After the Fall was Over – Resilience or ???

Resilience: the ability to be happy, successful, etc. again after something difficult or bad has happened  –  Merriam-Webster

 an ability to recover from or adjust easily to misfortune or change – Cambridge Dictionary

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In 1891 Harris wrote a lilting waltz tune about a young man’s disappointment “After the Ball was Over”. The tune came to mind as I was recovering from a recent fall hence the blog title. I haven’t written much about falls, because fortune has favored me with few of them in my decades of aging and none has been more traumatic than leaving me feeling a bit banged up for a time. But I have felt disappointment, even anger, certainly frustration after the fall was over.

My recent fall resulted in minor trauma. But at 97 it was a different experience. By this time my half dozen ARC imps (age related changes) had become my constant companions, poking their noses into many if not most of my daily activities. They seemed to see my fall and slightly banged up state as a great time to create more mischief. My Balance ARC kept me scarily feeling like I might topple over whenever I was upright, particularly when I first rose in the morning. My Strength ARC imp’s tactic was to make it even more difficult for me to rise from sitting to standing and to grasp or manipulate things with my already weakened hands. Stamina’s imp made me head for the recliner after just a small amount of activity and made me feel as if this was the only place to be. My Short Term Memory ARC, as usual (only more so) sneakily bedeviled me with its unpredictability in enabling me to recall information I needed and caused worry that there might be some recall I needed but didn’t even realize. My self-confidence was shaken. And all this with hardly any trauma! My well springs of reserve seemed drained dry and snail-paced at refilling. Now with so much ARC imp mischief, how was I going to be “happy and successful” again, “recover from or adjust easily”?

Well, it appeared I was going to have plenty of time to think about it as I lazed in my recliner.   My long term memory (that seems to be working very well) came up with a Bible verse. “The spirit indeed is willing but the flesh is weak. . .” (Matthew 26:41). That’s where I was now. Fortunately, I found that I still had spirit, I had blog ideas just waiting to be written, projects in various states—things to think about, things I could do that didn’t take much physical energy or strength. Some of them, I could do sitting at my desk or even making notes in my recliner.   I wanted and needed to recover in the best way possible. I accepted that it might be frustratingly slow, but at least it seemed doable and highly desirable.

Of course it helped immeasurably that family and nearby friends checked in on me by phone and in person, did the few things I needed but couldn’t do. And provided me with salads, soups and easy to fix food. But pacing myself and being satisfied with small gains would be frustrating. I also realized that falls, like having pneumonia, made one more vulnerable for recurrence.   I needed to keep my wits about me, be careful and no hurrying!!!!!!

Days later I realized that falls actually were learning opportunities. I analyzed this last fall and saw that I had broken two of my EWA commandments:

always keep nose and toes in alignment when turning

stop and center consciously before taking that first step after turning (particularly after rising from sitting).

If I were to avoid high risk falls now, I needed to purposefully follow both of these. I needed to avoid hurrying for any reason. I needed to keep my expectations and plans in alignment with my capacities.

Beyond these, I would work on patience, identify small gains and be grateful for them. I’m still green, still growing.

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Living Well with ARCs Means “Seeing” Details

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“The devil is in the details, but so is salvation”
~ Hyman G. Rickover

I’ve come to like living alone in the home my husband built for us.  That has meant finding different ways to do what I want or must do in the face of accumulating ARCS  (age related changes) that now are interfering ever-more with basics of daily living. And, changing something requires one to “see” what needs to be changed.

That sounds obvious.  Obvious, but in practice, not easy.   To see what I mean, select one really routine activity you do every day, e.g. taking an item out of the refrigerator.  Notice every tiny individual element of what your body needs to do to move that item.  That’s what you’ll need to do when an ARC interferes with your capacity to grasp and move things.   That’s the devil that is in the details.  And these are the details that have become so automatic, that we are essentially blind to them!  

To illustrate how I found my way to “see” the important details and put them to use, here’s an example using turning (one of several disabling elements within my balance ARC).

 I chose to work on turning because it was frequent and dangerous.

  • I was able to link a sensation of “near falls” or falling to the behavior of my head and upper body being in one direction while my feet pointed in another
  • I needed to link the risky turning behavior to specific turn-demanding activities
  • I wanted to identify environmental features that increased/decreased turning risks.

Here is what I found and what I did:

Where did most of my turning occur?   In the kitchen.

When/why did near-falls occur? When I was making 90°-180° turns between sink, prep areas, stove, refrigerator, cabinets, oven, dishwasher.   In “open” areas I needed both hands to carry things as I was turning.  I experienced near-falls when I had no solid surface to steady me.

What made turning safer?

Working next to counters on three connected sides of my kitchen work areas where I found I could press my lower body against the counter as I worked and turned.  I was steady even as I worked with both hands.

