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.

If the Shoe Fits

Many years ago I worked for a sarcastic boss with a wicked sense of humor. He loved to tease, and even when I was the target, I found him funny. Once, noticing that I had small feet, he said it was because “nothing grows in the shade.” Fast forward a few decades and my feet, with no loss of shade, are no longer so small. When I retrieved a pair of seasonal shoes I had put away, I found they didn’t fit. I pulled out some boots from last year, and same thing. Once a size 7, then 7.5, I was an 8 for about a year, and my new shoes are a size 9. What’s happening to my feet?

At midlife, and carrying extra weight, my feet are succumbing to the perils of living. According to the Arthritis Foundation, each foot is made up of 28 bones, 30 joints and more than 100 muscles, tendons and ligaments. As this complex structure takes a regular pounding, footpads thin and tendons lose elasticity, which can make feet widen. Stuffed into small shoes, big toes can turn inward toward the other toes, causing the joint to jut out into what’s commonly called a bunion. The arches can “fall.” According to WebMD, when the tendons all pull properly, your foot forms a moderate, normal arch. When tendons do not pull together properly, there is little or no arch. This is called flat feet or fallen arches.

I tested my feet to see if this was the issue I faced. I wet the sole of my foot and stood on a piece of heavy paper. The imprint showed most of my foot; a higher arch would have resulted in a larger dry spot in the middle. So my arches are falling—what now? I don’t experience much foot pain yet, but I put my feet up when I’m sitting. I’ll try to support my feet with insoles and, at this stage, I think generic arch supports will do. I found exercises that I can do while I’m sitting and other tips at EverydayHealth.com.

A study at a veteran’s hospital found that three-quarters of the patients—mostly men—were wearing the wrong size shoe. Other studies suggest that 90 percent of women have at least one pair of shoes that doesn’t fit, perhaps because they’ve chosen style over size.

I’m over that. If style were the only issue, maybe I would suffer through sore feet, but I do care about the health conditions that come into play. An article from the Los Angeles Times said:

“Osteoarthritis, rheumatoid arthritis and osteoporosis can pester joints and bones of the feet as well, especially in the big toe, already hampered by tendons and ligaments pulling it up. These conditions can cause damage to bones and joints, and thin bones are more prone to stress fractures.”

Still unconvinced you need supportive shoes? Foot pain could change your gait, forcing you to put weight on parts of the foot that throw you off balance. And that leads to falls.

I’d like to blame my growing feet on years of wearing high heels and poorly made footwear, but really I need to look no further than weight and mileage: I’m carrying extra pounds, and life and career have kept me on my feet a great deal.

So now I choose shoes according to fit, not the size that’s written on them. (This is becoming easier since I can’t find or read the number anymore.) I’ve shopped until I found a brand with good arch support, then I bought a style that was comfortable and came in several colors. I’ll have to add more as the seasons and my needs change, but that just gives me an excuse to shop. Wearing shoes that fit makes a world of difference.

Books to Give or Keep in 2017

Friends all know I’m an avid reader, and it’s that time of year when they ask me to recommend books for holiday gift lists. I primarily seek out new fiction, but I enjoy deviating for an interesting memoir. Each of my picks connects to aging, from midlife on up.

I was fascinated that my daughter’s college freshman class was assigned Being Mortal: Medicine and What Matters in the End (2015). When I was 18, I certainly wasn’t thinking about how people die—even though I was her age when my dad died at 48 in a nursing home. But after watching his father’s death, author and physician Atul Gawande asks if we could be dying better. The advent of improved medicine and life-extending options means those who are terminally ill may die only after years of uncomfortable and expensive interventions—and without fulfilling their goals for the time remaining. Both in his medical practice and when his father became terminally ill, Gawande recognized how ingrained it is for physicians to try to fix and cure, when what is needed is care and a listening caregiver. Now he wants us all to see what he sees: that everyone has desires, needs and goals, no matter how long they have left. Let’s listen.

Don’t we all, sadly, know someone closely tied to a loved one with Alzheimer’s? Just when you think you’ve read all of the books you’ll ever need on dementia and the long goodbye, along comes this glorious novella from Fredrik Backman. And Every Morning the Way Home Gets Longer and Longer: A Novella (2016) is easily the best thing to come to the United States from Sweden since IKEA. Backman wrote this to explore his feelings on familial love and loss. Readers familiar with his work (A Man Called Ove, Britt-Marie Was Here) will recognize his positive portrayals of older adults. Here, on a bench with his beloved grandson Noah, Grandfather realizes his memory is slipping and worries he’ll forget the loves of his life. Understanding what’s at stake, Noah tries to help his grandfather hold on to the happy times. Through a shared love of mathematics, the pair can face infinity and the concept of forever without fear. This gem is sprinkled with illustrations, but it’s the poetry of Backman’s words that creates a visually memorable experience, to be read, reread and shared.

If it seems as though the bookshelves are full of crotchety old-people stories, and you’re left aching to believe that all of us don’t end up curmudgeons, Elizabeth Berg’s The Story of Arthur Truluv: A Novel (2017) may be just what the doctor (or librarian) ordered. Every day, 85-year-old Arthur Moses packs a lunch, leaves his garden and Gordon, his aloof cat, and takes the bus to the cemetery to talk to Nola, his late wife. His only other regular companion is Lucille, an 80-year-old neighbor who still pines over a lost love. In the cemetery, Maddie, an 18-year-old rebel with poor taste in suitors, avoids the bullies at school and a cold father at home. When she hears Arthur talking to Nola, she names him Truluv, and an unlikely friendship forms. Arthur is a found treasure in Maddie’s sad life, and ultimately she gives purpose to his. Soon Arthur and Lucille support Maddie and give her what she’s always craved, while Maddie helps them to live independently at home. Read this one to restore your faith that aging won’t leave you grumpy.

After heiress Gloria Vanderbilt, the “poor little rich girl” of the infamous 1940s child custody battle, has a life-threatening illness at 91, her son Anderson Cooper, the CNN news correspondent, commits to understanding his mother better in the time they have left. What follows, The Rainbow Comes and Goes: A Mother and Son on Life, Love, and Loss (2016), is a year-long email exchange between the two that allows for revelations and unburdening. She exploited the family name; he shunned it. She worked the socialite circles; he, in war zones. Ever the journalist, Cooper delves into his mother’s lonely, privileged childhood, her salacious affairs and multiple marriages, as well as who she was in her professional life far beyond her iconic designer jeans. (I had some!) Deeply personal, at times heartbreaking, the book is full of wisdom and insights on the freedom and clarity aging has brought to her, plus some maternal advice; the mutual affection is clear. A love story, beautifully told.

I’d love to hear what books you would recommend to your reader friends so I can put them on my list in 2018. In the meantime, I wish you a warm, cozy spot, with good light to read, and a wonderful year ahead.

Not Your Mother’s Genes?

I once had a discussion with a friend, who is a geneticist, about his research. Perhaps a bit tongue-in-cheek, I suggested that he rethink his current cell experiments and instead study someone healthy—like me. I consider myself to have an exceptional immune system, passed down from my mother and now, in turn, passed to my daughters.

My mother lived to just shy of her 80th birthday. Granted, it’s not a record, but what is remarkable is that I don’t remember her ever taking a day off because of illness when I was growing up. Like many of her generation, she smoked cigarettes, drank too much (she eventually quit both) and didn’t eat the foods that we now know are good for us. I never saw her exercise and she loved chocolate, but she kept her weight in check and seemed to get enough sleep. I can’t remember anything more than an occasional cold or sore throat. Did she even take a vitamin? I don’t know.

I hope I am not tempting fate here, but I seem to enjoy the same good health. (Hear me knocking on wood?) I have never had the flu that I recall, and I don’t miss work due to illness. My kids are also blessed with good health. Neither of my daughters has ever been treated for strep throat or earaches or had an antibiotic for an illness. I take some good-natured ribbing that my poor housekeeping builds immunity, but who knows why we are spared.

As you might imagine, I felt validated to read that scientists are studying some centenarians to see why they live so long and what protects them from various diseases. I know it isn’t genetics alone that decide one’s fate. Lifestyle choices play a significant role. But I am glad to see that scientists are looking at the healthiest among us for some answers.

Lying to Mom?

A few years ago, a New York Times New Old Age blog had me thinking about my mother’s later-life driving. The blog is about lying to an older person, ostensibly for his or her own good. In one tale, a grown daughter sabotages her mother’s driver’s license renewal to avoid confrontation over concerns about waning driving skills.

My mother lived independently until she was in her late 60s. She drove, but not far and never at night. She had her routine and I had no reason to worry. Then she had a fender bender that bruised her ego. She got back behind the wheel, but less confidently. A second accident—an over-correction on a rural road that took out a mailbox and left her with a gash above her eye—prompted her to ask me to help her reconsider her future in the driver’s seat.

We made the decision together because she worried that she would be a burden and her errands would fall to me. Truth be told, I selfishly enjoyed knowing she had the option to drive if she needed to. I could barely imagine how difficult it would be to give up that freedom, her independence. I worried she would be angry and frustrated when she felt cooped up because she was unaccustomed to asking for help.

