Agers as Enhancers?

To enhance: augment, boost, enrich, add to

After I wrote the EWA posting on enhancers who were the “wind beneath my wings” (8/29/19), it occurred to me that my enhancers were leading very busy lives. Even so, they were able to augment, boost and enrich my life in significant ways. Encounters with enhancers were positive and intriguing. I began to think about the reality that perhaps agers might be in a very good position to become effective enhancers.

We agers have time to think and reflect upon ourselves and others. Time to see and think about qualities and talents in others to which we respond. Seeing and responding to their capacities and potential may augment, boost and enrich their lives.

I thought about what enhancers have given me and how they’ve done it. They:

noticed specific qualities/capacities in me that I hadn’t seen, acknowledged or used; they responded to them in both behavior and words. At times they’ve identified specific capabilities and ideas in ways I hadn’t considered

showed genuine pleasure in my company.

listened, asked questions, posed ideas that conveyed genuine interest and added to those I’d offered.

Now these things I could do, one way or another.

So I began to ponder more widely on how we agers, each with our own attitudes and capacities, might softly enhance others. We wouldn’t need to be perfect, but we could try, starting in little, safe ways.

My lifetime best friend is almost two years older than me. Her ARCs have taken much from her. Still, she manages to enhance care givers and visitors alike. Care givers as well as family reportedly leave her bedside feeling better than when they came. I don’t know how she does it, but it’s an example that it can be done, even with very limited capacities. It’s led me to think about ways to communicate appreciation of and pleasure in qualities in others, other than just telling them. Eye contact, facial expression, body language, touch where appropriate come to mind. But it all starts with an attitude of genuinely caring, noticing and appreciating specifics in another person.

Another outcome enhancers produced in me is incentive. Many times, even in my advanced years, I’ve felt the need to “live up” to qualities or potential others believed in and shared with me. I’ve had two situations in which encounters resulted in visible incentivizing

During an intake appointment with a physician, I was impressed with a specific question he asked while he was washing his hands that changed my patient-doctor relationship with him in a meaningful way. He asked what I wanted from this first meeting. That immediately changed my participation from cooperation to collaboration in this session and subsequently.   In my next visit I told him how what he’d said had made such a difference. Apparently he hadn’t been aware of its impact and seemed pleased to learn of it, said he’d use it more purposefully .

Remembering his reaction, I decided to give specific feedback to a physical therapist who had: been welcoming of data from me on specific ARCs that were affecting my participation, and created a remarkably useful form to keep track of expectations and activity steps (despite my short term memory ARCs). After giving him this feedback the same collaborative relationship I had with the physician evolved.

As recipients of others’ care and attention, we agers have multiple opportunities to give feedback to care providers when something fosters engagement (and also when it deters it).

As I have thought about my role as enhancer I have (as usual), been my own lab rat. I notice myself enjoying

becoming more aware of qualities and behaviors in others that resonate with me

desiring to respond to them in ways that reflect my appreciation/respect/engagement

aware of my body language, facial expression, eye contact and touch to communicate in appropriate natural ways.

Whether I am a ‘wind beneath the wings’ of others, I may not know—nor does it matter. It does however seem that it may a way for agers to give as well as receive, even as our capacities become more limited and dependencies grow. And for me to remain green and growing.

Fat Clustered in One’s Middle and Lost in Extremities – Winter Becomes a Different Experience

Reality and research agree that the total amount of fat and its regional distribution changes with age.   Total weight tends to increase as we continue to eat the way we always have, even as our basal metabolic rate for burning calories drops sharply and our activities decrease.

These fat increases relocate themselves to the abdominal area. But at the same time that we agers gain visceral fat, there are decreases in the insulating subcutaneous fat in our arms and legs. The non-scientific fat-in-the-middle explanation, as I’ve heard it, is that it’s there to keep one’s vital organs warm in the winter. Well that sounds as logical an explanation as any.

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During recent decades I’ve very slowly lost weight, probably due to loss of muscle mass plus planning my meals to follow the sharp downward curve in my ability to burn calories (basal metabolic rate), and my decreasing activity. I was determined not to think of the needed changes in my way of eating as “dieting”. That felt too negative. And besides, this low metabolism and activity are ongoing.   Was I going to diet for the rest of my life?   I enjoy eating and there’s no way I was going to give up that pleasure. So, I just weigh in every morning and that keeps me shopping, cooking and eating reasonably for that day. I choose foods I like and prepare them in ways that still keep me looking forward to enjoyable meals. The result has been that my weight has come back down to what it was in my late 20’s, but my shape is no way what it was then. Instead my middle is disgustingly “thick” while my limbs have become scrawnier by the year. It’s a sort of a fat scarecrow look. Vanity, vanity!

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Strangely enough, I’ve come to think that Mother Nature is at least partly wise. So even as I am disgusted by the fat in my middle, I’m glad it’s keeping my ancient vital organs warm enough that they function as well as they can. But why, I wonder, was it necessary to take away the insulating fat in my arms and legs? After all, they’re vital too! I guess they just carry on, hot or cold.

