Healthy Ageing

We were given a thorough review of ageing, by Dick Sainsbury, Emeritus Professor of Geriatric Medicine at Christchurch School of Medicine and Health Sciences. He did his M.A. thesis on Older People and Ageing in the fiction of Thomas Hardy.

Dick started with a quote from Henry Ford: Anyone who stops learning is old, whether at 20 or 80. Anyone who keeps learning stays young. This was encouraging for his audience who were there because they want to keep learning. He said that older years are a bonus, and can be considered a time of productivity, rather than being in the departure lounge of life. It’s important to maintain physical, psychological, and social functions in old age. There are several forces that can affect older people:

Chronological – the number of years lived
Biological – genetics and disease
Sociological – you may be as old as others (society) make you
Psychological – as old as you make yourself

To age healthily (or to be healthy at any time) requires the maintenance of good health, and the reduction of risks, but there are no cast iron guarantees. There are some myths about old age which can lead to a tendency not to seek help, because we think problems are caused by age. Dick told of the 99 year old who had a bad knee, and whose doctor said it could be expected at his age. The man replied that his other knee was also 99 but fit and well.

Ageing well requires a positive attitude to ageing, which can improve health outcomes. We need to eat well and maintain a healthy body weight. Regular physical exercise is important, e.g resistance exercise. (I detest those sit to stand exercises, but do them at least weekly.) It’s important to remain socially connected, to get plenty of sleep, and to find meaning and joy in your life. Dick suggested writing your memoirs as a way of doing the latter. He didn’t specifically mention the Five Ways to Wellbeing, but they would fit in here too.

Tennyson wrote: Old age hath yet his honour and his toil; Death closes all: but something ere the end, Some work of noble note, may yet be done . . .

Memory loss is not an inevitable consequence of ageing. 65% of 85 year olds have no memory loss. Some of us may have Mild Cognitive Impairment (MCI) which is different from dementia. Personally, I have for years been inclined to write things down rather than rely solely on my memory – not sure if that counts as MCI? MCI is a self-reported lapse of memory, whereas dementia is often reported by others. 50% of those with MCI will not progress to dementia, but it is important to have early assessment to enable future planning, and to maintain physical and mental activity. There is active research on MCI in Aotearoa, and more info on this can be obtained from Alzheimer’s Canterbury.

An interesting article on ageing in Aotearoa was published in the Australian Women’s Weekly in 2015. So, why are populations ageing? In 1850, 50% of people in Manchester, England died before the age of 12. During the later Victorian period people started to live longer because of improved sanitation, housing, and food, together with less disease. Although we are living longer, the age to which we are likely to live in good health without disability is not increasing at the same rate as life expectancy.

As well as having a regular medical review, it’s important to plan ahead, and have an Enduring Power of Attorney and Advance Care Plan.

Asked about whether Joe Biden reflects the United States’ attitude to ageing, Dick said he hopes Joe is being carefully assessed, and that his gait can sometimes be worrying. Recommended readings are In Sickness and in Power by David Owen, and The Pathology of Leadership by Hugh L’Etang, both of which consider medical problems in leadership.

Asked whether romance is okay in the late 80s, Dick said it’s important at any age, and too good to be wasted on the young. He quoted Alex Comfort who said: The things that stop you having sex with age are exactly the same as those that stop you riding a bicycle.

This was a comprehensive talk which affirmed for me that although I live more slowly these days I’m doing plenty of things that will help me stay healthy as I age. I hope you are too?

I like this card sent to me by an ‘old’ friend

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Relinquishing Responsibility

I like to be able to choose what I do with my time each day. As I grow older I find I’m less inclined to take on tasks or roles unless I get satisfaction from doing them. I have a number of voluntary roles and some of them I’ve held for several years. In most cases they use skills I’ve learned and developed, and it feels good to continue using these skills. Other roles, although they use my skills, have become onerous, and over the last year I’ve been pleased to drop a couple of those. Relinquishing responsibility does not mean my mental functions are diminished. It simply means I’m choosing to spend time doing what I enjoy.

In many organisations it gets increasingly harder to find a new person willing to take on a responsible role. In two instances I’ve simply resigned from the role, and someone else has eventually volunteered to take it on. It’s not easy to say I resign when there’s no obvious candidate to take over, but I’ve been pleasantly surprised at the outcome. I also believe it’s healthier for an organisation to have regular changes in their positions of responsibility.

With a couple of my roles gone I’ve been able to join a new writing group, and have more time and energy for socializing. I can recommend making such a change.

It’s great to prune out some old wood
and do the things that just feel good

Not quite so busy these days

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Venturing to Victoria Street

Walking over to Victoria Street I discovered a new mural I hadn’t seen before. The image of the street in a bottle reflects the high incidence of hospitality venues in this area.

Mural at 395 Montreal Street

I couldn’t see any acknowledgment of the artist, but later discovered it is by Dcypher.