In open areas, I became able to move securely and function efficiently carrying objects on a tray on the seat of my walker and using its handles to steady me.

In moving hot containers from the oven, I “saw” I had two close pull-out boards almost adjoining and level with the oven door. Pulling the hot container out onto the open oven door and sliding it over to the adjacent boards involved no turning.   

For now, my salvation in turning has been that I’ve had no new falls or sensations of “near falls” in the kitchen.  I also felt comfortable using my question and answer strategy on other ARCs and activities.

I’ve increasingly come to realize, that we agers (barring blind spots and cognitive disabilities), are the experts on our own aging experiences and needs.  We

are the ones experiencing:  the risk elements of our ARCs pose, the discomfort, awkwardness or injury when we can’t do things well, or at all.

know what we need and want to do, the changes which we can find a way to accept

have the greatest familiarity with nooks and crannies of our environment.

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Others may help when we can’t, but they too need to purposefully consider our capacities and wishes if the most acceptable changes are to be found.  They can only do this well if we agers prepare ourselves to share what we can about the details rather than expect (or allow) others to guess or intuit.

Resilience in Aging

When I began this blog-writing journey over a year ago, one of the topics I thought I would write about was resilience. Strangely enough, it never would take shape. The vision I brought of resilience to aging was that of springiness, of bouncing back, or as one definition said “return to the original state.”

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That vision was incongruent with what I saw in my own and others’ aging. True, I saw other elderly “come back” from injury or acute disease episodes or from changes in their support systems.   And those with chronic pathology return from exacerbations.   But bouncing back to an original state didn’t describe it. Even for those of us who journey through aging with little pathology, the nature of our long downward trajectory requires quite a different way of looking at resilience. Engaging with aging is not a sprint, but a marathon on a downward slope that requires staying power and constrains “bouncing.”

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For us all, well or ailing, our journeys are accompanied by normal losses in both our coping capacities and the external resources we have at our command. One after another of our capacities predictably progress from being merely inconvenient to becoming downright challenging. We’d be happy just return to our more competent, earlier selves, but to quote the old Scot’s proverb, “And if wishes were horses, pure [poor] men wald ride.”

In the best of circumstances, our resilience is rarely flashy. But it’s there. It resides in our inner wellsprings of insight, and our courage to honestly face the path of our aging in daily living as it presents itself on this day, knowing the likely direction it will continue to take. It is in the creativity we bring to bear in terms of not only making the best of what we have but finding sometimes crazy ways of managing our losses. It’s in the creative ways of handling difficulties that keep us enjoying little triumphs. And certainly in our use of our reservoir of humor, when we see the absolute ridiculousness of some of the situations in which we find ourselves. All in all there is an inherent sturdiness about it and us.

If this is resilience elderly style, then we have it, in spades!

Decision Dysfunction

“You don’t know what you have until it’s gone.”   All my life I had been blessed with opportunities to make choices in many areas and apparently the ability to comfortably decide. It was so ever-present that I took both for granted. Then (somewhere in my late 80’s I think), my decision-making functions insidiously began to change. I still was fortunate to have choices to make, but my comfortable deciding process was eroding. Instead of automatically deciding and doing, I was increasingly dithering, delaying and distressing.

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It would begin in the morning with decisions about what to wear that day and then what to eat morning, noon and night. As time progressed I found myself sitting in my recliner thinking about onerous chores that needed to be done and then delay doing any of them until I reached deadlines. I excused my inertia by thinking that the cause was lack of initiative or energy. If I invited guests, I’d fuss about the menu. If I was invited to go with the family for a weekend or a week’s vacation, I’d shillyshally about what to pack until the last possible moment and then put things into the bag. Since mini and maxi decisions were an integral part of each day, a deeply underlying mood change was growing. I was subliminally and increasingly uneasy.

Then I came upon an article reporting research on decision making that involved multiple elements.

Frey, R., Mata, R., & Hertwig, R. The role of cognitive abilities in decisions from experience: Age differences emerge as a function of choice set sizeCognition, 2015: 142, 60-80 DOI:

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A bright light illuminated my situation. My old brain had been struggling hard to satisfy my decision-making needs when it came to making choices involving larger numbers of items. These choices were so daily and ordinary that the number of items as a cause for complexity never occurred to me. What a relief to understand what was happening. Was it going to change my decision-making capacity? No! But now I knew what to expect and could work with it.

In clothing choices I could think whether I was dressing to please only me if no planned visits were on tap; or what would please the particular visitor, or suit the errands of the day. At least I had that much structure. I could also prune my wardrobe. As for packing, I accept that I will continue to settle for making last minute decisions. So far, they seem to work.

