I overheard a conversation. “How are your parents doing?” one asked. “Oh, you know, they’re deteriorating,” said the other. “That’s it?” I thought. “That’s how she sums up her parents… They’re deteriorating? What about, “They’re facing some challenges but they’re coping ” or “They’re declining and struggling to maintain their independence” or “All things considered, they’re pretty resilient…” . Almost anything was better than reducing her parents to a short description of passive diminishment. And that’s when I thought about my dog.
Yesterday, a friend reminded me about a conversation we had a few weeks earlier that I had forgotten. “I’m beginning to worry about you,” she said.
Then I began to worry about me. Was this an indication of something serious?
I began checking for other signs of forgetfulness. Nothing stuck out. I handle a million details with my business, and remember most of them. So how to explain my “losing” that conversation until she reminded me of it? I think I figured it out. I see it every night. I sit on the sofa with my iPad, my husband tells me something, and then asks, “Are you paying attention?” “Yes,” I answer, and I am telling the truth. I am paying attention — just not to him. I am fully engrossed in what I am reading on my iPad. My hearing is normal. My memory is ok. It’s my ability to multitask that is shot.
I hear what my husband tells me, but when I am multitasking, I just don’t take it in. These days, it seems I need to focus more on what I am doing, and have fewer distractions. Perhaps I was focusing on something else when my friend called a few weeks ago. I decide that is what it is, and feel relieved. I am no longer worried about me, but I know that something has changed.
I think about a quote I read by a man diagnosed with Alzheimer’s disease: ” I say something and they blame it on the Alzheimer’s. Someone else says the same thing, and no one notices.” I get it. If someone young forgets a conversation, we assume they weren’t paying attention, but when you reach a certain age and you forget something, then people “begin to worry about you,” and you begin to worry about yourself as well.
For now I’ve concluded that my memory is ok, and that I need to concentrate more and have fewer distractions. I can live with that, but it is food for thought. We take an act, like forgetting (I prefer the term misremembering), and make assumptions based on a person’s age. Sounds like ageism to me. What makes it so sinister is that we not only make assumptions about others, we make assumptions about ourselves, too. I rant about ageism in print and in the media, but ageism is much closer to home. I might do better fighting ageism outside if I had better control of the ageism in myself.
I thought that using a cane would make me feel dimished.
Instead, it has made my life larger.
The following is a guest post from Andrea Frayser of The Intentional Caregiver:
I have to make a confession. This has been the hardest post for me to write. I have sat down, time and again to put the words together and they just wouldn’t come. It has taken me weeks of prayer, of introspection and a swift kick in the butt to finally get this done. I guess the kick dislodged the words, so here we go…
I use a cane. (Even typing that statement pulled at my heart.) Please understand that I have been fighting this inevitability for several years. I would rather rely on my husband, children and friends to prop me up, and yes, sometimes pick me up, as long as I did not have to use a cane.
I understand the benefits of using the device in my mind, and over the years, I have had many conversations with friends and clients convincing them to use their canes. But when it came down to me getting one – oh boy – all of that good sense just went to the wayside.
To me, the cane represented weakness, old age, and an inability to care for my family. Therefore when necessity prevailed and the need for the cane became apparent, it felt like accepting this device would also mean that I had to accept being weak, losing my vitality and not being able to do the thing I love the most- caring for my family. I really felt that using the cane would change people’s view of me from a fortress of strength and stability to a pile of dust, and I was not ready to accept that reality shift.
I needed some serious reinforcements to support me in this decision. My husband, who also happens to be my best friend, went with me to pick it out. After trying out several models I found one that suited me. It was young looking, sparkly and had a comfort grip handle. I used it to get to the car, where I proceeded to break down and cry. Partially because it was so much easier for me to get from the sidewalk to the car and I had less pain. Admitting that seemed like I was choosing my comfort over my family.
We went to Sam’s Club to pick up a few things, and my husband asked me if I wanted to “take ‘er for a spin” inside Sam’s. I couldn’t do it. So he graciously went in, while I stayed in the car and watched the people go by (yes, and to cry some more). To get my mind off of my “problem” I went on Facebook to see what was going on in other people’s lives. As I was looking down at my phone, a hand appeared through the window and a giant box of my favorite chocolates appeared, quickly followed by a kiss on the cheek. He went back into the store and shopped, leaving me time to dry my tears and think.
