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.

 

Clocks and More Clocks

Clocks

Here I am, a fully retired 96 year old woman, living in my own home and able to do what I wish, when I wish. Many of my days are wide open. Yet I have and want clocks, accurate in their action in every room. There is one that is night lighted beside my bed. There’s one on my desk in addition to the one on the computer monitor. There is one opposite my recliner, and a lovely grandmother clock that chimes the hour and quarter hour (rather loudly) in the living room (it was a no-occasion surprise from my husband one time). In the kitchen there are clocks on the radio, the oven and the microwave. And on top of that, I wear a watch! It doesn’t make sense.

Somehow, time seems important to me, even now. Maybe it harks back to my childhood. My Swedish parents respected being on time. They consistently modeled it. Decades later I encountered a man who’d been posted to the American consulate in Stockholm. He told me that there was a 4-minute window for arriving at a social engagement such as a dinner—2 minutes before the appointed time to 2 minutes after. That rang a bell as I recalled how my mother made her last minute dinner preparations to coincide with guests arriving at the hour invited. And arrive promptly they did.   Even our supper tended to be at 5:00 each week night. Fortunately, my husband’s patterns were similar and our sons had little choice in the earliest years.   So this way of living continued through the decades

What has complicated this even tenor of my ways is my changing capacities that threaten meeting deadlines, whether it is expecting guests or being ready to leave when my ride arrives. I don’t mind when others are early or late, so it’s only my behavior that’s involved. For ordinary days when I’m alone it’s no problem, but I’m uneasy about being ready in time when it involves others. It’s hard to know how long it’s going to take me to get ready. All sorts of calamities strew my path. I have trouble making decisions, so they take longer. I have trouble putting on a piece of clothing. I drop things, spill things, have trouble manipulating things. And hurrying just increases the risks. I try to be organized and plan ahead. Then I start early to allow for my calamities, watch the clock and most often relax for a few minutes before the deadline; or feel comfortable greeting guests or the ride if they are early.

Nurture or nature, apparently I’m wired or conditioned to enjoy some predictability in rhythm and flow of my days even in the midst of age related changes.   Addressing my need to be ready on time and the barriers to it is a work in progress.    

C’est la vie! And lucky to have my home, my clocks, people who can fix or adjust them, visitors who accept me as I am, and people willing to take me and my walker out and about.

Have You Ever Thought of Aging as a School?

school-2666640_960_720

Aging, a school? Really?   I’m not quite sure why or how this thought popped up in my mind. But as I considered it, I realized that this is just what it is. The latest decades of aging have made learning a necessity. I’m actually engaging in home schooling.  The more I examined this idea, the more concrete it became.

Aging and living with it is the subject of the curriculum. It involves both knowledge and skills. My home is my classroom and my laboratory. The age related changes (ARCs) form the different courses. Attendance is mandatory and the school year is 365 days with no weekends, holidays or summer vacations. There are even some night classes. As a student, I can be a “seat-warmer,” an avid learner or something in between, but attend I must. I may be a “special education” student if mental pathology intervenes. And pathology may be the cause of “drop outs”.

There are “libraries” of books about aging, blogs and products that are available. Occasionally there are teachers, guides, sometimes student “buddies” from other ages or age mates where we serve as sounding boards to each other. Most often I seem to be self-teaching.

I grade myself on the degree to which I manage to maintain a satisfying balance between the requirements (including my desires) on the one side of my dally living and my capacities and external resources to meet those demands on the other.   I look at my creativity in finding solutions and I also consider my contentment with the level at which I currently can maintain that balance. Others also “grade” me in terms of their perceptions of “how I’m doing”.

Particular “courses” are dictated by presenting situations/challenges of normal age related changes, pathology, accidents, changes in my environment or external resources. The timing and sequence of courses varies with each student. But there is a general predictable sequence based on when age related changes begin and the pace at which they accumulate. As Germaine Greer suggests, we age in our own ways, but aging is so commonplace that none of us should feel uniquely afflicted. So we all attend the School of Aging, but approach it in different ways.