But we sat with the adding machine, calculated the money she would save on gas, repairs and insurance, then decided she could give herself that much allowance to hire a driver or to pay for a ride any time she felt like it. Still, it was a life-altering decision, and we both knew there would be hard times ahead.

I have mixed feelings about benevolent lying. I would hope that adult children would respect the wisdom of their parents and choose to tell the truth whenever possible. In hindsight, I’d say my mother and I had it easy compared to friends who were forced to take away keys against a parent’s wishes. It would have been worse if we’d lived apart and I was unavailable to help make and support a decision about driving. Fortunately, my mother’s choice was made before anyone was seriously hurt.

And I never had to lie.

Helping Hands, Joined Online

When you’re coping with the needs of someone who is hospitalized or convalescing, you may wish you could clone yourself to handle everything on your plate. Take heart—a website can become your personal assistant. What’s more, it won’t cost you a thing.

When my friend, Missy, was undergoing aggressive cancer treatment, a mutual friend set up a free account at Lotsa Helping Hands to coordinate meals, rides and child care for Missy’s husband and family. Other friends logged into the account and, like magic, things fell into place. A calendar page listed the family’s needs—rides to school and sports, doctor appointments, errands, meals—allowing us to choose what dates and times we could help. We could include notes to avoid confusion or duplication (“tuna casserole Thursday was a big hit,” “must show ID at after-school pickup”).

In addition, Missy’s friends could see updates on her condition and leave messages. Her husband could post useful comments: “Do not ring the doorbell, baby is asleep” or “Wheelchair did not fit in Prius trunk.”

My fellow SCF blogger, Flora Davis, used CarePages (now defunct) when her husband was hospitalized, to keep his global family and friends abreast of his condition.

Flora remembers, “I posted messages daily. For his siblings on three continents, that meant they could get an update every 24 hours. Best of all, at a time when I was exhausted and busy every minute, I wasn’t getting nonstop anxious phone calls. The messages they left me on CarePages meant a lot to me.”

Others caregiving sites include Take Them a Meal, Caring Bridge and Volunteer Spot.

Caregiving websites aren’t just for those who are ill. I encourage my mom-to-be friends and those with scheduled elective surgeries to set up calendars ahead of time. It could be a lifesaver for you and your family. If you have used a caregivers website you can recommend, please tell us.

Weighty Issue

Are we teaching our children today what they need to know to assure good health beyond childhood and throughout their lives?

Confuse Hamlet with Macbeth and you may not graduate from high school. Forget that pi is 3.141592 and it’s summer school for you. But should not knowing basic health risks also merit a failing grade? This knowledge, over time, could have life-changing consequences unlike anything you’ve forgotten from music theory.

An article at WebMD reports that one-third of today’s teens are overweight and 17 percent are obese but claims parents are more uncomfortable talking about weight than they are about discussing sex or drugs. A study on the PubMed website suggests that parents are not able to see their child as overweight, even when obesity is an issue.

And though doctors want parents to talk to their kids about weight, it seems physicians themselves are somewhat unsure how to motivate parents to do so. According to an article in the Los Angeles Times, doctors must watch how they word a potential problem—telling a parent that a child is “fat” invokes feelings of blame and defensiveness, but using the words “weight problem” could actually spur them to action.

Parents and doctors are key, of course, but I also believe schools can play an important role in helping to curb the growing (pardon the pun) number of teens who are overweight and obese.

Many folks think schools fail in the cafeteria options. My daughter started a new school at age 9. I remember asking the principal about the hardest adjustment she’d have there and was told that navigating the cafeteria was number one. Because at the time it seemed frivolous, I laughed when she said it, but that was the first time my daughter would have freedom to choose how she spent her lunch money. There are healthy choices mixed in among the not-so-healthy, but kids are kids, and they may choose to double up on the ice cream instead of the fruit options—with no parent the wiser. What is the message we send kids when the cafeteria options run the gamut?

Educators of all types are beginning to recognize that they need to step in to teach children how to make healthy eating choices. Former first lady Michele Obama had an impact on kids’ eating choices. She would pop up on the television channels my teenagers watch with her “Let’s Move” initiative to show kids a healthier lifestyle. She even got McDonald’s to add more fruit—and less fries—to Happy Meals. Jamie Oliver, a British chef and television personality, started a foundation to raise awareness about processed foods in our schools and is educating people to make healthier food choices for their children and for themselves.

My kids are both extremely active with extracurricular sports, so their weight is not an issue today. I don’t think they’ll always be quite this active in their 20s and beyond, and as a mom, I want them to understand that they need to be aware of health risks as their bodies change. Better to ingrain good habits now to assure a longer, healthier life.

The Happiness Check

I received a milestone-birthday gift from a dear, longtime friend. It was a generous monetary gift that came with a caveat: I must spend it on myself. No college tuition help, no car repair, no electric bill—I had to spend it on something that made me happy

As I get older, the things that make me happy usually aren’t things at all. My happiness comes from my college-age daughters, who amaze and inspire me. From my friends, my pets and my volunteer work. From reading fiction. So this gift really made me stop to think about actually buying some happiness.

I thought about a spa day or a makeover, a treat I received when I turned 35. I went to Elizabeth Arden in Manhattan. I was the youngest client by a long shot, so maybe it would be more age-appropriate today. My next inclination was to spend the money on a couple of sumptuous restaurant meals that are far, far out of my normal budget, but after deliberation, that left me more hungry than inspired. I decided that the pampering and fancy dinners were just too fleeting to warrant my just-for-me money.

For the last decade or so, since I’ve been widowed, discretionary money has been elusive. I raised my two girls with few of the luxuries our friends enjoyed. And while no one went to bed hungry, other areas suffered, home upkeep being one of them. The house is in need of some attention, yet gutter repair would hardly make me happy. But fixing up the interior? Well, yes, that would fit the bill. Could I actually make my Pinterest home boards come to life?

I know what will make me happy, and that is transforming the too-busy-to-care home into one that will welcome a friend for a cup of tea or a meal to share. Because along with the milestone birthday, I’m entering a new phase of my life: my younger daughter is heading to college, leaving me an empty nester. Letting go of being the hands-on mom and being relegated to mom-from-afar is sad, scary and thrilling. The girls think I could end up isolated or, more likely, filling the house with cats. But I know better.

There’s much to be done now that I have the goal in my mind. I’ll start with a closet cleaning and purge some accumulated clutter. Once the decks have been cleared, I’ll have a better picture of what needs to be done. Maybe I’ll start by sprucing up my bedding or recovering a chair.

I’m already happy, and I haven’t spent a dime. 

Mind Your Qs, Help Your Diet

Is your midlife palate bored to ambivalence about mealtime? Often I lament the ho-hum of my menu repertoire, but I still go back to the tried and true in every food group. But recently, in an unlikely coincidence, I tried and enjoyed two new- to-me foods that begin with the letter Q: quinoa and quark.

Quinoa (KEEN wah) has been around for centuries, dating back to the Incas, but only popular in the recipe books for a few years. I didn’t try it sooner because I thought it was time consuming to prepare, but even with the required prerinse it can be ready to eat in 15 minutes and is available at any grocery store.

Quinoa is called a grain (and by some, “the perfect grain”) but it is actually a seed. It’s “perfect” because it provides high levels of protein and amino acids, has many minerals and is gluten-free. The flavor is a little nutty, and its unique texture is mildly chewy with a tiny crunch. I cook mine in broth and it absorbs flavors nicely. Quinoa can be eaten as a side dish or in a salad or casserole, like rice. You may think of the grain-shaped pasta called couscous when you see quinoa, but quinoa is smaller, not as soft and so much better for you. For quinoa recipes and tips, I suggest Savvy Vegetarian.

My German friends introduced me to quark. As much time as I spend in the grocery store, I had never heard of it! Quark is a fresh (not aged), soft cheese. A little like yogurt or whipped ricotta, it can be on the menu any time of day. I first had quark served with fresh fruit but have since experimented by mixing in savory spices to use as a dip and a baked-potato topper.

In Germany, quark is a dessert staple for cheesecake and other treats. With twice the calcium of cottage cheese, and half the carbs of low-fat yogurt, quark is very low in fat and high in protein. I found it in Whole Foods in tubs in the dairy aisle.

Add a “Q” to your menu this weektell us what you think.

Now Hear This

I love to feel connected and informed—both, keys to successful aging. I no longer get a newspaper and don’t watch much television. I live between New York City and Philadelphia, where there’s no shortage of media outlets, but I get virtually all of my news from the radio. I know—old school. The radio is on in my kitchen, home office and car, not for music but to stay on top of what’s happening in the world and for infotainment. I’m sort of an NPR junkie. The hosts’ voices are as familiar to me as my family’s.

Not too long ago, I lamented to a friend that I had missed half a segment that I found so interesting. “Don’t you listen to podcasts?” she asked. And just like that, a whole world opened to me and I joined the 57 million Americans who listen to podcasts.

Think of podcasts as a library of radio and audio programs you put on your cell phone or computer to listen to at your convenience. Once downloaded, no need for wi-fi. Some are as short as five minutes; others go for hours. You may have heard of the hit program Serial, which was formatted like a docudrama with a new episode once a week for several weeks. (My personal preference is for something more quickly digested.)

