Can You Afford to Die?

My two sisters, two brothers and I knew our mother’s condition was terminal. Together with her, we gathered to have a painful conversation about her final wishes. Grieving for a loved one is acutely hard enough; the last thing anyone wants to do just after the loss is sit across from a funeral director, rushed, making high-pressure, expensive choices.

Funeral homes provide essential services, but they are also profit-driven businesses. Staff may try to sell products and services you do not want or need or that you can’t afford. Most funerals and burial arrangements in the United States cost between $7,000 and $10,000, with cremation slightly less. Averages are broken down by state here. There is nothing wrong with an expensive funeral if that’s what the family wants. But many families who might prefer (or need) a simple, dignified ceremony can end up with something lavish and costly and live to regret it.

After Mom died, my older brother and I went to the funeral home she chose. We picked a casket, the date and times for the viewing and arranged for the priest Mom liked at the chapel where she worshiped. We gave the funeral home the outfit Mom chose and called the loved ones she wanted to participate in the service. It was lovely, and we knew it was what she wanted. 

Fast-forward a year and a half, and my husband died suddenly. He had cardiac issues complicated by insulin-dependent diabetes. I should have been more prepared, but sadly, indefensibly, I was not. 

I did what every guide tells you not to do. I went to the funeral home alone; I did not take along a companion to assure me that sensible, cost-saving decisions are OK. Unaware of the extent to which I’d now be living with crippling medical debt and the loss of the primary breadwinner’s salary, I still had the wherewithal to ask about the cost of what they recommended, to make choices based on price. But it made me feel cold and uncaring. 

I opted for cremation but still had the menu of services that are standard practice. I learned that I’d have to pay for transportation from the morgue, and every day his body was stored would be an additional cost. I had to rent the parlor for the mourners for a fee based on how many people I expected. How would I know? The newspapers carried obituaries, but they charged by the line, so my husband’s was brief and not at all what I wanted. Add to the bill the cost of transportation to the crematorium and the actual cremation. We’re not religious; there was no ceremony. 

In the fog of grief, I made no arrangements for anyone after the viewing. I took some criticism for that later, but it was what it was. I had two children to get to school the next day, and they were my singular focus. No one offered to counsel me and help me navigate the funeral world or even ask me if they could buy a tray of sandwiches. 

The key here is to plan in advance. And while it can be difficult, preplanning your own funeral is sensible and gives valuable input to your survivors when they are forced to make many decisions on short notice. 

Write down and share your preferences with loved ones and include them in the process to make sure their emotional needs are met. When we had the family sit-down, my mother said she didn’t care if she was cremated or not. My sisters said they wanted Mom buried along with my father. Decision made.

If you decide to go the traditional route with a funeral home, start by asking for its general price list in writing. The Federal Trade Commission requires funeral homes to provide a copy of their prices if you ask. Some funeral directors may encourage you to come in person. Deal only with funeral homes that readily supply detailed pricing information without requiring an in-person appointment. 

Many funeral homes push plans that let you prepay for your funeral. These agreements represent significant financial commitments, and many unscrupulous places have not protected their customers’ (prepaid) wishes. A better arrangement is to open a joint savings account with a likely survivor who will get immediate access to the funds upon your death. I have a small insurance policy earmarked for funeral costs.

There are several options for handling remains, such as burial with a traditional funeral, immediate burial, or cremation (with or without a funeral). I opted to cremate my husband’s remains. With my mother, we chose burial. It required a casket, a cemetery plot, fees to open and close the grave, cemetery upkeep, and a headstone. Needless to say, we didn’t “shop around.” We simply went to the monument business recommended by the funeral director.  

I learned that, for cost saving, immediate burial with a basic casket is the practical choice. A funeral home files the necessary paperwork, places the unembalmed body in a casket and takes the remains to a cemetery in one day, without services. 

Cremation is an increasingly popular choice. Like burial, it can be direct or after a funeral service. Cremation and immediate burial allow flexibility in the timing and location of services; many families now hold memorial services in a place of their choosing. Cremated remains may be scattered, kept at home, buried in a cemetery or interred in a columbarium. Burial of remains adds to the cost. 

You’ll want to make your wishes known to loved ones, your choice between a religious and secular service and where it will be held, along with any other requests. I can oversimplify my own cavalier approach by saying, “I don’t care, I’ll be dead.” But I’m woefully behind on identifying my own end-of-life wishes, despite being immensely grateful to my mother for spelling out her wishes and so remorseful about how I handled my husband’s celebration of life. It’s high time I let my daughters know what I’d like. In the end, it will be my last gift to them.

Books to Give or Keep, 2022

Silver Century regularly recommends books—fiction, nonfiction, memoirs—that reflect our mission through a positive portrayal of aging or that offer insight from thought leaders in the field. Here are some of our favorites for holiday giving or to save for the winter months ahead.

Sixty-two-year-old Annie Wilkins, diagnosed with terminal tuberculosis, bought an aging horse and, along with her mutt, rode west from Maine to fulfill a lifelong dream to see the Pacific Ocean. The Ride of Her Life (2021) shares the remarkable true story of Annie’s journey, detailing all the surprises, hardships, joys, mishaps and extraordinary human kindness she experienced along the way. This 1950s history-packed story, sure to cement your faith in humanity, is a life-affirming tale of a woman living out her days on her own terms.

In In Love (2022), Amy Bloom and Brian Ameche found each other in a whirlwind, later-life romance, enjoying travel, fine food and friends. But Ameche started showing signs of dementia and was aghast at the prospect of life without a fully functioning brain. He asked Bloom to research his options for assisted suicide, which were limited. She eventually discovered a nonprofit in Switzerland offering  “accompanied suicide.” Gently and lovingly, Bloom shares how they carried out his final wishes. Sad but not morbid, this is the candid and powerful story that Bloom promised her husband she would write. You’ll want to talk about this book.

Tova is a widow in her 70s, coping with the mysterious loss of her teen son. To distract herself from her grief, Tova works as a cleaner in the local aquarium, where she communes with the creatures housed there. In Remarkably Bright Creatures (2022), Tova has a special bond with Marcellus, an aging, giant Pacific octopus, who was rescued and rehabilitated at the aquarium. She knows he escapes and visits the other tanks, sometimes for a social call and other times for a snack. But Tova keeps his secrets; Marcellus is grateful. A young man named Cameron arrives, looking for the father he never knew, and takes a job at the aquarium. While Cam settles in, the intelligent and erudite Marcellus pieces together what happened to Tova’s son. Can the old octopus give Tova the peace she seeks before he dies? Narrated by the octopus and Tova, this charming story will have you longing for a trip to the nearest aquarium. 

In another intergenerational story, The Reading List (2021), we meet Mukesh Patel, a lonely widower living in a London suburb, simply going through the motions of daily life, and Aleisha, a disaffected 17-year-old, who cares for her mentally ill mother, and, although not a reader, works at a small library. She finds a scrap of paper listing book titles, “just in case you need it,” and she decides to work her way through the suggestions. When Aleisha is rude to Mukesh at the library, her supervisor asks her to apologize. She then makes a recommendation from this secret list; the book’s magic sparks a friendship. The two confide in each other and bring others into their circle. But when tragedy strikes Aleisha’s family, she pulls away from Mukesh and from reading altogether. Can Mukesh use the life lessons gleaned in the shared pages to bring Aleisha back from despair

If you enjoyed Olive Kitteridge (2008) by Elizabeth Strout and followed the goings-on in her New England community, you’ve already met Lucy Barton (My Name is Lucy Barton (2016) and Oh, William (2021). She’s back in Lucy by the Sea (2022), revealing how she navigated the pandemic back in her hometown with her first husband, Edward.

The third installation of the Thursday Murder Club is out. The original, The Thursday Murder Club (2021), by Richard Osman, introduced us to a diverse group of amateur sleuths who reside in an upscale retirement community. It was followed by The Man Who Died Twice (2021) and The Bullet That Missed (2022). There’s much mayhem and suspense as the self-proclaimed detectives solve other mysteries that stumped the local police. If you haven’t joined the fun, it’s time to catch up.

Happy reading in 2023!

Paper Books, E-books, Audiobooks—It Really Doesn’t Matter Which, Just Read

MRIs show what we have learned over the millennia—reading has a positive impact on brain health. The National Institute on Aging recommends reading books and magazines to keep your mind engaged as you grow older. Good news for meI’m a bookworm. 

I enjoy books in every format. I listen to books on audio, I read books on my Kindle and I have paper books from the library. I’m not a speedreader, but I read consisently and am never without. I often research what I’ll read next when I’m not reading. 

In a discussion with someone unfamiliar with the wide world of audiobooks, he imagined that I was trudging through computer text-to-speech. Nothing could be further from the truth! Some very talented folks narrate audiobooks—sometimes several artists on one recording, and the books become almost theatrical to hear. (Tom Hanks made The Dutch House seem as if he grew up there.) I have a Bluetooth-capable radio to play audiobooks from my phone. I have a subscription to Audible, where I can choose from a wide selection of trending titles. I have other apps for free audiobooks, like my library app, though I may not be able to get a best seller immediately. (That can be said for hardcover best sellers as well). I can even ask Alexa to play the book of the day and go seamlessly between car and home. 

If you’re reading for pleasure, consume books in a way that’s most accessible to you. Researchers conducted a study in 2019 in which they used neuroimaging to see how written words and heard words are processed in the brain. Participants read or listened to the same stories for several hours. The researchers found that language is processed similarly by the brain whether you listen or read with your eyes. One difference: if you’re studying for a test, you might be better off with print. 

There’s a bit of magic and comfort in being read to, especially when the author is the narrator. A narrator’s accent adds authenticity if the story takes place in a foreign land. Or, in the case of an autobiography, the author’s voice comes through with such honesty.

So, if your friends are talking about the newest best seller, and you think you don’t have time to read it, give the audiobook a try. Plug in your earphones and take a walk or fold laundry with the author, and in no time, you’ll be a bookworm like me.

Keep Up!

When chatting with others, do you ever struggle to feel “in the know”? This is how I’ve been feeling about my place in society lately. The world is changing, and I don’t want to be left behind. 

My daughters do their best in their quest to keep me current, albeit not without eye rolls. When my husband died, leaving me a single mother, it was more of a challenge to stay current with news and culture, but once the kids had earphones, I was free to listen to NPR or escape with a best seller. I disavowed those “when-I-was-your-age” admonitions, but I had many occasions when I recognized their world was very different from the one in which I grew up. I enjoyed my kids’ music, in contrast with the arguments I had with my parents about the hippie sounds of the lawless, morality-free ʼ60s. 

I could count on my daughters to help me with technology. “How many times do I have to show you…” came from the child, not the parent. (Really? I taught you how to use a spoon.) As they grew older, more changes became harder for me to process, not the least of which revolved around appropriate attire. Did they miss the lesson on modesty, or did I miss the lesson on freedom of expression? I couldn’t keep up.

One daughter had a beau over for a movie and make-out. I felt compelled to remind them I was in the house, party pooper that I am. The young man was African American, and I was caught in thoughts about how far we’ve come. I told her that young Black men were lynched for less when I was in high school in the ʼ70s, and my daughter was shocked to realize just how recently mind-sets have changed. On this matter, I can say I have kept up. 

A decade ago, my 14-year-old daughter asked me if she could get her belly button pierced and I agreed. I was vilified by many. Today I have friends who accompany their kids to get matching tattoos. I’m trying to keep up. 

I experience challenges around language that I hope to overcome. I’ve had a lifetime of using terms that I now know to be offensive to others. I accidentally asked a new high school grad if they felt “gypped” out of their rites of passage by COVID. I caught it and apologized. When I was rebuked by my daughter for saying “lame excuse,” I was taken to task: refrain from ableist language. Not quite there yet.

I may not master current practices, but I do want to stay relevant and, of course, respectful, and that’s going to take some open-mindedness and gentle reminders. But let it be known that I am determined to keep up.

Cool It

I don’t like summer. There. I’ve said it. Seaside, poolside, outdoor activities—not my thing. I hibernate in the summer. An unseasonably hot day in May caused me to miss out on a community Spring Fling arts-and-crafts event I looked forward to all winter.

One reason I don’t fare well in heat is that I carry extra weight. Imagine doing what you like to do in 90-degree weather, wearing a backpack full of bricks. Add in some chafing and perspiration-laced sunscreen dripping into your eyes, and you begin to understand why I’m not playing frisbee on the beach.