In my heart, I went back to holding my children’s hands when they were little to keep them safe. I realized that now that they are adults, we were still holding hands but they were doing it to keep ME safe. I also realized that my stubbornness in using the cane was keeping me dependent upon them and others, that in reality, they had slowly become my guardians and caregivers and that I was not really caring for their emotional health with my choice. By the time my husband had returned I had decided that I was going to try to make peace with this.
When we got home I decided to use my cane to walk to the door. My son saw me walking towards the house, he ran and opened the door, and said “Hey Mom, looking good!” (I cannot describe how good that felt.) When my daughters came to visit, they both ribbed me horribly (in my family that is a sign of acceptance and love), and I could sense the feeling of relief that came to them seeing me walk steadier (the jokes about no longer looking like a drunken sailor were also an indicator).
That night, when we sat down to read the bible and pray together, I asked them how they felt about my new accessory. They all agreed that they loved it because, it gave me freedom, and they would worry less about me because I had my “personal assistant” and that I could go back to being Mom again. Amazing how our own visions of ourselves can be so far off from what others really perceive.
I named my cane Whizzy- for two reasons. First it is because I can now “whiz” around from one place to another, without waiting for someone to steady me, and second as a reminder that “Wisdom is proved righteous by its works.” (Matthew 11:19) Every time I pick Whizzy up, I am reminded that it was the wisest choice, and that by using her, I am providing proof of Godly wisdom to myself and others – especially my children.
The response and support have been overwhelmingly positive. There are some who look at me with that look of: “why her?” The real question is: ”Why not me?” I deserve to be able to feel safe and secure, to reduce my physical pain, to not have to rely on people to keep me on my feet, (literally) and to have to dignity of being able to overcome my negative thinking and experience the emotional, physical and psychological freedom that comes with my lovely red cane – Whizzy.
When I started Moving Solutions 18 years ago, I knew I was in the business
of aging, not the business of moving, so it is not surprising that my writing is about aging as well. When you delve into the details of people’s lives, as Senior Move Managers do, you observe the impact of caregiving and getting older on individuals and on relationships. This makes me think about my own getting older and my own relationships, and I share these thoughts in my blog.
I enjoy using metaphors — describing how helping family members move forward can seem like tacking in a boat — sometimes you have to go sideways to make progress, and how some family dynamics are so fragile that, like fine china with a hairline fracture, no matter how much care you take, they break under the added pressure of a move.
I write about my 21 year old cat, and how he taught me how to age with dignity even as abilities faded, and about geriatric fiblets — white lies we use with people we love to help them preserve their sense of self.
Much of my writing is about Bubbie, my mother-in-law and for many years, my muse, who showed me how to live a full and rewarding life even with multiple chronic conditions. Bubbie, who wanted to be buried in a pink sweat suit and slip-on sneakers, because, “I’m not wearing pantyhose for eternity.”
Mostly, I write because I ponder things, and because turning thoughts into well-written prose is exciting, and sharing them is an act of joy.
“The doctors talk to me like I’m an old man,” my uncle grumbled.“Mike,” said my aunt. “You’re 92. You are an old man.”
“I know,” he said, “but no one wants to be talked to like they’re an old man.”
The blog below is from guest blogger, Karen Austen.
About a year after I started volunteering at a skilled nursing home, I observed a set of new teenaged volunteers who came to help with a craft at the monthly meeting of the Red Hat Society. I heard several of the volunteers speak slowly and loudly, using a sing-song voice. In response, I saw many of the residents roll their eyes.
Unfortunately, I had flashbacks to when I also first started as a volunteer. I altered my speech inappropriately as well, hoping to be supportive but coming off as patronizing instead.
I have since learned to identify the features of elderspeak. Continue reading
I didn’t know when or how my mother-in-law, Bubbie, was going to die, but I knew one thing for sure: she wanted to be buried in a pink sweatsuit and slip-on sneakers. “Sneakers?” I asked. “Absolutely,” she said. “I’m not wearing pantyhose for eternity.”
The Conversation Project was started to encourage people to have honest discussions with loved ones about how they want to spend their last days and, by extension, what they want for their funeral. According to Ellen Goodman, one of the founders of the Conversation Project, the difference between a good death and a difficult death is whether the dying person has shared his or her wishes. By all measures, Bubbie had a good death. She had an advance directive that outlined her wishes regarding medical care, she had described what she wanted for her funeral, and she died in her sleep, at 94, with an unfinished crossword puzzle on her lap.
