Tuesday, April 24, 2012

Pro-Active Aging 2: Fine-Tuning The Habits of a Lifetime

For most of my childhood our family lived in Glenside, Pennsylvania, but from 1934-39 we rented a house on the trolley line in nearby Roslyn. Those were our years of poverty, caused by the Great Depression, and the most excitement I remember was when the WPA men came to work on the tracks. During that time (and most of my life before I went off to college) we didn’t own a car. If we wanted to go somewhere, we walked and thought nothing of it. My earliest memory is of going for a hike in the woods with my brothers and sister when I was about three. The elementary school was a little less than a mile from our house, which meant we did not qualify for the bus. In all kinds of weather my brother and I were bundled up and hustled out the door for the walk to school. It was a three-mile hilly trek to Glenside where all the fun stuff was, but we did it regularly especially in the summer. We were often sent on an errand to take something to a neighbor, mail a letter at the post office, buy some stew beef from the butcher or run to the grocer for a missing ingredient while Mother was in the midst of stirring up a casserole. That habit of walking was a gift of my childhood that has never stopped giving.

Our days were punctuated occasionally by the tradesmen who came to the door: the ice man carrying a large block of ice with mammoth single-handle tongs, the uniformed meter reader, the coal man, farmers selling vegetables in the summer and apples or pumpkins in the fall. My favorite was the Seventh Day Adventist peddler, who drove a beat-up old delivery truck full of strange groceries and literature explaining the Adventist beliefs about food and health. He was a small wiry man with a pointy nose, a ruddy complexion, and he always wore a rumpled old fedora. I would hang around and watch, hoping the peddler would give me a little piece of healthy candy. After chatting a few minutes and accepting a leaflet to read later, Mother would buy nourishing things like hot cereal mixes with weird grains, whole wheat Fig Newtons, black strap molasses, lentils and dried fruit. If she had enough small change left, she would buy toasted, salted soybeans. Although I liked peanuts more, I was happy to get the soybeans, since we didn’t have many snack foods. Little did I know that I was absorbing an attitude toward food and the choices we make about our diet that was the cornerstone of my interest in healthy eating.

Bill and I and our three young children lived in Guatemala from 1964 to 1967, where we were co-directors of a Peace Corps-type program with the American Friends Service Committee. Each year when a new group of volunteers arrived to join the unit, we had an orientation program, which included a discussion of disease prevention with our physician. Dr. Carlos Perez. A handsome man with a keen sense of humor, he was one of the best doctors who ever provided our care. He warned the volunteers that they would be living in the rural areas where the conditions were unsanitary and dysentery was rampant. He urged them to eat only cooked foods when they ate in restaurants or private homes. When they fixed their own meals he urged them to wash all vegetables and fruits including melons, papayas, bananas, and other fruit before peeling or cutting into them. He explained that if they didn't do that, bacteria could enter the fruit on the knives they used. Bottled water was not yet available, and he directed them to boil all their drinking water for twenty minutes. Then he said, “Our digestive system is designed to protect us from things like dysentery, but it only works when you are healthy. So the best way to prevent disease is to eat a good diet, and get enough sleep.” He didn’t worry about enough exercise, because he knew they didn’t have vehicles and most of them lived a distance from public buses.

We quickly discovered that many of these young adults didn’t know what constituted a good diet, and none of them knew how to cook when everything had to be made from scratch. The ones who learned—often from the Guatemalans they worked with—how to use the local foods and fresh produce, were healthier. An unexpected result from the experience was our determination to make sure our own children learned all the skills that the many of the volunteers lacked.

It’s hard to imagine that there is anyone in America today, given the plethora of media health messages and ads, that doesn’t know smoking is bad for you, exercising and maintaining the right weight are good, and some food groups are better than others. For anyone reading this who is uncertain about the best lifestyle choices as you age, I recommend Andrew Weil’s book Healthy Aging. He covers all the bases (physical, emotional, intellectual, spiritual, and social).

