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.

102

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.

*******************

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.

101

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.

Automaticity, How I Miss It! But . . .

91-1

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.

91

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.

87 1

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.

87 2

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

87 3

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.

87 4

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.

 

We Agers Are Experts On Our Own Aging Experience

With that expertise come responsibilities

84 1

Many of the people who study old people, theorize and write about us, take care of us, or relate to us are not “old’ themselves. They experience old age second handedly. Earlier in my life as a nurse I often had older patients. As a daughter I shared my parents’ aging. In my 50’s I blithely participated in three editions of a nursing book about caring for the elderly without taking note of myself as the “outsider.”

Now I feel as If I had been a pilot flying over the city of aging, assuming I knew how the residents lived. What an illusion!   It’s not that what I knew, used or wrote about elderly people was inaccurate. But it paid only narrow attention to the significant ways normal aging was changing agers’ capacities to manage their ever-present tasks and relationships. I had looked at them narrowly as they related to a particular issue, pathology or health status. Also, somehow, at some level, I gained a vague notion that aging made people less credible whether it was reporting about themselves or their opinions. Dumb!

84 2

Now, I’m the insider. I‘m aware of my hard-won knowledge on normal aging in general and my specialist knowledge on my own aging.   I notice when my insider-knowledge and perceptions (not necessarily right or wrong), are just different from those who are not old.

I see myself as a practical person. I realize that health care providers and others have focused areas of interest and expertise and limitations on their time. Health care providers of all stripes and levels are, in particular, intermittent, time-regulated resources. And even my near and dear ones, friends and neighbors have very full, demanding lives of their own. (But given the nature of our relationships they tend to be more familiar with how I experience and manage both the pesky ordinary parts of my daily living snarled by my aging and the richness of my life.) Each of these people (professional or other), play an important naturally limited role in my life, as I do in theirs.

So, what is my responsibility in enabling them to see my aged world as I need them to and they may wish to? I tell myself, “Doris, they are not mind-readers! They know what they see, hear and what you tell them!” I see how they tend to use what they discover and how it fits with their specific role relationship with me, e.g. professional health care provider, relative, friend, neighbor etc.

I’m accepting that I as an aged “ insider” have responsibilities to them. Instead of taking it for granted, I owe it to them to appropriately :

  1. notice what they might need or want to know about me that satisfies us both
  2. share myself in ways and language that is natural to them and the situation (it’s different for professionals and personal relationships and situations)
  3. give/seek feedback on ways they might participate in my aging and daily living that are comfortable to them and me, given their roles
  4. share with them and include them in the joys and richness of my days

I realize that a lot of this is what has been going on intuitively. It’s just that now with this insider-outsider perspective I see a greater need to become more sensitive and skilled at it.

Downsizing Involves More than Things – Decreasing Capacities Downsize Lifestyle Too

Initially I thought of downsizing as relating to material possessions and environment, externals. Even there I recognized that not only the concrete things were involved. As important was my attachment to them. How precious were they to me? What would giving them up mean to me? How would my life change without them?

I found it easier to downsize in small steps. I’m finding happy homes for things that have deep meaning to me. Now others can cherish them.   Clothing, linens, household items go in small batches to our local volunteer recycling group. I‘ve gone through stages in my reactions: first a sense of loss and then feelings of relief, as if my load had been lightened.

As years rolled by and my ARCs (age-related changes) progressed, I awakened to the reality that my downsizing involved not only things, but activities and choices in my lifestyle, significant ones. Of course as a non-aged “outsider” I had watched it taking place in others as they aged. Now I was no longer a watcher, I was the “insider”. It was my self-image, my control, my privacy that were being changed in my own eyes and in the eyes of others. Downsizing took on a different color and meaning.

Now I was dealing with closely held values, goals, my contentment. I knew that self-sufficiency and feeling competent were both important to me and would be major deterrents to adapting to this kind of downsizing (even as they would serve me well in the process). For example, it took more than a few risky experiences involving close calls with my decreasing balance, or hand grip to convince me some activities risked unacceptable dangers.   Sometimes it has required others to point out how my “making do” was creating intolerable risks.   It was time to acknowledge that this kind of pride was foolhardy.

So I purposefully began to look for ways in which I could be deal with new dependencies as they occurred, and to plan ahead for them where they were predictable. Ongoing contentment and pleasure in daily living was my goal.

