“Co” – An Important Prefix to Some Words In Engaging with Aging

Coexist: to live/exist with

Cooperate: to willingly to work with

Collaborate: to actively engage in partnership with

No man is an island entire of itself” (John Dunne, 1624). Nor do we age in total isolation though it may feel like it at times.

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As an ager who lives alone in her home I’m very much an insider within my world of the aging and an outsider to others’ age-related worlds. But I’m not really alone. In varying degrees of closeness I’m relating to others, one way or another. I’m fortunate to have caring, interested people with whom I have face to face contact and many I know only virtually as we share of ourselves via computer and other means. Some relationships are family, friends, or casual encounters. Others are intermittent, time limited professional contacts. So there are many interpersonal options for my “ co-relationships”.

At present I can’t think of any who merely co-exist for me. Perhaps fleeting, focused ones via computer communication. But even casual intermittent contacts with those who primarily relate to me in terms of service tend to turn into momentary enjoyable, mutual encounters. As for the future?   I may yet have to learn how to coexist and tolerate. Will it occur in situations where I have less control over my lifestyle, lose my ability to speak or ?

I can identify some instances where the relationship is one of cooperation. Recently I was meeting a dental hygienist for the first time. Sitting with one’s mouth open suggests necessary cooperation and not much more.   I wondered if I could achieve more than a cooperative relationship. To my surprise and delight, it became possible through snatches of conversation before, during and after. We each learned from the other and looked forward to the next encounter.

It seems that most of my relationships are purposefully collaborative, whatever the encounter. With family and friends in our frequent casual contacts, mutuality and collaboration seem to be central to our enjoying each other as thoroughly as possible. (My need to have everyone “feel at home” and pitch in on any needed activity tends to dispense with formality.) Our interactions offer personal perspectives and often spark ideas that might not have emerged otherwise. In the end it feels as if each one is feeling both more fulfilled and enjoyed.

Even when I met my new doctor for the first time, he opened the door to collaboration by asking what I wanted to achieve in the intake interaction. I was taken aback as no physician had ever asked me that. I surprised him by responding that I wanted to begin to form a working relationship with him. (I wanted one where we each understood the needs and goals of the other.) In my next appointment, once I’d met his needs to update my database, I asked him if he wanted to know the status of my ARCs (age related changes), as they might affect my health care. He did. My concise presentation probably took a couple of minutes. (I’d rehearsed it.) He took notes and asked questions. He had data about me that he wouldn’t have had if I had only cooperated. Based on that collaborative endeavor, months later, I handled a post-fall emergency appointment with a different physician by providing data on my ARC status and daily living demands that were serious deterrents to the proposed treatment. For the first time in my life I rejected the normally accepted treatment— I’m living well with a tiny broken bone in my left hand.

For my part, it would seem that all this may be possible because I still can see, hear (with some assistance) think and react. I have no pain or other manifestations of pathology that interfere with my capacity to interact freely. A time may come when that will change. “To everything there is a season . . .”

Comments from readers who are having different experiences with coexisting, cooperating and collaborating will be enlightening for me and other readers

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An Engaging with Aging Logo and Its Interpretation

Recently, the idea came to me that it might be possible to create a logo that would display and encompass Engaging with Aging as presented in this blog. I found that I could identify the elements and their relationships. But translating them into a little logo was totally beyond me. My younger son came to the rescue and offered the talents of a young artist in his company. I shared the ideas. In a month Michael created this logo.

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The circular area symbolizes the world of daily living as the ager is experiencing it, seeks to understand and engages with it. This “world” surrounds the aging insider wherever that daily living is occurring. It becomes the basis for the “engaging” activities. Outsiders’ visions of the same experience may or may not be congruent with those of the insider.

The perimeter has multiple openings to permit outsiders’ contributions to enter the ager’s world and the insider to reach out and interact directly or virtually with others’ worlds.

The river of aging wends its way through the countryside of the ager’s daily living and inevitably out to the sea. All rivers of aging have in common: changing currents, obstacles, white water and waterfalls to be navigated.   But each individual’s river of aging is unique in its length, currents, obstacles, white water and waterfalls. The ager has options to go with the flow, or to actively seek to “read the river” and actively navigate it, as capacities allow.

The green leaf symbolizes ongoing “greenness” as new experiences and challenges test capacities and offer opportunities for personal growth, even as capacities are altered by normal age related changes (ARCs) and pathology.

The individual in the center is the engager. The nature of engagement will depend on levels of interest, courage, and cognitive and physical capacities. Others may help out by identifying blind spots, enhancing the engager’s resources, supporting in ways to make engaging possible, easier or more effective. But only the engager can do the engaging.

The sun is the symbol of the life force that makes possible the engaging. Bright or dim, its light and outward rays affect all parts of the engager’s world. Its rays reach out to outsiders as well.