Most podcasts are free. There’s no spam and few, if any, commercials. To find a podcast, you can download an app (for example, iTunes, Swell Radio or Stitcher, among many), look on your favorite radio station’s website or google a topic to see what’s out there. You’re going to be astounded at what you find.

NPR’s offerings on aging are very interesting, from an inspiring story on a 105-year-old cyclist to the latest in health or technology for elders, and more. But podcasts aren’t all archived radio shows; some estimate there are a quarter million different ones from which to choose. There are podcasts from names you know and trust, like Jane Gross and AARP. Want variety and topics to add dimension to your conversations? You can pick one from a list promising to make you smarter—or sound smarter, anyway. I like history, particularly if it’s offbeat, so I was happy to find Stuff You Missed in History Class. This podcast is searchable by topic or time period. The history of beer, anyone?

I have been enjoying the portability, variety and depth of the programs I listen to, and I never worry about being caught somewhere with nothing to read. A few swipes on my cell phone or tablet and I have hours’ worth of listening on every subject that interests me. No more sitting in the driveway with the radio on to hear the program in its entirety. 

Whose Vision Problem Is It?

I recently saw a feature in a magazine about an item so intriguing that I was compelled to investigate the retailer’s website. I left my comfy reading chair to go to the computer with the intention of making a purchase. When I got to the website, I found that I could barely make out the product description because of the font and color they used. The print was small and the colors—gray on gray—did not provide contrast for me to read what I wanted to learn. So frustrating!

This has happened to me before, and maybe it has happened to you. Occasionally I have resorted to cutting and pasting to a blank document, where I can manipulate the text so I can read it. But this time, I was miffed, so I emailed the webmaster:

I came to your website intending to buy a product I saw in a magazine but found I was unable to read the light gray text. Please let your design team know that not everyone has the vision of a 20-year-old. It is very hard to read without enough contrast and the text is too small. If you only want to sell your product to young people, please don’t change a thing.

Today, they responded:

Hello Ms. Evans,

Thanks for your email. (Our product) is perfect for everyone and we would never want to exclude anyone from the possibility of enjoying its benefits. We’re sorry to hear of your difficulty with the text on our website and will take your comments into consideration for future redesign.

Best regards,

Autumn

Well, Autumn, perhaps I didn’t make myself clear, because your response to my request for contrast and a bigger font was written in light gray, 10-point Helvetica. In other words, I couldn’t read it.

Lest you think I am being unreasonable by wanting graphic designers and marketing people to cater to my vision challenges, I reached out to a friend of mine who’s an Internet expert. He confirmed that this is really a simple fix—just add the “AAA button, and readers can increase the text size to what works for them. My IT friend says even a very basic website has this capacity. I’m happy to say the SCF website features this option

So, attention, folks selling ideas, services and products: it isn’t hard to make your website easy to read for all of your potential customers. And should you decide that’s not right for your site, I don’t think that I am the one with the vision problem.

Save the Planet, Harm your Family?

I like to think of myself as being more open to new ideas at midlife, willing to change some practices in the name of progress. I have, for example, taken greater personal responsibility in the reduce, reuse, recycle realm.

A few years ago I made the decision to carry canvas shopping bags that I could use again and again. Giving up single-use, plastic bags seemed a simple way to help the environment. I am more in tune with environmental issues in later life than I was when I was younger, although there may not have been the public awareness a few decades ago. But now I think of legacy and what we leave our children, and I want to do what I can, even if it seems insignificant, for future generations.

I really don’t like the waste and ecological impact of plastic grocery bags so I only shop when I have them, even if it means buying another or forcing myself to return home for them. I’ve begun to keep the bags in the car. In fact, so uber-conscious of the bags am I that I have found myself in the store having remembered my trusty totes, my frequent-shopper card and my cents-off coupons—but without my wallet. Is that a “senior moment” or failed multitasking?

But just when I thought I was doing the right thing by never leaving home without my reusable bags, I find that I may actually be doing myself—and my family—some harm.

According to a study reported at eatright.org, I should be washing the sacks I use to carry my groceries home. I should even be using those dreaded plastic bags for meats, to avoid leaks and cross contamination. Apparently, less than 15 percent of us (myself included) take the proper steps to prevent potentially harmful bacteria from growing in our environmentally friendly bags.

Here is what food-safety experts suggest:

  • Wash your grocery tote frequently, either in the washing machine or by hand, with hot, soapy water.
  • Clean all areas where you place your totes, such as the kitchen counter.
  • Store totes in a clean, dry location, but not in the trunk of a vehicle.

I passed this knowledge on to a friend who pointed out yet another no-no I regularly commit in the grocery store: putting produce on the cart’s baby seat to keep it above the heavy grocery items. That is where a diaper may have been. (Yuck!)

So, I’ll be washing my reusable bags, and looking for a place other than the car trunk to stash them. Hopefully, my teenage daughters will embrace this habit as well.

Mom’s Bridge Club

Lately I’m reading a surprising number of memoirs written by adult children about their experiences with their parent(s) as they age. I find myself identifying so often with the authors’ stories, though my parents are no longer living.

So it was with The Bridge Ladies (2016), a memoir from 60-something Betsy Lerner, who finds herself living with her 83-year-old mother, Roz, for a week to assist with her recovery after surgery. They were never close; it seems that anti-establishment Betsy recoiled from most things Roz stood for, not the least of which was the bridge club. And now, 50 years later, Betsy returns to find the bridge ladies are still together. 

Personally, I have fond memories of my mother’s bridge-club friends, although I could be giving it the rosy tint that memory sometimes offers. I’ve asked my siblings what they remember, and we agree; the ladies were terrific, but the ritual must have been hard for my mother, who often felt she didn’t measure up: her wardrobe was ho-hum, her decorating wasn’t current, she wasn’t an expert at the game itself. My mother had lived a charmed life until the Crash, when her stockbroker father lost so much more than his livelihood. I think Mom always felt she deserved more glamor and ease than she got from life. In my father, she found a life partner and a bridge partner. They played socially in different groups for years, but my mother lamented she wasn’t up to my dad’s proficiency. 

When it was her turn to host the bridge ladies, though, she pulled out all the stops. We kids would be guinea pigs for the latest recipe, chosen to impress. Out came playing-card sets that included matching score pads, pencils, ashtrays and cigarette lighters. Linen tablecloths and napkins were ironed crisp for the two card tables. Polished and shined were the good china, crystal nut dishes, silver coffee-and-tea service and sherry glasses. And, yes, the living room was subjected to the dreaded white-glove test.

The ladies would play and eat and laugh. But their ritual lacked closeness, though I’m not sure the women themselves would have thought so. They never talked about anything intimate, never ventured into waters too personal or revealing.

Upon reentry into her mother’s world of bridge ladies, Betsy Lerner observed the same thing. There were life issues not discussed or belabored as they met in each other’s homes. A casserole, a ride, but no sharing of life’s disappointments and unrealized dreams. While she was writing her book, however, Lerner did get the bridge ladies to open up, to discuss parts of their lives they had never shared around the game table.

My mother always thought my generation revealed too much, was too intimate. Like the ladies at Roz’s bridge game, my mother kept so much inside, never sharing her inner thoughts or feelings even with this group of women she saw week after week, year after year. It wasn’t stoicism so much as the times. She often explained, “It just wasn’t done that way.” My siblings and I provided enough angst for my mother to discuss until the cows came home, but Mom’s bridge ladies shied away from the topic of their kids. (I know. I eavesdropped.)

No one in my immediate circle plays bridge, although maybe the book clubs are a modern-day incarnation. Some book clubs are more wine (and whine) than book, but the women forge bonds based on shared experience rather than the simple ritual of meeting. I wonder how many book clubs will stand the test of time for half a century, and how books of my daughters’ generation will judge our rituals.

Books to Give or Keep in 2016

It’s that time of year—when I am asked to recommend books I’ve read to friends who are working on their gift lists. I primarily seek out new fiction, but I enjoy deviating for an interesting memoir. Each of these books connects to aging, from midlife on up.

No matter their taste in books, I think anyone can enjoy The One-in-a-Million Boy (2016) by Monica Wood. Quinn, a professional musician perennially on the road, feels remorse for missing so much of his sweet and unusual son’s too-short life.  As penance, he takes on a Boy Scout commitment his son made and meets 104-year-old Ona Vitkus, a contrary, reclusive woman who has seen more than her share of well-intentioned Scouts. While filling Ona’s birdfeeders, Quinn learns that his son had endeared himself to Ona and had started a recording of her life for a school project. He also discovers his son was a savant, of sorts, when it came to the Guinness World Records, and Quinn takes up the eight-year-old’s quest to get Ona into the record book. Sentimental without ever being sappy, this is a heartwarming, heartbreaking story of friendship and of not knowing what you’ve got until it’s gone. My favorite book of the year.

