"Old age is no place for sissies"
Bette Davis
This blog has been about growing old and basically dying. It is something that most people struggle to accept. We know that everyone else will die but we think we are the exceptions. It is just something that I think most of us struggle to get our head's around. We can accept the concept of death when it relates to others that we don't know but not when it involves our loved ones or ourselves. It is always a big surprise when it happens. My grandfather died at the age of 89 but I still remember feeling like something tragic and unexpected had happened. Why him, cut down in his prime! How is it possible for people we love to suddenly be gone never to be seen or spoken to again in our lifetime? We talk matter-of-factly about how we would like our bodies to be disposed the way we might talk about our favorite ice cream flavor. Why? Because it doesn't seem real! or because we think by talking without fear about our grand finale we can will ourselves to feel less afraid. A woman I know paid quite a lot of money for her drawer at the mausoleum because she doesn't like the idea of being below ground (which on some strange level I understand). I prefer cremation myself. All cultures have their rituals for death. I actually gave one of my speechs in communications class on death rituals around the world in my undergraduate years. I think if I tried really hard I could remember it all right now 20 years later. Nice to know I still have that crystallized intelligence thing going on. When I look around and think what do we need in this country, I think two things:
affordable, nice assisted living for the elderly and affordable, nice assisted living for the disabled.
What does nice mean? It means whatever the people who are living there want it to mean. However, I have yet to meet someone who did not wish to be treated with dignity and respect.
Wednesday, November 12, 2008
Tuesday, November 4, 2008
Aging into Saging
I am in Indianapolis this week attending a conference for work and I thought I would share some of what I learned today. Wish you could be here sitting with me in a straight back banquet chair for five days on a permanent caffeine high trying to stay awake. (boo hiss the Embassy Suites charges $10.00 a day for internet access and I just paid $2.00 for a soda from the vending machine)
The first speaker talked about what he does which is talking to seniors about being more involved in the community and one thing that he said was that volunteering has a greater impact on reducing levels of mortality than attending church or exercising. He cited an author, Zalman Schater Shalomi, who wrote a book "Turning Aging into Saging" obviously I don't want a four page blog that no one will read but one interesting thing that he said was elders must resume the role that previous generations of elders had and part of that is serving future generations. He quoted the Great Law of the Iroquois "In every deliberation we must consider the impact on the 7th generation" I think this is what Erickson refers to when he talks about ego integrity. The elderly and society have suffered because of the diminished role they now play in a culture that does not value them. Would they not have had some sound advice about buying on credit and not saving after living through the great depression that might have prevented the current financial crisis that we are in?He suggests that elderly people began harvesting their wisdom, as he called it, by doing a life review. You look back on your life in 7 year segments. And think about who did I know during those 7 years? What events went on? What happened in that phase that contributed to who I am and my life? This helps you determine who you are and your mission. Gifts+vision+values+passion=mission. There is alot more but I thought that would be interesting to look back at one's life and ask those questions. We also had a speaker that talked about elder abuse and just some surprising statistics that she gave: the majority of elders that are abused live in their own homes, are females over 80 and are abused by family members. She ended with reading this following letter that I have heard many times, supposedly left behind by an elderly person and found after they died, that may or may not be true but it always brings tears to my eyes and reminds me that I owe the people that I have been hired to assist my very best:
What do you see, nurse... what do you see?
Are you thinking - when you look at me: "A crabbed old woman, not very wise;
Uncertain of habit with far-away eyes, Who dribbles her food and makes no reply
When you say in a loud voice 'I do wish you'd try.'"
Who seems not to notice the things that you do
And forever is losing a stocking or shoe;
Who, resisting or not, lets you do as you will
With bathing and feeding, the long day to fill.
Is that what you're thinking, is that what you see?
Then open your eyes, nurse. You're not looking at me!
I'll tell you who I am as I sit here so still.
As I move at your bidding, eat at your will:
I'm a small child of ten with a father and mother,
Brothers and sisters who love one another;
- A young girl of sixteen with wings on her feet,
Dreaming that soon a love she'll meet;
- A bride at twenty, my heart gives a leap,
Remembering the vows that I promised to keep;
- At twenty-five now I have young of my own
Who need me to build a secure, happy home.
