Senior Toronto blog

March 30, 2019

Retirement for introverts

I’ve always needed plenty of time alone. I enjoy getting together with a friend or two, but a lot of social activity or large groups make me feel exhausted. Then I need lots of solitude to recharge. I’m not unhappy. It’s not pathological, it just is what it is. No matter what line our culture tries to feed us, heavy socializing is not for everyone.

We introverts often find the workplace stressful, being surrounded by people and having to interact all day. So retirement can feel like a blessed relief. Finally, our time is our own, and we can choose how much interaction we want, and when, and with whom. I can spend days puttering around at home, taking my time with everything, not following a schedule. If I want to spend more time with other people I can easily arrange it. If I need a bit more structure, I can just sign up for something. I don’t have any bucket list; I’m happy to just float along. As long as I’m healthy, it’s bliss!

It would be lovely to imagine that I could just go on living in my own home until I die peacefully in my sleep some day. But realistically, at some point I’ll probably need care. And care homes are not designed for introverts.

If I can’t manage to look after my place anymore, have to stick close to home but still want easy access to activities and medical staff, then I’ll go shopping for a retirement home. They’re expensive and I might not find one I like, but at least I can take my time and do some comparison shopping. A lot of them seem to run sort of like an adult summer camp, with the expectation that you will socialize, socialize, socialize: join lots of activities, eat your meals in groups, get out of your room. But a few retirement homes are starting to recognize the need to accommodate introverts and include activities with lower social content in their programming, like using computers, puzzles, games, fitness, singing and gardening.

The real crunch will come if I get sick enough to need care round the clock – dementia, a broken hip – and have to go into a nursing home. Nursing homes in Ontario are warehouses: weakly regulated, poorly monitored, minimally staffed. About 70% of them are privatized. I would expect to share a room and the washroom will be down the hall. I’ll be lucky to get two diapers a day and a shower a week. The TV will be left blaring all day, and no one will answer the call bell at night. Programming, if there is any, will consist mostly of bingo. This is not fear-mongering; it is exactly what I discovered when I spent seven weeks in convalescent care in a nursing home a few years ago. There is no relief from the noise and no place to be alone. But neither is there much chance of companionship: of the 60 residents on my floor, not more than one or two were capable of carrying on a conversation. So I’d say nursing homes are probably equally hard on introverts and extroverts. But maybe I’d give a slight edge to introverts, who are used to entertaining ourselves with our own minds. With luck, maybe that will help see us through those rough days at the end of the road.

February 28, 2019

On rereading books

So many books, so little time! Why bother rereading a novel when there are so many new ones? Are we just being lazy, sticking to what’s familiar? Or is it the only way to really understand a book?

I got to thinking about this recently when I was home recovering from minor surgery. I found myself reading through all my old Brother Cadfael mystery novels. I didn’t care whodunit. I just wanted to spend time with a beloved familiar character. It was such a pleasure to be back in the company of the calm, compassionate, astute, spiritual yet worldly Brother Cadfael. A few years ago, when I was in a lot of pain with a ruptured disc, I reread all my Asterix comic books. They allowed me to escape to Gaul in Julius Caesar’s time, and have a good laugh. So sometimes rereading books can simply provide the comfort of something familiar, something we’ve enjoyed before and probably will enjoy again.

Some books provide a depth and breadth of vision that we discover only gradually on rereading. The second time around we can better appreciate the characters, atmosphere, writing style, structure and ideas: all that rich nuance we didn’t catch the first time because we were too curious to find out what would happen next. This works best with what are sometimes called literary novels, or classics: novels with depth and complexity. Middlemarch is a good example. The first time I read it, I was all caught up in following the threads of each character’s story. The second time, I could focus more on exploring some of the themes: confronting our failures, the place of women in Victorian society, the complexity of human motivation, the hunger for money, the power of compassion.

