Above: A quick ink and watercolor sketch of Phyl as she colors in her adult botanical coloring book. (She likes one from Lisa Congdon—and frankly I think Lisa’s are the best as the images are NOT psychedelically rendered with minute spaces too small for elderly eyes to color in. Besides having nicely sized shapes they are pleasing designs.) This is in a 5 x 8 inch Moleskine Sketchbook with the new whiter paper. Read the Moleskine Sketchbook review here. Click on the image to view an enlargement.
Besides showing you this sketch of Phyl done with a fine point Sakura Pigma Sensei (probably an 04 as I use that a lot) I wanted to make a couple points about aging—because it’s always on my mind these days, as I help and sometimes just sit with the folks.
If you have parents or in-laws who are entering their elder years you’ll soon discover that there will be hundreds, if not thousands, of small but involved tasks that you have to undertake on their behalf. Or if you don’t live nearby and therefore can’t do these tasks you’ll have to hire someone to do them.
Things may start changing as early as their fifties. And at first the accumulation of tasks will be small and you won’t notice it. After a decade or so it will even seem simply normal.
I’ve written about all that before.
What I want to draw your attention to today is a list of things you need to hear about yourself!
You are aging too.
And while you may not like to be reminded of this fact you need to start preparing as well. I’m not promising that you can avoid some of the effects of aging that have plagued Phyl and C.R., but I can tell you that if you do a few simple things right now, you’ll be in a far superior position to them when you are 95.
Why start to think about these things now when you are in your forties, fifties, and sixties? Small actions can actually yield high results.
You’ll hear some of this stuff from other people—maybe even seen an article on it that either tries to scare the shit out of your or candy coat things. But many of you might have no experience of aging, have no friends who've been through it with their parents yet, and many of you may never had helped someone through their elder years.
Just as I write a lot about art materials and things changing I feel I have to give you a heads up about these life changes, because all around me I see friends, acquaintances, and strangers acting and talking as if none of this can happen to them.
It all can.
Some of it you can’t escape. Be very careful about watching the final episode of Wallander with Kenneth Branagh if you think that Alzheimer’s can’t happen until you’re old, and that then it somehow won’t “matter.” (Branagh did a wonderful job—it’s just a difficult episode to watch as viewers will be invested in this character.)
There are obvious things that you can do to make your future life better.
You can stop smoking.
Let’s talk about that for a moment. Phyllis smoked for 40 years. She wears an oxygen mask and coughs and has little energy, as she has no breath. She doesn’t complain about any of this as she was never very active and she's not a complainer. But it does effect her health prospects.
C.R. smoked cigarettes and then switched to a pipe, which he likes to claim is better, or actually no health risk at all.
Dick, however, remembers going into his dad’s study and not being able to see his dad, or the opposite wall of the room, because of the density of the smoke filling the room. Smoking, in C.R.’s case led to bladder cancer which is an ongoing battle, and heart problems (triple by-pass), and hardened arteries. He didn’t attend to a blockage in the neck artery feeding his brain, so by the time he was in his 80s his mental functions had deteriorated—a difficult result for a man who lived his life proud of his mental capabilities. He has vascular dementia and has no short term memory (things flow through him in less than a minute). He can’t remember what he did five minutes ago, let alone earlier this morning, or yesterday. He is also losing past memories. Frequently he has vivid dreams or mishears someone and then believes something is true that isn’t—that Phyllis has died, or his daughter, or that someone has it in for him.
I watched both of them give up smoking almost 40 years ago. I know it’s a difficult thing to give up. If you smoke I hope you can find the help needed to give it up.
Here are some other things to think about that no one may have talked to you about yet.
When you lose your hearing your brain starts to forget how to put language together and you not only lose your hearing but your comprehension! I didn’t know this until I took Phyl in for hearing aids several years ago.
C.R. won’t wear hearing aids. Even with sound augmentation during testing he can only score 56 percent comprehension. He’s lost that much.
If you’re having difficulty hearing, get help. It will only get worse and have ramifications you don’t want to deal with.
Everyone knows that as you age it is more difficult to maintain a “healthy” weight, even if you have a healthy diet full of good foods. Your body just doesn’t process things as well as it did when you were young. For women you’ll probably see metabolism shifts during menopause. Keep this in mind as you put off giving up the candy for fruits and vegetables. (I’m not saying give up candy completely, heck, you would know I would never say that, but think about your diet and how it fuels you and enables you to do all the things you want to do and need to do.)