My first decision was to change words that frame downsizing my personal world. I use “simplifying” instead of “downsizing” and “differences” instead of losses.

I try to anticipate activities that will be affected by an ARC’s progression; then plan ahead for the new ways I will need to adapt.   I reasoned that this might reduce the shock and surprise when it happened. And it has given me a sense of greater control in some areas despite losses in others. (Still, I experience shocks at the point when an ARC abruptly rears its head, e.g. discovering one morning that I could no longer tie my shoes and another when I could no longer open the dishwasher.

I deliberately use my “watch bird” (see “Meet my Watchbird” 11/30/17) to force me to keep an eye on my:

ARCs, are they continuing to change? How?

adaptive strategies (How well are they working?)

satisfaction and contentment (Emotional responses are necessary data too.)

79

As a part of my ongoing need to feel as competent and independent as possible I plan for ways to make it as easy and efficient as possible for those who enable me to do the things I need and want to do . I

do as much as I can in the activity

identify specifically the areas of need

identify the specific assistance that appears to me being most efficient

integrate others’ perceptions and approaches

communicate appreciation and reciprocate any available ways.

Looking back over the weeks and months, I recognize that my world has indeed become increasingly simple. So far, I am comfortable and content. Do I miss some things? Yes, occasionally but most often fleetingly. The simpler life suits me, as I now am.

How long are my current approaches to growing dependency going to work? I have no idea. For now,   my mantras of, “Sufficient unto the day. . . . “ and “To everything there is a season. . . “seem to keep it all in perspective.     Tomorrow? “Que sera, sera” what will be will be.

Data About Me Are Neutral But I’m Not Neutral About Them

78 1

As a nurse, I learned about health-related data. I learned how to collect them appropriately and correctly, how to report them in usable form and how to use them to guide my nursing care. Often they were numbers ( temperatures, pulses, respirations, blood values), reports of surgical procedures and tissue findings. They also involved patients’ and families’ responses to the situations they were facing. I cared about their being accurate. The data themselves were neutral, neither good nor bad, just what they were and what they represented. The diagnoses and other judgments resulting from the data were also neutral to the scrutinizers and decision makers. But for the person generating the data, they all carried emotional weight that was anything but neutral. Data could elate! Data could depress! Data could frighten!

Now as I face daily the reality of my aging and the environment within which it is taking place, once again I am purposefully gathering data. But now I have to remind myself (sometimes forcefully), that indeed the data are still neutral and separate from my reaction to them. It is what it is. I need to keep in mind that my reaction is itself data that I need to use neutrally in order to engage with aging in the most effective way. I am what I am — no more, no less.

A sampling of frequent data these days includes:

I drop things, often. Reaction: frustration !!!!!

A sense of “near-fall” when I bend over to do things or turn without thinking. Reaction: my stomach “drops” and I experience everything but the fall itself. Near-falls leave me shaken and frightened (though massively relieved and grateful that the fall did not occur).

There are numbers on my scale. Reaction: Happy when they are the same or a bit less than yesterday. Reaction: Resolve to eat prudently when they are higher.

More hunger after a meal that should have been satisfying than I had before I started. Reaction: “That’s unfair.” Sometimes I resist giving in and eating more/sometimes I eat more; sometimes I deliberately get busy and distract myself till the hunger passes.

Signals of fatigue before tasks are completed. Reaction: resistance + dissatisfaction. Occasionally leaving task unfinished for the time being.

Recuperative periods characterized by an almost vegetative state when I’ve purposefully or unavoidably exceeded my limits. Reaction: impatience or “It was worth it” or both.

My balance is becoming noticeably tippier, as is my ability to rise from sitting to standing. Reaction:   Concern about how much longer I will be able to manage safely in my highly prized independent lifestyle.

In my intake visit the doctor pronounced me “healthy” and the blood work numbers a week later verified it. Reaction: walking on air. Relieved — “So far, so good.”

Careful comments from my family identifying blind spots or concerns. Reaction: wish they hadn’t been necessary. Sometimes guilt because I should have known better. Always gratitude that they are willing to do it and are so careful about how they do it.

Much as I believe in it, my seeing data as “neutral” is not automatic. I know that data are tools to be used for adaptation and I do use them that way.   But even with these beliefs and experience, seeing data as neutral is still a conscious decision that I have to make almost every time.

78 2