Looking back over the 3+ decades I’ve been officially classified as “old”, I see that I have gone through various levels of schooling. In my 60’s and well into my 70’s I was a preschooler and kindergartner.   My ARCs were still not particularly noticeable or affecting my lifestyle. I no doubt was being taught and learning and just didn’t realize it. As the ARCS became increasingly noticeable and began to impact more significantly on me and my daily living, I continued to adapt intuitively. If I was studying, I didn’t know it. But over time the assignments in adaptation to aging became increasingly difficult. I was having to recognize the challenges and the problems. I had to build on and manipulate what I had learned earlier just as had been required in my earlier schooling.

As the years and aging advanced, I feel as if I’ve moved on through high school and undergraduate level courses. At the current rate of accumulation of my ARCs, I suspect that more advanced schooling lies ahead.

These days, I see that I’m spending more time and effort in the laboratory studying and experimenting with the most mundane of daily living activities. I’m studying and experimenting with different approaches to engaging with specific ARCs, learning how to manage them and their impact on what I can do and how I feel about myself.   I reexamine what’s “important” to me.  I work to sustain a balance between what I need/want to do with the capacities and external resources I have available. I look at my satisfaction with my efforts and results. (It’s sometimes quite tedious—just as some school assignments had been.) But there are moments of achievement and triumphs too.

All of us will graduate from our Schools of Aging. When we go out the door of our schools for the last time, a certificate will be printed up. At our graduation others will probably acknowledge whether we graduated at an average or “magna cum laude” level. But we probably won’t care.

certificate-576788_960_720

“It’s Not Easy Being Green,” and Writing About it

When green is all there is to be

It could make you wonder why

But why wonder

I’m green and it’ll be fine

It’s beautiful and what I want to be.

                    ~ Jim Henson

In one of the earliest blog posts in this series I wrote about a grad school professor who encouraged me by telling me that as long as I was green I was growing. (I don’t remember that she told me the rest of the saying, “and it scares people”. At that time (my late 30’s) I could accept then that being green and growing was better by far than being brown and static. I was relatively young so it seemed logical. I did find that being green was not always a comfortable way to live then.

Little did I think that in my advanced years I’d choose to “engage” so actively with my aging and thus find myself purposefully identifying and addressing ongoing changes and challenges that begged for creative approaches. Here I was, still as green as springtime grass. This time I was green at being old.   One would think that years of experiencing being new at things would make being old and green a more comfortable status, but for me it didn’t. Intellectually I still value my changing life and its demands for adaptation. But I do wish I could find more comforting certainty in the midst of it. “Green” and “certainty” feel paradoxical.

Beyond that, here I am, revealing my green status to an unknown audience in writing this blog on engaging with aging.   From the beginning I acknowledged that it meant exposing my “greenness” to strangers in ways that cut “close to the bone.” In my earlier years of writing, in books on nursing of individuals with cancer or the elderly I knowingly exposed my intellect, my nursing knowledge and my writing competence, but I was never the subject. I was writing for a nursing readership about situations I was viewing from a safe professional perspective. Now, here I am, using my very old, very personal, increasingly less functional self as the point of departure.

Well, “in for a penny, in for a pound.” Honest acknowledgement of my ongoing greenness with aging does shape the way I write. It causes me to be tentative in offering my experiences and insights. No answers, but one or many possible points of departure in my greenness for any reader’s own exploration and engagement. I leave to others who are sturdier in this aging business to offer answers or “how- to’s.”

There’s still at least one more thing to be said for “being green”. It may be a bit uncertain but it’s never boring.

hang-in-there

Finding A Place for our Talents as we Age

mind-767592__340

talent: a special natural ability to do something well

Each of us, over our lifetime, has developed abilities to do something well. For some it is a towering or outlandish gift. The rest of us manage with more modest abilities.