- A woman of thirty, my young now grow fast.
Bound together with ties that should last.
- At forty, my young sons have grown up and gone,
But my man's beside me to see I don't mourn;
- At fifty once more babies play 'round my knee
Again we know children, my loved ones and me...
Dark days are upon me, my husband is dead.
I look at the future, I shudder with dread.
For my young are all rearing young of their own,
And I think of the years and the love that I've known.
I'm an old woman now, and nature is cruel.
'Tis her jest to make old age look like a fool.
The body, it crumbles, grace and vigor depart.
There is a stone where I once had a heart.
I think of the years, all too few, gone too fast
And accept the stark fact that nothing can last;
So open your eyes, nurse, open and see...
not a crabbed old woman.
Look closer... see me
The first speaker talked about what he does which is talking to seniors about being more involved in the community and one thing that he said was that volunteering has a greater impact on reducing levels of mortality than attending church or exercising. He cited an author, Zalman Schater Shalomi, who wrote a book "Turning Aging into Saging" obviously I don't want a four page blog that no one will read but one interesting thing that he said was elders must resume the role that previous generations of elders had and part of that is serving future generations. He quoted the Great Law of the Iroquois "In every deliberation we must consider the impact on the 7th generation" I think this is what Erickson refers to when he talks about ego integrity. The elderly and society have suffered because of the diminished role they now play in a culture that does not value them. Would they not have had some sound advice about buying on credit and not saving after living through the great depression that might have prevented the current financial crisis that we are in?He suggests that elderly people began harvesting their wisdom, as he called it, by doing a life review. You look back on your life in 7 year segments. And think about who did I know during those 7 years? What events went on? What happened in that phase that contributed to who I am and my life? This helps you determine who you are and your mission. Gifts+vision+values+passion=mission. There is alot more but I thought that would be interesting to look back at one's life and ask those questions. We also had a speaker that talked about elder abuse and just some surprising statistics that she gave: the majority of elders that are abused live in their own homes, are females over 80 and are abused by family members. She ended with reading this following letter that I have heard many times, supposedly left behind by an elderly person and found after they died, that may or may not be true but it always brings tears to my eyes and reminds me that I owe the people that I have been hired to assist my very best:
What do you see, nurse... what do you see?
Are you thinking - when you look at me: "A crabbed old woman, not very wise;
Uncertain of habit with far-away eyes, Who dribbles her food and makes no reply
When you say in a loud voice 'I do wish you'd try.'"
Who seems not to notice the things that you do
And forever is losing a stocking or shoe;
Who, resisting or not, lets you do as you will
With bathing and feeding, the long day to fill.
Is that what you're thinking, is that what you see?
Then open your eyes, nurse. You're not looking at me!
I'll tell you who I am as I sit here so still.
As I move at your bidding, eat at your will:
I'm a small child of ten with a father and mother,
Brothers and sisters who love one another;
- A young girl of sixteen with wings on her feet,
Dreaming that soon a love she'll meet;
- A bride at twenty, my heart gives a leap,
Remembering the vows that I promised to keep;
- At twenty-five now I have young of my own
Who need me to build a secure, happy home.
- A woman of thirty, my young now grow fast.
Bound together with ties that should last.
- At forty, my young sons have grown up and gone,
But my man's beside me to see I don't mourn;
- At fifty once more babies play 'round my knee
Again we know children, my loved ones and me...
Dark days are upon me, my husband is dead.
I look at the future, I shudder with dread.
For my young are all rearing young of their own,
And I think of the years and the love that I've known.
I'm an old woman now, and nature is cruel.
'Tis her jest to make old age look like a fool.
The body, it crumbles, grace and vigor depart.
There is a stone where I once had a heart.
I think of the years, all too few, gone too fast
And accept the stark fact that nothing can last;
So open your eyes, nurse, open and see...
not a crabbed old woman.