Articles about having “the conversation” all stress how difficult it is to initiate discussion on this topic. What they fail to touch on is how satisfying it can be for the older adult. According to author David Solie, the secret mission of aging adults is legacy and control, and so it was with Bubbie. Bubbie lived in an assisted living residence. She depended on others to clean her room, prepare her food, take her on errands. She used a walker and oxygen. Like many older adults for whom losses accumulate, independence and control were among her highest priorities. And that is why Bubbie loved the idea of defining her end of life wishes.
She had little to say about her advance directive; it was prepared quickly and without fanfare or drama. But she had a lot to say about her funeral.
As I had coffee with Bubbie one day, I described how I had been at a meeting where a funeral director talked about how personalized funerals have become…how people can define exactly what they want their funeral to be like. “Would you like to do that?” I asked. “Absolutely,” said Bubbie, “It’s my funeral; I want to be in control.”
And so we began. I learned that Bubbie did not want hymns; she wanted Stardust Memories, which had been her and husband Herm’s favorite song. She did not want to be buried with any jewelry except her wedding ring. “Dead is dead; let someone else use it.”
I asked if she wanted to be buried with any books —Bubbie loved to read. She thought about this for a few minutes and decided against it. “Perhaps a crossword puzzle and a pen,” she said. “I don’t plan to erase.” Clearly, she was having fun.
For the funeral meal, she wanted nothing low-salt. “I’ve had to watch salt for the past 30 years. No Alpine Lace at my funeral.” She declined fancy dresses; she would be buried in her pink sweatsuit and sneakers…which led to her iconic pantyhose statement.
Then we got to the subject of caskets. Bubbie wanted the least expensive that could be found. “In fact,” she said, “I am pretty short. Do you think I could fit in one of your wardrobe cartons? I would be dust-to-dust pretty fast in cardboard; it would be very green.”
During this entire conversation and afterward, Bubbie was, if not glad to have had “the conversation,” at least satisfied that it had occurred, content that she had been consulted and that her opinion mattered. And so it was, when Bubbie died several years later, that there were no questions about what she wanted. It was her funeral; she had it her way.
For resources on initiating end of life discussions with loved ones, go to www.theconversationproject.org.
For information on how to plan and personalize your own funeral, visit www.mywonderfullife.com.
To learn more about the Secret Mission of Aging Parents Series, go to David Solie’s Second Half of Life blog www.davidsolie.com/blog/
We buried Tiger on Saturday. When you have a very old pet, you hope they will give you a sign, letting you know that “it’s time.” And then, when they do, you don’t want to believe it. Tiger was 21 — really old for a cat — and we are grateful for every year we had with this wonderful, loving, dignified friend.
A few months ago, I wrote about how we had modified our home in order to help Tiger age in place. (Helping Tiger Age in Place). Since Saturday, I’ve been thinking about how Bill and I became Tiger’s caregivers as he became increasingly frail. Although the tasks were sometimes unpleasant, we did them without disgust or resentment. I was in charge of litter duty. During his last year of life, Tiger drank huge quantities of water because his kidneys were failing and routinely urinated outside the litter box, even though we had lowered two sides so he could step in more easily. I also cleaned Tiger when he fell into the litter because his hind legs could no longer support him as he squatted. I am not surprised that Bill was a wonderful caregiver; nurturing is second nature to him. But I am a let-me-cross-things-off-my-list kind of person, not a let-me-help-you kind of person. I am worried about my ability to provide the kind of assistance a love one may need some day.
Yes, I prepared my mother-in-law’s medications each week and took care of my mother’s medical bills, but these were list-type tasks, not the intimate, embarrassing, personal tasks that often accompany caregiving. I’m worried I won’t be good enough, or selfless enough, when the time comes. I know I did it with Tiger, but Tiger was not my husband or my parent.
Next week, we will rescue Jackson, a 12 week old kitten, from a nearby shelter, just as we rescued Tiger 21 years ago. It’s not that we are trying to replace Tiger —Tiger can’t be replaced. It’s that we have experienced the joy of living with pets and know that this is the way we want to live our lives. But I can’t get a replacement mother or husband a week later. Perhaps it is this permanence that makes caregiving for loved ones so much harder than caregiving for a pet. But who knows. I was a better caregiver than I thought I would be with Tiger, perhaps I will be better than I expect with the people I love as well. I hope so.
“Bill, the Presto machine says it has a paper jam.”
