Behind the Old Face Aging in America and the Coming Elder Boom
By Angil Tarach-Ritchey RN, GCM
Transfigured By Time From moment to moment everything is being transfigured. With each moment, second, minute, hour, day, and year everything is aging and transforming. We would never recognize moment by moment changes because they are so subtle, but those moments become the life map etched in us and around us, until they are visually recognized. Our physical bodies began aging the moment we were conceived. We wear the years and experiences on our bodies and faces. The scars of injuries, illnesses, and pregnancy are etched in our skin. The lines of joy and sorrow form around our eyes and faces, and the loss of melanin shows in the hair that turns grey. Will you focus on the signs of aging with only a mirror view, or will you be introspective and see the grey hair and wrinkles as a by-product of what your life has evolved into from years gone by? Everything goes through metamorphosis, like a caterpillar to a gorgeous butterfly, or a bud to a beautiful rose, and you will too. Seeing your first grey hair and wrinkles can be met with fear and the dread of aging or you can view it as the unfolding of your life, like the rose that grows into the amazing fullness of what it can be. Although your exterior will be etched with your past your soul never ages. Your soul is your past, present and future. The essence of who you are internally is best described by a quote from Edward G Bulwer-Lyttont, “it is not by the gray of the hair that one knows the age of the heart.�
Slowing Down to the Speed of Life Do you feel there are never enough hours in the day? Do you ever evaluate how you spend your time or are you just speeding through life so fast you don’t recognize where the time goes? Just as time is recorded in your physical appearance, you have a life relationship with time. If you’ve ever heard “hurry up and wait” it is a pretty reflective statement about how we live our lives. As children we have a very primitive concept of the fact that there is time, but we don’t understand how it works and why everything can’t happen now. Yet time also feels unending. As we get a bit older we can understand day from night and the days between the two, but we still want everything now. This starts to form a pattern for our teenage and adult years, and for Americans at least, we cram as much as we can into our days because we want it now.
We end up in what we call the rat race only to find ourselves looking at leaving it all for retirement and time. How you’ll spend your days prior to retirement and post retirement is very different. We never felt there were enough hours when our days were filled with work, raising families, maintaining our daily lives, and the activities we were involved in. We seemed to have endless energy when we were young and did it all, but as the years pass our energy reserves are less. When you were young, did you have no problem meeting friends at 11pm because you had the energy to do so? As we age, we begin planning our time and energy more carefully. Friends we used to meet any night of the week at 11pm become friends we meet on a weekend for dinner. We have some loss of social connection and begin focusing on using the energy we have to take care of the things we need to. Activities are lost because we no longer have the energy to do them. If you have activities you love, such as golf, gardening or volunteering, and you no longer have the energy to do those, how will you feel? I recently started thinking about amusement parks and roller coasters. I loved roller coasters but haven’t been on one for a few years now. I think about going again, but I don’t know if I have the energy to stand in the lines, and walk for hours in the heat. This makes me wonder if I have already ridden a roller coaster for the last time. Do you wonder how long you’ll be able to do and enjoy activities as you age? Some activities will be lost without realizing they are gone, others will be lost suddenly by an injury or illness that won’t allow you to return to that activity again. Some activities you’ll just give up because of the loss of energy or stamina to do them. When activities and socialization are lost what will bring you joy? What will fill your days? What will you have the energy to do? Will you find joy in a meal, or will your big activity of the week be a doctor appointment? Will you be satisfied with how you spent your time, or will you have regrets?