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In this Engaging with Aging blog I’ve applied the ideas of this logo to the elderly. But the reality is that infants begin engaging with aging and daily living from the moment they are born.   So this logo, its elements and relationships are equally usable at any age. Yet-to-be-agers and care providers who are interacting with others of any age can find its elements and the relationships between them a useful perspective for shaping their expectations and interaction.

Creativity, an Essential Element of Engaging with Aging?

Creativity: the use of the imagination or original ideas, especially in production of artistic work.  Inventiveness, imagination, innovation, originality.

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When I was an “outsider” to the world of the aged, it never occurred to me that creativity might be a part of it, much less an essential one. I thought of creativity as being associated with the prime of life. Common knowledge seemed to be that aged people are “past their prime”. I also apparently limited creativity to the definition up above. Besides, who linked being old with imagination or originality?

It was only as my ARCs (age related changes) not only emerged but progressed, accumulated and began to invade the nooks and crannies of my life that the need for creativity became obvious. And it didn’t seem to involve imagination as much as paying attention to: details of what I could no longer take for granted, do easily or at all, and which changes in capacities were snarling things up.   I suppose if I had been content to just ride the river of aging and let things happen, this issue of creativity would not have arisen. But I wasn’t one who was happy with letting things slide. Gradually I began to see a pattern in the changes I was having to make. EWA was born. Eventually I even came up with a shorthand formula for it

Age Related Changes Impacting on Daily Living Activity Leading to Adaptation

or shorter still

ARC →Impact Area→ Adaptation

Now the inventiveness, innovation and even imagination began to come into play. As clumsiness and weaknesses grew, my response was, “OK Doris, now how can you do it differently? more safely? Some things I found I could do early in the day but not later. Sometimes I had to break the activity up or space them out. Sometimes I had to use objects in ways they weren’t intended.

ARC: Weak hands

Impact Area: inability to open dishwasher not only when it was “on the latch”, but even just partially closed. I needed to put dishes in it often during the day.

Adaptation:   I propped the door open with a rolled up terry towel. I also timed my dishwashing to fit with my primary care giver’s visits to open it

Impact Area: inability to open drawers for which my husband had created circular wooden pulls

Adaptation: I found some cord, made a sliding noose that I could slip over the knob and a foot long “tail” to wrap around my hand and pull it open.
Pretty primitive creativity, not the least artistic, but efficient!

I also began planning for what-if’s.

ARC:   Decreased night vision.

Impact Area: What if I needed to call someone during the night.

Adaptation: On the shelf next to the side of the bed where I sleep I placed reading glasses and a flashlight (the light switch was too far away) and my cell phone with a list of speed dial numbers for people who could help.

A colleague taught me about having a “nest” around the seat where I’d spend the most time. It would include all of the items it would be nice or necessary for activities I carried out there plus adequate lighting.

And so it has gone. When my adaptations work, tiny triumphs brighten my day. Failed attempts lead to revision or sometimes making a decision about whether the activity is essential to my well-being. I suspect there will be more of them as my ARC imps invade more nooks and crannies in my life.

There may well come a time when I am no longer able to create and adapt for myself. In preparation for that “what if”, I’m keeping my near and dear ones informed of my preferred approach and strategies. They may well need to be my keeper of the flame.

I’m coming to believe that this creativity in aging is an attitude as well as an approach. I also realize that it takes cognitive abilities as well as physical and emotional energy. Those are not always assured as one ages. Then one can only hope that one’s care givers also see this creative approach to aging as worth pursuing.

100th Blog Posting: A Time to Look Back and Ahead

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It’s still hard to believe that I (a social media troglodyte) began writing a blog at the age of 95. I’m so grateful for the two people who made it come to life. The one who believed I had something to write about and the creative expert who generously and dependably takes care of the technical aspects each week.

I know it’s true, but it’s rather mind-boggling to realize that in the two years since that first posting (mid-August, 2017) I’m posting my 100th blog post. And there are more in varying states in the queue.

What a journey it has been! Such unanticipated impacts on my life! Writing to you has sharpened my own “engaging” skills. It’s one thing to engage with aging casually, harder to do it purposefully, and even harder to put it into words that will make sense and be usable to others. Thinking about this blog has become a red thread in the tapestry of my life as I interweave my ARCed aging capacities with daily living demands and then write about it. I wake in the morning, ideas churning, eager to start the day. The activity has changed and continues to change me. Others have commented that I seem younger and more vibrant at 97 than I was at 95, and it rings true (even as I obviously age).