There’s a special benefit to rereading books in old age: we become aware of change. The books haven’t changed, but we have. As we go through life, our experience has broadened, and our values and interests may have evolved too. So we may react very differently to a book now than we did years ago. Rereading connects us to our younger selves: how we thought and felt, what was important to us then, and how we look at things now. Things that didn’t make sense before make sense now. Jay Gatsby, who seemed so charming and flamboyant when I read The Great Gatsby years ago, now appears manipulative and grasping. When I read Animal Farm as a teenager, I was mostly intrigued by the characters and interactions of all the talking animals. Now I recognize in Napoleon the pig a chilling portrayal of a dictator masquerading as a liberator. Some books may not live up to our earlier experience. I loved Little Women as a child, but now I’m put off by all that tedious moralizing, and I’ve shattered a happy childhood memory.

I’ll leave the final word to Robertson Davies:

A truly great book should be read in youth, again in maturity and once more in old age, as a fine building should be seen by morning light, at noon and by moonlight.

January 29, 2019

Get some sleep

Sometimes I think I’m nothing but a leaky bucket. I’m up every couple of hours all night long. By about 4 am, my body gets fed up with all those interruptions, and won’t go back to sleep any more. So then the next day I’m a zombie, walking around in a daze, can’t get anything done. And the next night it’s the same thing all over again.

You too? We’re not alone. Over 50% of seniors have insomnia. There are plenty of possible reasons: medical or psychiatric disorders, chronic pain, medications, frequent urination at night, bereavement, financial problems, sedentary lifestyle, too much napping, and on and on. If you ask Dr Google, you’ll get lots of contradictory scientific-sounding advice, folk remedies, ads and testimonials. So I decided to search the medical literature, to see which insomnia therapies have actual hard evidence behind them.

Here’s a selective summary of what I found. I’ve included only actions you can take yourself at home, for free. Of course, you can also enroll in a sleep therapy program, but you have to pay for that. You should see your doctor to rule out or control medical conditions that might be affecting your sleep. If that results in a prescription, make sure you’ve discussed all the possible side effects and interactions with your other medications. You don’t want anything that will make you groggy in the daytime and liable to fall. It’s the same issue with over-the-counter remedies, with the added hazard that Health Canada maintains very lax standards and provides virtually no oversight over this industry. So you never know what you’re actually getting; producers can lie with impunity on their labels.

Pick whatever you want from these categories. Apparently you get better results if you use approaches from more than one category.

Stimulus control

  • The goal is to associate your bed only with sleep (well, and maybe one other thing)
  • Don’t watch TV, talk on the phone, listen to the radio, check your messages, read or eat in bed
  • Go to bed only when you feel sleepy
  • If you can’t fall asleep after 20 minutes, leave the bedroom and engage in relaxing activities like reading on the couch until you feel drowsy, then return to bed

Sleep hygiene

  • The goal is to practise healthy behaviours that promote good sleep
  • Exercise regularly, but not within four hours of bedtime
  • Avoid tobacco, stimulants, caffeine and alcohol six hours before bedtime
  • Avoid excessive liquids and heavy meals three hours before bedtime
  • If you have to take naps, limit them to 30 minutes or less, before 3 pm
  • Get up at the same time each morning
  • Make sure that the bedroom is dark and quiet, and that the temperature is comfortable
  • Increase your exposure to natural light and bright light during the day and early evening
  • Don’t watch the clock

Relaxation

  • The goal is to counteract stressors that interfere with sleep
  • Practise progressive muscle relaxation in bed
  • Avoid unpleasant or strenuous tasks right before bedtime
  • Don’t watch TV or use a computer near the time you want to fall asleep
  • Avoid strong or negative stimuli like computer games or horror movies near bedtime
  • If you have a smartphone, turn it off at night and don’t keep it in the bedroom
  • Schedule time to wind down before bed. Give yourself at least 15 – 30 minutes. Try meditation, deep abdominal breathing, yoga, crossword puzzles or a warm bath. Write down your thoughts in a journal