The Big Transition The transition from work, raising children and busy days to retirement can be compared to going from your teen years to moving away from home and beginning your life as an adult, only it will be met with an enormous amount of reflection. Will you enter your retirement years with regret or acceptance? Did you do enough, accomplish enough, and raise your children well enough? Did you follow your dreams or did you allow life to get in the way of what was really important to you, your happiness, and the happiness of our loved ones. Were you so wrapped up in work and/or raising children that you’ll enter retirement not even knowing who you are without the work and kids? Or will you be self accepting? Will you feel like you lived your years the best you could? Will you feel like you were aware of what was important? Will you be able to appreciate the joys and blessings, and even the lessons from the difficulties you’ve faced? Will you feel satisfied, accepting of yourself and ready to accept the new phase of your life? There are many losses and changes we can face when we retire. Besides the self reflection, we lose the daily interaction and socialization with our co-workers or staff. Many of us will decide to downsize our home or move to another location. Couples can begin having problems when they start spending so much time together, or a retiring spouse wants to move and the stay at home spouse doesn’t want to leave familiar surroundings and friends. Essentially we will all go from doing to being. How we perceive “being” is the difference between a successful or unsuccessful transition into our senior years. Is your identity wrapped up in your career or in raising your family? When you retire and the job and children are gone will you feel your value is gone? Remember the feelings of satisfaction when you first helped a parent or a teacher? Those same feelings can be renewed by service in your retirement years. What we seek is the feeling of value. Lying
on the grass watching the clouds or running to the window to see a robin brought such joy and peace when you were a child. Are you bypassing the simple things in the rat race of life? Will you renew those experiences when the constant pace of doing is over and you enter the world of” being”. Your perspective of what’s important and what gives you joy is open to you as you age. You can embrace your elderly years or fear what’s to come. Imagine for a moment, just “being.” Can you?
Our Whole Self In what shape will you find yourself in if you lose your vision, hearing, sense of smell, taste or touch after living a full life with everything intact? The fact is, as our body’s age we will most likely experience some loss. Whether we go to reading glasses or full blindness from macular degeneration, or from a slight hearing loss to needing hearing aids, we will have loss. We wear out parts, like a car. Some of your parts will wear better than others, but you will wear out. What emotions will you experience if you lose your senses or the ability to walk? Will you be angry or thankful there is a device to compensate for the loss, or an alternative way to function? What will you expect of yourself and those around you? Will you see yourself as less of a person, or will you still feel whole, if your vision is gone one day, or you can no longer walk? Do you think the loss would take away from the soul of who you are? What goes into a whole person? Will you feel like you should be treated differently, less respected, less valued? Loss is difficult in any form. We have all had loss. Loss of a pet, a family member or friend, a job or relationship, but a physical loss of one or more of our senses is much different. It affects the way we perceive ourselves and how we function in the world. Will you feel, or have you felt less than a whole person when you could no longer read without reading glasses? Will you deny needing glasses and strain to see, or find a fashionable pair and go on with your day? How about if you can no longer hear the birds, or someone calling your name? Will you focus on how old you think you look with a hearing aid and refuse to get one, or focus on being an active participant in life, accept the loss and get fitted for the hearing aide? What if you become weak and unstable and can no longer walk safely alone? Will you attempt to keep walking unaided and unsafe, give up and stay home, or do what is necessary to continue to be mobile in your home and in the world? Do you really want to live a happy life despite the challenges and losses you’ll face?
Made of Memories We have spent time thinking about our aging bodies, going from doing to being, and losing our senses, but those are minor in comparison to losing our memories. Losing the very thing that makes us who we are is the greatest loss of all. Our entire identity to ourselves and others resides in our memory. The childhood we had, the families we grew up with, the schools we went to, the people we marry, the children and friends we have, the work we did, and all the emotions, values and personality we developed is all encapsulated in our memories. Listening to a siren that warns of an emergency is from memory. Using a toothbrush or a fork to eat dinner is from memory. Receiving and reciprocating love is from memory.