As I’ve been thinking about prevention, defined as the action of stopping something from happening or arising, I’ve been struck by the fact that while an ounce of prevention may well be better than a pound of cure, it’s just not possible to stop everything bad from happening. About fifteen years ago, a friend about my age had a heart attack. When I took her a pot of soup and stayed for a visit, she was lamenting that she had done everything right to be healthy, and what good did it do, because she had a heart attack anyway. However, she recovered and is still active, busy, and generally in good health. My own experience in dealing with a range of medical problems in the last ten years has led me to believe that a lifetime of good habits sets the stage for the best possible recovery if medical problems do arise. I also believe that there are decisions that each of us can make later in life that will help prevent or mitigate the normal aging problems that affect our vision, hearing, bone density, balance, cognitive function and general well-being.

My concept of pro-active aging is that, in partnership with whatever health practitioners meet our needs, we look squarely at our own health and safety issues—current or potential—and then consider the resources available to us to maximize our ability to deal with them. Then it behooves us to take whatever preventive actions are reasonable and possible. High on my prevention list are tending the life of the spirit; physical and mental exercise; acupuncture and massages, nourishing myself with enough sleep and good food; and saving time for the activities and people that bring me joy.

A word to North Carolina readers on another subject: I was deeply moved by Governor Perdue’s short statement on  Amendment One on the ballot May 8. She thinks that it is just plain wrong to write discrimination into the N.C. Constitution. Here is the link.

Tuesday, April 17, 2012

Pro-Active Aging 1:"I've Fallen and I Can't Get Up."

It’s time for an ad break on TV, and we see a stylish, older woman in her kitchen, dressed as though she might be going out somewhere that day. Suddenly she falls and lies awkwardly on the floor calling in a weak voice, “Help. Help. I’ve fallen and I can’t get up.” The same voice continues, now as the narrator, telling how she laid there and might have been there for hours if a neighbor had not dropped by to visit. “It was then,” she says “that I knew I had to do something.” She tells listeners that what she did was order an alert system giving her a pendant/transmitter with a red help button. She would wear it when she was alone at home. If she ever fell again, she could push the button and be connected by way of a console to the monitoring center and an operator would call for help.

It isn’t reality TV; clearly it isn’t even very good acting. But her voice has worked its way into sitcoms, comedy sketches and probably into the mindset of older women living alone. I’ve been part of discussions with women my age that all had the same thrust: Maybe someday. But right now I’m fine. I don’t need it.  Also, I've had that conversation with my daughter-in-law Tammy several times over the past five years, usually when I wasn’t feeling well.

Last fall, a beloved member of our community, who is almost two decades younger that I am, had a stroke one Sunday morning. She lived alone and could not get to her phone either to answer it, when several family members called to check on her, or to call 911. She lay where she was for some four hours until her son arrived to find out why she hadn’t been in church. As she had lain helpless, she lost the vital window when early intervention can often mitigate the worst results of a stroke. Her extended family has rallied around to help her as she continues with physical therapy, but recovery is very slow.

Although I live alone, I don’t feel alone because my son Robin and Tammy live on the same property with me. However, I am often the only one at home during the day and, if they make a trip, for several days at a time. Fortunately my friend Kathy lives across the road from me and is willing to be my emergency back up. Once in a while I have felt really vulnerable when my heart was fibrillating and causing weakness or dizziness. In those moments I have thought about that woman in the TV ad, but it  seemed enough that I  had a phone by the bed. I was raised with the dictum, “Don’t ever make a decision based on fear.” (A questionable assertion but grooved deep in my psyche.) I’ll be honest and tell you that it was those words that came into my mind every time I considered getting an alert system for my home. I’ll go even one frank step further, and admit that such systems were to me the symbol of frail old age, and as I seek to be as well as is possible for me, the thought of wearing one of those pendants felt like capitulation. In addition, as a part of the physical therapy after my knee replacement, I was taught fall recovery so I thought I’d be able to say, “I’ve fallen and I know how to get up.”