Make good habits NOW, because if you think you’ll be able to start doing something when you’re elderly you’re just kidding yourself. Humans are creatures of habit and if you don’t have good habits now, they will only get worse.
Drink as much water as you can. Obviously not so much that you become lightheaded—but enough to keep hydrated (your doctor will tell you how to tell when enough is enough).
Why? Because as you age you’ll forget to drink water if you don’t have this HABIT of drinking water now. You'll also perhaps have incontinence problems, but if you're hydrated now you'll be able to come up with options for that later!
You need water to do all the things a body needs to do, but you also need it so that you don’t get dizzy, lose your balance, fall and…well you get the idea.
Physical Therapy Exercises
Start doing Physical Therapy Exercises for lifting your feet, using your shoulders, and a thousand other things you’ll depend on when you are old NOW.
You might tell yourself, “but I walk x amount each day” or “I ride 18 miles a day on my bike,” whatever.
It doesn’t matter. Participating in the latest endurance Mudder isn't indicative of your overall health. You aren’t practicing the necessary activities.
One of the main reasons elderly people fall is because they don’t lift up their toes. There are exercises you can do to keep your foot “action” healthy.
As you age, if you can’t use your shoulders you can’t get up out of chairs; you may not be able to use a walker; and you can’t dress yourself. You may even need help in the bathroom.
Talk to a physical therapist sometime in your 50s and learn the types of exercises (such as toe and heal lifts, and seated marching), as well as the proper way to get in and out of a chair (yes there is a proper way) NOW, so that you can get into the HABIT of doing things this way so that you have this habit as you age. You’ll stay mobile and independent (if you’re fortunate to avoid other issues) and you won’t have to learn new habits.
C.R. Is increasingly frail. I sit and do his exercises with him on every visit because if I don’t, he won’t, but he’ll tell me he has. We’ve tried charts to be ticked off, we’ve had helpers come in. Nothing works. Because he didn’t have a habit of doing any of this before he moved into advanced old age. (At this point his memory is so bad even if he had the habit it wouldn’t matter, but for the past 7 years I’ve been helping him with his PT because he wouldn’t do it without that input.
Most important start in on some balancing exercises. I have some that I do with a rubber cord attached to a door knob. (They actually also help my shoulder, so it’s a two-for-one type thing.) Again, talk to a physical therapist and find some that are suited to your current situation.
Eat Less Sugar Now
Look—I’m not telling you to give it up (we’ve been through that) just eat less sugar. If you live into your 80s or 90s all you’ll want to eat is sugar and you that will spoil your appetite for the protein you need to eat in order to keep your muscles from wasting too quickly.
The other day I took mini muffins over to the folks for a celebration. (Believe me these were mini, mini, mini. Much smaller than a regular cupcake size even. Basically 2 small bites.) I explained what each was. Phyllis chose a banana-chocolate chip muffin. C.R. chose a pumpkin and walnut muffin. Later he announced that it was really good and made with really good chocolate! There was no chocolate in his muffin. His taste buds hardly function at this point. He responds to sweet, maybe to salt, but really to sweet. Candy sweet not fruit sweet. His apartment is always littered with candy bar wrappers (because of his blindness he can’t see where they have fallen).
Eat the foods you need to fuel the activities you need to do. Get into this habit now so that later you can do it automatically. Because believe me you won’t be able to switch that habit on your own later.
Get some real cardio and strength exercise right now. It’s another good habit you need to form now, so that you can do it seamlessly in later life. (Your doctor can help you define what is "real" for your health and situation.)
Like Nike says, “Just do it.” You want at 85 to just get up and go out the door and run, walk, bike, whatever.
I should point out that if you can bring yourself to SWIM laps in a pool it’s the best thing you can do. Dick will tell you this himself if you ever meet him and exercise comes up. I’ll admit to it here but don’t tell anyone I said it or I’ll deny it. Here’s the deal— swimming is less stressful on your body. You can get a great cardio workout, but remain flexible (something key for the elderly) and injury-free.