Phaedra Patrick’s The Curious Charms of Arthur Pepper (2016) is a must-read for anyone who enjoyed the best-selling A Man Called Ove (2015). Arthur rarely deviates from routine: set meal times and same outfit, day in and out. At 69, he’s widowed and shouldering his grief the best he can, choosing to be alone as much as possible. He’ll connect with his adult children, one emotionally distant, the other geographically distant, but he hides from a neighbor who drops in with a meal. His only “friend” is his houseplant, Frederica. On the one-year anniversary of his wife’s death, Arthur finds an expensive charm bracelet he’s never seen before. Determined to solve the mystery of the bracelet, Arthur comes to realize each charm represents a piece of Miriam’s history before they met. His mission takes him to foreign places, where he meets people who broaden his comfort zone and leave him open to the possibility of what may lie ahead.

Do you remember the TV game show This Is Your Life, in which Ralph Emerson reveals the story of a guest’s life with anecdotes from significant people? This is the premise of the oddly dark but hopeful novel This Is Your Life, Harriet Chance (2016) by Jonathan Evison. Recently widowed 78-year-old Harriet receives a letter informing her that her husband bid on and won a cruise for two. Harriet, who believes the ghost of Bernard visits her, discusses with him the pros and cons of going alone on the trip or canceling, ultimately deciding to go with her friend, Mildred. In the end, Harriet goes without her, only to be joined later by her own less-than-welcome adult daughter. Harriet feels sucker-punched to find that Bernard was having an affair and planned to take the other woman on the cruise. The story is told with forward and backward reveals, making the reader feel the pinball game of Harriet’s life. A story about mothers and daughters, marriage, forgiveness, regret and reinvention; this is a deftly told page-turner.

Are there foodies on your gift list? Dinner with Edward: A Story of an Unexpected Friendship (2016) is a memoir that’ll have them salivating. Author Isabel Vincent agrees to look in on a friend’s recently widowed father, Edward, a man in his 90s. Edward meticulously prepares meals for Isabel’s visits, sharing the love story of his married life. Isabel, too, has lost a love, so they share that connection; their dinners help Isabel rebound from divorce and rebuild her self-esteem. The menus are highlighted at the start of each chapter, though, sadly, without the recipes. Nevertheless, you’ll find this book very satisfying.

In Bettyville: A Memoir (2016) we meet author George Hodgman, an urbane and sophisticated gay man blissfully separated from his upbringing in Paris, MO. When his irascible, outspoken, strong-willed mother, Betty, falling into dementia, loses her driver’s license, George returns to Paris intending to settle her into a care facility and head back to Manhattan. Once in his childhood home, George comes to terms with his closeted upbringing and the desire to please his parents. Mother and son reunite with a combination of drama and comedy that seems to leap off the page. Clearly, I’m not the only one to see it that way: a television series based on the book is coming, starring my personal dream cast of Matthew Broderick as George and the incomparable Shirley MacLaine as Betty.

With winter closing in, I hope you can hunker down with a book or two from this list. 

Getting over the Cold Shoulder

About a year ago I had a pain in my shoulder that didn’t go away. I am still not sure what caused the problem but it started with a tingling and got progressively worse. Over a period of a few weeks, it turned into a condition called frozen shoulder, when the large bone of the arm sticks to the shoulder blade. I could not raise my right arm above my head and had a hard time doing even simple daily tasks like getting dressed or reaching for something from a high pantry shelf.

I did what I usually do—denied it was a problem. I babied it and as long as I didn’t move my arm out of “comfort range,” it was something I could live with. But the comfort range began to shrink, so, reluctantly, I told my chiropractor. Several friends have had shoulder surgery for this condition and I know it’s no picnic. My fear was that I would need to go this route if my chiropractor couldn’t help me.

I did a little research and found that shoulder pain is common in the 50-plus crowd, not limited to Major League baseball players at all. I learned that shoulders are ball-and-socket joints that can become dislocated from something as innocuous as putting out your arms to break a fall or even being pulled along by your dog. The upper arm bone, called the humerus, can get knocked out of its socket in the shoulder blade, tearing the supporting muscles and tendons in the process. 

I was fortunate that my shoulder was not dislocated, nor did I have any nerve or artery damage, which would have required surgery.

If the shoulder is dislocated, a health care professional can reinsert the top of the humerus into the socket (don’t try this at home!), but often there is a rotator-cuff tear that requires surgery to repair. The rotator cuff is the nest of supporting muscles in the shoulder area very familiar to tennis players and pitchers—anyone in a profession that requires repetitive arm raising. For older people, however, falls are often the cause of a rotator-cuff issue.

My chiropractor suggested a few exercises to do at home and encouraged me to go to a sports massage therapist. My shoulder wasn’t noticeably improving and I was discouraged. The massage was 90 minutes of rubbing and stretching to increase range of motion, and it was not entirely pleasant. I was black and blue from the pressure on my upper arm.

I decided to try acupuncture, but after several weeks I still didn’t feel I was progressing fast enough. Wanting desperately to avoid surgery and return to full, pain-free mobility, I went with the suggestion of a physical trainer who recommended daily doses of ibuprofen, even in the absence of pain, and stretching until it hurt in the shower each day.

Finally, something kicked in. I felt the motion returning and the tingling down my arm faded to a memory.

Every case of shoulder pain is different and I can’t promise that my solution would be right for anyone else. As always, I encourage you to discuss all changes in your health with a medical professional. But as of now, I am back on track. Wii bowling, anyone? 

New Names for Today’s Households

As I wrote in a previous blog about older kids returning to live with their parents, it really wasn’t that long ago that it was OK, respectable even, for a young adult to live at home until marriage. Then it became almost unheard of in my generation. And now, everything old being new again, 85 percent of college grads return home before flying solo, according to Time magazine. Sociologist Katherine Newman, author of The Accordion Family: Boomerang Kids, Anxious Parents, and the Private Toll of Global Competition (2012), says it’s a global issue.

First, the trend was called “boomerang kids.” Next, returning kids were called an “accordion family.” In a PBS interview, Newman said, “The reason I use the accordion term is to capture this sense of expansion and contraction, that the family is not a stable group. It’s sort of moving in and out. But primarily, I mean multigenerational households with working or nonworking young adults and their parents.”

I recently learned a term coined in Japan for kids returning home as young adults to live with parents: parasite singles. When I am out of my realm with new terminology, I turn to the Urban Dictionary website. (It’s less humiliating than asking my teenagers for help.) Urban Dictionary defines a parasite single as “Someone (with) no plans for marriage any time soon, not dating, still living with parents. Most ‘parasingles’ don’t quit this lifestyle until their late 30s, early 40s.”

Why the derogatory slant? Because in Japan, parents are ashamed, blamed for failing to raise independent children. Not so everywhere—in Spain, disenchanted parents hold the government accountable for the loss of livelihoods that could establish independence. But in Italy and some Nordic countries, they welcome their kids back, if they had ever left.

Newman interviewed 300 accordion families and speculates that households in which both parents worked when kids were younger may be at a stage where they can really enjoy their kids as young adults.

Should we be worried about the growing trend of young adults returning home, spending their parents’ 401(k) and not making enough to start saving for their own futures? Or should we accept the “new normal” of multigenerational living and just learn to share a bathroom?

They’re Baaaaack!

I was intrigued to read Gallup poll findings that 14 percent of 24- to 34-year-olds are living with their parents, and more than half of 18- to 23-year-olds are still at home (or are back there again).

That is an about-face from when I was a 20-something. I couldn’t wait to move out—and stay out. Friends envied me when I got my first apartment after high school, a move that meant maturity and a freedom my peers did not share. Friends who went to college had a hard time returning to their family homes on summer break after having a taste of the grown-up life. They all sought to live free of parental rule. It would have been perceived as failure to have lived independently and then have to return home.

What’s going on with this generation? Lots of books would lead you to believe that, these days, no child leaves home for good. Boomerang Nation (2005) is a how-to for kids moving back to the family home. A Crowded Nest (2004) and Mom, Can I Move Back in with You? (2004) offer advice for parents of 20-somethings who want to move back home. Boomerang Kids (2011) assumes kids are failing at growing up and suggests ways for parents to help them succeed.

It’s not all bad. Some families are finding the multigenerational house to be a pleasant surprise. They are adjusting in ways that benefit all, both monetarily and emotionally, with the “kids” sharing chores and maybe paying a little rent. Some parents invite their young adults to return to the nest to give them an opportunity to save or to repay school loans.

Personally, I’d like to think more than repaying loans and saving rent is afoot here. Perhaps this ultraconnected lifestyle will diminish the generation gap a bit.

Historically and culturally, there is a great deal of precedent for the multigenerational home. Despite my own experience and hunger for independence when I was growing up in the suburbs, I knew several families that had a widowed grandmother living with them. As I got older, I had city friends who lived with or near their older relatives. Extended families worked well for them, providing shared child care and meals. An article in the New York Times reveals that:

Recent college graduates moving back home—so-called boomerang kids—are only part of the story. Whether prompted by a lost job, a house foreclosed or a sinking pension, grown children and their elderly parents are increasingly coming together under a single roof. Census figures show an uptick in the number of multigenerational families in New York.

The American dream of home ownership is elusive for young adults. An uncertain economy and job market, marrying later and less peer pressure to branch out from under mom and dad all factor in the decision to return to the nest. Families just look different today than they did in the ‘50s and ‘60s when I grew up.