We have memories that put us on constant autopilot to function in our everyday worlds. You don’t have to sit and think a glass is for drinking, or your home is on the road it is, or the word apple is the name for a piece of fruit. You just know. We have experiential memories that we can recall in joy, or sorrow. How we developed feelings for someone and other memories that guide our thoughts and values, right from wrong and loved ones from strangers all make up who we are. Imagine if you slowly lose the ability to recall simple words that you knew your whole life. Sure we have all experienced occasional times when a word won’t come to us, but what about when a common word like house has no meaning? What will it be like for you to get in the car with the intention of going to the store only to find yourself in an unfamiliar place where you don’t recognize anyone or anything, and you have no idea where to go or what to do? How frightful it must be to know you are losing your memories and there is nothing to stop it. Losing the ability to recall your spouse or partner you had been with for 50 years is not only devastating to you, but is also devastating to your families and friends. There comes a point in progressive dementia when you will not even be aware that you have lost your memory, because you don’t remember you ever had one, but your family and friends will continue to grieve because they feel they are losing you and who you are. What you need to recognize is the memories are still deep within the mind. They really aren’t lost. A disease has caused the inability to recall the memories. You wouldn’t really be gone. In the depths of dementia there can be lucid moments that prove the memories are there. They are trapped in a mind that no longer functions in a healthy deliberate way. As horrifying as dementia is, it can produce the most profound love. To unconditionally love, care and protect a spouse, parent or friend with memory loss is a very true and deep love. When there is no ability to receive anything on any purposeful basis and to fully give is amazing and beautiful. How much a family caregiver can wait for, appreciate, and be
touched by a moment of lucidity is simply the connection of souls that has always been there. You can only imagine for a few minutes the fear of losing yourself, and whether you have anyone in your life that has the kind of deep, unconditional love needed to care and protect you. Understand what individuals and families go through when they face and deal with Alzheimer’s or other dementias. Could you expect that kind of love? Could you give love that deep and committed without an expectation of anything in return? What would you expect from a professional care provider if there is no one who can care for you? What kind of caregiver would you be if you were a professional?
Fear of Aging Our aging fears vary around the globe, according to the Aging Services of California, in an international survey. They report the Dutch fear weight gain, Germans worry about loss of eyesight and mental alertness, the Belgians worry about incontinence and India’s population worries about getting grey hair or losing it all together. The MetLife Foundation reports that Americans fear Alzheimer’s more than diabetes, heart disease, or stroke. Although these fears vary around the world and in different cultures, we can agree that there is fear in aging. What is your fear? Is Alzheimer’s your greatest fear? It’s not actually the fear of the word, but what the word implies. If we have witnessed a family member lose their life to this dreadful disease we see that the losses are enormous. Losing the ability to direct one’s life is devastating. If you have Alzheimer’s and have a spouse or adult child or family that will do everything possible to keep you home, loved and safe, the devastation is not as bad, but what if you don’t? What if your family is not able to care for you or you have no one? Your sense of security and destiny is in the hands of those who will provide your care. You will be facing a life without choices. Your meals, showers, activities, and care are all on the care providers watch. Your surroundings are based on your income and the decor of the facility’s owner, which may or may not be to your liking. You will not have a voice in your own life. If you’ve been to a nursing home or assisted living, what did you think? Kathy Bradway, a friend of mine who is focused on changing the decor in long term care facilities through her company Periwinkle Designs for Living, recently told me that when she asks families and facility staff what
they think of the decor in current facilities and she often hears “it’s nice”. She then poses the question, “Nice for who? Nice for you?” The point being, why do families think a facility is nice enough for a loved one, but they wouldn’t want to live there? Will you want to live or receive care in any of the long term care facilities you’ve been to, or have seen on TV or videos? Do you think our eldercare system is sufficient for your home and care, or do you think there needs to be a change? There are many formidable factors that go into elder living and care. Should you live in a dingy dirty nursing home with substandard care from untrained individuals because you don’t have the money to live in a place that looks nice and appears to have better care? Do you think the ability to pay or not pay should be the primary value of your life? In
this current economic client we all know that our financial situations can easily change. There are also factors such as health care costs, whether you have a loved one who can provide care if you need it or you have to pay for care, which all will play into your financial situation as you age. Many elderly individuals who have worked hard, saved their money, and walked into retirement feeling comfortable have outlived their savings, or faced a crisis that devastated them financially, and it can happen to you. Although the picture is pretty grim from anyone’s standpoint we can make changes and provide better solutions for elder living and care. Think about what you want for yourself in your aging years. What do you want to see changed? How do you want to be treated and cared for? How can you make sure you’ll live in comfortable, clean surroundings and receive respectful, dignified assistance and care?
Housing the Elder Boom The statistical information provides evidence that there will not be enough long term care facilities to house even a fair portion of the 76 million Baby Boomers that started turning 65 in January 2011. For the next 19 years more than 10,000 will reach age 65, every single day. If you don’t get involved to advocate and change the way we care for aging adults now, you are headed for a much larger crisis and disaster than already exists. We must break the old school thoughts and patterns of how we view aging and what we expect for our elderly, and ourselves. There are doable models of housing and services that can answer the crisis, reduce costs, and improve care but we must advocate and work to see the realization of these necessary changes. Check any statistics to see how many seniors want to remain in their homes, and you’ll easily find 80% or more. I suspect that number will continue to grow. Do you want to live in a substandard nursing home? What are you going to do to prevent that?
