Help Has Several Faces

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Throughout my life I’ve been involved in helping and being helped. In earlier times I tended to take help more for granted. As a child I received help, some I wanted, some I didn’t. As a nursing student and RN I learned to offer purposeful specific health related types of help. It was what nurses did. As a teacher I learned ways to help my students. In familial and social relationships, I learned other approaches. From all of them I learned about the give and take of different helping relationships, somewhat as a matter of course.

Then came the time and experience of aging where my prevailing situation has become more often that of being the one in need of help, with only limited capacities and resources for helping others or even reciprocating to those who help me. Engaging with this helping element of aging led me to start looking at the basics of this helping business.

I began to see helping as consisting of three options: doing to, doing for and doing with. I looked for examples of each in my daily and found them.

I thought of those whose help involved doing to me.

I consult and use professionals to manage my physical health, e.g. the dentist, dental hygienist and physician who diagnose and prescribe and at times do to me, the pedicurist who keeps my (now distant) toes and feet in shape. Since I take the initiative in consulting them and the extent to which I follow up on their proposals, I still have some options. But I can readily foresee situations and institutionalizations in which the doing to will be increasingly extensive and out of my control.

The next “doing to” is less obvious. These examples involve those who knowingly or unknowingly communicate words and behavior that “do to” my mental and emotional status for good or ill.   But thus far, I sense that I do have some choices in how I use that input. (See Data are Neutral, My Reactions are Not 4/24/19, and Words Make a Difference 5/29/19)

Real, but even harder to detect, is the doing to by known and unknown people, businesses and institutions whose way of functioning or business model includes sharing information about me or purposefully invading my privacy with or without privacy forms (whose language is often so arcane and obfuscating that it’s hard to know what one is signing). They do to me without my knowledge.

I see doing for me as involving help that takes the place of what I would/might wish to do for myself.

Usually it occurs after learning what I need or want, but occasionally is based on what the helper thinks might be best for me. Sometimes it has been helping me to look at situations through “fresh eyes”.   And then there are people doing for me in ways that go beyond what I might have wished for, or even thought possible. And such thoughtfulness is as much a gift as the gift itself.

Finally, there is doing with.

This involves mutual engagement.   Here each of us has a sense of gains in the helping activity. The result feels greater than the “sum of the parts”. I’ll have to admit this is the most satisfying kind of helping I experience as helper or helped.

I find that each type of helping has its place.   Being an EWA-ing help recipient demands that I:

seek help appropriately in terms of when each type is most useful and desired

recognize the type of help that is being afford and respond accordingly

provide helpers with data and information to enable them offer help in ways that are most effective, efficient and satisfying to us both.

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Putting One’s Best Foot Forward In a Different Way

From the time my sister and I were very little, mother taught us by word and deed about the need to “put our best foot forward” when we had guests or were guests (though she didn’t use those words). We were taught how to use eating utensils, table manners, greet people and manners in general. As I look back on it, I remember our home as usually neat and clean, but it needed to be especially so when guests were invited. Mother was a good Swedish cook and knew how to prepare a delicious, attractive meal and serve it well. As my sister and I grew up and started families of our own, we tended to continue what we had been taught and enjoyed doing it. It all was unquestionably friendly, but had a certain degree of formality to it.

Fast forward to the present. Aging has not only moved in, but has gradually taken over my capacities to put my best foot forward. My standards and efforts are the same. The friendliness is as present as ever, but formality and execution have flown out the window. I still can set a table, have everything set up and arrange for beverages, but prepare and serve a meal? No way! So guests tend to come bearing food. Once here, everyone pitches in, chaos occasionally reigns.   Service may be buffet style with guests serving themselves from a counter in the kitchen and returning there for “seconds”. And they usually want to help with the cleanup, though I’m still capable of doing the dishes. The casual comradery seems to feel as good to everyone as the genteel service of earlier years.

I don’t go out much for meals, but even at home I may need assistance in serving myself and cutting things into bite size pieces. Once I got over my shyness about this and could accept it neutrally as “this is what it is”, no one else seems to mind at all. As someone once told me, “No use getting your knickers in a knot over it.” So I’m learning to accept who and what I am on any given day, and others do too, thank goodness!

I also look back on my days as a nursing student in a hospital based program where much of our learning took place as we cared for patients for hours each day, and later when I worked as a nurse and head nurse on hospital wards. It seemed to me that patients perked up and tended to want to put their best foot forward when the doctors were making their rounds. And I too on my infrequent doctor visits find myself wanting to do the same.