It was starting to rain so I caught a bus that took me most of the way home. When we approached St Luke’s corner I pressed the button to request a stop and stood by the back door. The driver called out to me to come to the front of the bus and I asked “Why?” He said that it was easier, by which I gathered he meant that he meant it would be easier for me to get off there. So far I’ve always managed to use the rear exit, with the use of the convenient handles, and this is the first time any driver has suggested the front exit would be easier. Maybe I’m looking older these days?

The driver obviously thought
that I was a decrepit sort

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“These Two Hands” by Renée

I found much that I could relate to in this inspiring, honest, and thoughtful memoir. It’s written spasmodically in patches, with many quotes from Renée’s writing and that of others. It’s not set out chronologically, but with different snippets from different times. There are many reminders of feminist times in Auckland with people I used to know, and of community theatres.

Stephen was involved in amateur drama for many years, and one time Cathryn and I went on stage as well. She would have been about eight or nine. The play was The Crucible and we were part of the crowd scene at the hanging.

Renée’s observations on growing old are compelling, e.g. accepting the need for a shopping trolley. I wonder if one of those might be easier than a backpack for transporting my library books? Now more than ninety years old, Renée has a constant struggle to be recognised as a living, breathing, intelligent human being. “Just because I’m ninety doesn’t mean I lose the power to feel, to experience, to know when I’m being patronised.”

When she wrote about how sisters giggle when they get together I was reminded of giggling with my Values Party “sisters”, especially those from New Plymouth.

Filling out a form to join the University of the Third Age Renée saw that one of the criteria was to be retired. She had no intention of ever retiring, so didn’t go any further with the form. I don’t recall that being on the form I filled out, but they did ask what my occupation had been.

I thoroughly enjoyed reading about Renée’s life, and warmly recommend her memoir.

Her life’s been a dramatic play
no wonder she has lots to say

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Operation Over

I wrote this poem when Stephen was in hospital recently.

Again

I’ve been here before
waiting alone
while you were operated on
twice we were prepared
twice sudden urgency
because of emergency
you are philosophical
take one day at a time
my mind races
considers the what ifs
as we grow older
the end grows closer
death is inevitable
but not this time
you pull through
           again
come safely home
           again
I give thanks
           again

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Reliable Rails

Neither of us is as agile as we used to be, and in wet or icy weather negotiating the brick front steps can be problematic. We decided a handrail would be a good safety measure, and I phoned Age Concern to ask if they would recommend someone who could install this. I also asked whether we might qualify for any kind of subsidy, and was told this would require a doctor’s referral and an assessment, and the process would take about nine months. It seemed easier to just go ahead and pay for it ourselves.

Handrail for front steps

By the time we met with Patrick from Safetech Installations Ltd we’d decided we would also have a rail by the steps near the back gate and safety handles on various internal door frames. Because our cottage is built on three different levels it’s often necessary to take a step up or down between rooms, and the handles give added security.

Handle beside door frame

Patrick obtained the necessary pipes and handles and installed them quickly and efficiently. We’re glad to have made this move towards future-proofing our home.

Now if our strength should start to fail
we will have a supportive rail

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Curbing Cataracts

In the operating theatre last week Alison held my hand. I’d never met Alison before but I was glad to hold her hand. She told me if I was uncomfortable or needed the surgeon to stop I should squeeze her hand. I didn’t need to squeeze, but it was comforting to know I could. This reminded me of my Advance Care Plan where I have requested to have someone with me to hold my hand when I am dying.

When I had my previous cataract operation (privately at Christchurch Eye Surgery) I was sedated. This time (at St George’s Hospital under a public CDHB contract) I had just a local anaesthetic and I was conscious and aware of what was going on in the theatre. I heard a sound like a dentist’s drill and knew they were cutting into my eye, but didn’t feel anything. Every now and then a disembodied voice would say “irrigation on” and I was aware of liquid movement. I knew this was a machine talking, perhaps a form of Artificial Intelligence.

I hope I don’t need more operations because the allied health workers are working to rule, and sometimes going on strike. I’ve been in an operating theatre twice in recent weeks and each time they put plastic booties over my shoes. I very much doubt that these get washed and re-used. So much waste!

The next day I went for a follow-up consultation and the surgeon said my new lens was not working in the expected way. Apparently my distance sight has improved, but not my short sight which was the intention. He suggested this effect may reverse in a few days. I wondered whether he might suggest my coming back sooner for a re-test, but no. My next appointment is for four weeks time.

My eye shield

I went home with an eye shield and instructions to leave it on overnight, then wear it in bed for five nights. I did this for the first two nights, but found it kept slipping so haven’t bothered after that. As before, I was given drops to be put regularly into my eye. Last time this was 4X daily for four weeks. This time it’s 4X daily for two weeks, then 2X daily for another fortnight. Last time I was told I needed to lie still for two minutes after each drop. This time I was told to just close my eye for a moment, which is so much easier!

At the follow-up appointment the nurse said I must avoid anything strenuous such as lifting heavy washing baskets. I told her she was too late as I’d already hung out the washing that morning. However I did avoid doing my usual daily exercises for four days.