My daughters are in college, working on their dreams and careers. I wonder where they will live …

All in Good Taste

Recently, I overheard someone turning down a gooey, brownie-like concoction, saying, “No thanks, it’s too sweet for my taste.” Wait a minute, was that me uttering those words? Too sweet? That’s up there with too rich and too thin, isn’t it? 

But as I consider this, I realize my palate is indeed changing. Those foods I loved as a kid—candy, especially—would now make me gag, and the herbs and spices that left me crying at my childhood dinner table are now the ones I crave. I love a nice, grainy mustard and I’m quite liberal with the hot sauce. What’s up with that? And is it a good thing?

I used to believe we all had the same taste sensors and they stayed constant throughout our lives. I also thought there were quadrants on the tongue that signaled sweet, sour, bitter or salty. But I learned that all parts of the tongue can detect the four common tastes. More research revealed that it is normal for our sense of taste to diminish with age. We start out as children with taste buds all over our mouths and lose some of them over time. Our sense of smell also contributes to the sensations we experience when we eat, and that too is affected by age or even menopause.

Of course, there could be medical reasons that tastes change. Some prescription drugs can interfere with the senses, as can smoking or an issue with oral hygiene. If your sense of taste has changed abruptly, you should talk to your doctor.

So I like different foods now. No harm done? Probably. I’ll want to be on guard against food spoilage, as I may not notice at first bite if something is past its prime. My credo of “when in doubt, throw it out” is even more sensible now. And I need to be careful about boosting flavor. I don’t want to oversalt. I seem to be less inclined to choose sweets now, but some folks crave more as time goes by and they should be leery of too much sugar.

Here are my thoughts on keeping mealtime a full, sensory experience: seek out good company, turn on some background music and perhaps set a nicer table. And pass the mustard, please!

Very Pinteresting

Lonely? Can’t find your best girlfriends, not even on Facebook? Don’t despair; I know where they all went. They are on Pinterest (pronounced like interest, only starting with a p, pin-trest). 

What, you ask, is Pinterest? It’s sort of an online scrapbook, a single place to store all those random web pages of ideas you don’t want to lose but don’t want to print out. Pinterest works like a bulletin board. You capture an image and save, or “pin,” it.

Here’s how it works: open an account through an invitation from a current Pinterest user (ask one of your MIA friends!) or go directly to www.pinterest.com and ask to join. It could take a day or so for your account to activate. In the meantime, browse the public boards and see who is pinning. It’s free, fun and easy, so look around. Once activated, you can set up your virtual bulletin boards by using default category headings or invent your own. The boards might contain a theme, say, Recipes to Try, Holiday Crafts, Summer Reading…get the idea?

While you are scrolling around, you might see a few things (or 100 things) that catch your eye. I recently found a few organizing tips I love, so I saved them on my Tips and Trix board. I filed away a couple of items I’d love to have on my Dream Home board. You get to peek at what is catching other pinners’ attention—re-pin if you like! I am always a little honored when someone re-pins a gem I found.

My friend introduced her 70-year-old mother to Pinterest. Reluctant to try, she thought she’d have no use for it. But she was gathering ideas for her summer window boxes and saved them on her Pinterest board. A few weeks later at the Philadelphia Flower Show, she had some questions for an expert about planting time. She pulled out her smart phone with her Pinterest account enabled, showed him her ideas and got some valuable advice.

At first, my teenage daughter disparaged the idea, thinking it was for “older women.” (To a 13-year-old, that’s older than 25.) But I left my computer on and she noticed I had some springtime cupcakes pinned on my Company’s Coming board. Intrigued, she thought she might have a use for Pinterest, just for cupcakes. Or cupcakes and desserts. Or make that cupcakes, desserts and her bedroom redo. You can see how quickly a gal can become a convert—now I have to bump her off my computer.

I feel I should caution you: this site may awaken your inner hoarder. Your obsession may be so consuming that your partner may accuse you of having an affair. You may start pinning and following and forget to make dinner. OK, go on, join Pinterest at your own risk—but don’t say I didn’t warn you.

Homesick

Two friends of mine recently experienced something you don’t hear about often: grieving the loss of their childhood homes. For people who spent a long stretch of their formative years at a single address, the childhood home is a repository of memories, an emotional scrapbook of sorts. 

One friend moved her parents into a 55-plus community. While the parents were eagerly anticipating this next phase of life, my friend was remarkably sad. Another friend, whose parents are no longer living, had his century-old, uninhabitable family home demolished. Both friends are adults with families, happily living in their own residences for many years. Both friends were in mourning.

I think what we are grieving when we lose our childhood homes is the passage of youth, the aging of parents and the knowledge that we can’t return to the tire swing in the backyard, literally or figuratively.

When I was young, my parents moved a few times for Dad’s work before we settled into the home where I spent the bulk of my childhood. I moved out after high school. After my father died and my mother remarried, she and my stepfather wanted to start fresh in a new home. By then I was in my early 20s and hadn’t lived with my family for years. But I can still remember helping out the day my family moved, my brother and I the last to leave, sweeping up, leaving the keys and saying goodbye to the house. He teased me then for being sentimental, but the home held so many fond memories that seemed somehow more tangible while the deed was in our name.

My brother—the nonsentimental one—has returned to the house a few times over the years, explaining to current residents that he grew up there and hoped for a trip down memory lane. I have only driven by with my girls, who pester me to take them inside someday.  

Homes are our refuges, shelters from the elements; but more than just walls, they are monuments that hold a piece of our hearts, a place of memories and dreams. I think I’ll go for a drive and maybe this time, I’ll knock. 

Avoiding Drug Interactions Just Got Easier

My mom had a great relationship with her regular pharmacy. In addition to getting prescriptions filled, a visit there included a dedicated, professional woman assembling our nonpharmacy shopping list so Mom could go to the back of the store and her “order” would be ready. On days when I was not free to drive her to that pharmacy, the backup was a drugstore with free delivery. They wouldn’t add in a box of tissues or a magazine, however, so we used it as a last resort. 

The problem was that, with several doctors and two different pharmacies filling prescriptions, no single person had a handle on exactly what was in the medicine cabinet. On top of that, we ordered some long-term meds in cost-saving bulk by mail. My mother kept a list of her medications in her wallet with her emergency contact information, but I can’t say it was always current.

We started bringing the medicine bottles to the doctor’s office just to be safe, and many times we learned we had duplicates—same drug, different name—or that there were potential interaction dangers.

Once, while seated in a waiting room, I spied a brochure with a list of medicines that may be dangerous for older people. It was called the Beers Criteria, named for the physician who created the list about 20 years ago. Updated in 2012, it names about 75 drugs that seem to affect older people in potentially harmful ways. It turned out to be a great tool for Mom’s doctor visits.

I knew I had to be proactive, but back then it was a challenge. Today there are easy ways to avoid prescription mix-ups, or at least minimize them. Drugs.com has a free, simple-to-use, interaction checker. I use it when I am caregiving and recommend it to anyone taking or managing multiple prescription medications. It’s easy to enter the medicines you take, even over-the-counter medications, vitamins and supplements. You can see if a new medication will interact with what you already take. Drugs.com will keep a list of your medications, too. I spent a few minutes entering information and netted some real peace of mind.

The doctor’s office can be intimidating, so it is a good idea to go prepared. I make a list of questions and concerns that includes any changes in routine, like sleeplessness, diet or stress levels. It helps to bring a list of current medications, including how and when they are taken—with meals, before bed, etc. I keep all the information together in a journal to take to every appointment. It’s there for me to jot down questions between visits and helps me organize my thoughts so all of my concerns are addressed before I leave. Try a health journal to manage your own health care.

An article in the Atlantic reports that side effects from four well-known drugs are the cause of one-third of all ER visits by older people. Not falls, not heart issues. In light of this news, I am reminded how important it is to know what medicines you are taking and to make sure you share that information with everyone involved in your health care, from doctors to pharmacists to daughters.

Drinks on Me

I am not a big drinker. Most days, I need to remind myself to drink liquids to stay healthy and hydrated. A normal part of aging, I have learned, is that I don't register thirst the same way I did when I was younger. A friend told me she drinks more water if she has a straw, and I find that is true for me as well. Then I read that pursing your lips to drink from a straw causes mouth wrinkles. You just can't win, can you? 

I do drink my share of coffee (some might say too much), but I can't justify the expense of buying my cups of Joe out. That may be partly because I am older. A  study by Accounting Principals showed younger office workers spend an average of $25 on coffee each week, while those 45-plus spend $14. (Still, $14 is more than I spend.)

While I do rely heavily on caffeine to get me through my busy days—my home brew, sipped from a trusty, reusable mug—I don't buy the energy drinks that claim to boost your metabolism for five hours or more. My peers, and even those older than I, however, seem to be a different story. According to the Wall Street Journal, the high-caffeine shots—usually $2 or $3 each—are, surprisingly, being consumed by an older audience. Energy shots come in compact bottles, making them portable and quick to drink down when you feel that slump coming on. My friend's 60-something father-in-law drinks one before exercising for a little extra “oomph.”