“Ok Mom, I’ll be over tomorrow morning Mom to fix it.”
“Tomorrow morning? What happens to my email that arrives tonight?”
Never did we imagine, when we got my 88-year old mother-in-law a Presto machine, that she would turn into an email junkie.
Bubbie loved the phone and had long conversations with her extended family daily. But as her hearing worsened, using the telephone became more difficult. The high-pitched voices of her great grandchildren were especially hard to hear. Communicating was such a source of joy for Bubbie. We worried that her world would get smaller and that she would be lonely. Email seemed like a logical solution, but Bubbie refused. She had not gone beyond 8th grade and had never used a typewriter. She wanted no parts of a keyboard or the Internet.
Bubbie was pretty stubborn, but so were we. When her grandson David told us about Presto, a computerless email system, we were excited, even though we had no idea how we would convince Bubbie to use it. Presto is a combination email printer and mail service that enables you to send emails to someone who does not use a computer. David opened a Presto email account for Bubbie and registered friends and family (Presto users only receive mail from registered senders, so they never get spam or viruses). The machine arrived. We set it up, installed the ink cartridge and paper, and Bubbie firmly announced, “I’m not using it.”
“No one will call me,” she said. “I like phone calls.”
“They will continue to call you,” we assured her.
“I won’t know if I should answer the phone,” she countered. (Presto works on your reguar phone line).
“We’ll program the emails to arrive while you are at dinner, so you won’t have to worry if you should pick up the phone when it rings,” we responded.
“I’m not going to like it,” she insisted.
“Look, it’s here and it’s hooked up. Try it. If you don’t like it at the end of a week, we’ll give it away.”
Bubbie glared at the machine for several hours, and went down to dinner. When she returned, she had email. Her great grandchildren had scanned in their homework and two art projects. Her daughter had sent humor and health tips. Cousins sent newsy email letters. Family friends sent political commentary. An army of people had been mobilized to make Bubbie’s first email experience glorious. We didn’t hear from Bubbie until the next morning, when we got the call about the paper jam. One day of email, and Bubbie was hooked.
Bubbie’s email interests were eclectic. She liked letters, news, and health information. She liked political commentary, puzzles and humor. She loved art from her great grandchildren. Soon, her dinners were cut short. “I have to get back to my room;” she would say. “I have mail.”
At her request, I brought over a ream of paper and Bubbie learned how to refill paper on her own. She still needed help to replace printer cartridges, and that was when we would hear her lament, “You can’t come till tomorrow?”
“How come you never send me email?” she soon asked us.
“Mom, we’re right here. We see you every day. Why would we send you email?”
“Everyone else does.”
We had created a monster, we joked. But in truth, we were thrilled. Bubbie said that being part of the high tech world made her feel young. She had learned something new, and conquered something that had intimidated her. She felt special; she was the only person at her dinner table who was “online.” Best of all, email gave Bubbie stories to tell and information to share. Bubbie loved to communicate.
Physically, Bubbie’s world was very small. Her 8×9 sitting room — where she spent virtually all her time — housed her TV, her refrigerator and microwave, her recliner, hundreds of family photos and her Parakeet, Pookie. Bubbie sat in the recliner to watch TV, talk on the phone, read books and emails, and slept in the recliner as well because it helped her breathe better. But emotionally, Bubbie’s world was very large. She had meaningful relationships, was passionate about world events, and conquered new challenges. Bubbie’s large world was made possible by many things — caring friends and family, an understanding physician, a very special bird — and by Presto.
To learn more about Presto computerless email service, go to www.presto.com.
Tiger walks slowly, very slowly. His legs are bowed, his back is crooked, and his once powerful hind legs are wasted. Years ago, Tiger easily leapt into the air. Now, he needs help getting on and off my husband’s chair. Externally, Tiger is very changed from the strong young cat he was. Internally, though, Tiger seems much the same. His favorite pastime is still sitting quietly on Bill’s lap, giving and receiving love. As we noticed physical changes in Tiger, we began to think about what we could do to help him remain independent and injury-free. In addition, we felt badly each time Tiger failed at something he had once done so easily; we worried that he was embarrassed, and we wanted to preserve his dignity. Tiger has always had a lot of dignity. So we began to implement a series of aging in place modifications.