Sleep restriction

  • The goal is to improve sleep efficiency through mild sleep deprivation
  • Figure out how much time you actually spend sleeping
  • Limit the amount of time you spend in bed to the number of hours you spend sleeping, but it shouldn’t be less than five hours. If you’re not sure, pick six hours
  • Spend only that number of hours in bed. Adjust your bedtime, but still get up at the same time each morning
  • If you are wide awake during this time, get out of bed and carry out a quiet activity like reading outside the bedroom. Go back to bed only when you feel drowsy
  • Keep to this schedule for two to four weeks
  • After you reach 85% sleep efficiency, increase sleep time by 15 minutes each week until you obtain seven to nine hours of sleep per night

December 29, 2018

How do you know you’re old?

We’ve all read those jokes, mostly written by young people, and usually downright mean. See what you think of these. They’ve been vetted by a group of wise seniors (my pals and I).

You know you’re old when

  • No one asks you for ID to prove you’re old enough for the senior discount
  • Salespeople at the hardware store come up to you unbidden and ask you if you need help
  • Middle-aged people offer you a seat on the subway
  • Grocery store cashiers spread out the heavy items among all your bags, so no bag will be too heavy for your old bones
  • You don’t have a smartphone because you don't see the need and don’t want the distraction
  • Sales staff and receptionists paste on a benevolent smile and talk to you loudly and slowly
  • People stop asking you for directions
  • You still cook from scratch and don’t think it’s any big deal
  • Waiters stand there watching to see if you can figure out the pay-at-the-table credit card reader
  • You’re glad to have a whole day at home

November 29, 2018

What to do when you’re stuck at home

Winter started early this year, with snow and slush already in mid-November. Looks like it’s going to be a long haul. For those of us seniors with a fear of falling, this means a long season of staying put. What can we do with those dreary days at home? Here are a few ideas to keep from landing in that blue funk:

  • Get an e-reader so that you can download books from the Toronto Public Library. Then you don’t have to worry about getting to the physical library if the weather’s bad. Make sure you pick an e-reader that allows you to download library books. See TPL’s instructions.
  • Pick some kind of music you want to learn more about. Find an internet radio station that plays that music. Start listening.
  • Learn to cook something new. Maybe learn how to bake bread, or cook some vegan dishes.
  • Learn to play euchre or cribbage. There are lots of websites that explain how to play and let you practise online. Then, if you move into a retirement home later on, you can join right in.
  • Find some exercise videos you can work out to. There are plenty of free workouts for all levels of fitness. Here’s a good starting point.
  • Stock up on puzzle magazines. Try different kinds: crosswords, Sudoku, cryptograms, logic. Use a mechanical pencil so the point stays sharp.
  • Start a blog. It’s easy to do with free software you can find online. We seniors need to make ourselves heard.
  • Get a Lego set or some jumbo jigsaw puzzles. Set them up someplace where you can leave them out, and just keep returning to them when you feel like it.
  • Teach yourself to play the ukulele. Buy a cheap one and maybe an instruction book, or try some online tutorials. Once you know three or four chords you can play hundreds of songs. Sing and play your heart out.
  • Volunteer from home. Go to Charity Village and check the box that reads Only show home-office based volunteer positions.

October 30, 2018

We’re getting soaked

Why is it that so many products and services we seniors need to maintain our aging bodies and manage our lives are so bloody expensive? I guess people in these businesses haven’t been reading the StatsCan reports and think we’re all millionaires. Here are some of the more outrageous examples.