While I was absorbing the consequences of my friend’s stroke and joining the multitude of folks praying for her recovery, I began to develop a different attitude toward that panic button. As I considered it, I made a list of all the kinds of protection I already had, starting with health, home and auto insurance designed to protect individuals from financial ruin in the face of various adversities. No fear was involved when I signed up for those protections. I can walk perfectly well without a walking stick, but I carry one most of the time because I know that it will help me avoid a fall should I lose my balance, get dizzy, or turn my foot on a stone. I’m not afraid that those things will happen; it just makes sense to walk softly and carry my big stick. I have several risk factors for stroke so I take warfarin sodium to protect my body from tiny clots that might wreak havoc. I have surge protectors on all my electronic equipment. I recently got a shingles vaccine shot. I have several sensor lights to help me make my way around safely at night. My list goes on…

Each year when I spend two winter months on Tybee Island, I am alone for close to half the time. Although I’ve made a few acquaintances, I don’t have the same ready access to help that I have at home. I’ve had a few anxious nights there over the past several years, when I felt less than well and tried to plan a strategy for getting help if I got worse. When I started thinking seriously about an alert system, the knowledge that I would soon be turning eighty somehow made that bright red button seem more age appropriate than it had been, and I did a mental shift from fear to prudence and from capitulation to acceptance.

Tammy willingly did the research and decided Alert One was the best bet for many reasons. I called and talked to their representative and then checked out two other systems before I concluded that she was right. It’s easy to move it from one location to another and set up different instructions according to where I am. If I were to use it here in my Celo home, they have the following instructions from me: if I can’t talk, they are to call 911 and then call Robin and Tammy; if no one answers they should call Kathy or my grandson Miles. If I can talk, I may give a different instruction. At Tybee, they are to call 911, then a neighbor and then a notification call to Robin. They provided a key box to hold my door key, and explained that EMT’s would be given the combination so they could easily enter my house. While I was at the beach in January and February, I was far more relaxed at night and felt that my pendant was an adequate contingency plan. At home there have been several nights when I have felt less than well at bedtime and have looked at my pendant and thought, “I’m glad you’re here.” I hope I’ll never need it, but it’s good to have it. I also remember that it was mighty nice to have the homeowner’s insurance pay all the damages when a tree fell on my house a few years ago—something else I hoped I’d never need.

There was another unexpected benefit. After I made the decision and signed the contract, Robin said to me, “This will give me so much peace of mind, especially while you’re on Tybee Island.” Me too!

This is the first of a four-part alliterative series on Pro-Active Aging. (Protection, Prevention, Preparation, Priorities). 

Tuesday, April 10, 2012

Gardening, Family and Nurturing the Spirit

One of the unanticipated joys of my aging years has been the expansion of my interests and activities through the addition of in-laws when my four oldest grandchildren married. Wes, my hard-working, good-natured, trout-fishing grandson-in-law (shown here with his eight-month-old son Karik) has broadened my knowledge of popular culture, sports, fishing, and all the things you can do with computer data (mining, scrubbing, etc.). Jenny, Torey, and Polly, my three equally hard-working, talented, and creative granddaughters-in-law, have introduced me to car seat safety, games, the woes and wonders of public school teaching, many genres of music and books, and fascinating discussions on parenting, ethics, and politics. They’ve also brought their religious and/or secular holiday traditions.

It has become natural since Polly married my grandson Miles for me to consider Hanukkah as I make plans for December holidays and Passover at Easter. This year Passover and the full moon fell on Good Friday, and I was looking forward with great anticipation to beginning the weekend by taking part in the Seder and festive meal with Miles and Polly, who would lead the gathered family members through the ritual. Saturday night I planned to go with my friend Lynn to All Souls Episcopal Cathedral in Asheville for the Great Easter Vigil, an inspirational and dramatic liturgy for the end of Lent and the beginning of Easter. The finale of the weekend was to be the secular celebration at Penland School of Crafts where there is a community brunch and Easter egg hunt for beautiful and whimsical handcrafted eggs. However, last week I came back from my trip to Morristown, NJ and Philadelphia, with the beginnings of a cold that quickly escalated into a full-blown respiratory infection, and I developed bronchitis.

Intervention at the Emergency Room in Spruce Pine, strong antibiotics, acupuncture, Chinese herbs, and the ministrations of many friends and family have me back on my feet, as long as I take two naps every day.  Even so, fearing a relapse, I cancelled all the weekend plans except for the Seder. When the bulk of that service was finished, and it was time for the festive feast to begin, Miles and Polly packed up a meal for me. As I ate my dinner alone in the comfort and warmth of my home, I thought about the stories that were told in the Haggadah and the importance of remembering and honoring our history.