I haven’t been in a pool for 30 years. I had an ear infection in graduate school that was a pain to get rid of. And then I got tired of dealing with all this hair and the chlorine. Green-blonde is a nice shade on Dick, giving an interesting complement to the ginger flecks that still remain, but I’m not interested in going there. Yes, we’ve reached the point where MY vanity kicks in.
Also I don’t care to shave my legs. Since I almost always wear slacks there isn’t any need, as long as I don’t go swimming. (Do you know how many HOURS of my life I have saved and used productively in drawing, exercising, and just having fun because I refused to shave my legs!?) I am still at the point where going swimming without shaving my legs would be "traumatic" in some way for me. Silly as that might seem. I recognize this, laugh about it, and continue simply to cycle. (Which of course means wearing cycling shorts at least part of the year and I still don’t shave my legs—what’s the difference? I like to tell myself that I’m going so fast no one has time to register anything about my legs, shaved or not.)
And while we are on the subject of cycling let me say something about cycling shorts—everything I own is about 2 sizes too large, except for my cycling shorts (and tights for fall). I like my clothing to be LOOSE. I like to be comfortable. I like to be able to MOVE (i.e., run, if chased by spies). But if you cycle, let me tell you—go out and buy some cycling shorts. Yes they are tight, but you can get them so they are form fitting not constraining, and your legs will love you for it as they will actually make it easier for you to pedal.
When I returned to cycling in 2008 (after a break while we had dogs) I wore cut off sweat pants for awhile, and then some combo shorts that looked liked regular shorts but had a cycling pant inside. Both of these options worked OK, or so I thought. But one day on a whim I used my REI member dividend to buy a pair of Pearl Izumi Select cycling shorts for women and my life changed immediately! I could stand up and pedal wildly up a hill and not have to “rearrange” myself when I sat down. I didn’t get any chaffing, ever. My cycling times and distances improved. I immediately went out and bought another pair, and then another. Now I have multiple pairs all the time. I wash them in cold water and put them on a drying rack. They LAST FOREVER. I have put 6,000 miles on one pair and they still function as intended.
If I, who am claustrophobic in tight clothing, can wear these shorts, so can you. And you will see an immediate improvement in your riding speed, duration, and enjoyment.
I might wear t-shirts filled with holes and covered with ink and paint stains when I cycle, but where it matters (shorts and shoes) I encourage you to buy-in. Your body will thank you. (Oh, and yes I have some jackets that are for cycling, but I don’t have to wear them much.) What I’m saying is, you don’t have to dress in a full body cycling suit covered with lime green and pink logos and endorsements. You can still be stealth and incognito. But you’re going to want to have some cycling shorts and shoes.
But back to swimming, if you swim and walk now (for the weight bearing aspect that will help your bones), and get that habit, by the time you are elderly you’ll have a habit that will keep you fit.
Maybe that’s worth a little green hair. Or maybe you can tolerate hair-care-product fragrances enough that this won’t be an issue for you?
Think about it.
Do something now that will ensure you’ll keep moving later.
And if for some unfortunate reason you get injured as you age, GO IN TO THE DOCTOR and get physical therapy immediately. It only takes two weeks (TWO WEEKS) for an injury-induced gait change to become permanent. Toughing it out is never a good idea.
Putting Your Things in Order and Clearing Your House/Home
If you are seventy or older and you haven’t done this already—shame on you. You are basically egotistically deciding that your kids or other family members will do this. Don’t pass this task on to someone else. It isn’t about you giving up control and having to move “to an old folks home.” It’s about you getting your life organized so that someone who is helping you (typically for free) can get into your environment, make sure it’s safe, find important tax and medical records they might have to start filing for you, and not have to use their life to wade through yours.
If this job has been relegated to you, you have my deepest sympathies. I recommend that you work extra hours to be able to afford hiring someone who then does this task.
And when it does come time for someone to move out of his/her home, there are companies you can hire who will also clear out the house and prepare it for sale. You want to hire them as well. Save your time for spending with the elderly, and not injuring yourself by doing work that shouldn’t have been left so late. I learned this first hand.
Save a Ton of Money And Talk Things Through with Your Family
Yes, I know this isn’t going to be possible for most people who read this. I’m just saying it because I wish someone had said this to me when I was in my 20s. And at the same time shown me eldercare examples—dire examples. Something concrete that the logical mind, even a young and “invincible” logical mind couldn’t argue around.
Care is not cheap.
