Senior Toronto blog

June 29, 2022

Middle old age

Everyone ages differently, so I’m only speaking for myself here. I’m 76 now, and all those creeping age-related changes seem to have joined forces and given me a different self and a different life. I think and act very differently than I did even just a few years ago. It feels as if I’ve entered a new stage in aging: middle old age.

My late sixties were really the glory years. Retired on a pension, in pretty good health, I finally felt free to do just as I pleased and enjoy myself. It was a marvellous time of life. What I didn’t realize is that it’s a stage, young old age, and that it lasts for only a few short years.

But then, bit by bit, or sometimes suddenly, health issues begin to crowd in. I keep trying to compensate with more fitness, a healthier diet, good preventive care, and those things all help. But I can’t get over how much work it is, how much energy it takes to look after myself now. Chronic pain and chronic fatigue rule my life. They tell me how long I can sit, stand and walk, and are unforgiving if I don’t obey, so now I’m mostly housebound. It’s frustrating having to pay so much attention to my body; I’d certainly rather think about other things, and try my best to do so. But middle old age imposes limitations that cannot be denied.

My friends are going through middle old age too, and it’s a different path for each of them. Of course we all want to support one another, but figuring out how best to do it is a minefield. Health issues loom large in all our lives now, so we need to talk about them, but we don’t want to give in to endless whining. None of us are doctors, so although we would like the comfort of knowing that others share our experience, it’s not especially helpful to assume that your aches and pains are just like mine, so here are the exercises and herbal supplements that worked for me, why don’t you try them? Neither is it helpful to view this situation as a contest, the winner being the poor sod with the worst health. Some people reverse this ploy: one so-called friend keeps reminding me triumphantly that I’m worse off than she is.

I think one of the hardest challenges is managing a friendship with someone who is suffering from worsening memory loss. There’s still a warm connection, and we keep our conversation light, but so many of our shared memories and experiences have simply been wiped out.

I struggled for a while to come up with something upbeat to end this post. But then I decided that in this new stage of life, aging has become a formidable force and deserves more than cheery platitudes. So I’ll just say that middle old age is what it is. It’s my new life now, and I have to play the cards I’ve been dealt.

May 29, 2022

Seniors in Adland

Have you ever looked closely at pictures of seniors in ads? They look a lot like us regular human seniors, but actually they’re a different species, living on a different planet, called Adland. Here’s how to identify this species:

  • The men all have a full head of hair
  • Almost nobody wears glasses
  • Their skin is marvellously smooth, with just a few decorative wrinkles around the eyes and neck, and no age spots
  • They all come in couples
  • They’re slim and trim, with no batwing arms or pot bellies
  • Nobody uses a cane or walker
  • They live in modern, spacious homes, with sunlight pouring in through the windows
  • They use their notebook computers while curled up on the couch, and their tough, pain-free backs don’t mind a bit
  • They wear stylish casual clothes in mostly pale colours: white, beige or pastels
  • They like to hike and jog and ride bikes
  • They hold hands a lot
  • They hang out in multiethnic groups

Wouldn’t you like to live in Adland? You’d never get old!

April 30, 2022

Why read literature?

What with the endless pandemic and the horrors in the headlines, lately I’ve often turned to reading to escape. Mostly it’s been easy reading: mystery novels or best sellers. But now I’m finding that it’s not enough: I can’t keep living just on this fast-food reading diet anymore. I need to get back to the kind of fiction that engages your whole mind and soul: good quality novels, the kind we call literature.

What sort of book qualifies as literature? It has to be of high artistic quality, well constructed and well written. It addresses themes that have universal appeal and stand the test of time. The characters have depth and complexity, and their interactions ring true. Good literature still speaks to us, still has new things to tell us, no matter when and where it was written.

It takes effort and attention to read literature, but it’s a great cognitive workout for our aging brains. We get to spend a long time inside the minds and societies of other people, including people who may not be like us. We deepen our understanding of people’s emotions and desires, and feel empathy for them. We develop an appreciation of differing perspectives, motivations and values. We watch competing values come into conflict with each other, sometimes with no easy resolution, and learn to weigh them against each other. We resist the temptation to draw conclusions too soon. Reading literature requires us to slow down, take in a lot of information, and then change our minds as we read, sometimes reassessing our own long-held beliefs. We strengthen our powers of insight and imagination. We see that the world can be different from the world we know.