  • Eyeglasses. Many of us need bifocals, so the lenses alone can cost from $500 to $1000. But then why does it cost hundreds of dollars more for frames? They’re just a bit of plastic or metal and a few screws, all mass-produced. Did you know that just one company controls most of the market?
  • Hearing aids. These can range from $1200 to $4000 and more for each ear. You sometimes have to pay dispensing fees too. Ontario’s Assistive Devices program may subsidize you to a maximum of $500 for each aid. The components actually cost only about $100 to make.
  • Orthotics. If you have fallen arches or plantar fasciitis, you might be given a prescription for custom orthotics. They typically cost between $300 and $600. In Ontario, they can be prescribed only by physicians, podiatrists or chiropodists, and provided by podiatrists, chiropodists or pedorthists. There is strong evidence of effectiveness for only a few conditions. There are lots of unauthorized people selling orthotics for conditions that won’t get any benefit. Do your homework.
  • Good walking shoes. If you have orthotics, you need roomy, sturdy walking shoes to put them in. These days, a pair can cost from $100 up to $400. Good walking shoes have always been expensive, but in the last few years the price has stayed high while the quality has gone down. Nowadays the treads wear smooth in a year or two, and sometimes even fall off in pieces. Many shoes are now made of synthetic materials instead of leather, and they cause blisters. Often the manufacturer doesn’t even tell you any more what the shoes are made of, not in the shoe, not on the box. They do tell you what the box is made of, though.
  • Dentures. It’s pretty common to lose teeth in old age, and then we need dentures. They can cost from $1000 to $30000 or more, depending on whether they’re partial or complete and what techniques are used. Even if you have extended health insurance, dentures are often considered cosmetic and aren’t covered. Explain that to someone who has no teeth.
  • Mobility aids. The Ontario Assistive Devices program (ADP) pays 75% of the cost of mobility aids such as manual wheelchairs, power wheelchairs, power scooters and wheeled walkers. You are allowed to buy only ADP-approved equipment from ADP-approved vendors. But the pricing framework does not reflect current costs. An equipment vendor may not be able to provide certain ADP-approved equipment because the maximum funding through the ADP does not cover the wholesale cost of the equipment. Small independent stores selling mobility aids can’t absorb these cost overruns and therefore often cannot provide the prescribed equipment, even though it is on the ADP-approved list.
  • Physiotherapy. In 2013 the Ministry of Health delisted non-hospital physiotherapy from OHIP. They also delisted one-on-one physiotherapy in retirement homes. Now some insurance providers are delisting it too. Seniors (65+) can still get coverage if we meet the criteria, which focus on acute care. To get the service, you must go to one of the designated publicly funded clinics. Typically, they provide 20-minute group sessions. You may be put on a wait list to get in. If your condition doesn’t fit the government’s criteria, you’ll have to go to a private clinic and pay for the treatments yourself.
  • Extended health insurance. If you were lucky enough to have extended health and dental coverage while you were working, you’re in for a shock in retirement. These plans provide only partial reimbursement for the various services, and limit the number of times per year you can use them. The caps or maximum limits for drugs, dental, vision, hearing and allied health care are generally low. You are really paying in advance for these services, whether you use them or not, plus the administrative costs and profits of the insurance company. So it makes more sense to just budget for these costs, set the money aside, and pay them yourself. If sometimes those expenses are lower than you expected, then the money’s there for you to use for other things.
  • Medications in long term care homes. The Ontario Drug Benefit Plan (ODB) allows pharmacies to charge a copayment of $2 for low-income seniors, or $6.11 for higher-income seniors, for each prescription. In practice, most pharmacies waive the $2 fee for seniors living in the community. But in long-term care homes, residents routinely get charged $2 for each prescription. Many prescriptions in these homes are packaged to supply a week at a time, and residents are charged $2 for each weekly package, forcing them to pay at least four times what they would pay in the community. It’s a fantastic windfall for the few pharmacy services that control this market.
  • Corporate trustees. Suppose you can’t manage your own finances any more, but don’t have anyone to appoint as your power of attorney for finance. You’d like to find a professional to handle this. Until a few years ago, you could arrange it through a trust company. But now trust companies will take this on only if your portfolio is worth a million dollars or more. Lucky for us we’re all millionaires.