Tending our Boundaries in Advanced Aging

Growing up and growing old years are times when personal boundary setting receives more attention. The nurturing of our early years taught us one way or another about sense of self, boundary setting and the associated values.  Growing up and growing old years are also times of greater dependency when personal borders tend to be  more porous and ignored in  both casual encounters and targeted helping relationships.

As an example of nurturance, my own boundary learning was acquired in a bicultural, bilingual Swedish-American household where I was taught not only by my parents but by my 5 year younger sister. Two specific aspects of personal boundaries of it were linked to my relationship with her. She developed a sharp sense of self very early and vehemently announced in one of her first multiple word sentences, “You ain’t the boss o’ me!” At seven, she began her long journey to becoming a highly respected professional violinist and teacher. I joined her in the first decade as I learned the skills of being a piano accompanist. During music lessons we were taught that making music together required merging both egos and skills. We worked on it in hours and hours of practicing and performances. Once we grasped the idea we were able to recognize the difference in both the quality of our performance and our experience. i.e. the emotional high’s when we achieved unity and the disappointment when we hadn’t. 

Another pivotal learning experience took place at 18 when I began the clinical phase of learning to become a nurse. Here, patient care required us to regularly invade our patients’ physical borders and sometimes even the emotional ones. We were taught how to do it “professionally” and also the important ethical responsibilities.

As a nurse and later an educator, I continued to learn about professional border-related encounters. Both casual and more purposeful encounter opportunities abounded daily in relating to colleagues as well as students.

Being nudged into writing this blog has led to my seeking even more knowledge from the aged person’s needs and perspectives. My being almost housebound and living alone limits social encounters and even those may relate to  my  age related changes (ARCs). I’ve found I’m uncomfortable about revealing my progressing limitations and compensatory strategies that don’t work. But, on the other hand that approach is self-defeating. I do need help (or at least adaptations to my ARCs) and that help tends to be more efficient when it is tailored to real capacities, strategies, and requirements.  So, pride swallowed, I try to share my status when it’s called for. What I’ve found with professional care providers is that sharing ARCed capacities requires seeing the situation from their perspective.  Paid encounters are most often time limited ones where both focus and task are discipline-specific.

In a rehab center recovering from broken forearm bones (encased in a full arm splint), my treatment included physical therapy to strengthen and manage the rest of my body. The ARC data I needed to share with her was related to my ARCed stamina. Exercises and repetitions I could manage in the morning were more than I could do in the afternoon. It was viewed as failure to try so she worked on my motivation. My effort and motivation were 100% but my capacity was not. I tried to share specific ARC data in ways that didn’t sound like whining excuses or resistance, e.g. I could do isometric exercises in later hours just not mobility ones.

At 100 I’m realizing that my ARC s of decreased short term and working memory are also affected by my distractibility. (Even a rubber band for snapping on the wrist to remind me gets forgotten.)

I’ve finally become up-front about this situation and have alerted family, friends and colleagues to stop me. Some will, but people really are remarkably tolerant even with this person I don’t want to be. I also notice that while others are assessing me, I’m assessing them and then storing that information for my adaptive strategies.

It’s obvious that boundary protecting is truly complex. Still, it’s there to be dealt with, however we manage it.

Tending Self-respect in Advancing Years

Nature: traits/personality prewired by genetic and other biological factors

Nurture: the influence of external factors after conception, e.g., the product of exposure, life experiences and learning on an individual

Self-image:  the mental images we have of ourselves built up over time

Self-respect: one’s sense of self- worthiness, esteem

Self-respect is a strong but rather quiet element of our being that routinely gets less attention than some of our other qualities.  It is linked to both our nature and nurture. We build our self-respect during the decades of our pre-adulthood. A large and solid research project that followed over 3,500 Americans showed that it grows during the years of adulthood, peaking at the age of 60. Then, self-respect is buffeted by: the changes in our social/work relationships (including retirements, and deaths of those important to us), and the arrival of normal age related changes (ARCs) affecting both appearance and function, overlays of abnormalities which affect both capacities and requirements.

This then is the situation and our personal reality within it. But there is the other very important dimension, our responses to our own situation. Given our nature and nurturance, how are we dealing or going to deal with it.

It has taken me decades and the buffeting of my own aging experience, but I seem to have found some ways to retain/ regain self-respect. It seems to have come from:

• honestly examining the deterrents in both environment and  life events
• acknowledging/owning changing capacities as a point of departure. 

In retrospect there was a need to personally ponder on what was possible to best manage individual elements of the  presenting situation. In the beginning (as you could see in these blogs), I looked at capacities in terms of what had been lost and the requirements as uncomfortable hurdles, even threats.  But at some point, after reading about the 100% approach. . .  a different perspective emerged. Capacities were viewed as 100% for that day. Still later requirements emerged as opportunities to exercise my adaptiveness and 100%’s. The perspective shifted to a micro rather than macro approach. What followed was increased acknowledgement that capacities were actually each doing their best with their current 100%. Rickover’s quote, “The devil is in the detail, but so is salvation” became a constant perspective. Details and a valuing of small, even very small seem to be the keys to protecting and even growing the sense self-respect/worth/esteem.

Personal progress report:  At 100, the 100%’s of capacities keep dropping. The requirements in daily living (though much simplified), remain to be managed in one way or another.  Expectations are becomingly increasingly modest. The physical world has never been smaller, but the virtual world has never been larger.  It’s producing a sense of tentative contentment, and a tested but more solid self esteem, with an  expectation of  continued serious testing of it lying ahead in the time that remains.

How are you tending your self-respect?

When Older Means Colder

Everyone notices that older people tend to dress more warmly and want their living space heater set at higher temperatures.  Feeling chillier with the onset of autumn and winter is the response to normal age related changes (ARCs), in four major body systems.

Body metabolism (the chemical reactions in the body’s cells that change food into energy).  This in turn contributes to one’s body heat. Metabolism decreases with increasing age. This means that our internal furnace is not working as well.

Arterial and arteriole blood-vessel walls become thicker, less elastic and tend to have more buildup. They lose ability to relax as quickly during the rhythmic pumping of the heart as they carry oxygen-rich blood to all other parts of the body.

Body fat distribution that serves as insulation changes with age in both women and men as it shifts from extremities to the trunk where it insulates vital organs.

Muscle mass is lost .                                                  Skin thins and its structure changes.

These then are the hindrances we face as we try to stay comfortably warm.

We each have living conditions and resources that determine how we can deal with the cold in our own situation. The following responses are those I found in the literature and used as guidelines for my own staying -warm strategies.

Foods/nutrients can rev up metabolism. Protein is important. It is found in lean meats, poultry, sea food, no-fat or low-fat dairy products such as milk, Greek yogurt, cheese, tree nuts; oatmeal and vegetables such as dried beans and lentils.  Fruits include: oranges, grapefruit, kiwis, strawberries, pineapple, mango, guava, and papaya. In beverages, coffee, tea (black or green) and cacao. Alcohol however is the enemy of metabolism!

Clothing creates external insulation. Clothing items, fabric and style whose weight, weave and texture keep our body heat in and the cold out for each exposed body part. I find myself using multiple layers and my slippers are fleecy. For bedding we can choose flannel sheets and pillow cases, quilts and even use electrically heated mattress pads or blankets as well as wear head coverings keep one warm at night.

Drapes over the windows can be pulled to close out the cold.

Ambient air around us offers a comfortable temperature.  I’m  one of the fortunate ones with both a thermostat controlled furnace and a gas fireplace close by my recliner. The glow of the fire adds coziness to longer black nights as well as comforting warmth.