I am writing this on Easter, which is an amalgam of the retelling of the Christian story and the celebration of spring, renewal, and growth. I have been thinking about the past week, the generous help I received, and the cumulative spiritual nurturing that has made this a happy, albeit quiet, Easter Day. It has been a meditation and the theme has been gardening. It started with Miles, who has become an excellent, somewhat cerebral, gardener. During a visit with me a few days ago, he mentioned the early spring and his excitement about having a longer growing season in which to raise nourishing food. He is a good cook and, like his parents Robin and Tammy, enjoys the rhythm of planting, cultivating, harvesting, and preparing food for the table.

After the Seder, Miles commented that since Polly came into his life he’s been sharing not just the holiday rituals but also the lighting of the candles for Shabbat. He noted that one of the appealing qualities about Judaism is that it isn’t necessary to go to temple to observe and take comfort in its rituals. It was a different kind of a seed planted in the garden of my heart. What a comfort that has been to me this weekend as I continue to create home-based, spiritually-oriented rituals for myself.

Today I started off my morning by tuning in to On Being, the Krista Tippett’s program that I’ve have mentioned before on this blog. The topic was restoring the senses through gardening, and her guest was Vigen Groian, who has written several books on the spiritual nurturing he’s found by working and being in his gardens. Their conversation seemed to be a continuation of my own reverie about growing flowers, vegetables, and relationships. My first phone call of the day was from Lynn, who had decided not to go alone to the Great Vigil the night before, but was going to the Easter service at the Cathedral. She was so excited because she had reread the Resurrection story in the Gospel of John, and had been struck that Mary supposed that the risen Jesus was the gardener, which meant that Jesus had come in that guise. I told her it was a timely observation for me because I’d been contemplating the connections I found in gardening, tending my spirit, family, and my new thoughts about home-based rituals. We were both enlivened by the conversation.

Early in the afternoon, just as I was getting up from my nap, my friend Liz called and we chatted about her thoughts on Easter and some childhood memories. Then she asked me if I knew the hymn called In the Garden. (It starts: I come to the garden alone.) I laughed and told her I had sung it that morning, when I went out walking alone. We had both learned it as children and agreed that the ending of it had always been confusing. “Sing it for me now,” she said. Written in 1913 and once recorded by Elvis Presley, In the Garden is definitely anachronistic, but it’s also part of my past, and so I sang it, as best I could. I celebrate life and wake up my spirit by singing in the morning: all sorts of songs that I learned in church, Girl Scouts, school and during my musical life with Bill. It’s one of my rituals.

This Easter Day as I considered the metaphor of the family as a garden that grows both by the addition of in-laws and the birth of children, I was amazed at the synchronicity of the ideas and comments that came my way and strengthened my reflections. My Easter basket has been filled with ideas rather than eggs or jellybeans. Suddenly I knew how I would celebrate Easter. “I’ll go clean out one of my flower boxes and plant the flat of pansies that Tammy brought me earlier in the week,” I said to myself. “ I’ve already missed too many days of puttering around in my garden.” The truth is I’d done enough thinking for the day; it was time for action.

Tuesday, April 3, 2012

In Praise of Families

As I walked from my daughter Melissa’s car toward the door of the Summit Church Fellowship Hall in the West Mt. Airy section of Philadelphia, I was thinking about the Cook family reunion we held there in 1997. It was the year my mother might have turned one hundred, had she not died at age ninety-four. Ours is a family that seldom gets together in large groups, not because of simmering grudges or rivalries. Rather it is a family of independent-minded people, most of whom are lucky enough to be busy doing what they love. My parents had four children who went forth and multiplied, producing nineteen grandchildren, twenty-three great-grandchildren and six great-great-grandchildren so far. Add in the spouses and it is an unwieldy group; that’s probably why we’ve only had that one reunion.

I had flown to Newark three days earlier so that I could rest in Melissa’s lovely new home in Morristown, NJ. Then she and I drove to Philadelphia to celebrate my sister Dorothy’s ninetieth birthday.  Her six children, most of their spouses, and eight grandchildren were there along with two enchanting great-grandchildren. There were also several cousins. I have a strong emotional attachment to all of my nieces and nephews and am especially close to Dorothy’s brood because they all spent lots of time with me when they were growing up.