When I was younger, I thought about talent in terms of the arts, performance sports, inventions, organization and business acumen. Amazing stars! Eventually my concept broadened as I recognized unsung, special abilities involving more mundane activities and encounters in daily living. These were tremendously gifted people whose abilities made significant contributions to the wellbeing and happiness in places large and small in the world. Sometimes they were recognized; more often they were unsung and taken for granted.

During our adult years our talents and abilities find a place in all parts of our daily life. We further develop them and discover the places and uses for them. They tend to become a part of how we see ourselves and how others define us as well.

As we age, suddenly or gradually we lose places to use our talents. Even compromises or substitutions for lost opportunities become scarce or unsatisfying. This happens whether one works outside of the home or within it. Within the home, we’ve become empty nesters; family members move away. If we live long enough, we become a drain on the next generation. Where do we use our talents then?

We risk seeing ourselves as “less.” We presume that others see us as “less.” We feel less valuable despite the reality the talent and abilities are often still there.

I managed retirement from the university comfortably as I continued to write, consult and do workshops for more than a decade. It was when I aged out of all of these (about the same time), that I felt a distinct loss of identity which I tried to assuage by volunteering as a writing coach with 4th graders .

My husband’s death robbed me of still another place for my talents.   I wallowed around rather aimlessly for a time. Finally I decided it was time to inventory abilities I still had available. I found some that still would have a place in my current, circumscribed life: listening genuinely, responding with thought and creativity, putting myself in someone else’s shoes, creating situations within my limitations that might give pleasure to others, offering what skills I had e.g. mentoring others who wanted to write. I looked for doors that others might not see for themselves and then supported them, as others had done for me earlier. With awareness, I was using talents and skills I’d developed in nursing, marriage, parenting, teaching and writing. I‘m using them where I think they might do some good without manipulating people into thinking they have to need me.

Then, at 95, someone challenged me to write a blog about my approach to aging. What an intriguing opportunity that has become to use my thinking and writing abilities. It has given my life zest and vibrancy that was not there before.   And last week at 96, again out of the blue, I was offered an even more demanding challenge.   It leaves me wondering, not where to use my talent, but whether I have sufficient talent to meet it.   My millpond life is suddenly roiling.

So here’s a toast to my age mates who find ways every day to recognize and use their talents, whatever they might be in whatever situation they can find for them.   And here’s an even bigger toast to those around us who identify our talents and offer us recognizable opportunities to use them.

5d7ba743362595b0a9f1534d98f02aef

Meet My Watchbird

My watchbird came into being in a series of stages over decades. Most of the time it was maturing, piece by piece, without my being aware of it. It finally came together for me consciously when I found that I wanted, needed a tangible one.

As my parents began shaping my behavior to enable me to live well in society their interventions affected the part of my brain dealing with conscience and judgment. Though of course they didn’t think about it from that perspective, but my inner watchbird was beginning to mature.

Then one day, a chance event occurred that exposed me to the idea of an outside monitor to my conscience (though that was not the way I as able to think about it at the time).

I was playing at the home of a grade school friend and saw a kid’s cartoon in several copies of McCall’s women’s magazine. The drawings were about things little Betsy McCall should or shouldn’t do and the caption was, “This is a watchbird watching you!” For a time I continued to think about that bird when I was either doing what I should and sometimes when I was doing what I shouldn’t.

In my pre-nursing college experience courses in anatomy, physiology and psychology added knowledge about the specific part of my brain that others had been shaping in me for almost two decades. I learned it had the function of dealing with all these conscience/judgment–based experiences. It was a wrinkled area behind my left forehead, my prefrontal cortex (PFC).

Brain

I also learned that it was useful in situations involving:   planning /decision making/problem solving, overcoming of habitual responses and dealing with situations that were dangerous or technically difficult. Now I had specific knowledge of both external and internal watchbirds available to me. They were functioning whether I thought about them or not. Again I took in this knowledge without linking them or purposefully engaging them.

