Those Golden Years
The golden years
We call them “the golden years,” those years beyond age 60, or thereabouts. For some, they truly are. It's a time when the “rat race” of career and competition are over. There is wisdom, peace, and a perspective coming from years of experience.
Many seniors can look back over their lives and say, “It's been a great life, and these are truly the best years of my life! I still have a lot to look forward to.”
Problems of aging
For many, however, these years are not so golden. As people grow older, they often experience problems such as:
When Daniel lost his wife of 54 years, he cried and dealt with his grief. He finally arrived at a point where he could continue engaging in previous activities and having meaningful relations with old friends. Without warning he slipped into a deep depression. He wouldn't eat, slept most of the day and his weight began decreasing. When he spoke at all, it usually centered around death. His family began worrying about him and consulted a therapist for advice.
“What has been happening in your father's life lately,” the therapist asked? “Have there been any serious losses other than your mother's death?” The daughter answered “Nothing important,” she answered, “other than a few minor things.” But nothing to could compare with the loss of our mother.”
“What were they,” asked the therapist. Daniel's son answered “the Motor Vehicle Department refused to renew his driver's license, but he rarely drove anymore.” “The other thing involved a dog,” Daniel's daughter chimed in. “I bought him a puppy after mom died and it was hit by a car.” “But he couldn't have been too attached since we only had it for a short while. I don't see how losing a drivers license and dog could compare to losing your wife.
Do you think it possible?” The answer is yes. Losses can affect seniors in different, unforeseen ways. Some losses experienced by seniors might include:
Loss of spouse.
Loss of friends and family members.
Loss of health.
Loss of freedom and physical mobility.
Loss of dreams and ambitions.
Tremendous emotional losses
It's easy to see some of these, such as loss of a mate, can create tremendous emotional problems in elderly seniors. Other losses, such as loss of a drivers license, or realizing a life long dream will never be fulfilled, might be less tangible, but still painful. All these, whether tangible or intangible, must be successfully grieved before a joyful life can be realized.
Sometimes a response to loss of will, can be confusing and disproportionate. A minor loss may seem more intense than a major one, such as losing a spouse. Many factors make up reactions to losses, and can help determine whether a response to it will be healthy or unhealthy. Those factors include:
Timing. When losses come in bunches they can easily overload the ability to respond to them. A couple of minor losses following a major one may be the “straw that broke the camels' back.” Some might react to one loss by saying, “That was terrible, but I'll get through it. By the third or fourth loss that person may say, “Life is too painful and I don't want to deal with it anymore.”
Meaning. Loss of a drivers license may seem of little consequence for someone who rarely drives. But in this case the loss had cataclysmic and serious emotional meaning. It was a loss of freedom and independence. He could no longer go where ever or when ever he wanted. The loss, although seeming minor had practical significance, and enormous emotional and symbolic significance for Daniel.
Upsetting life's equilibrium. If a major loss occurs during a time of relative calm, it may be painful, but probably bearable. However, if it occurs when someone is emotionally off-balance because of financial problems, emotional stress, family conflicts, and the like, then it could be a crushing blow.
Circumstances surrounding the loss. If a senior suddenly loses a mate when their future seemed bright and rosy, it could be more shocking and painful than if the loss came as a “release.” For example, a long battle against cancer, Alzheimer's, or other chronic debilitating condition. Also if the person blames them self for the loss, the grief can be more intense.
Here are some ways to help a senior continue recovering after a major loss:
Encourage them to talk about it.
Listen non-judgmentally. Help them re-experience past events and emotions never addressed.
Help them remain connected with a support system such as church attendance, Bible study, or grief support groups.
Encourage them to maintain healthy routines with friendships, activities, personal hygiene, and spiritual pursuits.
The grieving process
Grief is a highly individualized process. No two people experience it the same way. The stages of grief are only an approximation of the way people generally process it and actual progression will vary from person to person.
If someone close to you is experiencing grief, you may experience anxiety and emotional discomfort. There will be the desire to rush your loved one through the process. But it takes time. Avoid temptations telling them to ignore their emotions. If you believe they're experiencing depression beyond normal, have them assessed by a geriatric psychiatrist.