As I began thinking about writing a blog, I saw myself as a female ager writing from my encounters in engaging with aging as I gain insights. I am definitely not an expert on aging in general, just mine! I am limited in my vision by the reality that I am a remarkably healthy former RN/faculty member/writer and widowed nonagenarian, living alone in a home she owns, with two supportive sons, their wives and three granddaughters (all of whom live within a few miles). I realized that my blog would reflect my blind spots about aging in other circumstances. So there would be no “how to’s”, just vignettes of my own EWA encounters, reactions and insights. We all are being carried down the river of aging, but each of us has our own river to navigate and our own approaches.

With these caveats in mind I decided that I would:

  • offer my experiences, insights and ideas as potential points of departure for the reader’s own unique situation and capacities.
  • limit my focus to EWAing with normal age-related changes (ARCs) precisely because I didn’t have pathology and its treatment interwoven with my normal ARCs and daily living.   My thinking is that ARC-affected capacities are what any ager brings to living with an overlay of pathology and its management. (Care providers need to know about them too.)
  • view the aging experience broadly while giving the health element its necessary place
  • focus on the impact of ARCs on the details of everyday living. Again, because I was living with these nasty snags. (Besides outsiders to the world of the aged were researching and writing about ARCs, but it takes an insider to see their personal impact.)
  • use a “light” approach in my writing style in line with my belief that data are neutral, including data on one’s emotional-laden responses to aging and its effects
  • seek images to enhance the ideas to stretch the reader’s mind

Looking ahead, I foresee postings that reflect my accumulating, progressing ARCs, their effects that are creating increasingly difficult challenges and the constant, conscious adaptations that fill the minutes and hours of my day. I’ll continue to share what I can of my ongoing journey.

When I no longer can, let’s agree that, “To everything there is a season. . . .”

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I am so grateful to those of you who join me on my blogging efforts by commenting or otherwise giving me feedback.   I feel like Longfellow’s archer who “ . . . shot an arrow into the air, It fell to earth, I knew not where. . .”.   Your input lets me know where at least some of them land. Beyond that I value your reactions and learn from your comments. Let’s move on together.

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.

Automaticity, How I Miss It! But . . .

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As the old saying goes, “You don’t know what you had until it’s gone.” I‘d had no idea how much I had been able to take for granted, nor how much I’ve been able to do on auto pilot. If I was going to make breakfast, all I thought about was what I would eat. Then my automaticity took over. It knew where the items were and how to put them together. To dress, I had to decide what to wear, but the rest of the process followed without purposeful thought about how to put the pieces on. And so it would go through much of the day. All this automaticity freed me to address issues, ideas and activities that required purposeful thought and effort. (I read recently that it took only one side of my brain then, but takes two sides now.)

Then ARCs (age related changes) sneakily but surely began taking automaticity away from me. I found myself having to think about how to lift a glass or a jar, depending on its diameter and weight—one hand or two–grasp around the sides or with one hand underneath? For a while, I had to think about how to tie shoelaces until one morning I couldn’t tie them at all. Time for slip-on’s. My comb flipped out of my hand when it encountered a snarl. Adopt a simpler haircut. Stairs required me to rely heavily on a railing or wall in order to climb them and knees threatened to buckle when I descended. My family, standing behind me, finally couldn’t stand watching me and a son proposed (pushed for), a lift that now gets me safely from the house to street level and back. Supportive arms on either side help me manage stairs when no lift or ramps are available. A granddaughter took over the laundry tasks that had to be done in the basement (reached by a circular stairway with no railing). I now live on one floor of my home. A son noticed my difficulty in rising from my recliner, he placed 4” risers under it and later added another 2”. One day while on vacation with my family, I discovered for myself that putting my hands on the back of a wheelchair made me steadier in my walking. I ordered a walker that enabled me to take long walks for years and now keeps me steady here at home. I found that a shopping cart in the market served the same purpose for quite a while until recently that too became unsafe and a neighbor offered to take over the shopping.

And so it has gone from year to year, month to month and recently sometimes day to day. My capacities change and so do my adaptations. Sometimes I’ve been able to see and manage them on my own. Sometimes times others have noticed and stepped in (with my acceptance!) to help me manage.

And there have been times when certain activities simply are no longer possible automatically, intentionally or with adaptations. Then it has been time to simplify my life. I’ve enjoyed baking orange rye bread and Swedish cardamom rolls for me and my family. First I reduced the size of the recipe to weights and size I could handle. Recently that too was beyond me. Fortunately, I’d taught the next two generations how to do it. Now the time had come to pass the tradition on.

Do I miss the things I no longer can do or automaticity? Of course. Still, in the grand scheme of things I’m grateful for all that’s still possible, for family, friends and colleagues who support me and offer adventures within their view of my capabilities (often far more than I can see in myself). When all else fails I call on my mantras of “Sufficient unto the day. . . .” and “To everything there is a season.” And, so far, I’m feeling content with what I still have.

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