I would have assumed that energy drinks would be most popular in dormitories and in the cabs of 18 wheelers, but one company is giving out samples at AARP conventions and another is distributing coupons in doctors' offices. The FDA doesn’t regulate nutritional supplements, so I can't say if the caffeine-herb-chemical mix actually does more than give you a jolt, but the disclaimer says the drinks are not for kids.

Could these little bottles of energy be having an impact on soda consumption? An article at theatlantic.com suggests soda drinking is on the decline while water consumption is up by 38 percent in the last 15 years. Many of us are trying to get that oft-touted 64 ounces a day. But who is to say we need eight glasses of water each day? I remember a show with humorist Andy Rooney asking, “When did Americans get so thirsty?” Most of us likely get enough water from the tap, the teapot and the foods we eat during the day, so just drink when you’re thirsty, unless your health care provider tells you otherwise. The straw is your call.

 

May Day Surprise

“Make new friends, but keep the old; one is silver and the other, gold.” —Girl Scouts

We are often reminded of the importance of keeping social as we age; isolation has proven to be hazardous to healthy aging, while friendships engage and stimulate us. I am fortunate to have longtime friends as well as newer ones. I have two friends from grade school who have been dear to me for 50 years. Every summer we meet for lunch to catch up and to recharge those life-shaping memories.

My own childhood memory was awakened this spring when I put the dog out and found on the porch a pretty dahlia plant with a card that read, “Happy May Day.” I was transported to another time, when May Day was celebrated. I remember leaving an anonymous basket of flowers from the garden on a neighbor’s porch. And I recall making a little paper cone for a tiny bouquet—maybe even dandelions—and hanging it on a door knob for Mom to find.

My mother always celebrated May 1 with a trip to church and a cleaning spree. My aunt also had the notion that you thoroughly clean your house on the first of May or risk “making the Blessed Mother cry.” This May Day dahlia also reminded me of the maypole dances of my youth and of crowning a Queen of the May. I recalled, so clearly, my longing to be the one wearing the ring of flowers on my head.

I did not see the stealth drop-off of the dahlia, but I knew who left it. It was not a childhood friend as you might think, but clearly one with a similar upbringing (and a very kind heart). Friendships old or new have the power to stimulate our brains, whether we’re making new memories or sharing cherished history.

Yo, Am I Ageist?

Unless you are Peter Pan, one day you’ll be old. I don’t want to experience discrimination because of a date on my birth certificate. I don’t want people to lump me into a one-size-fits-all assumption based solely on my age. Neither does author Ashton Applewhite, whose book, This Chair Rocks: A Manifesto Against Ageism (2016), calls upon the thought leaders of aging to debunk the myths that are filling us with dread and keep us from realizing that all aging can be successful aging. 

When I hear the word “manifesto,” it brings to mind fighting injustices in my activist youth, so why not take a stand against ageism too? Operating on the assumption that all older people are the same is like saying all blondes are the same. It’s shallow thinking that keeps older people out of contention for jobs, medical trials, bank loans, housing, even pet adoption. Applewhite points out time and time again where this one-size-fits-all philosophy is unfair, illogical and often illegal.

After challenging the myth of the despondent, divorced woman in her book Cutting Loose: Why Women Who End Their Marriages Do So Well (2009), Applewhite embraced becoming an “old person in training” with a blog, This Chair Rocks, and an online forum for self-check called Yo, Is This Ageist? To get an idea of what makes Ashton Applewhite so popular, here’s a question from that website. The Silver Century Foundation reposts some of Applewhite’s blogs here.

Given our raison d’être at SCF, we’re hyperconscious about ageism, but Applewhite shows us that even aware individuals make mistakes. Asking if someone still works, still drives or still lives alone assumes that they are somehow diminished by their longevity. When someone says “for your age,” it’s simply ageist (and here I’m guilty). Why can’t we just be attractive, accomplished or effective and leave it at that? Heaven knows I’d never call someone a “young lady” unless she was, literally, a young lady.

Yet as my closest friends and I hit milestone birthdays, we’ve gone from despairing over what must lie ahead to denying what must lie ahead. Why are we unmoved by the research that shows we are actually more satisfied with our lives in later life?

Applewhite says that we must reframe our thinking, that we must embrace an approach that does not define us as people of a particular age. It’s going to take some real thought-tweaking for me to get where she is on ageism. I continue to find most age-slamming greeting cards and commercials more funny than offensive. It will take a while for me to embrace saying “olders” vs “elders,” as Applewhite does. I may not go to the rally, but I’ll buy the bumper sticker.

What if we all tried a little harder to look for the beauty in older faces, to strive to stay healthy rather than stay young, to seek out the company of those with different life experiences and embrace our good fortune to be living longer? Remove the worry about candles on the cake and we might even be free to focus on what really matters to us. Let’s commit to changing the culture in which we are aging. Baby steps. (Or is that ageist?)

Taking a Stand

By now you have probably read the headlines about the negative health effects of sitting too long. The studies show that not only couch potatoes, but desk jockeys as well, are compromising health and longevity by sitting for long periods of time. Runners and gym rats are not exempt. In fact, many articles claim that sitting is the new smoking. 

I won't pretend I'm an exerciser—far from it. But because I have kids and caregiving commitments that keep me moving, I don't think of myself as sedentary. Or am I? On days when I have uninterrupted time in front of my desktop, I can log many back-to-back hours at the computer. Whether I'm researching for SCF, reading, or watching a TV minimarathon, I am sitting, and sitting for a long time. I don't want my autopsy report to read death by sitting, so I decided to research some options.

A teacher at a local elementary school told me she felt better and more focused, having switched to sitting on a balance ball instead of a desk chair. She even put her students on the balls to add a little movement to a sedentary day. It's still sitting, but using different muscles to keep from falling off.

A runner friend said she mounted a laptop to her treadmill for her walks. My sister added a similar shelf to her stationary bike.

Because, as I said, I’m not the treadmill type, what appealed to me most was a stand-up desk. I was using a kidney-shaped vanity in my home office because I liked its lines; it felt like an old-fashioned writing desk. I had been sitting on an ergonomic kneeling chair but I decided these two old fixtures would be finding new homes.

I bought a 36-inch-high craft table with ample work space and set out to become a stand-up type of gal.

It was more challenging than I anticipated.

On the very first day, I found myself shifting from foot to foot, changing shoes and leaning (a lot) against the desk. My legs throbbed that night in bed. You'd think a marathon shopper wouldn't ache so, but my feet felt as if I had put some miles on them. I even woke up with neck pain.

The second day wasn’t much better, with my legs feeling weak and a heating pad on my neck and shoulders. I almost brought my old desk back. Then it occurred to me to raise the monitor so I wasn't looking down, and that helped the top half of my body. But I still wasn't able to stick out more than a few hours in the standing-still position, so I alternated work spaces by taking my laptop to the table and traded my flats for walking shoes.

I was surprised it was so hard—I thought I was active enough on my feet that this would translate with ease to standing. A few weeks into my new regime, I considered an anti-fatigue mat, and it was in my search that I stumbled upon a website for anyone getting started in stand-up computing. What a treasure trove of research on exactly what ailed me.

Desk Hacks offers all sorts of tips and tricks, even a 28-day, standing-desk challenge to aid in the transition to the standing life. Each day I received an email with the suggested time on my feet. I was already halfway there, but it made such good sense to build up over a month rather than to quit sitting, cold turkey, as I did.

This lifestyle change isn't the only key to a healthier life, but it's a start. If you would like to try a stand-up desk, I'd encourage you to do more research than I did and definitely to:

  • Wear supportive shoes
  • Purchase an anti-fatigue mat
  • Position the monitor at eye level
  • Use a stool or a box to allow you to raise one leg
  • Stand up straight

In the “no good deed goes unpunished” department: standing in one place for a long time poses health risks of its own, so take regular breaks to walk and stretch.

Now that I’ve convinced you to think about a stand-up desk, here’s the kicker to my story. I gave it a solid try for a year before I conceded that my work was suffering due to my constant walking breaks…to the refrigerator. (We all know how that story ends.) So I set up my little vanity table and kneeling chair again and now I alternate between that and the stand-up desk.

The moral of the story is that it might take some time to find a combination that works for you. For the record too, my teacher friend gave up the ball chair and moved to pedal desks or resistance bands on the desk leg or chair as an outlet for fidgeters. Even if it takes some trial and error, it’s worth it to figure out a way to sit less and move more—as long as you don’t move to the fridge.

 

Getting Out Alive (and Staying That Way)

My role as caregiver and advocate has me quite familiar with transitioning a patient from hospital back to home sweet home. In my experience, the weak link in the process is almost always with discharge instructions and expectations. Patients leaving facilities are overwhelmed with instructions they (and even their caregivers) can't understand; doctors' orders get lost and misinterpreted; one doctor doesn't know what the other has prescribed, and so on. When patients return home to an unsafe environment, unprepared to cope with new limitations, too often they end up right back in the hospital. It's a problem so pervasive that hospitals are now literally paying the price for readmissions—they're fined by Medicare. 

We need better lines of communication, but we need to be better-informed patients too.