As climate change is making summers longer, older adults—even thin gardeners and fit sun-worshippers—need to know about heat-related health challenges that caused 1,577 deaths in the United States alone in 2021. As we age, we can lose the feeling that we’re thirsty, making us less inclined to grab a drink. Medications may have a diuretic effect, or we drink alcohol, coffee or tea, which also promote fluid loss. This, along with perspiration, and even breathing, can leave us dangerously low on the fluids, salt and minerals we need to cool ourselves down naturally. 

The two most common risks to the dehydrated are heat exhaustion and heat stroke. Heat exhaustion is your body’s way of saying your fluids are low and your body can’t cool down. Dizziness, fatigue and confusion can be accompanied by muscle cramps, loss of balance, headaches and thirst. Hallmarks of heat stroke are skin that’s not sweating, an elevated body temperature and severe confusion, possibly convulsions. Heat stroke can occur suddenly, without the precursor of heat exhaustion symptoms, and can cause organ failure. Heat stroke should be considered a 911-level emergency. 

To prevent these heat-related illnesses, stay hydrated. Mark your water bottle and set a goal, so you can be reminded that you need to drink. Consider a sports drink like Gatorade with salt and minerals to replenish your electrolytes. Always pack more drinks than you think you’ll need. Choose foods that have a high water content, like watermelon or strawberries, that won’t weigh you down and will give you some electrolytes. Stay in the shade or, at the very least, know where to find shade if you start to feel overheated. Dress in breathable, light-colored fabrics. Plan your activities for times of the day or week (or season!) when the temperature is more forgiving. 

As for me, you’ll find me in an air-conditioned room until the community Fall Fest comes around in October. 

Setting the Table

As the eldest daughter in a big family, it fell to me to set the table as my mother prepared dinner each night. Once my father arrived home from work, all seven of us ate together. I grew up with both “everyday” dishes and “good” porcelain china, reserved for holidays and special occasions. When I got married, I registered for and received ”good china,” but I set a table for my family using simpler, stoneware plates.

When my husband died, our dinners became more casual, with less of a focus on the ceremony and more centered on communicating about our day. Once my kids became involved in extracurricular activities, like sports, scouts and friends, dinner was rushed; no one set the table, it was every woman for herself. Pasta. Chicken nuggets. Pizza. Ramen. Repeat. We often ate in front of the television, then they went off to do homework before bed. 

Now that I’m an empty nester, my “table” is actually a tray, but it’s set: fork, knife, water glass, cloth napkin. I bring it to the family room to eat while catching the nightly news and a little Jeopardy. This is, actually, what my mother did in later life, when she was an empty nester. My siblings and I would chide her about taking her good china and silver with her to her smaller house where she ate off Pottery Barn plates. “Use the china that makes you happy,” we’d say, to no avail. 

As I slowly downsize for my next, smaller home, I ask myself why I’m packing my good china instead of selling it. I haven’t used it in a long time, but knowing it’s behind the doors of the china cabinet is a sentimental comfort that harkens back to the promise of my marriage and what the future would hold: proper dinner parties with perfectly plated meals for family and friends. That spelled success to me. 

My daughters don’t want the china. And like my mother, I wouldn’t use it while dining alone. I don’t see myself doing any entertaining on the scale that would merit the lovely French china, but if such an occasion should arise, I know how to set a table. 

A Fine Romance

The pandemic’s isolation and loneliness hit us hard. At residential care facilities, some residents were locked in, meals left at the door, no one in or out. People who are homebound turned to delivery services, cautioned against having any face-to-face contact, even with family members. It’s no wonder we all turned to screen-based conversations. FaceTime and Zoom became our connection to the outside world. Many of us made new friends online, using Facebook and dating sites. Even elders who were reluctant to use social media were forced to join—or embrace the silence. 

Sadly, along with the new users came their exploitation. According to the Federal Trade Commission (FTC), reported losses to romance scams reached a record $304 million in 2020, up about 50 percent from 2019. Mind the word “reported” here—many victims, feeling foolish, are too embarrassed to report these crimes.

These scams often start with a friend request. Ensuing conversations can go back and forth for weeks, months, longer—scammers could be targeting multiple victims at the same time, and they can wait for the payoff. Often a scammer has a fake profile that looks like a real one to the untrained eye. Once a “friendship” has begun, conversations often go off social media to the more private settings of email or text but never occur in person. Craving a connection, a lonely person may believe a romance is blossoming, and when the request to send money comes, the hopeful romantic can be sucked in.

The hardest-hit group has been adults ages 60 to 79, with their median loss close to $9,500. 

How can you protect yourself? The FTC recommends: 

  • Never send money or gifts to someone you haven’t met in person, even if they send you money first.
  • Don’t give out your personal information, like birthdate, Social Security number, PINs or account numbers.
  • Talk to someone you trust about this new love interest, because it can be easy to miss things that don’t add up. 
  • Ask a lot of questions and take note of  inconsistent answers.
  • Report the scam to the FTC at ReportFraud.ftc.gov.

Were you scammed online and feel duped and ashamed? Take comfort that you’re not alone. If you are a victim of an online dating or romance scam, the Minnesota Attorney General’s Office suggests taking the following steps:

  • Cease all contact and block phone numbers, IM accounts and email addresses.
  • Keep copies of all communications.
  • Report the matter to the dating website.
  • Report the matter to your local police.

 

 

 

 

A Loss Without a Funeral

After months of medical intervention and prayer, a friend made the agonizing decision to euthanize her very old, very loyal dog. I am an animal lover who has been in her shoes, so I could appreciate what she was going through. Making the call to “put them to sleep” is merciful, but not easy, and can leave feelings of guilt and doubt for quite some time. Did I give up too soon? Should the call have been sooner? Did I end their suffering, or mine?

So many of us find love and companionship in later life from faithful canines. If you’re lucky enough to know the steadfast love of a good dog, you know they can be relied upon to never judge and to always comfort. Often, our dogs outlast loved ones, who leave us for a variety of reasons. When they come after the parting, dogs fill holes in our hearts. I got my bulldog, Maisy, after my oldest daughter left for college. Maisy’s at my desk now and by my side whenever I’m home. I know she won’t live forever, but I can’t imagine my life without her, and I’ve lost friends, parents and my husband. 

Why is it so hard to lose a cherished pet? When I lost a human partner, there were the usual funeral rituals and sharing of memories and support for weeks afterward. Being an emotional basket case seemed understandable. But our culture treats the death of a pet more like the loss of an automobile. When it wears out, you should just go buy another one. When I lost my dog, well-meaning friends and family members had advised this in their attempts to help me feel better. What they didn’t get was that I had lost a soul mate—an irreplaceable relationship—not a piece of property.

We’ve learned that pets can help us maintain our health by reducing stress, lowering blood pressure, imparting a sense of purpose and bringing us companionship and joy. As an older adult myself, having a dog gets me out of the house—a little walk each day, moderate exercise and often a chance to meet new people. 

So I’m asking you to understand, if you don’t already, the very real grief that someone can feel when they lose a furry friend, especially if they had to make the choice to end their companion’s life. 

Books to Give or Keep, 2021

Silver Century regularly recommends books—fiction, nonfiction, memoirs—that we feel reflect our mission by portraying aging in a positive light or that offer insights from thought leaders in the field of aging. Here are some of our favorites for holiday giving or to read yourself in the winter months ahead. 

When it comes to role models for aging well, you can’t go wrong by emulating Queen Elizabeth. In Long Live the Queen: 23 Rules for Living from Britain’s Longest-Reigning Monarch (2020), we learn Her Highness’s habits that keep her so vital: she works, sticks to a routine, walks her corgis, eats simply and reads voraciously to keep abreast of global current affairs. This book contains many insider observations we’ve not read anywhere else. A gem for royal-lovers and anyone who wants to age like one. 

In The Thursday Murder Club: A Novel (2020), a group of amateur detectives work on unsolved crimes each Thursday in their retirement village. When a local contractor turns up dead, they couldn’t be happier to have an actual murder to solve. The four quirky octogenarians use their wits and life experiences to uncover the killer ahead of the befuddled local law enforcement. It’s a smart whodunit laced with mirth.

Lionel Shriver’s thought-provoking novel Should We Stay or Should We Go (2021) has a couple—Kay and Cyril, both health care workers in their 50s—making a pact to end their lives when they turn 80. They’ve just supported a dying friend and now have both professional and personal experience with a drawn-out death, and they refuse to let the same fate be their own. The next three decades pass and, now at the age where the pact might come to fruition, a dozen different possibilities, brilliantly thought out, are explored. In one alternate universe, they end up in residential care, neglected and forgotten; in another, at a posh facility, they’re treated like royalty. This novel is serious and provocative but not morbid, and an excellent discussion-starter for you and your family or your book club. 

There is no cold so bitter that The Funny Thing About Norman Foreman: A Novel (2021) can’t overcome. Norman, age 12, and his best (and only) friend, Jax, make a terrific comedic duo with a dream of appearing on stage at the famous Edinburgh Fringe. Jax has the presence and timing; Norman, the straight man, has an unfailing belief in his friend. When Jax suddenly dies, Norman is inconsolable until he decides to honor Jax’s memory by appearing at the Fringe himself. His single mother, Sadie, is dubious about making the trip because Norman also wants to meet his biological father along the way. Making that quest more challenging is the fact that Sadie isn’t sure exactly who Norman’s father is. It’s only when 80-something Leonard, Sadie’s co-worker, agrees to join the quest that the threesome head off. Leonard is the brains behind the trip; he brings the common sense, the computer savvy and a lifetime of useful skills, upon which Sadie and Norman draw time and time again. There are snags, hits and misses along the way, but if you’re up for a sweet escape, this is the trip for you. The “Little Big Man of Comedy” will warm you from the inside out. 

So Much Stuff

I’m a widow with two daughters in their 20s, who both live on their own. I have a two-story, four-bedroom house that is becoming harder to maintain. Could it be a good time for me to sell? It seems to be a “seller’s market,” and I am considering what’s best for me for the next phase of life. 

Whether I stay or go, it’s kind of overwhelming. On the “stay” side of the argument is that my daughters will have a place to return to for holidays and comfortable, familiar bedrooms waiting for them if life doesn’t go according to plan. I have a nice backyard for my dog to play in, and moving is just so hard.

The “go” side is clearer but no easier. I am at a stage where I can find a condo in a 55+ community, and it could conceivably be the right home for me in which to grow older. I’m looking at first-floor, two-bedroom units and no steps. I want to stay in this town that’s been home for almost 50 years. And it’s quite possible that I could end up lowering my monthly expenses.

Of course, I would have to downsize—that’s challenging and so time consuming. I have too much stuff. And I like my stuff. I tell myself I can always get different stuff and I’ll like that as well. 

But did you know that it’s also expensive to get rid of stuff? I just paid a small fortune to have junk removers empty two-thirds of my unfinished basement. (Time-plus-damp adds up to unsalvageable stuff. Ewww, what did that used to be, anyway?) You really can point and make it disappear (with your checkbook handy). A truckload cost $700, but it’s gone.

As for the upstairs, if I move, I won’t need the girls’ beds and dressers—they have little value, that’s easy. But they have stuff collecting dust that carries a great deal of sentimental value for them. They are apartment dwellers, so they’ll need to invest in a storage unit for things I can’t take. On one hand, I feel badly about making them choose, but I tell myself that downsizing benefits them in the long run. My conscience tugs at me: how much do I owe them in memory-storage? A few large, plastic tubs? A second bedroom-full? It is an emotional point to consider that gives me heartache.

Beyond the extra furniture, knickknacks and kitsch, I have trappings of my former, married life. I have a teapot collection, sterling silver and “good” china that the girls don’t want and I don’t use. I won’t be entertaining on a grand scale and I won’t need it. But it will hurt to put it into consignment. There are a few furniture pieces I like and will keep for my next home, but if I consider the cost to move something versus the prospect of having something new, I can let most things go. (I’m talking to you, saggy, old mattress. You too, every-single-holiday decoration.)

Meanwhile, a multifamily yard sale is being planned in my neighborhood. I need to A) stay away from their stuff and B) promise myself to bring absolutely nothing of my own back inside. 

Do you need any stuff?

 

I Want to Be Alone, Not Lonely

There was a time when I could outlast every guest at a party. And though I gave up the bar scene decades ago, for the longest time you could still think of me as Pepper “Last Call” Evans. As I get older, however, I get my fill earlier and earlier. It’s not the hour of the day that does me in, but I get “people-full.” I’m spent. It takes more energy to make the small talk and chit chat that I relished in younger days. At the weekend-long family reunion, my need for conversation can now be met in an afternoon. The very thought of having company—or being company—for an extended period holds absolutely no appeal. Am I becoming a late-blooming introvert?