When selecting novels from this genre, we don’t need to be too choosy; any literature will do. Skip the best sellers. Here are some suggestions for finding titles:

  • Check lists of prize-winning books: the Giller prize, the Governor-General’s award, the Booker prize, or books by authors who have won the Nobel Prize for literature
  • Pick titles from Penguin Classics
  • Review book lists from literature courses. You can find some at sites such as Bibliomania
  • Ask a librarian for recommendations

March 30, 2022

Under the bus

It all happened in a flash. Suddenly, there are no more mandates for masking, vaccine certificates, social distancing or isolation requirements, and testing and case reporting are strictly limited. We’re behaving as if Covid were over. But of course, it’s far from over. As of March 29, there were 790 people with Covid in Ontario hospitals, up from 655 the day before, and 9 new deaths. A deadly new wave that has been sweeping through Europe and Asia is just beginning to appear here. In the headlong rush to get back to normal, people don’t want to hear about this. But if you’re immunocompromised, you’re worse off now than ever. Your body may not respond to the vaccine, so you wear a good mask, try to keep your distance and stay home a lot. You used to have more protection when everyone else was wearing a mask, getting vaccinated, and keeping their distance too. But that’s all gone now, and you’re on your own.

Who are the immunocompromised? They’re people with weakened immune systems. People with HIV, organ transplants, blood cancers, diabetes, malnutrition and certain genetic disorders; people receiving chemotherapy, radiation therapy, or high-dose corticosteroids for diseases like rheumatoid arthritis, lupus and vasculitis. Seniors are immunocompromised too, even if we don’t have those disorders. Our immune systems become more and more impaired the older we get. That puts us in double jeopardy: we’re more likely to be hospitalized or die because of Covid, and we’re also less able to mount a robust response to the vaccine. Most of us have happily gone to get booster shots, and then believe we’re protected from severe disease, and many of us may be, but which people? Some older seniors with complex medical conditions living in long-term care might not get enough protection through the vaccine, but what if you’re a younger, community-dwelling senior, maybe with diabetes? There’s no simple algorithm or diagnostic test to determine the status of your immune system. But if you have reason to worry, there are a few things you can do. You can ask your family doctor for a requisition for an immunoglobulin blood test, which helps diagnose immunodeficiency. Once you’ve had your Covid booster, you can wait for a few weeks, then ask your doctor for a requisition for a Covid antibody test; in Ontario, you have to pay for this test.

Don’t assume that you’ll have a mild case of Covid if you catch the omicron variant. Emerging data indicates that, for the immunocompromised, the risk of death from omicron is as high as it was with earlier variants. If you can verify that you are immunocompromised and you come down with Covid symptoms, there are some things you have to do in a hurry. You need to have a positive Covid test, find a clinic that offers monoclonal antibody or oral antiviral treatment, get a referral from your doctor, and get yourself to the clinic within five days of symptom onset. And you have to do all this while you’re sick! There aren’t many clinics; check the referral form for the current list of clinics and figure out in advance where you would go. There’s a new long-acting monoclonal antibody medication called Evusheld that can be used for Covid prevention in immunocompromised people. It was approved in the United States in December 2021, but it is still awaiting approval by Health Canada. Canada has signed a conditional agreement to buy 100,000 doses once it is approved. That won’t go very far, and it’s taking too long, but it’s a step in the right direction.

What would an equitable public health system look like? Its mission would be to protect the health of the whole population, particularly the most vulnerable. It would ensure that monoclonal antibody treatment and prophylaxis for the immunocompromised were approved, and adequate supplies made readily available, before lifting all the Covid mandates. Robust testing, tracking and public reporting would remain in place. Mask mandates would be encouraged during dedicated time slots in essential spaces like grocery stores and pharmacies. Employees across the province would have at least one week of paid sick leave, so they wouldn’t feel obliged to go to work sick. Where possible, people would have the option of continuing to work from home to protect their health, and virtual access to doctors and other service providers would be maintained. Building codes would be amended to provide for a higher standard of ventilation, and windows you can open. An equitable public health system would never simply abandon a vulnerable group like the immunocompromised to their fate, so that younger and healthier people can go back to the way things were.

But everyone is sick and tired of Covid. Businesses are eager to recoup their losses. Nobody wants to see those truckers again. There’s a provincial election coming in June, so the economy has to be booming. The immunocompromised are a minority group, without the clout to sway elections. Many people see us as a burden, one that Covid could neatly eliminate. We are deemed to be disposable, at very little political cost. So they threw us under the bus.

