Senior Toronto blog

July 29, 2018

Elder wisdom

I’m 72 now, and as my stamina wanes and health issues take their toll, I find myself turning more and more often to nonfiction for guidance. Old age really feels like life on a different planet; you can’t imagine what it’s like until you get here. So I don’t usually pay much attention to what younger people write about old age. That’s mostly about financing your retirement, getting your aging parents safely into care when they get frail, and worrying about seniors bankrupting the healthcare system. Or they fall back on tired old stereotypes: 90-year-old marathon runners, miserable curmudgeons, ditzy old ladies falling for scams. I want guidance from wise, articulate seniors who are travelling this road with me, or younger writers who are listening carefully to them and learning from what they hear. Here are a few books that have helped me. These are not feel-good advice books, and they don’t trade on clichés. They’re honest and hard-hitting, and full of surprises too.

  • Being mortal, by Atul Gawande. A surgeon discusses how to live our last days, what’s important, and what doctors could do better. Doctors need to go beyond the medical facts, listen to the patient’s wishes and guide decisions to meet the patient’s goals. Ask the patient: What do you understand of what is happening to you? What are your fears and hopes? What are your goals if your condition worsens? What trade-offs are you willing to make and not willing to make? Which choice best responds to this? Touching, provocative, and personal.
  • Dancing fish and ammonites, by Penelope Lively. This award-winning British novelist writes a personal memoir at age 80, exploring old age, history, memory, reading and writing, and six items of import in her life. The mind expands while the body declines. For this author, reading is a meaningful part of lived experience. Rich, eloquent, and reflective.
  • Happiness is a choice you make: lessons from a year among the oldest old, by John Leland. This New York Times journalist spent a year interviewing six seniors aged 85 and over, probing how they live and think. Most of them have disabilities and pain, but they don’t define themselves by those things. Freed up from having to build a future, they focus on the present, and make their lives out of what they have to work with now. Written with depth, empathy, and understanding. The experience changed the author’s life.

June 29, 2018

Snake oil

We seniors are major users of natural health products: vitamins, minerals, herbal teas, glucosamine, sleep aids, you name it. On every package, you’ll see an eight-digit Natural Product Number (NPN), which means that the product has been authorized and approved for sale by Health Canada’s Natural and Non-prescription Health Products Directorate. So it’s safe and effective, right?

One of my relatives has chronic lymphocytic leukemia. So he was very interested in some recent clinical trials run at the Mayo Clinic (Phase I and Phase II), which showed promising results using high doses of EGCG, an ingredient found in green tea. He contacted the chief investigator, who told him how to run his own trial. He asked a naturopath to recommend a good brand of green tea capsules, bought some at a local health food store, and started taking them. When blood tests showed no significant effect after a few months, he wanted to make sure he was getting enough EGCG. So he took the capsules to a lab. The label on the bottle claims there are 315 mg of EGCG in each capsule. The lab found 39.8 mg of EGCG per capsule – not even 13% of what they claim on the label, and far too little to have any therapeutic effect.

This is no blip. There is virtually no enforcement of quality control for the manufacture and labelling of natural health products in Canada. Furthermore, Health Canada accepts a very weak level of evidence to qualify a natural health product for approval in the first place. For homeopathic products, for example, anecdotal information will do. A few years ago, the CBC TV show, Marketplace, demonstrated just how low the evidence bar is when they created a fake product, called it Nighton (an anagram of Nothing), said it was meant to treat fevers in children, and submitted their application with a few pages photocopied from a 1903 homeopathy text. Yup, it got approved. When Marketplace presented their findings to Health Canada, Health Canada didn’t even apologize; they claimed they were offering consumers choice. What sort of choice do we have when manufacturers can lie on the label? How can we trust any natural health product, when the industry is free to sell snake oil with Health Canada’s blessing?

As for my relative, now he gets his green tea capsules directly from the scientist in Japan who supplied them to the Mayo Clinic. It’s too early to tell whether green tea will help him, but at least he gets to find out.