A quick Google search, asking if it’s common to become more introverted as we age, shows that I’m not alone in my introverted inclinations. Like me, others commented on feeling less inclined to go out or even gab on the phone, as they did when younger. Could it be that the sense of who we are is more developed, and we no longer need the quantity of interactions, but are satisfied with more quality interactions?

Even though I crave company less, I have no fear of becoming a hermit or one of the many, isolated older adults dying of loneliness. Many older people living alone have felt the absence of connections, especially in the pandemic. No one wants to feel neglected or forgotten.

Studies show loneliness and social isolation can accelerate dementia and cause mental health issues like depression, anxiety, even suicide. My primary care provider always asks if I remain social, and I do. I’m an elected official in my town and serve on the boards of a couple of nonprofits, plus my work has me in the company of others and my adult children are close. I am not concerned that my social pendulum has swung too far in the other direction, I’ve simply begun to appreciate solitude over conversation as I age.

I have a long day ahead tomorrow—my regular workday plus a doctor’s appointment and a board meeting. I’ll be on the go from 8 am to 9 pm. I need to mentally prepare for a few conversations so I can make them more efficient, and I know at day’s end, I won’t join colleagues after the meeting, nor will I make phone calls when I get home. I’ll need to just curl up with a book or watch some mindless television. Like Greta Garbo, I’ll want to be alone.  

Stop Me if I Told You This Already

For a while now, I’ve felt as though I’m not firing on all cylinders. I have no complaints about my health; I just feel like I’m not my old self. Not the well-oiled machine of yesterday. I’m more tired than usual, forgetting more and struggling to focus. I can attribute some of this to COVID. No, I haven’t had it, but the trauma of the pandemic seems to have taken its toll on me. 

I was concerned that I was suffering from early-onset dementia, so you can imagine how relieved I was to read about a very real (and likely temporary) state some are calling “brain fog.” According to neurologist Andrew E. Budson, MD, “Brain fog is not a medical or scientific term; it is used by individuals to describe how they feel when their thinking is sluggish, fuzzy, and not sharp.”

How does brain fog manifest in my life? My memory is worse than usual—not simply forgetting why I am in the living room, but locking myself out of the car, key on the front seat. I’m easily distracted and cannot stay on track, daydreaming through Zoom calls and forgetting what I’ve just read or heard. I’m not incorporating new information in a way that I can recall later: which insurance plan offered the lower co-pay and which one was a lower premium? Back to page one.

Maybe we all have a little brain fog. How many times during lockdown did you wonder what day it was or lose your train of thought? Stress is a major cause of brain fog. Let’s not minimize that. We are trying to process a traumatic change in our daily lives—we’ve been isolated, assaulted by masked faces and constant reminders to wash our hands. We are bombarded with death tolls and fear-inducing newscasts. We’re living a Groundhog Day-life without the positive, stimulating experiences that kept us vital and engaged, and it’s this sameness that’s causing our brains to shut down, suggests Moya Sarner in the Guardian. Boredom from the blending of one day into the next—no new experiences or change of pace—can rob the brain of the context it needs to process information. 

But what can we do other than ride out the pandemic and hope our ability to multitask comes back? Switch things up when possible. Call someone different. Move some furniture. Work from a different room. Less screen time, better sleep, move your body. Then move some more. Outside is better. 

A little change can make a big difference. As soon as it’s safe, we can get back into the world and enjoy a variety of stimulating people and experiences to shoo away the fog. The worst is behind us and, with any luck, our resilience will kick in, leaving 2020 and 2021 in our rearview mirrors. 

Note: Brain fog could be a symptom of a bigger issue: nutritional deficiency from a poor diet, poor sleep, boredom and inactivity, depression, or even a thyroid condition. Certain medications can cause brain fog. Serious brain fog may be a sign of an underlying condition. Share your concerns with your doctor.

 

At What Price Is Your Good Death?

I’m watching out my kitchen window as cars come and go from my neighbor Tony’s house. Last month, Tony celebrated his 89th birthday, and family came out of the woodwork. Last week, he left the hospital to die at home on hospice care; the family has returned. Saturday morning, I brought over some bagels, looking for information. Tony’s kids were grown and out of the house when I moved here 15 years ago, but I see the local ones regularly. In truth, I see the adult daughters. I asked one of the daughters how it was going with hospice. Her reply: don’t die on the weekend. 

Like many who are terminally ill, Tony insisted that he not die in a sterile and impersonal hospital, hooked up to machines. Despite the family’s lack of familiarity with dementia care, they brought him home. They weren’t told that hospice services would begin on Monday; they were on their own for the weekend with a man who would not go gently into that good night. 

Tony’s daughters spent the better part of Friday night on the phone with the hospice helpline, learning which medications would help calm their frightened, agitated father. They needed to go to several pharmacies to fill the prescriptions and retrieve the items on the list from hospice. Sadly, Tony needed to be restrained until the medications kicked in. So much for the dignity they hoped would be a benefit to dying at home.

When a hospice nurse finally arrived, she only took his vitals and made a few suggestions for the family to keep Tony comfortable. Tony was polite to her, but he had been horrible to his family. The nurse had no resolution for that. 

My own experience with my mother’s end-of-life wishes and her hospice care was also disappointing. I had heard stories of the angels of hospice, so my expectations were high. I was also under the impression that the medical pieces would be handled by professionals. This was not the case.

I might have made a different choice for her if I had known the deeply intimate and personal care required of me and my sisters. The physical strength, fortitude and patience needed, even with a compliant patient like my mother, can’t be glossed over. Being a primary caregiver at the end of a loved one’s life requires resources beyond measure at a time when it’s hard to summon them. I regret that the caregiving took over the actual caring, but the tasks before me were overwhelming.

I don’t know if my neighbor has weeks or days, but I know it’s hard on the family. I now question if I can have a “good death” and die at home.

Have a Ball

When a 70-something friend went to a podiatrist for foot issues, the prescription for alleviating the pain—mostly in her arches—involved a golf ball. Not to walk the links with her clubs, but to massage foot muscles by rolling her bare foot over the golf ball. 

Many people live a sedentary lifestyle with long hours of office jobs or inactivity. Sitting in one place can become a serious problem because it contributes to muscle tightness. This can result in pain in your lower back, hips, tailbone, knees and feet. A few minutes a day of exercising with a therapy ball at home can help you manage muscle pain—a simple, low-tech solution, a drug-free answer for your muscular and joint problems. The right ball can improve blood circulation and relieve tension with prolonged, gentle pressure that you control. But what ball do you choose? 

Though some massage balls are made for massaging, others are repurposed sports balls. A medium-size one—think playground size—may be a good place to start (always consult your health care provider before starting a new exercise). I used this size when I had a frozen shoulder and simply pressed against it, against the wall, push-up style. Ten-dollar physical therapy is hard to beat. Sadly, the ball didn’t hold up against my dog’s teeth. For deeper muscle pain, try a lacrosse ball, which is hard and tennis ball-sized. 

Massage balls work immediately to target knots and pain anywhere on your body. They’re great for muscles and their surrounding tissue to relieve tightness in the muscle. You can use a ball anywhere—sit in a chair, stretch out on a yoga mat, or even lie on a bed. 

While muscle rollers (another possibility) have many benefits, they usually relieve pain in larger areas that may not be as deep. Chiropractors from the Cleveland Clinic suggest the best way to roll out your pain:

  1. Get in position: Place the roller under your trigger points and lie across it. Let your body weight press the roller into the tight spots.
  2. Slow your roll: Less wiggle, more pressure. Try to press the roller into the tight spot and stay there. That deep, steady pressure should ease tension.
  3. Hit the spot: It may help to roll just above or below a trigger point. Use some trial and error to find the right place to press. It might feel uncomfortable while you roll, but your muscles should feel more relaxed when you’re done.

Other beneficial tricks with balls include putting tennis balls in a sock, then pressing into them with your back, shoulder or hips against the wall or the floor on a yoga mat. See this video for more ideas with tennis balls

What about the spiky balls that look like what I put in my clothes dryer instead of fabric softener? Roll them over sensitive areas all over the body; they’re especially good for the arches of the feet.

In the end, my friend did find relief from her foot pain with the golf ball exercise: she simply rolled her arches over the ball, getting to the smaller muscles and breaking up tightness. She may even be back in her heels before too long, having a ball.

Getting the Jab

My phone rings, my laptop pings—proof that I remain popular with the many, many websites and organizations that took my information so I could get the COVID-19 vaccine, or “the jab,” if you listen to BBC radio, into my arm and into the arms of people in my care. 

In January, I became eligible for vaccination as an elder-care provider. I also qualified due to comorbidities, but rather than saying I’m plump and old, let’s stick with my eligibility via my profession. 

Initially, I had no idea of the time it would take to lock in my appointment, let alone schedule my clients, who qualified by virtue of age or health status. My initial foray was to sign up online everywhere: on New Jersey’s official registration system, at county websites, health care groups and hyperlocal locations, plus getting notifications from Facebook and Twitter. I optimistically and naively sat back and waited, but no one responded. 

I observed that caregivers who worked with agencies were getting vaccinated (I am a self-employed consultant)—and returned to my task more aggressively, more singularly focused on getting myself vaccinated. In a plane crash, we’re told to put our own oxygen masks on before we help others, right?

I sat at the computer at the website of a health care consortium that I heard had a wide range of available time slots. The tips I found on a Facebook page suggested that loading the sign-up page and hitting refresh over and over might turn up an appointment, but you had to immediately put your information in lest you lose out to a faster typist. I finally secured an appointment an hour away, at the end of the month. The relief I felt is hard to describe.

A week before my appointment, I was told they were rescheduling everyone for some time in the future, as they were not given the promised allotment of vaccines. It was back to the drawing board for me. So close!

The frustration, anxiety and sense of futility when I made no progress made me decide to limit my attempts to once in the morning and once before bed. Finally, I secured appointments for myself and two family members, and eventually for some of my clients. 

The next step was getting the vaccine itself. A client with intellectual disabilities was up first. I drove him an hour away, parked, then nearly fainted when I saw the line snaking around the building. A staff member with a counter said there were 250 people ahead of us. Thank heavens, it was a nice day. We later learned that two days’ worth of appointments canceled due to snow had been rescheduled for that day. What bad luck.

But the line moved quickly enough; we were scheduled for 1:15 and the shot was administered around 3:00. When I regaled friends with this story, some asked why I stayed in the line at all. What choice did I have—return to the drawing board, pushing the vaccine date out by weeks or months? Fortunately, the rest of my clients’ appointments went smoothly.

When my date came, I drove 35 minutes to an empty department store. My second dose also went without a hitch. I had no side effects beyond fatigue. The nurse administering the vaccine told me it was the “happiest place” she ever worked. My own feeling was of a weight being lifted, or an exhalation of long-held breath. 

For the remaining client appointments, I turned to a group of vaccine volunteers who found a spot at a pharmacy close to home. When I took a client, he was one of three people who showed up for 12 doses. They, like other pharmacies in my area, had begun calling people to claim immediate appointments. 

Everyone I know who wanted to be vaccinated is now a card-carrying member of the club. The world is reopening for many of us. I had an Easter dinner with family I hadn’t seen in the pandemic, and my daughter will have an in-person, outdoor, college graduation in May. 

All that’s left for me is to get myself off all the lists, websites and social media pages that offered vaccine sign-ups. This could take a while. 

Cashless?

As part of my job assisting older people to live independently, I pay their bills by check, as requested. But I’m in my 60s and I rarely write a check for my own bills. I pay them online either at my computer or on my phone. When I get paid by check, I use my phone to deposit it. 

It’s no secret that we’re moving away from paper transactions toward a completely digital economy. With new payment technologies emerging left and right, it’s important to stay up-to-date. 

As my 20-something daughters are quick to remind me, there’s no need to carry cash or credit cards when you have a “digital wallet” on your smartphone. A digital wallet serves as a virtual bank where you can store payment information securely. Your wallet can contain your bank accounts and credit cards, as well as apps that allow you to pay with your phone—without ever touching a keypad, card slot or cashier. 

These digital, contactless transactions are as secure as the “old-fashioned” payments we are used to. They are much more convenient and safer in our COVID-avoidance environment. Apple Pay and Google Pay let you take advantage of this technology—the apps link to your credit or debit card to make contactless purchases from your cell phone. 