My eye is still red and the eyelid inclined to droop. It’s hard to focus on the jigsaw I enjoy doing during The Panel each afternoon, but reading is fine – probably I’m using only one eye for this.

I’m waiting for my improved vision
now I’ve had cataract incision

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“The Pomegranate Journal” by Juliet Batten

This is an absorbing story of Juliet’s adjustment to getting older. We all eventually face old age, except for those whose lives are cut short. I learned recently that our age can be estimated from our DNA because our chromosomes get shorter as we age.

Juliet suggests that the simple pleasure of being in the moment can be more frequent as we age. She also advocates the need to surrender to fatigue and allow ourselves a rest day when required. I like her idea that we can have rest days and test days, and I’ve had both of those recently. I can also relate to the idea that the limb that opens childproof lids and cans may drop off as we get older. Mine went some time ago.

The links and tendrils of connection are important, like the fungi that communicate beneath the earth through the roots of trees, creating a thriving ecosystem. This reminded me of my recent pleasure in meeting an old friend, unseen for years, who suggested a lunch date next week. Spirituality is another important support as we grow older.

I found it hard to read of Juliet experiencing continual pain, and am grateful not to be dealing with that, although over the last few weeks Stephen and I (and Ziggy) have all had hospital appointments in preparation and follow-up for various surgeries. While I don’t have chronic pain I’m aware that parts of me no longer work the way they used to and anything strained or damaged takes longer to heal.

Juliet’s few poems had an inspiring resonance for me. In her last chapter Juliet invites us to keep a reflective journal, writing about the challenges of life. I used to write Morning Pages, but rarely do these days. This blog has become my journal, although I avoid sharing anything too personal here.

We learn just how this author copes
and gently cultivates her hopes

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Hospital Happenings

This week I had early morning appointments at two different hospitals on two consecutive days.

On Tuesday I needed to be at St George’s Eye Clinic at 8am for an assessment of my second cataract. I had a similar assessment at Christchurch Public last August, but Covid meant the operation never happened, and I was happy to be transferred to St George’s where parking is easier. While my eyes were thoroughly examined Stephen enjoyed a late breakfast of bacon and egg pie fresh from the oven in the hospital cafe. My cataract operation is now scheduled for mid May.

Yesterday I was booked at Burwood Hospital to have the excision of a nodule on my right index finger. This was a soft tissue lump which had been annoying but not painful for some months.

Lump on finger

At Burwood there is plenty of parking on open ground and we arrived at 8,30am as instructed. It was another hour with form filling before I was admitted and Stephen went off to the cafe – only a cold sandwich this time.

I was given a Covid RAT test, the first I’ve had, and after this proved negative the surgeon came to inject local anaesthetic with the longest needle I’ve ever experienced. At 10.30 I was told my operation would be in 20 minutes, but in fact it was 11.30am before I went to theatre with a gown over my clothes and covers on my shoes.

I was impressed that the surgeon introduced each of the group of four nurses and two medical students (Burwood is a teaching hospital), and chatted about his personal life. The whole atmosphere was efficient and relaxed. It did seem a little strange to be lying on an operating table while fully awake. The lump removed resembled a chickpea. I was not invited to take it home because it has to go to the lab to be analysed. Before the operation my blood pressure was 153/96, but afterwards it had returned to a healthier 135/79.

Lump gone and finger dressed

While I was recovering with a cup of tea and biscuit someone kindly fetched Stephen. The nurse discharging me recognised him and it turned out she had cared for him at St George’s twenty years ago when he had a heart valve replacement.

With my arm in a sling I was grateful to have Stephen ministering to any need, and I napped for a couple of hours in the afternoon. I’d taken a Patricia Wentworth murder mystery to the hospital for the waiting times – a small volume that fitted easily into my handbag – and I finished it before I went to bed. As instructed I took a codeine tablet and slept soundly.

The sling is supposed to stay on for three days, and the dressing for four weeks, so life is somewhat constricted. I’m reminded of the time in 1985 when I broke bones in my right hand and had my arm in traction plaster for six weeks. Typing on the computer is possible but challenging with only one hand. No exercises for me today, I may just go for a short walk, then settle down with the Listener.

A small wound in Ziggy’s ear appears to be infected, so he now has a hospital appointment for tomorrow morning. We’re just hoping Stephen stays healthy!

Health’s been the focus of this week
with me at less than prime physique

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“Should We Stay or Should We Go” by Lionel Shriver

I support euthanasia being available to those who want it, and I voted in favour of the End of Choice Act last October. As someone now facing the latter stage of life, the topic of this book attracted me, but I was disappointed.

The central couple make a pact that they will commit suicide together when they’ve both turned 80, but it doesn’t work out the way they’d planned. The author gives twelve different scenarios for what might happen, but I started to find them tedious. After three days of sporadic reading I’d got only half way through and decided not to bother with the rest. I’ve been disappointed by this author’s books before, and it seems she’s not able to repeat the success of “We Need to Talk about Kevin”. Have you tried this latest novel?

The question of to stay or go
to me seemed infinitely slow

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