With food, I took several routes. I would still cook from scratch; that was non-negotiable, for now. I:

stocked the pantry, refrigerator and freezer with foods /ingredients that would lend themselves to impromptu decisions.

made larger pots of soups or soup bases and entrées that met my nutritional needs to store in the freezer in meal size containers that could be quickly thawed.

opted for pre-washed salad greens and made up a variety of vinaigrettes to dress them—quick, easy choices

found a breakfast that met my nutritional requirements and that I thoroughly enjoyed in taste and texture, so that became a happy standard.

Now it was only lunch and dinner . Even if I dallied in my choice, there was always something quick to fix.   As for guest meals, they’re potluck. My energy level has dictated that I set the table and make one item, and they provide the rest. Together we make the decisions on the meal and their brains are working better than mine.

As for chores, I blend deadlines, logic and conscience, reminding myself how good it feels when they are done in a timely fashion and I can just enjoy their being done instead of feeling guilty for not doing them. That seems to be working, at least some of the time.

All in all, I’m feeling much more sanguine about the challenges and my responses. I’m “stroking” my limping brain for doing the best that it can. I’m also deliberately and regularly valuing the areas of choices I still have and the adaptations that seem to be working. For now at least, my sense of balance in this area is restored.

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Three “R’s” for Aging – Resourcefulness, Resilience, Relevance

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The three ”R’s” are 1) the fundamentals taught in elementary school; especially : reading, writing, and arithmetic  2) the fundamental skills in a field of endeavor [Merriam Webster]

As I skipped off to school for the first time on that cold January day in 1928, I knew I’d be studying the basic “3 R’s”—“Readin, Ritin, and Rithmatic”.   I couldn’t wait and it didn’t disappoint.   A little more than seven decades later I was to discover that for me, there were 3 R’s associated with life as an elder. I hadn’t thought of it as a “field of endeavor” at the time, but so it proved to be.   This time my classroom was my home schooling, my assignments were daily living.   Over time I came to discover that three basic fundamental skills I needed to engage with aging were also “3 R’s”. Generically defined, they are:

Resourcefulness : the ability to deal with new situations or difficulties quickly and capably

Resilience: the ability to recover/return to normal from adversity.

Relevance: the ability to be accurate and appropriate in relating to others.

The three R’s were spot on but the generic definitions had to be modified in order to make them accurate when applied to engaging with aging.

RESOURCEFULNESS.   As the years piled on and even normal aging changed my functional capacities, the words describing resourceful behavior as being “quick /capable” no longer described my resourceful behavior. Now it takes time for me to gain insight on what the new situation or difficulty really is before I can even begin to think about how to deal with I and then put the thought into action. What remains quick is that, once recognized, I can quickly look at them from the two sides of the balance model, thinking : “What areas of Daily Living Demands are involved in this new situation? And “Which of my functional capacities and outer resources are involved?” “What are the linkages?” Then I figure out what to do. And as for capably, years of experience have made me quite capable in terms of setting up the balance equations, and I’ve been reasonably satisfied with the outcomes my planning has achieved, I also realistically realize that I’m dealing with a constantly moving situation.

RESILLIENCE.  The situations requiring resilience in aging differ from those I experienced earlier. True there are major adversities that can occur . . . . major illnesses, trauma, loss of dear ones, being priced or taxed out one’s home,   etc. Fortunately I’ve experienced only the loss of loved ones. But, I found lots of less obvious little, but genuine adversities that occur when my age related changes reach a tipping point and create imbalances in daily living. I find that my resilience means, not a return to a previous normal, but finding ways to establish a satisfying balance between the affected demands and resources for new norms that often are at a lower level. Even then, I know it’s only temporary as the functional changes continue to progress and new norms will be set. Except for the loss of two loved ones, resilience, as I’ve been experiencing it is an ongoing, unseen, underappreciated activity.

In some reading I did in order to try to make sense of what I was doing, I found that characteristics which improve one’s resilience are said to include: flexibility, engagement , perseverance, seeing meaning in the situation and “paddling one’s own canoe”. They all seem to fit with my experience.

Resilience is an activity that includes a necessary a lag time between the occurrence of the adversity and achievement of some level of recovery. I’ve been so fortunate to have had adequate lag time. But I’ve seen other peoples’ situations where the interval between adversities became so short that it was impossible to recover and re-norm from one before another adverse event occurred. Obviously that’s when the person loses ground and fails to thrive.

RELEVANCE.  Staying in tune with the times has become a tremendous challenge for those of us who are aging in this time of rapid innovation in technology, information availability, health care discoveries, cultural norms and just the general speeded up pace of life. As we’re slowing down, everyone and everything else is speeding up.

Why do I purposefully work to remain as relevant as I can? Think about the people you know or contact who either don’t or can’t maintain relevance.   Do you see or experience others tending to be patronizingly tolerant rather than engaged? Deprecating or discounting them along with their ideas? That’s what I hope to avoid for as long as possible. I’m especially concerned about being seen as being “with it” if or when I come in contact with different health care or other supportive services.

These then are my 3 R’s for engaging with aging.

What has your experience been?