You can have kids who help out. (If of course you have kids, and they are willing and able to help out with their time.) But if you don’t have kids, eldercare is going to cost you.
In the past 25 years Dick and I have been doing the things we do for the folks because in the previous 10 years for me, and throughout Dick’s life for him, the folks did things for us. And we are kind of fond of them. But we’ve also been fortunate in that my job as a self-employed person, and Dick’s work have allowed us flexibility so that we mostly lose time while doing things for the folks. I can work in the evenings (clients don’t need to know) and Dick has lots of vacation days he can use.
We talk about the choices we make often. We refine where our efforts are going.
Be sure that you talk to your family about what you can or can’t afford to do financially to help your elders.
Basically just talk and look for options. There are options.
When we got to the point that it was obvious the folks were unsafe at home and needed to go into assisted living there was a lot of discussion. And that discussion is ongoing, and will be, because their health situation is constantly in flux.
So start talking with your partner and your family right now about all of this. You have some hard choices you need to make. But they are easier if you start talking now.
And be prepared to make hard choices. You have to set boundaries that work for your life.
And talk to your FRIENDS. Talk to anyone you know who is going through eldercare. And if you have just started eldercare, ask everyone you know questions. There really isn't a manual for all this and you will daily be amazed at two things.
1. How many of your friends have already solved, or have options for a problem you are experiencing.
2. How what seems obvious to you is something your friend hasn't thought of yet and will need to think of pretty soon. And can be thinking of sooner if you mention it.
Protect Your Teeth and Eyes
The way the health of your teeth goes, so your health goes. This is true for dogs and PEOPLE.
The eye stuff goes without saying. Know the signs of retinal detachment and macular degeneration, go in for yearly checks.
Why I Wrote About All This Today
I didn’t write these things to scare you or bore you. You may be both.
I wrote them because even with several friends going ahead of me through eldercare with their parents, and honest discussions with them, no one ever talked to me about any of this stuff. Maybe it is so self evident people think they don’t need to talk about it, but when you are standing next to a 95 year old man who is almost too frail to walk, and when he does walk he’s in danger of falling, and you have to remind him to do his physical therapy, you’re glad that you sat down and did toe and heel lifts with him because you know you’re getting that habit NOW. (And I’m pretty fit and let me tell you some of the exercises he has are difficult even for me!)
I just want you to start to think about all this.
People tend to believe that one of two things will happen—they will die before any of this extreme old age stuff kicks in, or it simply won’t happen to them and they will die in their sleep.
Good luck with that. I’ve been involved in end of life with five people. Not one of them died in his or her sleep. I’m not saying that’s a large or even significant sample, I’m just saying I’ve never seen it. And young or old something happened to each one of them that severely limited their quality of life. The one person who came through it the best ate a healthy diet (with treats), kept her weight down, didn’t smoke, kept active, kept her flexibility. She did all that on her own. It was her habit! In the last 10 years of her life she had four adults on-call to help her, take her shopping, and eventually cooking for her. But the basic work, the habit building stuff that got her through, was all her doing.
Dick’s maternal grandmother was a great role model for living well into her 90s.
Of course she was also a role model for the hubris of man—“Dickie, I just had to get that pan from the top of the fridge right now,” she said, after she stood on telephone books to reach it and slipped and broke her hip. “And I’d do it again,” she continued. (Even though we were right upstairs and she could have just asked us.)
We might also all get into the habit of asking now and then.
Postscript 5:10 p.m.—Other Things To Think About
Readers of this post have brought up some really good points and I encourage you to scan through the comments on this post in case I have overlooked something, or someone adds something in the future.
There are a couple things I want to call to your attention that their comments reminded me of.
UTI—Urinary Tract Infections—Ask your doctor for the signs, and have them run tests to check for these if there is any doubt, as they can a huge problem with the elderly and lead to other issues.
ALWAYS carry a list of all hospitalizations and illnesses. Doctors will always ask you about this and you can't count on the elder to remember. CR has a metal valve in his heart and he would happily let people put him in an MRI which would not be good! We even have the part number on his info sheet. You also want to have a list of all medications (even vitamins) that your elder is taking. Dosages are important. I carry PDFs of both of these lists on my iPhone so that I can email them to the doctor if they want to print them out. (I also carry hard copy but sometimes you need more than one copy.)