Gone are the days of desperately searching for change or making sure you stop at the ATM for cash. There is no need for money to physically change hands, thanks to PayPal, Venmo and Zelle. Using these peer-to-peer apps, you can send and receive money from anyone in mere moments. 

My daughter and her roommate use these apps to share household expenses: they split the rent, utilities and groceries, paying each other using Venmo. Because their paychecks are directly deposited to their accounts, and they do their banking online, they never have to leave home or even enter the bank. They don’t carry cash, nor do they expect their friends or colleagues to. While checks may have come with their bank accounts, they’ve never used them—or a deposit slip or maybe even a postage stamp, for that matter!

Older adults are becoming more comfortable using these digital payment methods, yet they haven’t given up their checks yet. According to a 2020 report from AARP, smartphone adoption is 81 percent for those 60 to 69, but it drops to 62 percent for those 70 and older. When older Americans use smartphones, it’s most often for email, directions, online searches or checking social media, not bill paying.

I’ve embraced the cashless society, but even though COVID has pushed us closer to it, I don’t think it will be universally accepted for a while. Not everyone has a smartphone, and it takes time to become comfortable with using the technology. It’s important that banks and merchants don’t marginalize people who aren’t prepared to go cashless.

As for me, I’ll try to help my clients get up to speed, even as I write their checks. 

 

Just a Code, No Secret Handshake Required

The global pandemic in 2020 brought many changes to our way of life. Over the summer in some places, when it was moderately safe enough for us to leave our homes—masked up, travel-size hand sanitizer at the ready—many of us encountered a new protocol at banks, doctors’ offices and restaurants: the QR code.

A QR (Quick Response) code is similar to the box of lines you see on products that are scanned at store checkouts. The code consists of black squares arranged in a square grid on a white background, which can be read by an imaging device such as a smartphone camera. The code usually links to a website, so you don’t need to type in a web address. Easy, right? 

Maybe. For the tens of millions of Americans who still don’t carry smartphones, this new process can be a problem, as you must have one to read a QR code. I’m comfortable using my smartphone for everything, and I’m in my early 60s. While the device isn’t universally embraced by older adults, the tide is turning. A study found that the generation gap in smartphone adoption is narrowing—ownership has jumped 70 to 77 percent among older adults in the last two years. The rate is higher for adults who are slightly younger and lower for those over 70. 

But for those of us with the ability (and phone) to do so, scanning a QR code might be intimidating. One of my first experiences was when I schlepped my cat in a carrier to the veterinarian’s door, only to find it locked, with a sign containing a QR code. To announce my arrival, I followed the simple directions, held my phone camera to the code, then dutifully returned to my car. Kitty and I humorlessly awaited our summons, then banged and clanged our way back to the entrance. 

But I quickly adapted. I attended a function where participants checked in via QR code and answered quick health questions before they were admitted. You may encounter the QR code at a restaurant where diners don’t want to exchange paper menus with others. You may even be able to order without contact with a server. At some restaurants, customers order and pay with their phones as well. It’s actually pretty handy.

It’s almost certain we’re going to need to use QR codes for the foreseeable future, and that these types of procedures will stick. For the time being, if you don’t have a smartphone, you may want to call ahead to ask about procedures for entry to buildings, check-ins at appointments, ordering at restaurants, etc. As for me, I will miss the banter with my server at my table, and I resent the extra steps to get into the bank, but it’s grow-or-go time for getting around town in any familiar way.

Facing Mask Realities

Most of us have accepted the new normal of mask-wearing to help curb the spread of COVID-19. The benefits, sketchy at first, are now widely accepted, and masks are mandated apparel in more places than not. I jumped on the mask bandwagon, even pulling my sewing machine from the depths of the basement to make a few, so I wouldn’t need to wear the same white-on-the-inside, blue-on-the-outside as everyone else. 

But, good grief, what’s happening to my face? I’m too old for acne! It seems I have a type of dermatitis doctors call acne mechanica, or, as people are calling it, “maskne” (mask + acne = maskne). It’s caused by a combination of heat, friction, oils and bacteria accumulating under my mask. It’s quite common, especially for older skin, to react, and there are a few reasons why this is happening to me and likely to many of you too.

Aging skin is often thinner, more prone to dryness and more susceptible to irritation. The bridge of your nose and the area around your ears may be rubbed by the mask, which should be worn tightly, but not so tightly as to chafe. Wearing the mask in summer’s heat and humidity can cause a heat rash on your cheeks, which is often exacerbated by masks made from materials that don’t breathe or that are treated with antimicrobials or chemicals to kill bacteria. This can result in blemishes or skin with a red, rosacea-like appearance. If you are already suffering from skin issues, such as rosacea, acne, eczema or allergies, your mask can make breakouts worse. 

So for starters, masks must be clean. Disposable masks should not be worn over and over, and washable masks should be laundered with a non-irritating detergent, especially when new, to remove any chemicals in the fabric. Skin needs to breathe, so go mask-free when it’s safe.

WebMD offers these tips to avoid and treat maskne. Keep in mind, as with other self-care tips offered here, this blog is no substitute for the opinion of your health care provider—it is merely a guide to what’s going on behind the mask.

Cover wisely but don’t squeeze too tightly. Masks, bandanas or other barriers should fit snugly over your cheeks, nose and chin, but they don’t need to squeeze or press so tightly that they leave indented marks behind. 

Wash or replace your mask. Experts recommend washing or replacing your mask after every use. 

Cleanse your face regularly. Remove makeup, dirt, oil and bacteria from your skin by washing your face once or twice daily with a mild cleanser. If you don’t have immediate access to a bath, shower or sink, a sensitive-skin wipe may help to reduce breakouts.

Target bacteria. Cutibacterium acnes is a bacterium on the skin that’s known for causing pimples. Fight it with an over-the-counter ingredient, such as salicylic acid, benzoyl peroxide, glycolic acid, sulfur or tea tree oil. Suds up with a wash containing one of these ingredients once a day or apply a cream or gel version for a more powerful effect. Start sparingly and with caution, since any of these ingredients could be irritating or cause redness or an allergy. (And before you ruin your favorite T-shirt, remember that benzoyl peroxide bleaches fabric.)

Try a vitamin A cream. A nightly dab of adapalene gel has been proven to shrink and prevent blemishes. This vitamin A-derived ingredient is the most powerful retinoid available without a prescription. Find it in La Roche-Posay Effaclar Adapalene Gel, Differin Gel or ProactivMD Adapalene Gel 0.1 percent. Apply a thin layer to clean skin at bedtime with your regular moisturizer on top. Start just twice a week and gradually increase to using it every night if your skin tolerates it. At first, adapalene may cause dryness, peeling, redness or irritation. Any irritation tends to go away with continued use.

Handle skin with care. Avoid rubbing, picking or overscrubbing. Exfoliate no more than once or twice a week, use a broad-spectrum SPF and soothe your complexion with a moisturizer once or twice daily. 

Check your products. Scan your makeup and skin-care products to make sure the term “non-comedogenic” is on the label. This will help to ensure that whatever you put on your skin won’t contribute to clogged pores and pimples. 

With no end in sight to the virus, masks will be part of our wardrobes for the foreseeable future. I’m looking for a bright side: think of the money I’ll save not buying lipstick.

Books to Give or Keep, 2020

A year like no other, 2020 had many of us finding our way to the reading chair to escape the stress of the lockdowns and the fear brought on by the news. While fate played a cruel trick on me by wiping out my ability to focus on a plot, I was finally able to return to my favorite pastime and restore my sanity. As with my previous, year-end suggestions, each of my picks connects to aging, from midlife on up.

When I was pining for a visit with an old friend, taboo in the wake of COVID, Olive Kitteridge returned in Olive, Again (2019) by Elizabeth Strout. Now widowed at 73, Olive retains the acerbic demeanor that endeared us to her before. She reacquaints herself with a man she and her late husband once knew and finds they have a fair bit in common. To everyone’s surprise, they marry. As in the original novel, the story unfolds in vignettes that reveal the character of this exceptional woman. Gradually, she becomes the person we all hope to be in later life when confronted with the grow-or-die circumstances life throws at us. It’s not necessary to read the original to thoroughly enjoy this sequel.

Have You Seen Luis Velez (2019) by Catherine Ryan Hyde is the kind of story that will put the warmth back in your hot chocolate, if not your spirits. When 92-year-old, blind Mildred sticks her head out of her apartment and asks a neighbor, 16-year-old outcast Raymond, if he’s seen Luis Velez, it begins a friendship so life-affirming that you’ll want to share it with everyone you know. Raymond becomes the helpmate to Mildred that Luis was before disappearing and commits to tracking down the missing man, despite being awkwardly introverted and unconvinced that people are good at heart. This story will be enjoyed by readers of all ages. It’s a perfect pick-me-up for the times.

You’ve undoubtedly read about the crisis in residential care for older adults in this pandemic. It’s had many rethinking alternatives to care for their loved ones, which may mean accepting the role of default caregiver. If that’s you, drop everything and read Your Caregiver Relationship Contract: How to Navigate the Minefield of New Roles and Expectations (2019). Debra Hallisey writes from her own experience both as an adult daughter and as a professional caregiver. The “contract” is a discussion (or discussions) between caregiver and cared-for to identify ways the recipient can benefit from support and set boundaries. Creating the contract cements an understanding that will manage expectations for all concerned. Hallisey gives examples of ways to assess the person’s ability to undertake activities of daily living and how to assimilate the feelings that will come up along the way. We want loved ones in our care to feel dignity and autonomy but often unwittingly strip that away. She gives us techniques to state our own needs without feeling (as much) guilt. We’ve read many books on caregiving—this one gets five stars from us.

Buy two copies of A Glorious Freedom: Older Women Leading Extraordinary Lives (2017) by Lisa Congdon or you won’t be able to give it as a gift. This pretty book, with butterflies on its jacket illustrated by the author, is a collection of inspiring stories about women who have found or recreated themselves. Their journeys are different, but all embraced the freedom to be more truly themselves in later life. Each woman here felt empowered to try new things, caring not what others might think. You’ll find stories of the famous (Laura Ingalls Wilder, Julia Child) and meet those you’ve never heard of, such as a woman who started walking at age 64 and, at 74, has marathons and an ultra-marathon to her credit, and an 85-year-old lifestyle consultant who gives talks to audiences on creative aging. This is a book worth savoring and sharing, one to move you to find your sneakers or that old easel. These stories show us it’s never too late to live an extraordinary life.

I hope I’ve given you books to give or keep that will be warm on a cold night, provocative in a good way and a very pleasant diversion. As always, I welcome your suggestions for my 2021 reading list. 

 

 

 

Real Doctors, Virtual Visits

I recently deliberated about making an appointment for a routine colonoscopy. Not only are we in the middle of a pandemic, I had to change gastroenterologists, and I just wasn’t sure what to do. My primary care provider insisted there are many precautions in place for outpatient procedures and that it is important to stay on top of routine care, so I decided to move forward. 

I had to schedule a virtual appointment, which left me feeling uncertain about my needs being met and questions answered since it was a new-to-me practice. A staff member returned my call the next day to make the appointment, asking me the usual questions, but also whether I had access to a computer (yes) and could I respond to an emailed questionnaire (yes). Next, did I have an iPhone? As it happens, I do. She set up a day and time for the doctor to FaceTime with me. In the end, my virtual visit left me feeling confident about my new doctor and my procedure. 

Similarly, when a friend’s anxiety increased with the ever-present gloom of the virus, she found teletherapy to be better than she expected. Her psychologist held sessions over Zoom, so she got to stay home, curled up in her comfy chair with her laptop and mug of tea. She pays for her session with a banking app on her phone. She actually prefers her sessions this way.

In the pandemic, many providers are moving to telemedicine to help us maintain our health care routines the best we can. Many chronic conditions like diabetes, high blood pressure and skin issues can be easily managed through telemedicine; same for sudden, minor illnesses like a cold, rash, GI issues or headache. 

That’s all well and good if you and your doctor are computer-savvy. Unfortunately, the digital divide is affecting health care options for people 65 and older—the cohort also making up 80 percent of COVID-19 deaths. Senior centers and libraries that usually offer tech support are closed, and those who rely on family support are prevented from getting it by quarantine restrictions. 

For a telemedicine appointment, you need internet access and a computer or smartphone. Your doctor may set up a patient portal—a secure website to store your information—and may ask questions in advance of your appointment. At the designated time, your doctor will connect with you and you’ll discuss the issues at hand. 