March 1, 2022

Happiness in old age

Which stage of life is the happiest? The answer may surprise you. We all know the stereotypes: carefree youth, vigor and success in middle age, and a lonely old age spent languishing in a nursing home. In fact, the research tells us, happiness follows a u-curve over the years: it rises when we’re young, drops during midlife, then begins to rise again around age 50, reaching its peak near the end of life. We seniors are the happiest people.

It seems counterintuitive, so what’s the explanation? First, that middle-age dip. Actually midlife is often the most stressful period of all, as people deal with building their careers, raising families, sometimes also looking after elderly parents. They’re often comparing themselves to their peers, measuring themselves against their ideals, and feeling stressed and dissatisfied if they don’t match up. Their assumptions about the things that were supposed to bring happiness – more money, bigger houses, promotions at work – turn out to be wrong.

So once we pass middle age and reach retirement, why do we feel happier, even if mental acuity and physical health decline? Many of us had jobs we didn’t enjoy, peers and coworkers we had to compete with, and bosses who made us miserable. In retirement, we can put all that stress behind us. Our children are grown. Now we have the gift of time, and more control over how we spend our time and whom we spend it with. We finally get to spend our days on activities we enjoy, and in the company of people we like. We no longer have to build a career or compete with anyone. Time becomes precious: we want to make the most of the years we have left. We reap the benefits of maturity: better control of our emotions, more comfort with ambiguity, deeper gratitude for whatever life offers. We can focus more on emotional goals that enhance our well-being. Now we’re more interested in enjoying life and the present moment. We relish the small pleasures of everyday life. We accept that life is fragile and loss is inevitable. We take life as it comes and savour what we can.

It’s interesting to learn that this has held true even through the pandemic. How can this be, when we seniors are at much higher risk of getting seriously ill or dying of Covid than the young? While all age groups are feeling heightened stress because of the pandemic, many of us seniors are in a privileged position: we don’t have to go to work, have pension income to live on, can have supplies delivered, hire help as needed, and don’t have small children underfoot. The beginning of the pandemic was brutal for seniors in long term care, but now it’s younger people who have been suffering, losing out on live schooling, jobs, sports, a normal social life. Their lives have been disrupted much more than ours. And they don’t have the emotional resources that we have spent our lives building. So let’s continue to take care of our own physical and mental health, be grateful for what we have survived, and if we can, extend our caring and compassion to the young people in our lives.

January 29, 2022

The Engaging with Aging blog

We seniors are used to hearing from lots of experts on aging. Many of them focus on health issues: physical and mental changes, disease prevention, treatment, palliation. Others deal with psychosocial issues: loneliness, vulnerability, adjusting to loss. Most of these experts are not seniors themselves. But if there’s one thing many of us seniors have learned about aging, it’s that it’s unlike anything we imagined. We don’t really start to understand aging until we get there.

Enter Doris Carnevali, blogger extraordinaire. As a former nurse, nursing instructor and textbook author specializing in nursing management of the elderly, Doris brings a fine scientific mind and a wealth of knowledge and skill to apply to her own aging. But now in old age, she’s also keenly aware of what’s missing from that knowledge base. So in 2017, at age 95, she began to work out a personal, pragmatic approach to aging in her Engaging with Aging blog. Articulate, creative and uncompromisingly honest, Doris builds bridges between our age-related changes and our daily lives.

Aging can’t be prevented or cured. The aging process leads to a steady stream of physical and mental changes that affect our ability to manage our lives. How can we deal with these changes and live our lives as well as possible? Doris takes a completely personalized approach. She’s her own lab rat. When an age-related change begins to interfere with her life, first she tries to learn about it and understand it. Why are my hands getting weak? Why can’t I grip things securely? Then she analyzes which areas of daily living are being or are likely to be affected. Cooking, dressing? What related or helping capacities and assets do I have available to make the most satisfying adaptation to the new normal? I’m adaptable and resourceful, I can make foods that don’t need chopping, wear clothes that don’t have buttons. So instead of focusing on the loss, she’s dealing creatively with what the new situation is or can be. She’s constantly balancing challenges and resources.

There’s nothing simple about this. Adapting to age-related changes in our daily lives calls on all the critical thinking and resourcefulness we can muster. Over and over again, she demonstrates how she applies her model of thinking and problem-solving to her everyday life. As Doris shows us, aging is a school for grown-ups.