Since Tiger can no longer jump onto my husband’s chair, we installed a three-step pet ladder so Tiger could get on and off the chair on his own. At first, Tiger distained using the ladder, but when attempts to jump resulted in falls, he quietly adopted it as his normal method of access. We built similar steps to and from a sunroom window, and while Tiger seldom goes outside anymore, when he does, he uses these steps rather than jump the 18 inches.
Some months ago, we noticed that Tiger was urinating outside the litter box. At first, we wondered if he had become confused, which can happen to old cats. Then we guessed that perhaps Tiger could no longer step over the 5-inch high walls of the litter box. We cut out a special entrance to the litter box with a one inch high lip, and Tiger immediately began using it. He wanted to continue his former behavior; he just needed some modifications.
We’ve changed other things for Tiger as well. To keep his weight up, Tiger gets a can of wet food every night – a welcome change no doubt from the dry food he has eaten his whole life. So far, it’s working. Tiger tips the scales at 7 pounds—good for a very old cat. Like many old cats, Tiger has kidney problems and drinks huge quantities of water to compensate for his failing kidneys. As a result, the litter needs to be changed daily, and we’ve surrounded the entire litter box with paper since Tiger sometimes misses the actual entrance.
Tiger loses great quantities of hair, and because of his arthritis, he can no longer groom himself properly, so we brush him each night. We know that Tiger has cataracts in his eyes, his hearing is impaired and his meow is scratchy, but in our eyes, he remains a handsome elderly gentleman.
We sometimes think about how Tiger spends his days now, as compared to his youth. He still naps in the sunlight, enjoys watching birds on our front porch and sits on our lap every night. Although he cannot do many of the things he used to do, it seems to us that the essential Tiger – the sweet, loving cat we have always known –is still there, and that Tiger has a good quality of life.
As I think about Tiger, I can’t help but make comparisons to how I would treat an elderly family member, or how I would want to be treated myself. I would want to be as independent as possible, in a familiar environment that maximized my dignity and minimized the impact of my impairments. I would want to be surrounded by people who accept me for who I am, even though I may be different in many ways from who I once was. I would want a good quality of life, where I could continue to do the things that are important to me. And like Tiger, I would want to give love as well as receive it.
So in addition to being the best cat in the world, Tiger has even taught me lessons on how to age.
In sailing, the technique used to move upwind (or against the wind) is called “tacking.” Although tacking is actually a combination of vector mathematics and boat design, to most of us, it refers to the concept of making forward progress by zigzagging rather than moving forward directly. For adult children helping their parents transition from one home to another, tacking can be a very useful concept.
I met recently with a woman in her early eighties. She suffered a stroke last summer, and a few months later, she lost her husband. They had planned to move to a nearby retirement community, and my client decided that she wanted to continue with that plan even though her husband was no longer with her. As she recuperated from the stroke and dealt with the loss of her husband, one of the tasks that gave her great pleasure was planning her new home, a large two-bedroom villa separate from the main building on the retirement campus. She worked with a decorator and implemented a number of changes that made the villa her own. Both financially and emotionally, she was invested in the villa.
For nine months after her stroke, she was not permitted to drive. Shortly before her planned move, she underwent an evaluation to confirm her ability to resume driving, and was crushed to learn that she did not pass. Without driving, her children argued, moving to a villa detached from the main building was a mistake. She would be cut off from activities and opportunitiies for socializing — key factors that had motivated the decision to move in the first place. It was likely that she would need to move again within a few years, to an apartment within the main building. Wouldn’t it be better, they maintained, to move just once?
While I understood the children’s point of view, I saw the issue through different eyes. In less than one year, my client had lost her health, her husband, her ability to drive, and now she was leaving her home of forty years. The villa had been something to reach for and move toward, something in which she had invested time, energy and passion. Now her children were suggesting that she lose that as well. How much can a person lose at one time?
My client clearly preferred the villa to the main building. I hoped her children would support her decision, and fortunately, they did. If and when my client moves from her villa to an apartment at some point in the future, the difficult transition from the family home will already have been made. She will change spaces, but will be staying within a community that she already calls “home.”
The lesson here, for both adult children and Senior Move Managers, is to remember this sailing metaphor — how moving forward in the face of a strong wind requires going from side to side, not straight ahead. Sometimes getting parents or clients to agree to move requires supporting a decision that is less than optimal, but may be the decision that is accepted. Keeping this perspective will reduce conflict and improve the quality of interaction for all involved, because faced with formidable obstacles, going sideways is sometimes the most straightforward path.