November is here!   My arms, legs and especially hands and feet, minus their fat layers (and with changed circulation I expect), are predictably and uncomfortably cool to downright cold. My feet feel like ice cubes, and once in bed, I’d prefer to disown them. And they take forever to warm up. Spring and summer seem an eternity away.

The winter wardrobe is back in use with its multiple layering of tops and heavier pants, socks and slippers/shoes. (I don’t go outside much these days.) Fleece and down are “in”. The thermostat is set higher. I’ve moved my recliner inches closer to a gas fireplace that has become the love of my life (and my cat’s too). And my quilts have been changed to the winter version. The electrically heated mattress pad is turned on so the bed is warm when I retire. Still I often feel cool.

But here I am complaining when I have so much that enables me stay warm. I know that in our city we have hundreds who don’t have a predictably warm place to live nor warm clothing and bedding, and even warm food. Time to think about passing along extra bedding and clothes as well as a contribution to an organization whose purpose and business is in helping these folks stay warm and fed. My dad was sponsored and helped by the Salvation Army when he left Sweden and landed with just the clothes on his back on Ellis Island and moved on up to New England to start his new life. That will be my choice.

Dealing With Distraction

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One of the normal ARCs (age relate changes) affecting our cognition is the loss of control over our attention—the ability to focus on a single task and tune out distracting thoughts. Apparently, the circuitry gradually breaks down between two regions of the brain that had worked together to allow a person to attend to a single task and tune out other thoughts. And it too (like so many other) starts in one’s 40’s.

There was a time when I could focus intensely on a task without consciously having to prevent intrusion of other thoughts.   And at that time I also could count on my hands or my body to automatically take care of routine tasks or activities while my mind was free to go wherever it would, or needed to. It all happened so naturally that of course I took it for granted.

Now, a half century later, neither is true.   The most basic tasks my hands and body once could do without thought, now constantly require purposeful awareness and decision making. I’ve had to unlearn automaticity with them.   And at the same time my mind now keeps merrily flitting around to things that have nothing to do with the matter at hand. It’s a double whammy.

I tried reading about the underlying cognitive mechanisms creating this change, but most of the research was in discipline-specific language that was well beyond my ability to understand. However, in my reading I did learn that neurons and connections in the brain do keep on growing in some areas of the brain, even as we age. (But apparently not involved in attention/distraction). Now that‘s both encouraging and discouraging.

I decided to experiment using some of the strategies I’d developed in dealing with other changed capacities. Repeated use of the mantra “NOSE & TOES!” (thought loudly if that is possible), had been improving my balance when I was involved in turning maneuvers. And “CENTER YOURSELF!” worked if I remembered to think it when:

rising from sitting to standing or any bending-over activity and before taking the first step

lifting or carrying objects of any weight

I was about to be hugged.

My new anti-distraction mantras are: “FOCUS! FOCUS!” and “FINISH IT!” I’ve only been using these newly created mantras for a week or so, but they seem to be making a difference.   The tasks where I’ve been testing them are in the kitchen in meal preparation, clean up and all the other sundry tasks that pop up in this area throughout the day. And somehow, both my brain and I seem to be rather proud of the results. Life feels a bit more orderly and certainly the kitchen looks neater.

So far, I’m fortunate that I seem to be able to focus when I am writing or reading. (Here it is my ARCed short term memory that is the culprit creating havoc.)

Somehow my philosophy of “Sufficient unto the day. . .” continues to stand me in good stead. We’re engaging and managing. It is just more complex and challenging.

ARCed Balance is More Multidimensional Than I Thought

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Through most of my life my idea of balance was a general notion of being able to be upright and steady. In a physiology course I learned that the organ that enabled balance was a complex vestibular body located in the inner ear. The other day, a physical therapist taught me that it is three pronged: vestibular, vision and proprioception.   ARCs (age related changes) affecting balance tended to begin in one’s 40’s. And through it all balance seemed to me to be a generic, unitary function—being securely upright.

As the balance ARC crept silently into my life, I became increasingly aware of reaching out to put my hand on a solid surface to “steady myself”. But if I thought about it at all, it still was about uprightness and steadiness and found myself being curious about how it would manifest itself as the ARC progressed.

Well, that curiosity is now being satisfied. And (as with so many other realities of aging), it brought its surprises. It proved to be not just one entity. No, it was far more complex than that. It manifested itself in separate capacities which impacted specific daily activities linked to high risk locales. Different adaptive strategies were needed for each.

Six risk activities appeared to be altered by my Balance ARC, turning, centering, bending, dealing with darkness instability when moving about and now, even when standing.