May 30, 2018

Elder orphans

Are you an elder orphan? This is what it means:

An elder orphan is a senior who lives alone and has no children or family member or friend who can or is willing to act on his or her behalf in handling health, legal and financial issues.

More and more people are living alone these days. For many of us, it’s a lifestyle choice that we’re comfortable with. But as we age, we come up against healthcare, financial and legal systems that were not designed for us. You’re scheduled for day surgery, and the surgeon tells you someone has to pick you up and stay with you overnight. You break your arm and can’t go home right after surgery because you won’t be able to wash yourself or cook your meals. What if you have a stroke or develop dementia? Who can you appoint to have power of attorney over your care and your financial affairs?

There are no easy answers, but you can at least track down all the services available to you, and use them. Find out which agencies offer senior services in your area. You want one, or maybe more than one, that can provide some social and healthcare support: services like telephone reassurance, escort to medical appointments, case management. This is a messy search. To start with, find your LHIN. Click Seniors and then Seniors’ intervention and assistance services. If you don’t find enough there, try Community support services or Seniors’ centres or Advocacy and social action for seniors. Become a client; get to know the intake people. If you find yourself in hospital unexpectedly and can’t look after yourself while you recuperate, remember that Ontario offers a convalescent care program for those who qualify. You get a short-term stay bed in a long-term care facility. If you think you need this, ask to speak to a social worker at the hospital. Details about this program are remarkably hard to find online. Here’s a brochure from a jurisdiction outside Toronto.

As for powers of attorney, things get even murkier. You used to be able to arrange with a trust company for them to assume power of attorney for your finances, but now the trust companies will do this only for clients whose assets are worth a million dollars or more. There’s no regulated agency you can just call up and hire a professional to be your power of attorney for care or finance. You have to flounder around looking for someone on your own. You’re probably thinking that this field is ripe for exploitation, and you’d be right.

Obviously I have more questions than answers about the issues faced by elder orphans. If anyone reading this has some useful suggestions, please share them with everyone in the comments section. This can’t be the end of the story.

April 29, 2018

City of Toronto’s new website dishonours seniors

In December 2017, the City of Toronto proudly unveiled their revitalized website, designed to be service-focused and citizen-centric, visually appealing, action-oriented and easy to navigate. What a great opportunity to showcase the age-friendly city that Toronto is trying to become! So I was eager to check out the section on Seniors. I was in for a shock.

Feel free to follow me along on the tour. The new homepage, https://www.toronto.ca, has a link called Community & People. That sounds like the place to find Seniors, so let’s click on Community & People. We get a drop-down menu with a grab bag of topics including, among others, Children, Youth & Parenting; Animals & Pets; Health & Wellness; Housing & Shelter; but no Seniors. It took me a little while, but I eventually I found it, tucked away under Housing & Shelter. See it for yourself; it’s all about finding housing, long term care, or home help. One of the Housing links, called Seniors & Disabled, mentions seniors in the title, so let’s take a look at it. More about home support, with just two additional senior-relevant items under Related Information: a falls prevention program that caregivers can sign up for, and a link to the Toronto Seniors’ Forum. Other than that, the City of Toronto sees us as nothing but a housing issue.

It’s hard to believe that this is a city that took the trouble to create a Seniors’ Strategy back in 2013. Using the framework provided by the World Health Organization’s Guide to Global Age-Friendly Cities, they proclaimed some lofty goals, based on equity, inclusion, respect and quality of life. The report covered health, housing, transportation, recreation and community programs, safety and security, accessibility and civic engagement. So where are the links to resources for seniors in these areas? Even the Strategy itself is hidden away under the Toronto Seniors’ Forum. And if you’re lucky enough to stumble on it and click on the Toronto Seniors’ Strategy link, all you get is the decision to adopt the strategy in 2013. What’s happened to it since? Well, there have been progress reports, but there’s no sign of them here. And there are efforts underway to create a new strategy, but there’s no mention of that anywhere either. In any case, regardless of what the Seniors' Strategy may say, it's obvious that word has not gotten out.