Because I rely on my laptop and phone for virtual meetings, I am experienced in using my cameras and screens to chat. Before my appointment, I fully charged my phone because I know video calls can quickly exhaust a battery. I also have a dedicated space for teleconferencing with good lighting and privacy. When my doctor came online, I was ready.

My appointment was brief, about 10 minutes. That’s not to say I felt rushed, but my doctor was efficient. I had a list of questions, which she covered without my asking, and paper and pen for jotting down the instructions she gave. I should have had my pharmacy number handy; she had to wait while I looked it up. 

My expectation is that for many of us, the pandemic will change how routine health care is delivered even after the crisis is over. With no more waiting rooms, we may need to get our magazines at the newsstand.

 

Hire a Shopper

My college-age daughter is home. With orders to shelter in place, she lost her campus job and her restaurant job, and few opportunities were available when she arrived back in town. So she gamely decided to be an Instacart shopper.

I found this amusing because she’s never shown much interest in food—has, in fact, elevated picky eating to an art form—and never once offered to shop for our family groceries. And it wasn’t long before the first call came in.

DAUGHTER: Mom, is tarragon the same as oregano? 

MOM: No, why would you think that? 

DAUGHTER: I know sometimes things go by different names, like coriander and cilantro. (She knew that, wow!)

DAUGHTER: (Twenty minutes later) Mom, what is a shallot and how big should it be?

DAUGHTER: (Ten minutes later) Mom, where would I find chives?

So, I’ll admit I had a few laughs at her expense. Maybe more than a few. By her second trip, she didn’t call me at all. I was impressed. She did a few orders each day and was starting to earn some money. 

I wondered if I should give it a try. After all, I worked as a culinary professional for a decade, so I know my produce. I fed myself and my family for several decades and, above all, I love to shop. I know all the local stores, and I can work a grocery run into my schedule. It could really help someone who wasn’t leaving home. I signed up to be a shopper.

A prospective shopper answers basic questions and consents to a background check. You need to have a clean driving record and no arrests. You agree to the hygiene rules: always wear a mask, sanitize hands before shopping and wipe down the cart handle. To deliver prescription medications along with a grocery order, you need to pass a HIPAA test to show you understand patient privacy rights, as well as agree to Instacart protocols for leaving prescription meds with an adult. 

There is also a food-safety lesson that tests the shopper’s knowledge about keeping hot foods hot and cooked foods at a safe temperature. Instacart asked me to submit a photo of the cooler I’d use to transport temperature-sensitive foods, and, when it was accepted, I was good to start shopping.

With my first order queued up in the app, I swiped on my phone to start shopping. First items are customers’ priority items; I was sent to frozen foods. Nope, that had to wait. No one would start there, would they? OK then, paper towels. Not a big selection, so I grabbed one and scanned it. Wrong item, try again. Wrong item. Click: can’t find item requested, find substitute. Done. 

The next few items had me zigzagging all over the store. Fortunately, the app supplies the aisle numbers with the items. My inexperienced daughter was able to make good choices because there’s a photo of the item requested; when the bar code is scanned, the app tells you right away if there’s something wrong with your choice. For example, if a customer requested low-fat hot dogs and you scanned all-beef hot dogs, it lets you know. If a substitute is necessary, the app will text the customer with the available substitute, so the client can approve or cancel the item. 

I quickly learned that keeping six feet between myself and the next shopper slowed me down. Ditto with the required weighing of each produce item. Then there are quirks: for instance, customers may ask for six pieces of fish but then reject them because they wanted less than two pounds. 

On my maiden mission, the customer texted to tell me not to drop off the order for another hour or else to cancel it. I was an hour-plus into my trip with a cart full of carefully weighed meats and produce. What was I to do? Leave the cart? I opted to wait him out and killed time listening to my audiobook. 

But first I called my daughter for advice on whether I should comply or stay the course. I also had to ask her to bring a phone charger because running the app ate up my phone battery.

My second mission was also rocky. Again, I called my daughter. (Who’s laughing now, Mom?) My customer wanted to add items to the list and I didn’t know how. Also, my Instacart payment wasn’t going through at checkout. The groceries are paid through the app and my phone wasn’t connecting the way it was supposed to. I panicked, looking at the people who were in line behind me, glaring. Finally, something clicked and I was able to get out of there to deliver the groceries. Only I forgot to take a photo of the groceries on the bench where I left them. Maybe I’m not cut out for this after all?

When you’re at the store next time, look around for the professional shoppers. Some wear Instacart shirts or lanyards. They’ll be glued to their phones and scanning cans and bottles. Don’t engage; they are on the clock. It’s better for them if they finish quickly and move on to their next order. If you use a shopping service, keep my experience in mind when you tip. It’s not as easy as it looks!

 

Bye-Bye, Bookworm

I’m an unapologetic bookworm. I read four to six books a month. I consider reading to be my self-care and my hobby: it’s the thing that quiets the chatter in my brain. It’s my vacation when I can’t go anywhere. 

I have books on CD in my car, audiobooks on my phone, a Kindle app and a well-worn library card. When I got the email that my branch library was closing due to the pandemic, I drove straight to the library and checked out a dozen books. Given the feeling of doom in the air, I had passed over my usual literary fiction in favor of thrillers and memoirs. 

But a strange thing has happened. Nothing can hold my attention for more than a few moments. I’ve attempted book after book off the pile, only to abandon them after a failed attempt at reading before bed. Now it’s a magazine article here and there, and not the Atlantic or the Economist either. I’m reading Reader’s Digest and Real Simple. Which is how I feel—real simple. 

I went on a booklover’s Facebook page and admitted that, while I assumed my reading pile would evaporate with so much free time, it has grown instead of shrunk. At the page, I saw I was not alone. Many readers like me are struggling to concentrate on the words before them. They can’t read or can’t process what they’ve read. 

A friend of mine who is a therapist told me that even if I don’t feel stressed, I’m affected by my surroundings, subliminally picking up cues all around me, whether it’s noticing masks where there once were smiles or absorbing the news we can’t avoid. The toll it’s taking on my frontal lobe is not allowing me to process words on a page. Cruelly ironic, since that’s the one thing that always relaxes and comforts me.

My fellow bibliophiles suggest I relearn how to enjoy books by starting slow. Short stories or essays to start (really missing my library right now), then move on to something light and happy, like a “beach read.” If that fails, I will have to accept that this is temporary and find a different escape. Maybe TED Talks or podcasts? Just not snacks!

Who’s Aging Better?

How do you define successful aging? There are textbook definitions, but it’s a fair guess that we all know it when we see it. 

The ability to age in place is one of the most common themes of successful aging. When I’m not writing for the Silver Century Foundation, I work as an independent-living consultant. I help people stay in their homes—even a downsized home—for as long as possible. My tasks run the gamut from bill paying to property management, from interfacing with health care providers to keeping pantries stocked. I help clients remain able to navigate their homes even if they do not drive. (Mobility is another piece of successful aging.) 

My clients have sufficient wealth to maintain comfortable lifestyles. This relieves many of the challenges older people face and provides access to services that those with a low income may be denied. Yet what I’ve seen makes me wonder: financial security definitely enables people to age in place, but does it guarantee successful aging? 

One client is a widow who lives in a large home with a big yard and a live-in caregiver. She developed depression after her husband’s death several years ago, so her sleep schedule is out of whack and she’s prone to falling from tiredness. She has a yoga instructor, fitness coach and massage therapist who come to the house. She enjoys their company but doesn’t care for the exercise. An accountant and financial advisor also come to her. She was once gregarious and outgoing, but her friends—who no longer know what a good time would be to call—have stopped calling, so outings are limited to adult children and grandchildren. 

Another client is a brilliant woman whose husband has in-home hospice care. The couple always put careers first and never established a social network. They do not have family nearby. Their combined resources allow for unlimited support, including 24-hour caregivers, a housekeeper, a daytime caregiver/driver, a hospice nurse who comes on a schedule, a concierge doctor who visits and an omnipresent array of handymen. They have vacation properties they haven’t visited in years. I’m there to interface with the accountant and pay bills. My client goes out to physical therapy and to medical specialists. She feels her memory is too impaired to keep up with former professional colleagues, so she has no social life. Indeed, the staff, myself included, provide all of her conversation at this point. 

Are these women aging well?

By way of contrast, I assist Tom,* who has an intellectual disability and shares an apartment with Mike,* who has autism. They live like messy adolescents. They spill, forget to clean up, clog drains, break things and leave windows open when the heat or A/C is on. But they abide by their budgets, shop and prepare their own meals, use public transportation and come and go as they please. They both have hobbies and enjoy going to local athletic events and holiday gatherings with family. Both Medicare-eligible, the men work low-skilled, minimum-wage jobs five days a week. Their work gives them social contacts and a reason to get up in the morning. 

Who’s aging better?

I know other older adults whose astute financial planning affords them enviable opportunities in later life. I know women in their 70s and 80s who can take up bridge or go on long hikes if they’re so inclined. But when I consider how financial security impacts older people, it’s surprising to see that even with great privilege, aging well is not guaranteed. To age well, perhaps, is to remain relevant; it requires full participation and a level of emotional and physical health. 

I want my own later life to have purpose, good company and a fully stocked bookshelf. 

*Names have been changed to protect privacy

Remembering Life in Lockdown

I hope people living in the time of the coronavirus are journaling about their quarantine. Our memories are often distorted by time, and our memories are singularly ours to recall. 

What will my grandchildren want to know about this unprecedented time? In my journal, I’d write that I’m among the very fortunate right now. I’m healthy and so are my loved ones. If everyone over 60 is at a higher risk, count me in; ditto for anyone compromised by underlying health issues, as I’m carrying excess weight that I cannot attribute to quarantine. Medically speaking, I’m in good health; I have no chronic conditions and a remarkable immune system. I’m not denying my age as much as that I don’t feel like someone who is high risk. I’m a susceptibility denier. 

My future grands might wonder who I’m quarantined with. I’m sheltering in place with my daughter, Nelle, who was sent home from college early. I’ve come to love my empty nest, but Nelle is good company and we both value our solitude, so it’s working out. I can’t speak for her, but I’m loving this time together.

Did I lose my job? No, my work for Silver Century entails reading and writing about aging, which I do from home. My other work is caring for older adults who need a little support to stay in their homes. I have clients counting on my help to navigate the lockdown remotely, like with a little shopping or a car repair. I also have uncompensated but challenging work for the school board. Nelle’s college classes take place in the home office now, but we easily reconcile shared space. 

What do we do for fun since restaurants and movie theaters are closed? Nelle and I do jigsaw puzzles, play board games and try to remember rules to childhood card games. The best enhancement to the quarantine has been the absolutely glorious weather we’ve had in New Jersey. Our house has a wraparound porch that never translated to the repose and enjoyment one imagines. We’ve gotten more mileage out of that porch in lockdown than in all the other years put together. It feels like time stands still out there. And we walk the dog. 

We talk to my older daughter, Mariefred, who lives in Baltimore with a roommate, Daysi. They both telecommute to full-time jobs, but their part-time restaurant jobs shut down. Both young women are separated from family and, maybe harder, boyfriends. My daughter is considering hiring a rental car when that’s a possibility—public transportation is too risky for visits home or to her boyfriend. She worries she’ll be putting me, or those in my care, at risk if she comes home, and interstate travel is ill-advised right now anyway. I can’t be with her. It’s hard. 

If I wanted those future grandchildren to know how I survived the pandemic without losing hope, I’d want them to have this advice: stay connected, find joy in the simple things, get outside and keep mind and body active.

 

Track Your Zzzzs

I have joined the 17 percent of American adults over 50 who wear a smartwatch or fitness tracker to monitor their health. This purchase brought an eye roll and a snicker from my young-adult daughters, who know how much I hate to exercise. I don’t own a pair of yoga pants or a sports bra. Not a sneaker in sight. So, what would possess me to join the movement? (Pardon the pun.) I’m using my FitBit to track my sleep. 

In the last few years, I’ve noticed a change in my brainpower. Not only do I enter a room only to ask myself why I’m there, or lose the name of someone who was just introduced to me, I no longer seem to hold multiple thoughts in my head simultaneously. For instance, I regularly leave the house without everything I need. I’ll thoroughly prepare for a meeting, then honor my inner Girl Scout by bringing tissues, cough drops, extra pens and a safety pin—but leave my meeting notes on the counter. I sometimes find myself a few beats behind in a conversation and need to have something repeated, not because I don’t hear well but because it didn’t register. And most days by 5 pm, I really want a nap.