Still, what’s important for both doctor and patient, or any other care provider and recipient is an honest encounter where accurate data on the actual status becomes available. Putting our best foot forward in this situation now would seem to be preparing ourselves (as our capacities permit) to provide/communicate accurate data on our status in relevant areas rather than try to be seen “at our best”.

In my last checkup visit with the doctor, I had written out a list of my current ARCs so I could quickly, sharply present them (and, in case my short term memory lapses kicked in). After he had asked his questions and done his inspection, I asked if he was interested in the status of my age related changes. He was. I brought out my list, explained why I had one, provided data on each ARC’s status. He asked questions and made notations. He had important data he would not have had if I had not prepared and taken the initiative. I felt I’d put my best foot forward in a new way.

So, I’m learning new best-foot-forward lessons. It’s still fine to try to be the best I can be, but it’s in a new way where it’s truly important to be who and what I currently am, warts and all.

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Attention-Getting ARCs Create Challenges … Quiet Capacities and Assets Await Our Attention

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As my ARCs (age related changes) accumulate and progress, they increasingly resemble the attention-demanding behavior of two year olds. Impossible for me and sometimes others to ignore. On the other hand, my steady, silent capacities and assets just seem to patiently wait their turn to be acknowledged and attended to.   And this seems to be true, not only for me, but for those who help me manage my daily living these days. (Perhaps it’s the same way that more attention is given to our pathology than to our quiet immune systems.)

There’s no question that I need to continue to acknowledge and come to understand each ARC. But (better late than never) I’m seeing the need to pay more attention to acknowledging, understanding and creatively using my capacities and external assets. They are so essential to my well-being. I need to understand them as thoroughly as I do my ARCs. I need to value them. A slight variation on a current chant “Equal pay for equal work” may just need to be my motto as well.   Equal attention for equal work.

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By increasing my underlying knowledge about my capacities and assets in the same way I have my ARCs I may well be able to use them more creatively . In “The Mature Mind” Cohen examines the way agers’ brains change and what is there, available to be used. Some neurons are still growing and so are some connections between areas of the brain.

Obviously I’m at an early stage as I share my thoughts in these areas and plans . What I can share now is that:

I believe I have a responsibility to offer care providers accurate, crisp descriptions of the status of my capacities and assets (strengths and weaknesses as they are relevant to the presenting situation). This way they can anticipate how I will manage what they are asking me to do. e.g. If my physician changes my medication regimen, I need to offer the current status of my short term/working memory. If he were to expect me to change a dressing, I’d need to bring up the status of my clumsy, weak fingers and their potential inability to manipulate tape or dressings.   With my support figures (professional or otherwise) I need to offer data on what I can and cannot do as it is relevant to their desires or expectations.

I’m working on identifying (putting into words) and treasuring specific capacities and assets as they come into play in my adaptations. In my thoughts, I actually talk to them. When they do well in preventing a problem I praise them warmly, put gold stars in their crowns.   I sympathize with them when they try, but have difficulty. When they goof off, I give them black marks of the size and blackness warranted by the degree of failure.

I’m discovering that capacities and assets are like ingredients in my cooking—highly adaptable to be used in multiple ways. All my brain needs to do is figure out how success or lack of it in using them in one situation can be applied to another.  That means I need to know them, well.

As you can see, understanding and using my capacities and assets with greater creativity and effectiveness is a work in progress (like so much of my EWAing has proven to be).

If you readers have any ideas, please comment and share them with me. I can promise you that they will be well received and put to use.

To Bare or Not To Bare, That is the Question

With apologies to Shakespeare and Hamlet for distorting this notable quotation

For the past nine months this old, cold ager has been staying warm most days by layering long sleeved turtle necks and wearing warm pants and socks. Even then I went to bed with cool arms and legs and cold feet until the end of June.

This spring (even here in our marine climate), we’ve had a week here and there of abnormally high temperatures. Teasers or omens of things to come? The prediction is for a warmer and dryer summer. That means more (usually rare) days in the 90’s and more than usual in the 80’s.

Lore has it that summers here begin on the fifth of July so warm days are coming. I’m fine with days in the low 80’s in the house. But, if we’re going to have consecutively high 80’s and low 90’s days where the home itself warms up and stays warm, I’m going to need to give up even my intermediate weather wear. And this is where my dilemma lies. Long-sleeved turtle necks and slacks cover my wrinkled, droopy, mottled neck, arms and legs. Summer wear exposes them. I have no idea why exposing them seems more repulsive than inescapably exposing old hands and faces, but it does.