Look closer... see me
Wednesday, October 29, 2008
Growing old in America
Flipping through People Magazine at the check outline, I saw a picture of Courtney Cox and Demi Moore with the headline45 is the new 30!. Does that mean that 90 is the new 60?
Let me just say that I am not opposed to
plastic surgery, botox, restylane etc. I just can't afford any of that. However there is something to be said for aging gracefully. We live in a country that sees aging as unacceptable. Wouldn't Priscilla Presley look alot better if she had just aged naturally? This is not a wax figure from Madame Tussauds this is a photo of the real deal.
And what about this picture of Kenny Rogers. These people are in a profession that demands people look young so I am not judging their decision although it certainly may be something they are reconsidering, but I can't help 
but wonder how this media obsession of youth continues to impact our beliefs on aging and dying. Old is bad/young is good: Message received. Will we be reading headlines twenty years from now: 70 is the new 40 with a picture of Madonna wearing a black leather bra and holding a riding whip. On some small scale we all try with lotions and potions to look "our best" and many industries depend on our vanity and fear of age to survive but wouldn't it be nice if we valued our elderly for their knowledge and wisdom and saw wrinkles and gray hair as their badges of honor instead of things we should dye and inject away.
but wonder how this media obsession of youth continues to impact our beliefs on aging and dying. Old is bad/young is good: Message received. Will we be reading headlines twenty years from now: 70 is the new 40 with a picture of Madonna wearing a black leather bra and holding a riding whip. On some small scale we all try with lotions and potions to look "our best" and many industries depend on our vanity and fear of age to survive but wouldn't it be nice if we valued our elderly for their knowledge and wisdom and saw wrinkles and gray hair as their badges of honor instead of things we should dye and inject away.I have always loved Katherine Hepburn and I think she is beautiful in both photos.
Tuesday, October 21, 2008
What would you take to the nursing home?
I was thinking about what few things I would take with me if I found out today that I would be moving permanently into a nursing home. Maybe my comforter so that I would feel more at home and a few family pictures, but what about all of the knick knacks and bric a brac that I have collected throughout the years? I don't have anything that valuable but I would hate to see it all sold at a garage sale for a nickle a piece or given to Goodwill. Our textbook mentions that many people transition from a hospital to a nursing home and never get to see their home again and that it is important that they have that opportunity to visit their home and mentally say goodbye. The person may never see their possessions again and having that chance to look at everything and point to their loved one what should be given to charity and what should be sold on ebay would certainly be more comforting to me. Sometimes the person in the nursing home is the last to know that the move is a permanent one. They may have broken a hip and gone to the hospital and then the nursing home or rehabilitation center as it is often called now and the family realizes that the person will no longer be able to live alone and this will be a permanent move. They postone telling the person, maybe they don't want to upset them or they just are afraid to tell them, usually their parent, but eventually the person figures it out. Guess what, we sold your home and all of your belongings at an estate sale. Guess you have no choice but to stay here now. Nursing homes don't have to be sad places. A female client of mine in her 80's is transitioning from the hospital into a rehab center/nursing home for three weeks and she is looking forward to it. She says she really likes the staff there and always has alot of fun. Even in old age a positive attitude is everything. There are some nursing homes opening up now that are based on a smaller family type concept where instead of big institutional settings the homes have maybe 10 to 15 residents and it is not a sterile environment but a home like environment. People can even bring their pets. While I think that is great, most group homes for adults with developmental disabilities are small but they can still be pretty crummy places to live. It just depends on the staff and the only way to get good staff is to pay a decent salary. Something that is sadly lacking in the direct care field.
Tuesday, October 14, 2008
Dying Well
I read something interesting on the NPR website by a Dr. Ira Byock who works in hospice care. Dr. Byock believes in the idea of life long human development. This applies to people at the end of their lives as well and he points out that the developmental milestones of people at the end of life are remarkably similar to the developmental milestones of toddlers.
He writes, “Someone who is dying, like the developing child, goes through stages of discovery, insight, and adjustment to constantly changing circumstances in his person and in the ways people react to him. People who are dying often feel a sense of constant pressure to adapt to unwanted change.” Each day brings new changes and the world can seem like a very scary place. For many elderly people, their world becomes very small. They may no longer drive or feel physically able to go out. They are now dependent on others to do for them what they could once do for themselves.