As a contributor to the Silver Century Foundation, I read a great deal about the aging brain. Our brains don’t lose the ability to make new cells as we get older, so I don’t have to take memory lapses lying down. Or, in my case, I should take them lying down because not getting the proper amount of rest is often a reason for lack of focus. Enter my new wrist accessory, which monitors sleep and costs about the same as a visit to my doctor.

After a week of wear, I had a good idea of my baseline sleep time, which was about 80 percent of my goal of eight hours a night. Not only am I sleeping fewer hours than I would like but I am also getting less deep sleep than is optimal.

To get more (and better) sleep, I need to make some changes. I freelance and usually start my workday late. In the three years since my younger child went off to college, my default alarm has been my dog, but several mornings a month I need to rise and shine for a meeting or a breakfast date. I have to find a way that an earlier wake time won’t leave me feeling sleep deprived. My FitBit has alarms that can remind me to go to bed and get up at the same time every day. A regular routine like that can improve sleep. 

I’m also aware that environment plays a big role in whether we enjoy quality sleep, so I put my phone away 30 minutes before bed and read paper books. There’s no TV in my room, my bed is an oasis of cloud-like comfort and I keep the thermostat very low.

My FitBit offers more health benefits than sleep tracking, and I’ll share them in future posts. First, I plan to share my sleep log with my doctor, but if she suggests I sleep without the dog, I’ll switch doctors. 

Curry Adds More Than Flavor to Your Life

Isn’t it fabulous to discover that a food we enjoy is actually good for us? I’m thinking of curry in its many iterations. (It’s not always about you, chocolate.) 

American diets have been globally influenced since I was a kid in the ʹ60s. A recipe that my mom had included chicken, green pepper, canned pineapple and just a dash of curry powder—that was all our unsophisticated palates could handle. Even the color was new to us! 

I have to laugh at what passed for international cuisine back then. In the last few decades, my community has welcomed many more Asian families, and now we have some great Indian restaurants to choose from. Now I love so many curry dishes, from a vindaloo to a coconut-based korma. 

As it turns out, my addiction may have health benefits. Curry is a blend of super inflammation fighters—turmeric, chili powder, coriander, cumin, ginger and pepper. These spices are heart friendly and antioxidant rich. There’s science to support that a diet high in anti-inflammatory foods can reduce joint and muscle pain that may increase as we grow older.

With less pain, we’d likely feel better about exercise and maybe even enjoy hobbies that went by the wayside because of stiffness and discomfort. In addition, we now know that chronic inflammation has been linked to several diseases and conditions associated with aging, including some cancers, rheumatoid arthritis, dementia, diabetes and heart disease. Diet plays a major role both in causing inflammation (particularly from a high intake of sugar, trans fats and refined carbs) and in reducing it when we change our eating habits to include foods like curry.

And curry may do even more than fight inflammation. It may also help lower blood sugar and improve brain health. You can read more here.

You can buy curry powder at any store that carries spices, but a great thing about curry is that you can make your own to taste, allowing you to adjust the heat to whatever you prefer. If you’re not already a fan, you may want to try it for your health. To get you started, here are five family and budget-friendly recipes, with no canned pineapple in sight.

Doing 60 Around Town

 I’m a healthy, engaged, purpose-driven woman in my 60s. I consider myself an empty nester; one daughter has moved out of state and the other is in college, so it’s me and the pets. And I’m fine with that. Really. Don’t get me wrong, I’m not antisocial, and I do want to be invited to parties and group dinners out. I do want to see where my daughter is studying abroad. I just don’t want to go.  

I was widowed when my kids were 6 and 8, and I believed I needed to do the work, and put in the time, of two parents. And I did, no regrets. I allowed people to think of me as a helicopter parent and did nothing to dissuade them. Life as a single mom was intense, unrelenting and lonely. I was as active and attentive as any parent you’ve ever met. I worked a couple of part-time jobs so that I could attend school functions and sporting events. I coached, camped, cheered, baked. I did everything moms from two-adult households did and more. I went out to dinner where my daughters wanted to go, saw movies they wanted to see, took them to the farm every summer—their dream vacation. Our shared memories are priceless to me. I’m not feeling old, not feeling tired. I feel semi-retired from parenting, and I’m content.

Before my husband and I married, we traveled. A lot. I was in my late 30s, he, 20 years older; we seriously considered having stamped passports a viable alternative to having children. 

Now, friends and family are scattered around the country, and still, I don’t feel compelled to pack my bags. I am happy for childhood friends who are hiking the Appalachian Trail or kayaking the Colorado River in retirement. It’s just not for me. I’m not in a financial position to retire. I enjoy my work for the most part, and serving on the board of education and my other volunteer activities are very rewarding.

I don’t feel compelled to embody someone else’s idea of what their 60s should look like. Run a 10k, run a company, run to the airport, if that’s right for you. For now, staying closer to home feels just right to me. 

Books to Give or Keep, 2019

There’s no place on Earth I’d rather be than in my reading chair with a good book and a cup of tea. I think in a previous life I was a matchmaker because now I love to match people with their next great read. As with my earlier, year-end suggestions, each of my picks connects to aging, from midlife on up. 

One of my favorite feel-good books this year is The Lager Queen of Minnesota (2019) by J. Ryan Stradal. The story follows two sisters on divergent paths who both age into poverty—one scraping by on limited income, the other bereft of human connection. While Edith has a track record of making friends and making do, Helen‘s singular focus was becoming a success as a brewmaster. At its core, this is a family saga full of hurts and hopes, with the clear takeaway that you cannot underestimate the power of women who have succeeded in life for over 80 years. Cheers and tears. 

A crime-fiction enthusiast will appreciate the 17th installment of Lawrence Block’s Matthew Scudder series, A Time to Scatter Stones: A Matthew Scudder Novela (2019). Scudder has aged since he debuted in 1976, and his candor about his decline is entirely relatable: aching knees, waning stamina. He’s a long-retired cop married to a retired hooker he met on the job, and if you can handle the often-risqué subject matter, you’ll appreciate how they use their unique resources to stop a nasty pervert who’s threatening a friend. You won’t need to read the previous books to enjoy this one, but you may decide to go back for more. 

Emma Donoghue returns with an absolute gem, Akin (2019). Approaching his 80th birthday, Noah is preparing to return to France for the first time since he was a little boy when he gets a call out of the blue. Noah is the closest relative to 11-year-old great-nephew, Michael—whom he has never met—and who is in immediate need of a suitable, temporary home, lest he end up in foster care. With nowhere else to turn, Noah resigns himself to taking the grieving and sullen Michael along to France, for Noah’s long-planned trip is booked and he’s determined to unearth his family history. With Michael’s tech proficiency and Noah’s wisdom, they begin to understand the shortcomings and misunderstandings that come with assumptions and secrets. 

If you’re a sucker for an Irish brogue, you’ll be absolutely mesmerized by the audio of Anne Griffin’s When All Is Said (2019). We can only assume it’s equally good to read. In something like a farewell address to his son, 84-year-old Maurice Hannigan sits in the hotel bar telling his life story with a toast to each of the five most important people in his long and successful, if imperfect, life. His grief is palpable, his candor, remarkable. Later that night, Maurice plans to join his recently departed wife in the ever-after, but the story isn’t grim; rather, it leaves you thinking about the people in your own life who’ve made all the difference. Both moving and satisfying. 

We all miss the comic strip Cathy. In Fifty Things That Aren’t My Fault: Essays from the Grown-up Years (2019), creator/alter ego Cathy Guisewhite, now 69, riffs on her parents, downsizing, wardrobe and everything we’re likely to be going through as women in our later years. In the exact same way we related to Cathy as the burgeoning feminist and good daughter, this laugh-out-loud book makes you feel you’re in the company of an old friend and, sometimes, a mirror! 

To round out my suggestions, Hey Grandude! (2019) is a children’s book by the legendary Paul McCartney. Grandude and four grandchildren go off on merry adventures, each sparked by the chant, “See the compass needle spin, let the magic fun begin!” The needle spins, and around the world they go (with a guitar, as if I had to tell you).

I hope I’ve given you books to give or keep that will be warm on a cold night, provocative in a good way and rewarding. As always, I welcome your suggestions for my 2020 reading list.

Divorced by Night

While visiting a friend who was convalescing postsurgery, I noticed that the king-sized bed she shares with her husband is actually a pair of twin beds under a single bedspread. She says they always go to bed at the same time but don’t go to sleep or wake at the same time. (I see you, headphones.) The two-bed system allows her to have the softer mattress she likes, and they add or remove blankets to suit their personal thermostats. She says it saved her marriage. 

I like to joke that I have a 22-foot bed: four cats, one dog and me. Given that fact, I can’t claim to sleep alone, can I? But I have been out of a marital bed for over a decade. I sometimes miss the snuggling, but no one hogs the covers. My bulldog snores, but I’m used to it; my restless legs irritate the cats, but we manage. I believe that if my living situation changed to incorporate a human, I might want to keep my own bed. I’d be in good company.

I was surprised to learn that many couples sleep apart, having found that they simply sleep better in separate beds or even separate rooms. For some, it’s not just falling asleep in a shared bed that’s a challenge but staying asleep. Many people my age and older get up to use the bathroom during the night. The bed’s movement and lights going on could disrupt someone else’s good night’s sleep as well. And snoring can be an issue. That happens because as we age, we tend to lose muscle tone in our upper airways and gain weight in the neck area, due to lifestyle changes or menopause. If it’s your partner who snores, you may no longer be able to sleep through it as you did when you were younger. Snorers often rely on machines that in themselves make co-sleeping a feat. 

We’re learning more about the importance of quality sleep. When sleep is compromised, that impacts the way adults function and their cognitive performance, and it can take a toll on mood as well. Getting seven to nine hours each night is recommended, with studies showing improved health, including a reduction in cardiovascular disease, stress levels, inflammation and depression. Your body is better able to regulate appetite, repair itself and keep a positive attitude.

Some couples choose separate sleeping spaces for weekdays but not weekends, which may be better suited for intimacy. A nightly uncoupling could be just what your relationship needs to reignite a longing for one another. It’s hard to feel romantic when you’re exhausted. 

As for me, I’ve noticed that some mornings when I awake, my dog has left the bed for the living room chair. I guess my snoring is keeping her from a good night’s sleep.

Got Milk?

I’m an empty nester, but my chicks still come home. When they do, they give me a heads-up so I can “feather” the nest with the foods they like. Gone are the days with a fully stocked larder. I shop for one and I’m mindful of the food I waste. The girls were surprised that one thing I no longer buy regularly is milk. That’s partly because when they come home, I need to inquire what type of milk they drink now. The dairy cases have changed, and my young women’s tastes have too. 

Why are people down on cow’s milk? It is a remarkable food. According to Healthline, one eight-ounce glass provides almost every single nutrient a human body needs. Because of the calcium and protein in milk, it’s beneficial in promoting bone health, and studies show a correlation between milk consumption and lower blood pressure, both important to aging bodies. 

Today, the grocery shelves are chock full of alternative “milks” made from nuts or plants. A person may go dairy free for any number of reasons, including lactose intolerance or a need to reduce cholesterol or fat intake. People also choose nondairy milks because they are vegan or they want to stick to cruelty-free products. 

If you’re unable to drink milk as you age but worry about sacrificing health benefits, you’ll want to look for “enriched” nondairy alternatives that have added vitamins and minerals. They frequently contain added vitamin D, calcium and protein, making them similar to regular milk in nutritional content.

Of the nut milks, almond milk is probably the most popular. While low in protein, it’s high in vitamins and nutrients. Almond milk is slightly sweet, nutty and creamy. Many enjoy it straight from the glass, in coffee or poured over cereal. Almond milk can be used in most recipes, but given its sweetness, you may prefer to reserve it for desserts and smoothies.

Soy milk has the most protein of the nondairy milks. This may be the best choice for older adults, up to one-third of whom don’t get enough protein to aid in preserving muscle mass. Rich and creamy, soy milk is good for drinking straight from the glass, for cereal or in coffee. The taste is nutty and slightly sweet. When it comes to cooking, soy milk is one of the best milks to choose. It can be used in place of cow’s milk in almost any recipe. 

Rice milk is not as thick as other nondairy milks and is not as good for baking. It is made by blending boiled rice with water and adding some type of sweetener. It has a light, sweet flavor but it’s not the nutrition powerhouse of other milks.

Flax milk and oat milk are plant-based options. Flax oil and water, or oats blended in water, produce lactose-free, cholesterol-free beverages for coffee drinks, cereal and smoothies. 