The grief process can progress in unexpected ways. Remember this process normally occurs in response to loss of a loved one, one's health, or finances.
The principal warning signs of clinical depression after a loss, is lack of progress in dealing with it. A long grieving period, lasting several months to several years, isn't unusual or unhealthy in and of itself. But during that period some consistent progress should be noted. This can include a gradual resumption of relationships with friends, involvement in activities and hobbies, and improvement in mood. Failure to see these signs may indicate the beginning of deep clinical depression.
Other warning signs of clinical depression include sleeping disorders (frequently interrupted sleep, too much sleep, too little sleep, and inability to get to sleep); a long-term loss of appetite; sadness or anger, frequent crying; loss of interest in favorite activities; sitting alone and staring; and chronic lack of attention to grooming and personal hygiene. If dealing with a senior showing signs of clinical depression, here are some actions to take:
Encourage a full medical evaluation. A physician will check for physical problems contributing to it, such as imbalances of brain chemicals, nutrient deficiencies, medication problems, or glandular malfunction. Many organic problems can affect emotional states, and a geriatric specialist or psychiatrist can help identify and treat those problems.
Be alert to distorted thinking, like hearing statements as, “Everyone would be better off without me.” It's important the afflicted be assured of their continuing importance in the family.
Be alert to expressions concerning suicide. Don't hesitate to discuss those feelings calmly and honestly. Be empathetic and understanding. If a suicide plan appears to be in the works, take positive action. Remove any means of suicide from their reach and never leave them alone. Immediately contact a therapist or suicide prevention agency.
Hearing loss is prevalent in a third of women over 65, and half of men over 65. Although most age related hearing problems can be alleviated by a hearing aid, roughly 2/3 of those who need them neglect or refuse to wear one. In large part they consider them an embarrassing symbol of “getting old.”
Aging often brings about a condition called presbycusis, a degeneration of the inner ear. It causes decreased sensitivity to high frequencies and loss of ability to distinguish distinct speech sounds. Sounds can be heard sounds, but are muffled, and difficult to understand. Hearing evaluations should be scheduled periodically. Anyone experiencing problems understanding conversations should be tested by a physician. If the problem can be helped by a hearing aid, a prescription can be written.
When hearing loss is experienced, simple steps can be taken, to make communication easier and more pleasant. These steps can be beneficial to family relationships, communication, and the individual's health:
If you have a hearing impairment. When having conversations, avoid places having background noise, crowds, anywhere noise and echoes interfere with conversations, such a room corners. Find a place surrounded by upholstery, drapery, carpet, acoustical tile or places where background noise is absorbed. If you don't understand what someone says, ask them to repeat it or speak more distinctly and slowly.
If you are talking to someone with a hearing impairment. Don't shout, just speak a little louder, a little more clearly and carefully, and in briefer sentences. Even if the hearing impaired person is not a lip reader, it helps if they can see your lips as you speak, so look them squarely in the face. Speak with a slightly elevated voice level and keep direct eye contact.
As the body ages, it tends to operate at reduced efficiency. Bones become brittle and the elderly become more susceptible to viral infection, so it's important to ensure proper nutrition and have annual flu vaccinations. Seniors are more likely to require medical attention and hospitalization. Fear of debilitation, and hospitalization runs high in this group. To a senior, physical illness is a vivid reminder of their mortality.
Here are some suggestions for reducing their anxiety:
Help choose a doctor understanding special medical and emotional needs for geriatrics.
Many seniors tend to be submissive and intimidated when dealing with healthcare issues. They may need your support communicating with hospital staff about their needs.
Accompany them on Dr. visits and listen to their explanations. Ask questions the patient might forget to ask, explain information, and help them make wise medical options and decisions.
Be aware of their spiritual needs, if they are religious, during an illness or hospitalization. Contact their church so needs can be shared with prayer partners, Christian friends and those capable of making hospital visits.
Upon reaching age 65, the average person has lost about 25% of their original 10 billion brain cells. That is why some seniors see some deterioration in remembering, focusing, and thinking. Normally this loss is minor.
