Who “taught” you how to be old? The role models I grew up with included my maternal grandfather (who lived to 80), my paternal grandmother (who lived into her 90s), and cultural icons such as Grandma Moses and the centenarians who made it to the Today Show’s segment on folks turning 100 with Willard Scott (brought to you by Smuckers!)
My grandfather’s impact on me was enormous. I had daily interactions with him throughout my life. These evolved from being the sole grandchild who was entertained and adored to becoming his caregiver after he broke his hip in a fall, and continuing to provide care as he lost all function and was wheelchair bound.
An active, vibrant man for the majority of his life, he easily and effortlessly climbed three flights of stairs to his flat, and walked to and from work in downtown Chicago well into his early 60’s. He broke his hip in a fall while entering his office building. Fortunately, my grandfather’s fracture was successful treated, his hip surgically repaired and he returned to almost fully functional status. Therein lies the rub.
He did file a law suit for negligence on the part of the building owner. It took two years before my grandfather’s case came to trial. During those years, his physical functioning declined and his world become smaller.
I have a vivid memory of being at the trial and watching him use his cane to navigate the space between the plaintiff’s table and the witness stand. He rose with difficulty, and walked slowly but as dignified as possible and took the stand to describe what had happened and his subsequent decline in the ensuing two years. He won the case, but it was a Pyrrhic victory.
My grandfather was a widower. As he aged, his need for daily household help increased. Because he couldn’t climb three flights of stairs, my mother and I would visit him daily, do his shopping, bring him dinner, and make sure his laundry and the apartment were kept clean. I would stay during the weekends, both as a respite for my mother from me, and as a respite for me from my mother.
These were remarkably wonderful experiences for me, as my grandfather was a very wise and compassionate man. I literally had 24-hour access to him. It did not occur to me that, at ages 14-18, I was young to be providing intimate bathing and toileting care for an older man. Quite honestly, there were few options in those days, and it was expected in my family that we would do for each other. I learned an awful lot about biological functions in an aging adult.
But the biggest lesson for me was around giving and receiving. What my grandfather taught me is that while the individual’s capacity to function may decline in his or her physical world, spirit, mind, and personality can, and often do, remain strong.
Ever since I celebrated my 65th birthday I am keenly aware that my idea of what 65 is now is very different from what I remember 65 being when I cared for my grandfather. I currently enjoy an active, unrestricted lifestyle. I expect to be working and feeling useful well into my 70’s. I have access to surgeons and insurance to cover the cost of hip replacement should my functioning decline, and a reasonable expectation that this will result in a return to full functioning within days. What is required of me is that I exercise, lose weight, stay physically and socially engaged in activities that have purpose and meaning for me.
I have difficulty wrapping my mind around the number 65, since it does not reflect my inner experience of my energy, my thinking, or my short-term and long-term goals. I am not ready to step aside and “retire”. Instead, I am planning and initiating what I call the “Last Third” of my life. What will change for me in these years is my capacity for doing and creating the kind of life I want and expect to live. I will need different strategies for preserving my independence and creating income streams. I will need different networks of friends and neighbors (since I don’t have children of my own) to keep me connected and in touch with what is new and cutting edge. I will need access to different medical specialties at different times. I will need connection and support in adapting to things that I cannot control. All of which takes a mindset that is open and flexible.
I believe I have this mindset because I had a role model in my grandfather that showed me how to adapt and accommodate to the unexpected challenges and surprising gifts that aging brings.
Five Pillars of Aging: I encourage you to pay attention to what is happening with your Medicare benefits right now. As of this printing, there is a bill in Congress to markedly change pharmaceutical benefits (Medicare Part D) for individuals with chronic conditions including mental health conditions, epilepsy, Parkinson’s Disease, lupus, HIV/AIDS, cancer, and organ transplants. These are known as the Six Protected Classes, and were given protections when Part D was signed into law by President George W. Bush in 2003. The proposed rule (introduced in 2018, but now out of committee and before Congress) is directed at cost-containment which is a necessary thing; however, the proposed rule seeks to save money by requiring prior authorization for some medications, use of a step-therapy (also known as “fail-first)”, adding exceptions for new formulations of some medications (e.g., extended release medications), and excluding medications whose prices rise more quickly than inflation. Public comment has closed. There are still opportunities for you to voice your opinion. I encourage you to contact your elected representatives and express your thoughts on how these changes would destabilize patients’ existing regimens, prevent access to innovative new treatments, and create burdensome administrative processes for patients, their caretakers, and providers.
Thanks for reading!