A Cooperative Vision for the Coming Elder Boom As quick as we see subdivisions and housing communities going up we can build co-op villages that will not only provide affordable housing for seniors, but will also provide affordable housing for employable caregivers and their families, creating an intergenerational community. The costs could remain affordable by following a cooperative model of service. The vision is to develop villages for aging adults, care providers, and businesses that are self sufficient and self contained, as more of a co-op model than a traditional business model, but with some aspect of traditional business included. The villages include residential living for aging adults and professional caregiving families, basic healthcare, food and goods stores, banking, postal services, environmental services, restaurants, recreation, and several common areas that are scattered throughout the village. The common areas are buildings of different sizes including a bigger building with
a kitchen and comfortable living areas for large gatherings, to smaller buildings with multipurpose areas, for different groups and gatherings. There will also be some comfortable outdoor areas as well. Groups will be formed from a base list from input and interest from residents. Groups such as those for support, special interests, and education will meet the needs and desires of residents. Travel and arts groups, musical and fitness groups, literary, health promotion, family caregiver groups, and “meet the neighbours� are just a few examples of groups which can be formed. The villages will be overseen and managed by a committee of residents who are aging adults, professional care providers, key business owners/ managers who reside in the village and multi generational representation, most likely from care providers or managerial families. It is preferred to have business owners/managers live in the village, but if they choose not to reside in the village, they will still have residents as part of the management team and all, or most employees will be residents. Compare the images in your mind; Nursing home versus cooperative living villages. Where will you want to live? Will you have a choice? Will you do anything now to secure a choice later?
Creating Cooperative Villages A new cooperative healthcare model meets the needs of village residents in a variety of psychosocial, socioeconomic, and physical needs. The vast majority of retirees enter their mid-sixties healthy and active. If they choose to reside in a cooperative village, they will bring with them a variety of skills, educational backgrounds, experiences and interests. The loss of socialization, work, and activities that once provided value to their lives will be replaced by volunteerism in the village they reside. If an individual worked as a designer, landscaper, nurse, or janitor for example, they can easily provide those services to the village and to residents in need. As residents of the village age and need services, they can obtain those services from other capable residents, who will eventually be on the receiving side themselves. The residents and employable caregivers can either receive partial monetary compensation for their services, either in housing costs or money, or receive no monetary compensation, but have the ability to reside in affordable housing and obtain services for themselves when they are in need. An on sight medical clinic will reduce healthcare costs by providing some volunteers, and by attending to basic injuries and illnesses. Volunteer homecare residents will help provide assistance with care needs for those who require assistance and monitoring such as meal preparation, housekeeping, or other services that help them remain safely at home.
Are You Ready? Are you ready to accept and contribute to a better vision of housing, activity, and healthcare, or will any nursing home do? Are you fearful of what you are facing in your elder years? Will you continue to sit on the sidelines praying you’ll remain healthy until you die, or are you ready to start advocating and changing your future so the fear subsides? Will you one day regret your unwillingness to take action as you lie in a dreary and depressing nursing home bed, or will you be grateful you acted and can enjoy the rest of your years in a comfortable, clean, friendly and caring community with others who acted? Will you continue to see aging the same, and ignore it like it will go away, or are you ready to embrace formatting the 2nd half of your life? Do you have a slightly new perspective of what our elderly go through, and how
difficult it can be in the current system? Are you now going to be kinder and more caring towards aging adults who are our mothers, fathers, grandparents, sisters, brothers, friends, and neighbours? Do you really see yourself in the aging faces you now see, because others will be looking into your aged face one day and should be asked the same question? How do you want people to view, treat and care for you when you are in need and dealing with the losses you’ll most likely experience? The time to advocate and act is now. You can dread and fear aging, or you can embrace it as the beautiful time it can be. You can fear and dread how you will be cared for or act and change the future of care. The choice is yours. Every single one of us has a choice to let the current system dictate our future and how we live it, or we can act and direct our future now. Let’s work together to improve the treatment and care of aging adults and implement a beautiful vision of aging for everyone.
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