It’s pretty discouraging to see the City of Toronto present this narrow, reductive view of seniors to the world in 2018. Many other cities have adopted a much more welcoming, holistic approach on their websites. To see how it’s done, just check out Hamilton or Vancouver or Ottawa or Edmonton or Mississauga or Laval.

I can’t imagine what the Toronto Seniors’ Forum members have been doing with their time, but they might as well stay home. Judging from their website, an age-friendly Toronto couldn’t be farther from anyone’s mind at City Hall.

March 30, 2018

On being useful (or not)

It seems to be written into our DNA. Just about all of us want to be useful, reach out to others, play our part. Even little children like to help out. Whether we’re motivated by affection, a sense of moral obligation, or a need to prove ourselves worthy, most of us try to support our friends, family and colleagues. And of course, while we’re working, we’re paid to be useful. Once we stop working, we may feel bereft, unneeded. And if as we age we become more frail and need to receive help rather than giving it, we may start to ask ourselves, in consternation and distress, what the value of our life is now.

We’re creatures of our society, and our society places a high value on productivity, particularly through paid work. Never mind that we may have earned a living for years; once we’re retired, we’re viewed as a burden. We’re accused of sucking up all the health care resources, and left to languish in hospital beds, waiting months for a long-term care placement because there isn’t enough long term care. Or we languish at home because there isn’t enough home care for us either. We have outlived our usefulness, says our society, and so we are warehoused and neglected and shunted out of sight.

It’s not just seniors and the disabled who suffer from our preoccupation with usefulness. For generations, we have regarded the non-human world largely in terms of its usefulness to us. Plant and animal life and natural resources have all been bent to our needs, and we are only now just beginning to wake up to the devastating effects of what we have done to the earth.

Usefulness has its place, it helps us get along better and ease each other’s burdens, but I don’t think we should use it as a primary measure of our worth. Most of us value our own lives enormously, quite apart from our usefulness, and unless we are very ill or in pain or despair, we fight hard to go on living. If we feel that way about ourselves, we can assume that other people feel that way too. Life is clearly precious in itself, and we try to live as best we can. We need to incorporate that truth morally and feel it emotionally, place it in the centre of our moral universe. Some might find support for this in religion or philosophy. In a pinch the Golden Rule would do. We are not just a means to other people’s ends.

February 28, 2018

Giving up the car

The old rust bucket on my driveway is showing its age. It has served me well for 14 years, especially when I was working. But now the repairs are getting more frequent and more expensive. The car is growing old, and so am I. Never a driving fan, I find my worsening eyesight, slow reflexes and creaky joints now make me very uneasy behind the wheel. So I’m not driving it much, and that makes things even worse for the battery and brakes. The car is becoming a burden. Sometime soon the repair bill will be just too high, and I’ll give it up. But then what?

I’m not a menace on the road yet. I have to make a lifestyle choice, not a public safety one. If I don’t replace the car, how will I manage? I’ll still have lots of options for getting around. I’m lucky to live near shopping, a parking lot with ridesharing cars, a subway station and a GO train station; they’re all just a 15 to 20 minute walk away. There’s Toronto Ride to take me to medical appointments and shopping, or I can do most of my shopping online. If I’m feeling spry, I can haul a grocery cart or backpack down to the store. So it’s not independence I’ll be giving up; it’s spontaneity. Most of those alternatives require planning ahead. Will that matter?

There will be tradeoffs for sure. No more quick trips to Canadian Tire when I run out of ice melter. Things that used to be simple errands, like buying plants and fertilizer for the garden, will now become projects. And as my joints stiffen and my pace slows, what feels like an easy 20-minute walk right now could well turn into a journey to the other side of the moon. I’ll get rid of the burden of the car, but will be taking on new burdens in terms of the time and effort and foresight it will take to look after myself and manage my home.

Making adjustments, accepting new realities: it’s all part of aging. Gotta just roll with it, in the slow lane.