Turning: when my head and body/feet faced in different directions and the difference was greater than 90° “tippiness” and physiological “near-fall“ sensations (an instant nasty gut reaction without the subsequent fall). The highest risk area proved to be my kitchen with work areas on all four sides. Adaptation: Say/think “Nose&Toes!” to remind me to keep face and feet pointing in the same direction. (blog 11/16/17) To move objects about, slide them on nearby/adjoining surfaces. With 180° or greater turns, find intermittent surfaces to allow for reorienting one’s feet.

Centering was essential when moving from sitting to standing, after turning, when picking up or carrying items, or being hugged. (9/5/18) Adaptations: Say/think/do “Center yourself!” before engaging in the affecting behavior. Brace the body before lifting an object large/heavy enough to pull one off-center. Hold objects close to the body when moving. Alert huggers to the risks of pulling one off center or brace part of the body against something solid before hugs. Most recently, even merely standing triggers teetering. Now that’s really scary for the increasing risks it portends.

Bending:  during any activity below waist level, e.g. bed making, picking up/dealing with objects on low shelves or the floor. Adaptations: Brace one hand or body part against a solid object during the activity (e.g. lower legs resting against mattress in bed making, sit on walker to deal with things on lower shelves or picking up objects from the floor). Last resort: ask someone else to do the job.

Dealing with darkness: this challenge to balance occurs most for me in the living room where evenings are spent. Adaptation: Get up and turn on the wall switch before turning off the lamp. Turn on/off lights upon entering/leaving a room. Turn on night lights before retiring. Keep a working flashlight on the bedside stand in case of a blackout.

Needing hand contact with my walker or body contact with a solid surface in order to feel secure. Riskiest when getting up during the night and when moving about open space in the kitchen. Adaptation: Keep the walker within arm’s reach at all times. When both hands are needed for an activity, lean lower body on available solid objects (e.g. counters). Use a tray on the walker seat to transport objects about in open spaces. (4/26/18)

Being constantly mindful of my balance when I’m just standing still, even in the midst of everything or anything else, is a new reality that’s demanding adaptation. Hopefully an upcoming new physical therapy regimen will at least slow this ARC, perhaps even reverse it a bit.

“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

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.

Companions on my Journey in the World of Aging

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If I count the beginning of my journey into aging as my 65th birthday when I officially was placed in the demographic “check the over 65” box, then my road has been 32 years long. And what trip into both the known and unknown it has been. I’d seen others make the journey and read a lot about what the road and the territory would be like. But as with any journey, one’s personal road experience is much more vivid, filled with both the expected and surprises.

Sharing the first years of the journey with my husband, our sons and then their wives and daughters made for a secure and joyous experience. The experience of traveling solo, when he died was literally a first for me. It was not that I lacked for support from my family, but the day to day travel was suddenly so different. It took time to learn that I could be “good company” to myself and that solitude could be a positive experience.

Over the years as my ARCs (age related changes) crept in and accumulated, the edges of the world I could travel in also shrank. I became increasingly dependent on fellow travelers coming into my world, rather than my being able to move along on their roads.

And here is where more of aging’s surprises occurred. Companions appeared on the road to walk with me, both in the real and virtual world. I found friendships blooming in both worlds. By now, all of my companions are at least one generation younger than I, many three or four. And my companions turned out to be so thoughtful, generous and often exhilarating.

I’m fortunate that my sons and their families live geographically close. But beyond that, as family and individuals they have remained personally close to the point where we comfortably share parts of our lives, even though they have busy lives of their own. Importantly, they make me feel enjoyed and genuinely, thoughtfully included. What a gift that is!

I’ve also experienced other fellow travelers.   They not only share the journey, but offer so much more.   I have skilled cooks who provide food care packages, a man who keeps my hummingbird feeder cleaned and filled—dead heads the garden and sees other things that need attention, a woman who unfailingly keeps me supplied with library books that suit my reading taste, someone who now does my grocery shopping for me (I still cook-from-scratch). I have a primary care giver who drops over every morning to see “What needs doing?” and smoothly makes that day go well, checks the status of the house and negotiates with contractors for services needed if he can’t fix it—in other words, gives me security. The son and family who travel more have taken me along as a member of the family and make the adaptations needed to permit me to go.

Perhaps the greatest surprise of all has been that at 95, professional colleagues from my university reestablished contact with me as an emerita. The result has been my returning to use my brain in ways I wouldn’t have dreamed possible. It started with my dubious venturing into writing this blog,   Then at 96 it bloomed in to participation in a project to further study and utilize the Engaging with Aging approach to daily living with advancing years.   These colleagues not only come to my house for meetings, but bring food as well. Students and faculty have joined me on my journey and have made side excursions possible that I wouldn’t have dreamed of.

At 97 I look back at my trekking in the world of aging and see its surprising twists, turns and challenges.   I cherish and am amazed at the generosity and companionship of those who have offered to walk with me. They’ve not only kept me green and growing but made it a time of unanticipated support, caring, struggle, growth and joy.

For readers who are yet-to-be-ageds, don’t underestimate the value of your sharing the road with those of us who have been on it longer. You enable us to thrive.