The challenge is often that doctors see only a health issue and not a person with a health issue. If someone has fallen at home or accidentally overdosed or suffered a burn, a doctor treats the repercussions. Someone needs to step in, evaluate the cause, then ask what can be done to prevent this from happening again when the patient returns home. A surgeon may feel the job is done after the last stitch is sewn, removing him- or herself from the patient's continuum of care, failing to explain in detail the possible side effects and ramifications of surgery. So it falls on us, as patients and as caregivers, to ask every question we can think of—and more. We have to speak up.

After cancer treatment, my mother was discharged without a clear understanding of what medications to resume at home—and her oncologist didn’t have a list of drugs prescribed by her primary care physician. Luckily, an astute pharmacist caught a duplication in the mix of meds she took; unknowingly, Mom was taking one drug prescribed at the hospital and the same one, only with a different name, from her doctor.

What can you do to be better informed when you (or someone in your care) are released from the hospital? Plan ahead as much as you can. Consider asking these questions—and more that are specific to your personal health and living situation—before you are discharged, and get the answers in instructions that you understand.

Medical management:

  • What is the name of the condition for which I'm being treated? (What is my diagnosis?)

  • Do I need to adapt my home to be safe when I return and, if yes, how so? Is it safe to stay alone? To drive?

  • How/when will my primary care doctor be receiving my records? Is there anything that my doctor should know about my stay in the hospital?

Pharmacy management:

  • Do I have prescriptions to fill?

  • How much of each drug should I take and for how long?

  • Are the new meds compatible with the ones I took prior to the hospital visit?

  • Do I need to stop taking or change any medication I’m currently taking?

  • Are vitamins and over-the-counter meds OK?

Managing expectations:

  • What constitutes an emergency or warrants a call to the doctor?

  • Any dietary restrictions?

  • Any physical limitations? Is it safe to resume sex? How much exercise?

  • Are there any products that might offer relief for this condition? (Pillows, braces, orthopedic shoes, raised toilet, etc.)

  • What is the plan for my follow-up care? Do I need to make appointments with specialists? Physical therapy?

  • Where do you see my progress in one month? Ninety days? When will I have full function returned? 

There’s something else that I can’t recommend enough: consider identifying just one representative to advocate on your behalf (or, if you’re going to be the primary caregiver, ask the patient to appoint you as this advocate). This allows the health care professionals to spend their time with patients, rather than answering repetitive questions from several family members. The best approach is the proactive one. Speak up, ask questions before you leave for home—so you don't come back! 

In Dog Years

Have you met my dog, Ruffles? At her annual well-dog visit, my vet referred to her as geriatric. Ruffles is almost a decade young, and sure, she is a little grayer and sometimes doesn’t make the leap onto the bed on her first try, but geriatric?

The vet noted that my dog is showing signs of age-related vision loss and detected a benign heart murmur, but otherwise Ruffles looked fine; no inflammation, excess weight or tooth decay. He reminded me of the importance of keeping her entertained and added a vitamin supplement for her dry skin. Even with her mostly clean bill of health, I continued to think about her advancing years after we got home. I wondered if I should be changing her routine.

I looked online and found some interesting facts. Like people, dogs are living longer than ever.  One reason? The quality of dog food has improved and even store-brand kibble must meet nutritional standards. Ruffles eats more upscale than I do—her food includes salmon and buffalo. Now you can find food targeted for the changing needs of a dog’s life. There’s chow for puppies, for weight management, for joint issues and for dogs age 7 and up.

In addition to feeding our dogs better, we are taking better care of them overall. When I was growing up, we took the dogs for the occasional rabies shot and let them run loose in the neighborhood. Spaying was virtually unheard of for the males and we fed them table scraps. These days, most communities have leash laws and I rarely see a dog without its person. We license our dogs and are charged a fee for an unneutered pet.

But a doggie dentist? My dog-loving dad would turn in his grave. While I have never had Ruffles’s teeth cleaned, I know many people who take their dogs to a canine dentist a few times each year to remove plaque or address gum disease.

Defining a dog as geriatric isn’t an exact science. Generally speaking, larger breeds age faster, so a Great Dane will show signs of aging before a Yorkie. Eventually, though, all dogs slow down, tire more easily or lose agility. Some dogs experience cognitive shortcomings or diminished control over bodily functions. They can develop arthritis, heart problems and cancer. In fact, cancer is responsible for approximately half the deaths of pets over 10 years of age.

According to an article at msn.com, you should take your pup to the vet twice a year after age 7. With dogs aging up to 10 times faster than humans, this isn’t overkill. Often the vet can prescribe pain relief or supplements for health issues and advise on the right amount of calories and exercise for your dog’s specific needs. Your BFF may not be able to go on a long walk, but don’t give up on exercise; just shorten the duration and go more frequently.

Now that I see that Ruffles isn’t quite as spry as she once was, I’m getting her a better quality dog bed. She bunks with me at night, but during the day she has her “guard spot,” and maybe she’d appreciate more padding where she snoozes. And if she misses more than she hits when she jumps up on the bed, I will get her some doggie steps to help.

Check This Out

One day last summer when I was wearing cropped pants and flip flops, I thought my ankles looked swollen. Was I retaining water? Standing too long? Did I need a new pair of shoes? (Let’s hope.)

Looking for a quick answer, I went to my computer for a symptom checker. There are literally a hundred or more to choose from, but this time I chose one for its straightforward style. It asked a few intake questions and gave a range of possibilities from most likely to way out there. The possibilities for me were pregnancy, a sprain or fluid retention, and we can rule out the first two.

But hold on—here’s a study that says we can’t really trust the online symptom checkers. The study found that the tools’ diagnoses and recommendations fall short and often send people to the doctor unnecessarily or, worse, underestimate the gravity of the situation and don’t send them. 

According to PBS.org, ” the online checkers provided the correct diagnosis 34 percent of the time, listed the correct diagnosis within the top 20 results 58 percent of the time and provided the appropriate triage advice 57 percent of the time.” In other words, they often fail to provide reliable medical advice.

When can the checkers be helpful? When my daughters were babies, I took advantage (with embarrassing regularity) of a call-in feature at the pediatrician’s office. A nurse would triage the symptoms that might have had this first-time parent calling 911, poison control and a member of the clergy. They asked the types of questions you’d find on the symptom checker, and those issues resolved with a happy ending. Perhaps a new mother would consult a website, before a phone nurse, if her baby was still wailing at 3 a.m.

A symptom checker could offer enough information to keep concerned people from making unnecessary doctor’s appointments, but it could also be the source of misinformation that induces panic or drives your doctor crazy. There’s a name for that: cyberchondria is the false belief that you are suffering from a disease that you learned about on the Internet or on a specific website. Please play it safe and consult a health care professional when your instincts tell you so, or if symptoms persist. Fortunately, I enjoy good health and don’t have many occasions to self-diagnose. If I thought I had a true emergency, I would call 911, and I hope you would too.

But here’s another reason not to trust the symptom checkers—not a single one prescribed a visit to Zappos.com to cure my swollen ankles.

Mentors for Med Students

When my mother was alive, her medical care was spread out among specialists. She had an internist as her go-to, primary doctor, but she had a Rolodex of others to manage specific health issues: dermatologist, podiatrist, cardiologist. At one point she was referred to a geriatrician who we hoped would become a general contractor of sorts for Mom’s total care. Older bodies are different from younger ones. The same disorders produce different symptoms in elders, and they respond differently to medications and other therapies. Many doctors who are not geriatricians don’t know much about that. Sadly, the travel to the only geriatrician was far and the wait for a new patient appointment was months, so in the end she didn’t go. Why is there such a shortage of geriatricians? 

Only about 7,000 geriatricians are currently available  to care for an estimated 12 million elders, and significantly more are needed for our growing older population. Studies show that geriatrics is one of the least popular medical specialties, possibly because geriatricians make less money than other doctors, but also because of preconceptions about older people, such as the belief that they are too difficult and time-consuming to treat, and they are beyond help anyway. Studies show that these prejudices are common even in medical schools, perhaps partly because the only older patients med students see are hospitalized or live in nursing homes.

On the positive side is the increasing number of buddy programs for medical students, including a Silver Century Foundation-funded partnership with Rutgers-Robert Wood Johnson Medical School. Mentors for Med Students asks healthy older people who live independently to serve as mentors for second-year medical students. The goal of the program is to change misguided preconceptions that most elders whom doctors see will be demented or in residential care. The students visit the mentors at home, taking medical histories, reviewing therapies and getting to know them as individuals. This process helps the future physicians become familiar with healthy aging. It allows them to see how elders manage and how their health impacts their daily living and finances.           

Other US medical schools also now offer programs that are changing the way medical students interact with older people. The University of New England College of Osteopathic Medicine Learning by Living Project sends students to live 24/7 in a residential care facility. Each student is given a diagnosis and for two weeks is treated as an older adult would be with that same diagnosis. Asked about the impact of students interacting with the elderly, program director Marilyn R. Gugliucci, PhD, reports that the fear of aging and of nursing homes has decreased for all students who participated in the program. The real-world experience allows them to empathize with the residents and to see each of them as a whole person, not a list of infirmities. 