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

My need to deliberately, explicitly use my watch birds arose in the 1960’s when I was among nurses who began to recognize that we nurses had been providing professional care whose focus (though concrete and essential), had been buried deeply in the delegated medical care we also gave. We saw that nursing’s area of expertise focused on health related daily living where pathology & treatment were only two components. This nursing focus was complementary to, yet almost the reverse of medicine’s focus on pathology/ treatment where daily living was one component. With that awareness came the expectation that patients deserved the same discipline-specific rigor in diagnosing and treating health relate daily living issues as medicine offered within its pathology orientation.

But knowing and implementing were different and we faced real challenges.

Medicine had its huge American Medical Association’s official code-of-diagnoses book filled with thousands of diagnoses in their own esoteric language. Their diagnostic workups often involved laboratory work, x- rays, and other weird tangible procedures in addition to physical exams and history taking, again couched in arcane language. Their treatments also often involved pills, injections, surgery, radiation, metal or other support systems and more. All concrete, visible and anything-but-ordinary and almost all offered in specialized environments.

In stark contrast, nursing’s a health related daily living focus in nursing diagnosis was going to take place wherever the daily living was going on and use totally mundane, everyday language. Our diagnoses would come from talking about, and observing ordinary things. Treatment similarly would involve ordinary behavior, personal decisions about daily living patterns.   As one Swedish nurse complained to me in one of our workshops, “Doris, Dagligt liv är så daglig!” (Daily living is so daily). So where was the professional prestige, the unique language, the expertise in this kind of an approach? How could anything so commonplace make a professional contribution that patients, other health professionals and nurses themselves would see as valuable, and importantly, essential?

I soon realized that I was going to need not only a fresh orientation, but fresh eyes and ears to look at daily living from this very explicit, health-related perspective. I needed to recognize and value it and help patients and their families as well as other professionals to do so as well. It was then I thought about my prefrontal cortex that helped one to address “overcoming habitual responses.” But, strangely enough, my brain also brought Betsy McCall’s watchbird to my attention. I decided that I wanted to use both. Somehow, an external watchbird seemed a much more congenial partner in this task and I knew my wrinkled glob of brain matter would go on doing its thing as long as I worked with it.

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

I chose my bird carefully. I decided upon an owl for its sharp vision, a head that had a turning range of 270° and keen hearing—and perhaps its talons for a firm grasp on data and ideas I obtained.  It had a reputation for being “wise” and wisdom I needed! I chose a Pygmy Owl for its compact size and soft calls. For good measure I named her Athena, (the Greek goddess of wisdom). That done, I assigned her a perch on my left shoulder (same side as my prefrontal cortex). Then I began to train her to help me look at health related daily living with the specificity and precision needed to serve patients well.

Owl

Athena

Over the years I fed my inner and outer watchbirds as I gained knowledge and expertise. In turn they served me well, directing my attention to specifics and helping me to see linkages. I used the watchbird imagery in my teaching, workshops and writing. Others initially thought it silly, then found it worked for them too. (Some of my students thought I was the watchbird sitting on their shoulder as they delivered nursing care. And I’ve quite a collection of owls that have been given to me over the years.)

My watchbirds and I formed comfortable, casual relationships. So, when I moved on to engage with my own aging, it seemed natural that our learning/consulting working together would continue and be put to good use. Good thing they’ve both been as long-lived and functional as the rest of me. (It is something I’ve not taken for granted!)

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

And so finally we come to engaging with aging, which of course is health related daily living in spades. All that I, my Pre-frontal cortex and Athena “know” is now put to work every day.

Interacting with my owl continues to be a pleasure and am so grateful for my PFC and neural connections that seem to continue to work well despite our age. We enjoy when all goes well and we look at the challenges, explore options and possibilities, then do the best we can to deal with them in ways that are as satisfying and fulfilling as possible.

Do you have watchbirds? Do they help you engage with aging?