More interesting information from the NHPCO webstite:
"The term “hospice” (from the same linguistic root as “hospitality”) can be traced back to medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey. The name was first applied to specialized care for dying patients in 1967 by physician Dame Cicely Saunders, who founded the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London."
What is your definition of dying well? For many of us that would mean not dying in a hospital or dying in pain. Hospice care has made that possible and we have Dame Cicely Saunders to thank.
He writes, “Someone who is dying, like the developing child, goes through stages of discovery, insight, and adjustment to constantly changing circumstances in his person and in the ways people react to him. People who are dying often feel a sense of constant pressure to adapt to unwanted change.” Each day brings new changes and the world can seem like a very scary place. For many elderly people, their world becomes very small. They may no longer drive or feel physically able to go out. They are now dependent on others to do for them what they could once do for themselves.
More interesting information from the NHPCO webstite:
"The term “hospice” (from the same linguistic root as “hospitality”) can be traced back to medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey. The name was first applied to specialized care for dying patients in 1967 by physician Dame Cicely Saunders, who founded the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London."
What is your definition of dying well? For many of us that would mean not dying in a hospital or dying in pain. Hospice care has made that possible and we have Dame Cicely Saunders to thank.
Saturday, October 4, 2008
euthanasia
The subject of euthanasia periodically rears it's head; the Terry Schiavo case a couple of years ago and Dr. Kevorkian and his death machine many years ago were all front page stories.
Euthanasia.com lists the pros and cons:
Arguments For Euthanasia:
It provides a way to relieve extreme pain
It provides a way of relief when a person's quality of life is low
Frees up medical funds to help other people
It is another case of freedom of choice
Arguments Against Euthanasia:
Euthanasia devalues human life
Euthanasia can become a means of health care cost containment
Physicians and other medical care people should not be involved in directly causing death
There is a "slippery slope" effect that has occurred where euthanasia has been first been legalized for only
the terminally ill and later laws are changed to allow it for other people or to be done non-voluntarily.
There was a time when I supported euthanasia because I felt that people in extreme pain had the right to choose to die but the idea that it could become a way for insurance companies to save on health care or greedy relatives to collect on inheritances does give one second thoughts. I always wondered why the people who called Dr. Kervorkian couldn't just take a bottle of pills or shoot themselves if they were that hellbent on dying and what did Dr. Kervorkian get out of it? Was he motivated by helping others fullfill their wish to die or something more sinister? With the large number of elderly people and limited resources that we are looking at with the baby boomer generation it is possible that euthanasia could become a way to cull the population? There is a movie,Solent Green, with Charlton Heston that probably only a couple of my fellow baby boomers in class have seen. In the movie, the world is running out of resources and a new food product called solent green is introduced which turns out to be what the old people are being killed and turned into more or less. Should doctors even consider mercy killing considering their hypocratic oath? Isn't that a conflict of interest, do no harm unless the patient is requesting it?
You may be thinking about the option of a living will:
The following site has great information including a blank living will specific to the state of Alabama:
http://www.caringinfo.org/UserFiles/File/Alabama.pdf
--------------------------------------------------------------------------------
Euthanasia.com lists the pros and cons:
Arguments For Euthanasia:
It provides a way to relieve extreme pain
It provides a way of relief when a person's quality of life is low
Frees up medical funds to help other people
It is another case of freedom of choice
Arguments Against Euthanasia:
Euthanasia devalues human life
Euthanasia can become a means of health care cost containment
Physicians and other medical care people should not be involved in directly causing death
There is a "slippery slope" effect that has occurred where euthanasia has been first been legalized for only
the terminally ill and later laws are changed to allow it for other people or to be done non-voluntarily.