Nor have I any idea why I feel more concerned this year. Last year I wore sleeveless tank tops and skorts without much regret and I was out and about more than I am now. This year my neck and arms seem to me to be parts of me I’d rather keep covered. Admittedly, the skin is a bit more mottled, the muscles more shrunken and sagging, wrinkles more numerous and deeper. But at 97, even if I’d opted for plastic surgery, or exercised faithfully, I’d be abnormal if they weren’t like that.

Those of you who follow my blog notice that I try to include free images to enhance the writing. I tried hard to find images, even of just the bare arms or legs of old people let alone old people in clothing that showed them. Couldn’t find any!   Old folks walking on hot sunny beaches were all wearing long pants, tops with sleeves or dresses with sleeves.   Could it be that I’m not alone in not wanting to expose aging neck, arms and legs to others?

In the end I expect that I’ll be sensible and dress for summer with the summer clothes I‘ve worn for years. People seem to be very accepting of the old person I am in many other respects. So it’s probably more my problem than one anyone else will have about me.   People who drop in on me will find me as I am. But when I have planned visits, I wager I’ll be wearing lightweight pants and a top over my sleeveless tanks.

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Long in the Tooth

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“Long in the tooth” is a way of estimating the age of horses since their teeth continue to grow even as they wear down. It was also a somewhat derogatory comment describing an older person in earlier times.   There are some grains of truth in the label. Our teeth don’t continue to grow as the biting/chewing surfaces wear down, but losses in the underlying bone cause gums to recede, so teeth may look a bit longer.

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Being labeled “long in the tooth” wouldn’t bother me but the associated pockets between and around the teeth where stray food particles consistently hide and plaque (tooth bacteria) can flourish certainly do. So does knowing that the bacteria growing in unremoved plaque can get into the bloodstream and migrate to other organs, creating potentially dangerous inflammatory conditions there.

During my quarterly year visits to get rid of the now-faster-growing tartar, my dentist, and dental hygienist consistently remind me to floss and brush. I certainly agree as to its value. But knowing and doing are two different things when my hands have growing difficulty in grabbing and manipulating a toothbrush, much less skinny dental floss.

But, praise be, technology comes to the rescue! Electric toothbrushes have nice fat handles and mechanisms to do the brushing. All I have to do is guide the angle correctly and move it around properly to remove plaque from the gum line. And a water pick with a bit of mouthwash added to the water and force I can adjust takes care of those pesky nooks and crannies.

I might wish that my teeth were not so age-darkened, but I’m happy to still have them. And I’m delighted to have checkups that end with the comment, “Looking great. No additional treatment needed.”

Is There Artistry in Aging?

My sister and I apparently showed some musical talent and interest early. So we spent hours of our growing-up years hearing, studying and performing music as a sideline.   We studied with a variety of teachers. Some of them were satisfied to teach us to read music and develop our technic. But eventually we each encountered teachers and conductors who taught us that it was not enough to just play the notes correctly and in the style of the composer. Playing the notes, mastering the difficulties   and learning the style were to be seen as necessary steps in learning a piece of music. Once mastered, we were shown how to and expected to add finesse and artistry. We got so we could “hear” when others just “played the notes” and admire performances that went beyond. We worked to achieve it in our own performances, whether for ourselves or others.   We recognized when we could achieve it and when we did not.

Recently I got to wondering if aging might not be similar to playing music (though we agers don’t have the option to play or not to play). Still there are basic blocks of knowledge and skills to be learned about the aging processes in our bodies, how those changes alter our capacities and the kinds of skills it takes to manage our daily living with those changes and other forces that affect it. We can learn to study the nature of ARCs (age related changes), their effects on specific capacities and areas of impact of our lives. We can learn new ways of manage and more creative ways of using our available internal and external resources. We can learn about different styles of aging (living independently/semi-independently in separate housing, in congregate housing, in acute care settings), living with differing degrees of dependency. We can learn the music of our own aging, and at some level, master the technics of engaging with our aging.