How do you know which milk you’ll like? One complaint I hear is that you need to buy a half-gallon to sample, with no way to really compare milks without a financial commitment. 

There’s talk at the FDA about whether these items can be called “milk” at all, but new nondairy substitutes are showing up all the time. I would still prefer to dip my Oreo in icy-cold cow’s milk, while my daughters use nondairy in their coffee. Either way, if Starbucks has oat milk, it’s gone mainstream.

Talk to Me

In my work as an independent living consultant, I support people who need a little extra help to stay secure in their homes. Most of my clients are older adults. Being a helper-bee at heart, I find the work very rewarding, and I form deep connections to those in my care. 

I recently looked for an evening companion for one such client. She had just suffered a severe blow to the head along with a broken nose. She was neither immobile nor in need of any personal care; she wanted to have someone in her home while she bathed and got into bed. She is great company, interested and interesting; the home is lovely, the compensation more than generous. A companion can bring a book or watch television—the only challenge is to make sure she doesn’t fall asleep anywhere other than her bed and to respond in the unlikely event she slips in the bath. 

I pulled up my list of college students and posted a job description. Not one replied. Babysit? Yes. Dog-sit? Yes. Elder care, not so much. And that’s troubling. 

I tried to get to the root of the aversion to passing time with a septuagenarian, and sadly, the common refrain was that the young adults didn’t know how to talk to an older person. What would I say? What would we talk about? We would have nothing in common. Why would young people be so scared that they couldn’t to talk to older people? The answer, I’m afraid, is ageism. 

There’s a lot of missed opportunity if we can’t enjoy the company of someone from another generation. Years ago, I was reluctant to put my toddler in a preschool staffed by teenagers. It had been a very long time since I was in the company of anyone in that age bracket, and I wrongly assumed the worst of all teens based on stories that made the nightly news. How shortsighted of me. Now the mother of young adults, I welcome the chance to learn from a different life experience and perspective, but with the shoe on the other foot, I wonder if they feel so welcoming toward me. Ageism can be a bias we don’t see in ourselves, and it can impact relationships at any stage of life. 

How can we encourage intergenerational dialogue? Here’s what I do. I consider many conversation-starters to be universal, like weather or food, but to make conversations meaningful, I like to go deeper. I avoid starting with a question that requires philosophical thought or that will elicit just a yes-or-no answer, and I tread carefully around politics, war and, sometimes, family. Instead, I may ask about people’s taste in music, a favorite song or if they played an instrument. Or about a person’s first home away from parents and how that new-found independence felt. I might bring up a first trip, a book that everyone should read, childhood heroes. Around the holidays, my go-to question is about the best gift the person ever gave. That’s a keeper, because it’s an unexpected twist that can generate good memories. 

We are living in an era where many older adult lives are cut short due to loneliness. Social isolation is a public health crisis. What will it take to engage one another in what could be so mutually beneficial? 

I’m available for anyone to practice. Maybe over coffee.

Pain in the Neck

Do you wake up in the morning feeling like you “slept wrong” because you have a crick in your neck?

If you experience neck pain, you’re not alone. It’s most often attributed to neck arthritis, or cervical spondylosis, an age-related degeneration of the spine, and 85 percent of people over 60 are affected. The neck pain some people experience is debilitating, while others have few symptoms beyond a tingling, pins-and-needles sensation.

When I wake with the feeling that I can’t turn my head, I usually blame my pillow. But the causes are as varied as the discomfort levels. I read in bed and spend a fair amount of time looking down at my phone or sitting at my desk, bent over the keyboard. Holding your head at an unnatural angle over time will cause neck pain. Stress, inflammation, poor posture, genetics and occupational hazards all take their toll on neck health. But spondylosis is joint damage that comes from wear and tear and age-related degeneration of neck bones.

To understand neck arthritis and the part aging plays, it helps to know about the cervical discs and back ligaments. The Mayo Clinic website explains:

Dehydrated discs: Discs act like cushions between the vertebrae of your spine. By age 40, most people’s discs begin drying out and shrinking, which allows more bone-on-bone contact between the vertebrae.

Herniated discs: Age also affects the exterior of your spinal discs. Cracks often appear, leading to bulging (herniated) discs, which can press on the spinal cord and nerve roots.

Bone spurs: Disc degeneration often results in the production of extra bone in the body’s misguided effort to strengthen the spine. These bone spurs can pinch the spinal cord and nerve roots.

Stiff ligaments: Ligaments are cords of tissue that connect bone to bone. Spinal ligaments can stiffen with age, making your neck less flexible.

Most neck pain doesn’t stem from anything medically serious, so it can be safe to try self-care strategies before seeking medical help. Over-the-counter pain relief and massage are options, and experts say an ice pack wrapped in a thin towel is best for immediate relief. However, if your neck pain is so severe you can’t sit still, or if it is accompanied by fever, pain shooting down an arm or loss of sensation in your hand, contact a medical professional right away. A heart attack can cause neck pain, and severe symptoms could be a sign of something very serious, so trust your instincts if you believe you have more than a routine neck ache.

But for “normal” neck pain, WebMD offers some stretches that will loosen up that stiffness. When dealing with age-related cervical spondylosis, your best defense is a good offense: move frequently, don’t sit in one position for too long, sleep on a pillow—yes, only one—that supports your head and neck, and be mindful when carrying heavy handbags and weighty objects that pull on your neck, like toddlers. Or dogs. (I’m looking at you, Maisy.)

Living Longer with a Pet

We bought a puppy when the girls were small, and she was the perfect dog for us. I didn’t think I’d get another dog after she died. I wanted to be able to come and go worry-free. But as the first daughter’s college departure came closer, I anticipated the impact of her absence and knew I’d miss feeling needed. I started to look at Petfinder.com on a regular basis. The new puppy, Maisy, instantly became the love of my life. If you’re a pet person, you get it.

For older adults, pet ownership is proven to lower blood pressure and to lessen depression and feelings of loneliness. Residential care facilities are incorporating pets or farm animals as therapeutic assistants. Many people know of Oscar, the nursing home cat, from the bestselling book Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat (2010). Even caring for chickens can help older adults get a new lease on life.

Studies show that owning a dog, in particular, is linked to a longer life and may lower the risk of heart disease. Getting out for walks, even at a moderate pace, benefits heart health. Maisy isn’t likely to encourage me to exercise. In fact, she hides when I show her the leash. But every day, after she has relieved herself and plops down on the step, I see neighbors walking dogs; I wave and say hello. I’ve met people with dogs I’d have missed otherwise. I do take Maisy to the dog park and outdoor events where having a dog is a guaranteed conversation starter. And making new friends is a given if she’s out in her stroller. Don’t judge! One hot day, when we were not too far from home, she sat down and refused to budge. Too awkward, heavy and hot to carry, she made me wait her out. I ordered a stroller that afternoon. She loves to sit in it and I get my walk.

In addition to Maisy, I have four cats, each with her own personality. Because they make me happy, I endure the nasty litter boxes and the never-ending call to scoop. With that comes the need to buy litter—lots of litter. They use enough litter and eat enough kibble that I now buy cat and dog supplies online and have it delivered. While not always cost-effective, I buy bags and boxes that weigh under 25 pounds. They’re just easier to lift. I know folks who buy pet health insurance, but it’s expensive, so I keep a little money aside for an emergency.

Pets can be a nuisance—even dangerous when underfoot. I make Maisy precede me on stairs because she could knock me over. On more than one occasion, I’ve tripped over a cat. When I see my neighbors walking their dogs in inclement weather, especially at night, I worry that they might slip and fall. It would be so much safer to have a fenced-in yard.

But having a purring feline on my lap is more calming to me than ocean waves, and studies show that petting can release the hormone oxytocin, which relieves stress. As I write this, I have two cats sleeping on either side of me. In an attempt to keep kitties off the keyboard, I emptied two desk drawers and cushioned them. Like babies, they’re so sweet when they’re asleep. And if I can’t find them? They’re probably up to no good. I’ll hear a crash soon. You need a good sense of humor to have a houseful of critters.

Their antics make me laugh and I’m never lonely. They’re totally worth it.

Reading by the Numbers

I’m off to the family reunion this weekend, and along with the burgers and dogs, I’ll be bringing my list of books to share with the cousins. The reunion has been going strong for many years—so long that I’m no longer one of the kids but one of the matriarchs.

My family has a lot of readers. After the usual catching up, we talk about a book or two we’ve read (Florence Gordon, 2015), an author we discovered (Fredrik Backman), a plot that kept us up at night (Moving Day, 2014) or a memoir that got us through a rough patch (Can’t We Talk About Something More Pleasant?, 2016). So at our last reunion I was caught by surprise when I heard several contemporaries say they weren’t readers anymore, no longer finding the pleasure in it that they did when younger. The common themes seemed to be aging eyes, too tired to read, or reading was putting them to sleep. It made me wonder, is my family alone in this shift?

According to a Pew Research study from 2014, we do indeed read less as we grow older: younger adults (18-29) are more likely than their elders to have read a book in the past 12 months. While 80 percent of that age bracket read a book, only 71 percent of those 30-49 did so. Dropping slightly from there, 68 percent of adults 50-64 and 69 percent of those 65 and older read a book in the year’s time frame.

If you’re reading less because you’re falling asleep with a paperback, consider joining the one-in-five who listen to their books. I love my Audible account. I get one title for $15 a month—more if I want to pay extra. I listen on my phone with my earbuds, usually when I’m doing laundry or puttering around the house. I also try to have a book on CD for the car. I get those free from the library.

To stay awake, I suggest that you sit up (don’t get too-too comfy) in a room that’s not too warm. Find something to read that you truly enjoy; don’t feel it has to be what everyone else is reading. And you have my permission—if you don’t like the book, don’t finish it. Read whatever makes you happy.

As for my family of readers, it’s been a joy to bear witness as my young cousins became young adults and now parents themselves. I’ve been close enough to be invited to many a baby shower and, invariably, the request goes out to help build the child’s library. I’m a reader, so you can imagine how happy this makes me. My college-age daughters enjoy buying their infant cousins a treasured title from the bookshelves of their youth, and often they’ll include a warm inscription, detailing a memory of what the book means to them.

If you’re looking for some terrific book recommendations, we have many suggestions at SCF: fiction where older people are dynamic protagonists, and nonfiction to help you learn about growing older. We’ve even identified books for children that depict aging in a positive light. So move over, ketchup and mustard, I’m bring the reading list to the reunion. (And, hopefully, bringing some new book leads home!)

Organizing Your Documents, Part 1: In Case of Emergency

When I’m not working for the Silver Century Foundation, I help families with care management solutions. Most often, this involves meeting with an older person and a family member to coordinate resources that help my client continue to live independently.

One of the first tasks is organizing important contact numbers and documents. Over the years, I’ve created a process that I believe could help you, or someone in your care, do the same. I’d like to share my process with you, starting with how to deal with emergency contact information. (I’ll cover other areas of need in future blogs.)

Are you familiar with the acronym ICE? It stands for In Case of Emergency and provides critical, personal information in situations where you can’t speak for yourself. Most first responders—police, firefighters and EMTs—are trained to look for an ICE card in your wallet, in the glove compartment of your car or on the refrigerator. Using one of the many links available online, you can easily make ICE cards for yourself and give them to every member of your family. I also made cards for my daughters with their own information, to keep in the glove compartments of the cars they drove.  

This is a case where “old school” is better, so I suggest keeping a paper list of your emergency contacts. It’s a good idea to have ICE contacts designated on your cell phone as well. PC Magazine offers a helpful article that shows you how to add ICE numbers to a cell, so they can be accessed even if the phone is locked. Some phones are easier than others.

Who should be an ICE contact? Two or three people will suffice, usually someone who lives nearby and a family member or two. I have my daughters as mine, along with a local friend who knows how to reach family, has a key to my home and would let the dog out if necessary.

Choose people who would recognize a fraudulent call if they received one and who know what you would need to have done in an emergency. When you pick your ICE contacts, don’t forget to tell them—make sure they are comfortable with the role and won’t be surprised in an emergency. I also have my primary care physician’s name and phone number on my card. There’s room to note allergies and organ donor wishes.

In my cell phone contacts, I add the letters ICE to the person’s information under Company Name (your cell phone may have a different category title). That way, if someone wants to search for my emergency contacts, those names come up together.

After getting ICE all set up, I organize the client’s emergency health information. The key here is to always keep it current. I suggest to my clients that they carry a list of prescription medications and dosages in their wallets (and that they update it when any changes occur).

