cancer–a definite concern as he aged.)
  • Sleeveless cardigan (not over the head) sweater vest. Easier to get off and on if buttons aren’t a problem. Older people run cold. Dad wore it at home. It also looked good under a jacket when he went out. (This style is hard to find…know someone who knits?)
  • An easy-to-use umbrella–opens/closes with the push of a button. Note: there has been a lot of rain this spring. (Totes makes one.)

Computers–especially designed for seniors: Check the 6 options in my May post https://helpparentsagewell.com/2011/05/28/computers-especially-for-seniors/  .

  • A-Plus Senior Computer
  • Big Screen Live
  • Eldy
  • GO computer
  • WOW computer
  • Pzee computer

  For the even less-technology-talented, check out 

Entertainment:

  • Magazine Subscription
  • Netflix
  • Subscription to newspaper–hometown, financial
  • Tickets to sporting events etc.–accompany Dad or for Dad and a friend.
  • A short outing with Dad (fishing trip, golf game, movie, zoo, his old neighborhood if it’s near–you might learn additional family history).
Health:
  • Membership to the YMCA
  • Membership to a gym
  • Membership to Silver Sneakers
  • A good blood pressure gauge may be a gift that helps parents age well, possibly recommended by doctor.
  • A great pair of shoes for walking
  • **This medication reminder was featured in a respected hospital’s magazine, sent to seniors in surrounding communities.  http://www.guardianmedicalmonitoring.com/medication-management.asp.  Good idea for forgetful fathers (and mothers)?

Hearing:  Hearing loss in older people is a problem for them and us.

I pay little attention to company’s emails sent to my blog’s gmail, but because of the Times article–this interested me.  Click the amplified phones picture for Clarity’s offerings. A few phones (may or may not meet your Dad’s needs) are on sale for Father’s Day.
 
Googling “telephones for hearing loss” provides additional phone options.

Pampering
  • Starbucks VIA ready brew individual instant coffee packets–regular or decaf in 3 or 12 packs for coffee lovers. Microwave in mug. Pricey. Dad probably wouldn’t buy it for himself.
  • A massage or a professional shave
Vision: We know aging produces vision changes in many.
  • Large print books (for dads who still like the feel of a book)
  • The Kindle or other electronic book, where the font can be enlarged–a Godsend I hear
  • The mini-maglite, small flashlights that give great light in dark places.
  • Pocket magnifying-glass takes up little space, is light weight, not pricey ($9.95 at Barnes & Noble), remains lit without having to keep a finger on any button, great for reading (menus/bills) in dark restaurant.

You can laugh with Dad if your “hidden agenda” gift is discovered. But he will know your heart’s in the right place.

……..additional ideas in next post.




 

Combatting Vision Loss With Strategies You May Not Know About (includes special information for Veterans)

While vision loss is sobering and scary, Jane Brody’s NY Personal Health column in the December 28th NY Times, Science Times Section, is an important read, offering strategies and information for people with vision issues.  Those with macular degeneration and Veterans with impaired vision will find this column especially compelling.

An 84-year-old man of intelligence and means, who wouldn’t settle for a diminished life due to macular degeneration, finds ways to overcome low vision, enjoy independence and quality of life. His search and the information he uncovers is detailed in Jane Brody’s column.  http://www.nytimes.com/2010/12/28/health/28brody.html?_r=1&ref=health
Pass it on.

It’s hard to predict how people react, because we can’t stand in their shoes. Yet I think anyone with serious vision problems would consider the information in Jane Brody’s column a gift of hope.  Agreed?