The birthday luncheon was held at the church so that there would be room for Dorothy’s friends and associates from the neighborhood, the church, and the flourishing Weaver’s Way Food Co-op she helped establish many years ago. My sister was a major force in her immediate community as a communicator, innovator, organizer, board member, and hard worker. Today Dorothy is beautiful, witty and functioning with considerable independence despite being plagued by pervasive short-term memory loss. She has invented systems to keep her mind functioning in the present as much as possible, but she generally does much better with the past. I was one of several relatives that she didn’t recognize and my explanation that I was her sister did not find a hold in her mind. It was a sad moment for me in an otherwise splendid family day. The long tables in the Fellowship Hall made it easy to move about and join different groups of people for conversation. A long buffet was loaded with a wide variety of excellent food that all came from Weaver’s Way.

Although it was difficult to gauge just how much Dorothy processed, she was obviously delighted with the party and the many reminiscences that people shared. There were many tender moments and a few belly laughs as several of her children, three of their spouses, my only surviving first cousin, the manager of the Co-op, and several church and neighborhood friends gave tributes and told stories as my sister leaned forward in her chair and smiled at the speakers. After the party, the immediate family gathered at the house where she has lived for 56 years and where her family grew up. There we talked and laughed and played a game of Family Jeopardy, created by her daughter Rachel, and ate more food. Dorothy’s eyes were always on the two little great-grandchildren when they were in the living room; often they climbed into her lap, and I could see from her animated face that she was telling them stories.

My sister, who has always been an important part of my life, is not diminished in my eyes by the loss of facts and details. She continues to shine a light in her corner of the world and to take as much responsibility for her own daily life as is possible. Although I was sad to lose our personal connection, I was thrilled to see that she is thriving. Dorothy’s daughter Cynthia and her partner Greg have moved into my sister’s house to provide structure, stimulation, and safety, plus a lot of practical help with food, pills, medical appointments, and daily details. Both of them work so she is still alone much of the day. The other nearby family members visit when they can and are part of her support system.

The next day Melissa and I drove back to her house by way of New Hope, PA, where my husband Bill and I lived for five years and returned for visits scores of times. We went because I wanted to see my friend Alix. Over a year ago, not long after her husband died, she slipped on ice and had massive injuries from the fall. She can’t do anything for herself and has devoted caregivers who tend to her needs.  Despite their busy lives, her four children and her sister are steady in their support of her life: visiting often, arranging for her care, and managing her affairs and household. Alix tires easily and communicates with one or two words at a time. There was no lack of connection in that visit. She beamed at me with a smile in her eyes as well as her face. She also is still beautiful.

Back in Morristown with Melissa and her husband Ron, I felt cared for and loved as they did everything they could think of to make me feel comfortable, entertained, nourished, and welcome. Last Thursday, Melissa drove me to the airport and my son Robin and his wife Tammy picked me up in Asheville. They had been in San Francisco during the week I was with Melissa and had already collected Nigel from the kennel.  Old friends from our Guatemala days were in Asheville on a little vacation, and they met us at the airport. It was a beautiful, warm day so we went to a restaurant in the Montford area of Asheville and sat outside while we enjoyed unusual food and the conversation of dear friends.  Then Tammy did a bit of shopping for me and we headed home.

Sometimes I think about all the old folks (particularly those whose spouse has died) scattered around Yancey County who are living alone or with a relative and being cared for and supported by families. Stories like mine or Dorothy’s or Alix’s are not all that unusual. As Tammy has often said to me, “It’s what families do.” I am also mindful that it’s not everyone’s story. Some elders have no family, or circumstances (financial, geographic, physical, or emotional) prevent family members from being available. Dorothy was the primary caregiver for our mother at the end or her life, and I am profoundly grateful that her children are in turn taking care of her. I have no doubt that pattern will continue into the next generation. However, it is nothing to take for granted. As I look at the losses and the changes that come with aging, I also look at the wonders and the joys, and I take this moment to praise families—yours and mine.