There was a time when I supported euthanasia because I felt that people in extreme pain had the right to choose to die but the idea that it could become a way for insurance companies to save on health care or greedy relatives to collect on inheritances does give one second thoughts. I always wondered why the people who called Dr. Kervorkian couldn't just take a bottle of pills or shoot themselves if they were that hellbent on dying and what did Dr. Kervorkian get out of it? Was he motivated by helping others fullfill their wish to die or something more sinister? With the large number of elderly people and limited resources that we are looking at with the baby boomer generation it is possible that euthanasia could become a way to cull the population? There is a movie,Solent Green, with Charlton Heston that probably only a couple of my fellow baby boomers in class have seen. In the movie, the world is running out of resources and a new food product called solent green is introduced which turns out to be what the old people are being killed and turned into more or less. Should doctors even consider mercy killing considering their hypocratic oath? Isn't that a conflict of interest, do no harm unless the patient is requesting it?
You may be thinking about the option of a living will:
The following site has great information including a blank living will specific to the state of Alabama:
http://www.caringinfo.org/UserFiles/File/Alabama.pdf
--------------------------------------------------------------------------------
Monday, September 29, 2008
Hannah and her sisters
This is one my favorite scenes from the movie, Hannah and her sisters. Kip I hope you see my blog because I know you are a Woody Allen fan. Woody's character has been having a crisis of faith throughout the entire movie and has tried all kinds of religions trying to find something that resonates with him when he finally reaches a moment when he feels he cannot go on with his life with the fear of death hanging over him.
It reminds me of something that I went through in my mid twenties. I went through a period of hypochondria and I became kind of convinced that I had lupus or a brain tumor. I began having panic attacks and couldn't even drive by a funeral home near my house without freaking out. I was sure that I was dying even though my doctor couldn't find anything wrong with me (and was getting really irritated with me) I was really racking up the doctor's bills. Eventually, I went to this woman's mental health clinic where they charged on a sliding scale. The therapist, who was probably a student doing her field placement, asked what the problem was and I told her that I was scared of dying and she said "don't you think everyone is scared of dying?" Well that had never occurred to me to be honest and just knowing that everybody felt that way made me feel a whole lot better. It is so important for us to know that we are not kooks but so often we think we are alone in what we feel. I saw in the paper that Heather Locklear was pulled over for suspicion of driving under the influence and the article mentioned that she had been in some kind of program for anxiety and depression recently. It seems that none of us are safe from anxiety, depression, fear of getting older and fear of death, no matter how beautiful or famous. If you have ever seen the movie Brian's Song, you know that in the opening scene the narrator says, "Ernest Hemmingway once wrote that all true stories end in death, this is a true story." Very sad movie! The fact is regardless of what comes next, our lives are true stories, rich, poor, famous, homeless, we all share the same ending (so there, Donald Trump get over yourself), at least to this life on earth, what comes next? That is a topic for another blog.
It reminds me of something that I went through in my mid twenties. I went through a period of hypochondria and I became kind of convinced that I had lupus or a brain tumor. I began having panic attacks and couldn't even drive by a funeral home near my house without freaking out. I was sure that I was dying even though my doctor couldn't find anything wrong with me (and was getting really irritated with me) I was really racking up the doctor's bills. Eventually, I went to this woman's mental health clinic where they charged on a sliding scale. The therapist, who was probably a student doing her field placement, asked what the problem was and I told her that I was scared of dying and she said "don't you think everyone is scared of dying?" Well that had never occurred to me to be honest and just knowing that everybody felt that way made me feel a whole lot better. It is so important for us to know that we are not kooks but so often we think we are alone in what we feel. I saw in the paper that Heather Locklear was pulled over for suspicion of driving under the influence and the article mentioned that she had been in some kind of program for anxiety and depression recently. It seems that none of us are safe from anxiety, depression, fear of getting older and fear of death, no matter how beautiful or famous. If you have ever seen the movie Brian's Song, you know that in the opening scene the narrator says, "Ernest Hemmingway once wrote that all true stories end in death, this is a true story." Very sad movie! The fact is regardless of what comes next, our lives are true stories, rich, poor, famous, homeless, we all share the same ending (so there, Donald Trump get over yourself), at least to this life on earth, what comes next? That is a topic for another blog.
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