But with aging, additional factors may accentuate memory loss. For example, grief, or depression, can alter the balance of brain chemicals called neurotransmitters. Serotonin is an example of a neurotransmitter. If there is a drop in the level of serotonin a decreased ability to focus and remember can result. They may also display symptoms of moodiness, depression, and irritability.
Unfortunately, memory processing capacities begin slowing down at a time we have the most knowledge. We have an entire lifetime of memories, experience, and learning. Many older citizens seem to forget facts, and grope for words. However this isn't necessarily a sign of senility. On average their memories are still properly stored in the brain. It simply takes a little longer to access them. There are essentially three broad categories of memory loss common to senior adults:
The normal mild slowdown of memory access most aging adults experience.
Treatable, reversible memory impairments resulting from drug reactions, illnesses, nutritional imbalances, injuries, or emotional issues. (Depression, loneliness, and even the fear of forgetfulness can aggravate memory loss).
Alzheimer's disease, in which memory loss is irreversible.
Just the mention of Alzheimer's disease is enough to strike dread in the hearts of most. It's common when one experiences one of the first two categories listed above. However, there's a tendency to assume the worst and believe they're in the first stages of Alzheimer's. It's reassuring, and perfectly normal for seniors to sometimes forget details, a friend's name, or an appointment.
Only about 7% of those over age 65, will develop Alzheimer's disease or similar mentally degenerative condition. A little forgetfulness, although it can be an early sign of Alzheimer's, is in most cases merely a fact of old age. But significant signs of forgetfulness or confusion should not be simply dismissed as signs of old age, although many times, these symptoms are usually treatable disorders.
A disturbing feature of aging is it can cause changes in personality. People we have known for years as generous, kind, and courageous, may suddenly become irritable, fearful and bitter. Like memory loss, personality changes often result from a loss of brain cells. To a senior, physical illness is a vivid reminder of our mortality. Behavior may become extreme, and even childish as the brain begins functioning less effectively.
Aging and stress of emotional losses can contribute to chemical imbalances in the brain affecting the personality. For example, when another neurotransmitter called dopamine becomes too active. A person can experience hallucinations, delusions, and paranoia. Symptoms such as slurred speech, confusion, memory loss, and personality changes are indications a person needs medical evaluation.
Accidents can happen more easily. A mother had been living independently at home ever since her husband died years ago. But it became increasingly clear she could no longer live alone. Not long ago, she accidentally started a fire while preparing dinner.Two months earlier, she fell and could have easily broken her hip.
It was apparent she could no longer live alone. So the question became, should she be in a nursing home or live with a family member. This decision faces many regarding those who will be responsible. Some questions needing to be considered before inviting an aging parent to move in are:
- Do they need more care and attention than I can provide?
- Would it disrupt my family?
Is my parent manipulative or controlling?
What are my real reasons for wanting mom or dad to live with us? Am I really concerned or feeling guilty?
Experience shows it's rarely wise for senior parents to move in with their children. It becomes difficult to maintain good boundaries. Their children find it hard to discipline or deal with conflict. Family systems can become disrupted. A dependent senior needs more attention and caring than most can supply. Once the transition has occurred, one can't simply say “Oops, we made a mistake!” Don't enter into this commitment without a lot of thought and counsel.
Taking care of a dependent is a stressful full-time job. Research shows those caring for elderly parents are more likely to experience depression, high blood pressure, ulcers, and other stress-related disorders. Don't accept the job unless certain you can do it.
If you decide to care for an aging parent at home, it's suggested you join a support group for caregivers of senior adults to help deal with issues and stresses of the job. consider some of the following options:
A private duty nurse or live-in companion.
An assisted living residential facility that provides apartment style independence and privacy, along with part-time nursing care.
A nursing or convalescent home.
At-home care, combined with regular extended weekend or respite care, allowing a brief weekend break.
There are ways to improve the transition process and their quality of life:
Involve your parent in all decisions.
Assure them they aren't losing a home, just moving to a new address.
When they move in throw a “housewarming” party.
Help them select photos and keepsakes to make their environment seem more like home.
Make a point of taking your parent out every so often for a visit with old friends and relatives, lunch at a restaurant, shopping, or some other enjoyable outing.