On the refrigerator, I hang a File of Life, a magnetized pouch that holds the following information: street address and cross street (for calling an ambulance); home phone; date of birth; names of doctors; lists of medications and allergies; and, of course, ICE contacts. If there is more information you feel a first responder should know, put it in the file. For instance, when my husband was living, I identified him as a person with a pacemaker. I have my veterinarian’s number in the pouch as well.

Something to consider: adding your homeowner’s insurance contact information to your list could be very helpful in case of an evacuation, along with proof of pets’ vaccinations to get you into a shelter with Fido.

Check with your local government or first responders to see if they can provide an official File of Life. If not, you can label a large ziplock bag as such, fill it with your documents and hang that on your refrigerator.

Congratulations, you’ve begun your emergency preparedness plan and hopefully gained some peace of mind. Coming soon, part 2: organizing a master file of important documents.

Books to Give or to Keep, 2018

I am an unapologetic bookworm, and it’s that time of year when I’m asked to recommend books for gift lists. My first love is fiction, but I enjoy deviating for an interesting memoir or something new in nonfiction. Each of my picks connects to aging, from midlife on up.

We humans are living longer. We’ve seen the sandwich generation move to the club sandwich, as we care for not only parents and kids but grandparents and grandchildren, all at once. Is it any wonder we’re stressed out? In My Parent’s Keeper: The Guilt, Grief, Guesswork, and Unexpected Gifts of Caregiving(2018), social worker and vice president of senior care services at Care.com Jody Gastfriend delves into the challenges of caring for parents with declining health that impacts their independence. Drawing on 25 years in elder care, Gastfriend leaves no possible situation unaddressed, discussing the basics of dementia care, working with institutions, supporting families in distress and the future of caregiving via technology and robotics. Pitfalls and rewards are covered in equal measure.

After a five-year hiatus, humorist and essayist David Sedaris returns to the bestseller list with Calypso (2018), ruminating as only he can about family and aging (he’s 62). Those new to Sedaris’ writing will be quickly brought up to speed about his siblings, his dad (now in his 90s) and his late mother—whose influence continues long after her passing. Returning fans will find this essay collection as insightful, biting and funny as ever, if a bit darker at times. Facing his mortality, perhaps? If you love an I-can’t-believe-he-said-that moment, this is the book for you.

I stumbled upon a children’s book, for ages four to seven, that is pure treasure to anyone hoping to introduce positive images of aging to the very young. In Goodnight Whispers (2018) by Michael Leannah (author) and Dani Torrent (illustrator), a loving daddy whispers affirmations to his daughter as she falls asleep every night, reinforcing her best attributes. The ritual cements her self-image and carries her through the challenges of her teenage years and beyond. As an adult, the girl institutes this practice with her own child, and, yes, her aging father. What we say to the very young can be life changing, and the bonds we make, eternal.

We appreciate the air of authenticity that comes from an author the same age as her aging protagonist. Louise Penny came to writing later in life and has imagined for us a credible hero in Chief Inspector Armand Gamache, inspired by her husband, who suffered from dementia and passed in 2016. In Glass Houses: A Novel (2017), the 13th book of a series, Gamache is once again at the helm of the Canadian police force, Sûreté du Québec, after exposing corruption at the top in a previous novel. In his quiet hometown of Three Pines, a mysterious hooded person silently appears, then disappears. When a corpse is discovered, suspicions run wild—so many of the townspeople have something to hide. As in her previous books, Penny’s characters are well written and her plots are page-turners. Bonus: our beloved Gamache will be back before year’s end in the 14th installment, Kingdom of the Blind.

New York Times best-selling author Jamie Ford has another winner with Love and Other Consolation Prizes: A Novel (2017). This well-researched work of historical fiction tells the story of Ernest Young, a mixed-race, bastard child in the early 1900s. He travels alone on a freighter from China to the United States, sent by his mother, who is desperate for him to escape certain poverty and famine. Once in California, he is put in an orphanage, then auctioned to the highest bidder at the World’s Fair, to live as a servant in a brothel.

As a much older man, he is confronted by his daughter, who discovers buried pieces of her parents’ shared history. She feels she cannot talk to her mother, lost to dementia—or might a reminder of long-ago times bring her back? This novel is a story of a husband’s devotion to his beloved wife and the memories they’ve kept between them. It may get you thinking of how you defend the decisions you’ve made in difficult times, or about how you might choose to share the less flattering pieces of your life with your children. Could this book spur you to talk about something you’ve held back?

I hope these books will be conversation starters and a comfort to you or a dear one in the too few hours we have to escape or renew. As always, I welcome your suggestions for my 2019 reading list.

Becoming an Informed Patient

My health care provider admonishes me for my excess weight and lack of exercise, but my lab results have been no cause for alarm. So I was taken aback when she called after my last exam to say my cholesterol numbers—while not in the danger zone—were inching up and that it is more important than ever to make some lifestyle changes.

I wanted immediate information on elevated cholesterol and treatments, so like 93 million Americans, I went online for answers, to hold me over until I could see my doctor in person.

At first I wasn’t sure where to look. Today, eggs are good; last week, they were bad. Is chocolate in or out? Paleo or Keto? I read the lifestyle magazines and get a few health newsletters, and they seem to contradict each other. So how does anyone sort through everything a simple search can yield? How can you judge if it’s out-of-date, incomplete, biased or just plain wrong?

The National Institutes of Health (NIH) offers a guide to finding quality health information online. Start by asking these five questions (suggested by the NIH):

Who runs or created the site or app? Can you trust them?
What is the site or app promising or offering? Do its claims seem too good to be true?
When was its information written or reviewed? Is it up-to-date?
Where does the information come from? Is it based on scientific research?
Why does the site or app exist? Is it selling something?

Most often, health and medical information websites sponsored by the US government, nonprofit health or medical organizations, and university-affiliated medical centers are the most trustworthy. Look for site URLs with the endings .gov, .org and .edu. Drug manufacturers, insurance companies and other for-profit entities could be trying to sell you their products, so when you see .com in the URL, buyer beware.

The Federal Trade Commission suggests MedlinePlus, which is easy to use and very thorough. That’s where I started, to make sure I understood my diagnosis of elevated cholesterol levels. My LDL (bad cholesterol) is on the rise, the probable cause being poor diet and lack of exercise, compounded by menopause. Heredity is a factor; we do have heart disease in the family.

Medline suggests two eating plans for my condition and discusses the pros and cons of statin drugs. Medline also suggests that I ask my doctor about herbal supplements that might help and for guidance on the amount of exercise that is right for me.

I also trust this list of healthy food choices from Harvard Medical School. Popular sites like WebMD and Dr. Oz have similar advice for lowering cholesterol, but sites like those may be beholden to their sponsors and advertisers.

I feel confident that by searching for a reliable source for information, I’m a better informed patient. Now I’m off to have some salmon with oatmeal and watch my LDL drop.

Out with the Old

I was recently given a generous monetary gift to splurge on something that made me happy. After much deliberation, I decided to refresh the long-ignored state of my domicile, to make it a sanctuary for me and the new chapter of life I am embracing as both of my daughters head off to college.

I took a good look around and decided to start with my bedroom. I have an antique, drop-skirt bedspread that I love and I knew I wouldn’t replace that, but the bed itself? Well, that was far past its prime. I could buy a new bed frame with the gift allowance. I’d just move the old bedstead to the basement.

That’s when the inner dialogue began. Why would I keep the bedstead, having just determined it was past its use-by date? Why did I want to hang onto this old, broken frame, and why is it so hard to let go of things?

I remember when I got the bed. I was thrilled to stumble upon it in a secondhand furniture store. Headboard, footboard, sides and rails cost $20. Delivery would be extra, but my car wasn’t big enough to hold it. The shop’s owner told me it was ridiculous to pay $25 to have it delivered, not that she waived the price. The memory of that day, of that argument, will be forever etched in my mind.

I wish I could say it’s the only sentimental clutter I have, but my house is full of it. As I get older, it seems the hold that some items have on me gets stronger. In Real Simple magazine, Julie Holland, MD, an assistant clinical professor of psychiatry at New York University School of Medicine, writes, “Sentimental clutter is the adult equivalent of a teddy bear,” and assures us that wanting to hold on to a meaningful possession is normal.

The advice for letting go ran the spectrum: on one end, take your time, put things in boxes with dates to revisit; on the other end, call the Salvation Army and put it on the curb. Another article suggested removing items with no sentimental value—for instance, in the pantry or bathroom—to get in the disposing spirit. That appealed to me, so I built up some momentum by clearing out the outdated cans and boxes from the cupboards and moved seamlessly to the first aid kit, abandoned hair products and old towels. (Not the holiday-themed fingertip towels, oh no.) I was on a roll. I put the scratched wooden headboard out with the trash at the end of the driveway that night. It hurt.

My new bed frame does indeed make me happy. I like how my bed looks although, of course, now the rest of the room looks more shabby than chic. But I continue to purge, and my house feels more like a home with everything I toss.

Old-Lady Day

Ageism, according to the World Health Organization, is “the stereotyping and discrimination against individuals or groups on the basis of their age; ageism can take many forms, including prejudicial attitudes, discriminatory practices or institutional policies and practices that perpetuate stereotypical beliefs.” You’d think Americans would be more sensitive to openly perpetuating stereotypes and prejudices. Yet apparently older people are still fair game.

Recently, a friend was raving about the fun her preschooler had with a teacher allowing kids to celebrate pajama day, sports jersey day … and “dress like an old lady” day. I won’t apologize for finding that last one offensive. The toddler, I agreed, was adorable but a caricature of an older woman from days gone by: hair in a bun, a cane, a crooked hat and a dress to her shins. I don’t consider myself thin-skinned or humorless but in my mind, this school event crossed a line.

That image hardly fits the older people in my sphere. I have friends in their 90s who don’t dress like that, or rely on a cane, for that matter. What is the message the children and their parents get from this? That older people are all alike in their infirmities, indifferent to their appearances and fair game for mockery.

There are ways to get kids to think positively about the older adults in their communities. Here’s an example: an elementary school in my district invites older adults to read with the children over lunchtime. The mutual respect between the students and their “grandpals” is wonderful to witness. Many of these children will have fond memories of this experience and, going forward, will likely associate wisdom and nurturing with the older people they encounter, not ridicule or contempt.

I can’t change where my friend’s child goes to preschool, but I think I’ll send her a couple of age-appropriate books for her daughter that show aging in a more positive light. You can find some at our children’s-books page.

If we want our children and grandchildren to see aging as the natural and beautiful process that it is, and older adults for the unique, valuable individuals that they are, let’s start things out right from the beginning.

Where’s the Fire (Extinguisher)?

Some 40 million fire extinguishers sold between 1973 and 2017 were recently recalled, prompting me to check not only mine but those in homes where I am helping people live independently. In almost every case, the fire extinguisher was affected by the recall. The Consumer Product Safety Commission (CPSC) reports that these plastic-handle extinguishers become clogged and/or require a very good grip to activate. Hundreds of fire extinguishers failed when necessary, causing many injuries and property damage, and one death has been reported.

Now is a good time to check yours. It’s easy and could save your life.

Here’s how. First, check to see if you have the Kidde brand. I snapped a photo with my phone so I could enlarge the tiny print. Then I looked at the label to see if mine was on the list of recalls.

If your model is listed, you can call Kidde at 855-271-0773 from 8:30 am to 5 pm ET Monday through Friday and 9 am to 3 pm ET Saturday and Sunday. Or you can go online at the Kidde website and click on “Product Safety Recall” for more information.

I chose to make my claim online. I clicked on the “plastic handle” option, but if you have a “push button” extinguisher, choose that. I entered my contact information and, on the next page, entered the model number, which is located under the UL logo. You can use the drop-down menu or put your model number into the search bar. Then you’ll enter the serial number to the left of the model number next to the NO.

That’s it, you’re done. Kidde will send a replacement in two to three weeks, along with instructions on how to dispose of your old extinguisher, although replacements are running behind schedule.

As I completed this exercise I realized that I was most unfamiliar with the device itself. I hadn’t held my fire extinguisher since I wrote a home safety blog a few years ago. I’m embarrassed to admit that I had a very hard time extricating the extinguisher from its wall mount, and I imagined it wouldn’t be any easier if flames were coming from my oven and the smoke alarm was blaring. It doesn’t make sense to have a fire extinguisher if I don’t know how to use it, or if it’s bolted too tightly to grab in an emergency. I’ll consider this my personal fire drill, and I failed. I have promised myself to take the new one for a test drive when it comes.