In this vein of thought I began to wonder, “Is there an artistry in aging that goes beyond just “playing the notes” in our engagement with aging? Even before I became aged, I had seen different styles in aging. I saw some who seemed to want no part of aging, who seemed to avoid engagement with it though being harmed by their neglect. Even when the music of aging seemed not too difficult, their performance was dour. Others I saw managed whatever aging challenges they recognized and dealt with them in a matter-of-fact way. They were content to “play the notes” correctly.   And then there were some who managed to not only engage, but do so with varying degrees of brio, some glowed and reverberated quietly and others with flair and panache, seeming to find joy and richness in engaging with their advancing years.

The differences in approach and style of engaging with aging didn’t seem to entirely depend on the amount of difficulty that agers were experiencing.   I encountered some who appeared to have all the advantages yet became as vinegary as wine gone bad or cheese that dried up. Others with circumstances that seemed extremely challenging seemed to continue to manage their lives and aging with the vibrancy of Stradivarius violins that had been played by virtuosos over the years or the leaders in their fields of endeavor who became even more able as they aged.

Perhaps we’re all pre-wired for our approaches to live out our lives in a certain way and thus have less control of what we naturally will do as we age. And certainly through the years we lived with or experience models for aging that we emulate or reject.

So far, I’ve been blessed in:

having remarkable models of aging,

the way aging has presented itself and

in my support system.

While I sense that my EWA capacities are yet to be severely tested, I know how I want to continue. My goal? A quietly vibrant style with as much artistry as I can achieve.

What are your thoughts? Wishes? Expectations about artistry in aging? Does it exist? Is it worth thinking about? Working toward?

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Aging is More than Health

Healthy:   possessing or enjoying good health, a sound and vigorous mind and body; freedom from disease or ailment

Health: a perspective for judging the status of mind and body, or the merits of a presenting situation in terms of being conducive to a sound body and vigorous mind

The way non-aged people view aging and the aged tends to be linked to their background and particular interests. Individuals, relatives, groups, disciplines, professions, businesses, legislators, economists and governmental agencies each view aging and the aged through their own mindsets, value systems and purposes.   Many of them include the health of the aged or their environments in their considerations and actions.

As a nurse, I was taught to view aging from birth to death from the perspective of health, normal versus abnormal.

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I looked at my patients and their environments through the lens of health and I worked for its promotion, maintenance, preservation, treatment and palliation. My viewpoint was wide-ranging even as I aimed for specificity with individual patients. But in my mind (rightly or wrongly), health however applied, tended to involve gradients of healthy and unhealthy.

Now, decades into engaging with my own aging, I find that seeing aging solely, or even primarily, through the lens of health is too confining.

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I sense that it can put blinders and dampers on truly significant facets of my aging experience. That bothers me.

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I don’t question that my health is hugely important to the quality of my life and aging, nor that my behavior and activities are strong influences on my health. I know that my health determines what I can engage with and how I am able to engage.   It’s just that I’m discovering that aging is so much more than health.   For example, nutrition, hydration and exercise are seen as three pillars of healthy aging. Yet the experiences of eating drinking and moving about each day encompass so much more than the health promoting considerations.   I experience the sensory elements, the tastes, textures, aromas.   I recall wonderful associated memories of food-related occasions, both ordinary and grand. The same holds true with movement related experiences. Thinking about the richness of these memories it makes me want to anticipate and enjoy them in present and future activities without having to look at them through the lens of health during the experience.

My aging is filled with intangibles of life and living, with all its richness, its flaws, its details, its marvelous surprises and unexpected pitfalls.   It’s the contemplation of life and death. The experiences of blessed solitude and the warmth of companionship with people who have such wide interests and fresh ideas or different experiences of the past. It’s the seasons and weather in all their dimensions. It’s art and music, comedy and drama.   It’s my vistas of mountains and water; the busy daytime city and the quiet, amber of its nighttime. It’s the ballet and battles of hummingbirds at the feeder and the busyness of mason bees going in and out of their homes outside my kitchen window. It’s the movement in tall evergreens in the invisible winds and their windless stillness. It’s the comfort of a cat on my lap and the warmth of hugs. The aroma of the first cup of coffee and the uncertainty of completing the morning crossword puzzle.   It’s the joy in feeling fulfilled. It’s the mourning with losses. It’s being both needy and yet capable of helping others. It’s knowing and still learning. It’s . . . . . . . . . . . . . . .

I don’t want to feel hemmed in by obligatory calculations of their effect on my health in the midst of these experiences.   I want to freely, profoundly experience all these and more, unalloyed and unexamined.

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I’m not foolish. I want to retain and use my health lens appropriately and creatively. I want and need to securely keep and use it . . . . in its proper place.