At the John A. Burns School of Medicine in Hawaii—the state that’s home to the fastest-growing elder population in the country— first-year students pair up with someone living in a residential facility. They meet for several hours each week. The school also requires future doctors to perform a clinical rotation in geriatric medicine.

It’s been a decade since my mother’s passing, when I became aware of the dearth of geriatricians. Even as medical school buddy programs are beginning to take hold all over the country, I am afraid we are progressing too slowly.

We need more programs that directly address the shortage of geriatricians so that there will be enough knowledgeable, compassionate, medical professionals to care for us as we get older.

 

Books to Give or Keep

I am reprising my blog from 2014 with new suggestions for books to give or to keep this season. I have a few I’ve loved and can’t wait to share, and I get unparalleled joy from matching a book to a recipient. My personal choice in reading is usually new fiction, but I also have some tried-and-true nonfiction titles for your TBR (to be read) list. Each book connects to midlife and beyond. 

If you are an armchair traveler or know someone rethinking living arrangements for the second half of life, Rita Goldman Gelman’s Tales of a Female Nomad (2001) might be just the ticket (pun intended). An abrupt change in the author’s marital status sent her packing. Her first solo expedition to a somewhat primitive Mexican village sold her on the idea of living as a nomad, off the beaten path, and immersing herself in different cultures, unburdened by possessions and schedules. Though Tales was written in 2001, I still see it on the gift table at the bookstore—it’s that kind of book.

Looking for a crime novel with a credible older hero? I like feisty Brigid Quinn, who’s doing more in retirement than she did while working at the FBI. Rage Against the Dying (2014) and Fear the Darkness (2015) are the first two titles in Becky Masterman’s smart, page-turner series; I’ll look forward to more.

In the meantime, I can settle in with Louise Penny’s Chief Inspector Armand Gamache. This collection is now 13 strong. Still Life debuted in 2008 and this year’s addition is The Nature of the Beast (2015). The setting is a small Canadian town where Gamache is a beloved crime fighter, neighbor, husband and father. Each novel introduces new characters but familiar ones weave throughout. Award-winning Penny is often compared to Agatha Christie; it’s easy to see why.

A perfect choice for just about anyone is—don’t laugh—a coloring book.  Research shows how coloring ignites creativity and reduces stress. When I bought Coloring for Adults for Dummies (2015) for a type-A friend, I was amazed to see a full shelf of coloring books. I grabbed Follow Your Bliss (2015) for my teen. You’ll find mandalas, paisleys, retro designs, stained glass—too many to name, but something for everyone. Grab a fresh box of crayons to go with your choice. Like me, you may end up with several.

If “no time to read” is the sad refrain you’re hearing, or feeling, 100 Years of the Best American Short Stories (2015) offers commitment-free literary vignettes to return to again and again. This volume holds 40 impressive works written between 1915 and 2015. You may find you have more time to read than you thought.

A novel that really captures a time, place and voice is The Turner House (2015). As the family home in a crumbling Detroit sees widowed Viola Turner’s 13 children come and go (and come back), we’re privy to genuine dialogue between generations, unfolding the hopes and heartbreaks of this African American neighborhood. Viola can stay no longer, she will live with her son, but what will become of the house? Very moving.

Up for a laugh and a light-hearted look at getting older? I spied a terrific book while waiting online at the bookstore: You’re Not Old, You’re Vintage (2015). It’s a book of quotations and observations on aging from the famous to the obscure. I’ll be ordering a few copies from my independent bookseller; it’s the kind of book I like to have on hand for impromptu mood lifting.

The pile of new books on my nightstand keeps me from rereading old favorites with one exception. Author Kent Haruf died days after finishing Our Souls at Night (2015), a novel about finding later-life love after grief. As they say, “it’s complicated.” I found Souls to be so very rewarding that I hated to see it end and was compelled to reread several of Haruf’s previous works—all set in the same small town in Colorado—and loved them the second time around just as much, or more. You can’t go wrong.

I hope you find something on this list to curl up with; it could be a long winter. Books and tea get me through.

Addicted to Tech

My teens are considered “digital natives,” because they grew up with computers and other tech marvels. I, on the other hand, am considered a “digital immigrant,” because computing is a foreign language to me and people in my age bracket. I will say, though, that just to stay relevant, I took up computers as a second language, and I’m connected almost all the time with my smartphone, tablet, laptop and home desktop. I’m not “fluent” like my younger friends, but I’m not in the dark either.

I know folks who never turn off their tech. I’m not one of them, but I followed along with a radio quiz about tech habits, conducted by a therapist, to determine if I am “addicted” to tech.

I take lots of quizzes. Maybe I should see if I am addicted to quizzes. 

Parenting today requires a cell phone and a working knowledge of texting because teens are addicted to tech. It is how kids communicate and how parents keep tabs and have a little peace of mind. There are no pay phones at school. My teens watch their phone battery levels the way I watch my gas gauge. My kids have backup power sources—they must be connected. 

Beyond using my cell phone to reach my daughters, like texting upstairs to tell them that dinner is ready, I enjoy seeing friends’ posts on Facebook and keeping up with relatives I don’t see. I feel more connected to things that interest me. I get most of my news online now and get breaking news sent to my email and Facebook.

What I don’t do that addicts do, according to the quiz: I do not bring a phone to the family dinner table. Ever. I have stopped texting while driving. I don’t interrupt a human conversation to text unless it’s truly time-sensitive. I do not text or email on my phone in any way that interferes with commerce or is disruptive to others. I do not bring my phone into my bedroom unless one of my daughters is still out and I won’t be waiting up.

What the radio therapist called me on: multitasking with tech. I have my phone alongside my desktop or laptop and sometimes also have a tablet open when I’m working, to keep from having to toggle screens. When it’s TV night, sadly, we all have our phones in our laps as we watch.

I have experienced phantom rings and vibrations, in which I am certain I have heard or felt my phone when, in fact, I had imagined it. I have turned my car around, risking a late arrival, because I realized I didn’t have my phone. Knowing I’ve left it behind and I can’t get to it immediately, I feel a sense of panic. I brought tech backup on vacation “just in case.”  I have a technology-resurrection box that holds old phones, chargers, routers…

While on Facebook, I once lost track of time and left a daughter waiting for a ride (oops). I had to take Facebook off my phone because it became all-consuming. It remains my biggest time-sucker. I tried the websites that allow you to set a timer and lock you out of a social media site at self-selected intervals. But I always turn them off after a few days. I tell myself I should just delete my account as many friends (real and virtual) have done. Can’t do it!

So it’s clear that I do have a tech-abuse problem. (Could recognizing that be the first step in my recovery?) I know many people more addicted to technology than I am, but I am sure every heroin addict says the same thing. I read where a couple let their real-life child starve while they raised a kid in a virtual world. I’ll stop before I get that bad.

Wait—was that my phone?

I Shopped, I Dropped

Not too long ago my daughter needed some retail therapy. She works part time, had just gotten paid, and she could hear the stores calling her. The mall was the last place I wanted to be on the weekend, but I was a teenage girl once, and I knew exactly how she felt. In the absence of any BFFs, I was her default shopping partner. Now it was me, not the teenager, with the big sighs and eye rolls. 

The stores my daughter frequents don’t have a spot for me to sit while she hunts and gathers. The establishment that got most of her paycheck takes up two floors, and while it has an escalator, I just don’t want to run willy-nilly trying to keep up with her. Even with the requisite coffee stop (at the opposite end of the mall), I find I tire easily when there is nothing in the store that interests me.

On the other hand, the large department store that sells clothes I would actually wear has a sitting area outside the fitting rooms. Sometimes I see long-suffering husbands there, with their technology, to ride out the costume changes. That is a brilliant use of space and I really don’t know why other stores haven’t thought of it. Just imagine the impact in the junior department—put the football game on and dads will let their daughters shop without a care.

I also find many stores to be insensitive to the needs of people who can’t handle the sprawl of the big-box layout, or even the distance between the mall’s anchor stores. One end of the mall has the shoes, the other end, the candles. I realize that is intentional, to catch the impulse buyers, but at what cost to those who aren’t able or willing to put in the miles? I’d like to see more sitting areas (most malls do have a few scattered around), motorized scooters or shopping carts to lean on. My local Kohl’s has the right idea with carts the perfect size to wheel into the clearance corner, but it has no place to sit. Target offers enormous carts and scooters. Macy’s has sitting areas but no carts. I have rented carts from the centrally located mall service desk, but the stores aren’t set up for them and it’s hard to maneuver around the racks. Bring back the old five-and-dimes that had a lunch counter, I say!

My mother was an avid shopper, right up to the end. When I noticed she was less willing to accompany me, I knew something was amiss. It turned out that she needed a little help to traverse the square footage of the local shopping venues.  She had always been willing to take my girls out in their stroller and I realized that she relied on the extra support the device gave her while walking. So I searched out stores that offered carts, and sometimes we’d even bring the stroller just for coats or parcels (and Mom’s confidence).

Shops make many accommodations for those with physical impairments. I wish architects and designers would remember there are other unmet needs when it comes to midlife shoppers. It’s just good business to look beyond youthful clothes and youthful energy. As for me, my post-retail therapy may necessitate a foot massage and a large cup of tea.