Many years ago, my husband and I took a trip to Puerto Rico. Many people pass briefly through on the way to other Caribbean destinations. We talked with people with ties to Puerto Rico and decided to see more of the island by staying for two weeks and renting a car, staying in some of the smaller towns. Here are a few of my photos, while dated, show the beauty we found along the way.
I share this because I can validate the descriptions of the island as a special place with extreme physical beauty and proud and welcoming people. The people of Puerto Ricans have suffered due to Hurricane Maria and the lack of support from the federal government. It is a different response than was given to other US disasters.
A co-worker of mine tells me her family, including her 98 year old father, get by day to day with food and water not a sure thing, and they are not in a remote location. I don’t believe her story is unusual.
Take a look at this interesting story of Jason Maddy, who with a group of US veterans that call themselves “Grunt Rescue” took it upon themselves to go to Puerto Rico and help those in the isolated towns to get the assistance they need. You can look him up on Facebook, it seems to be legitimate. There are multiple posts from concerned family members who can’t get to family in remote areas of the island.
I was confronted with a difficult realization today when talking with a co-worker. We were working with an older couple, the wife has Alzheimer’s dementia and he is her very devoted caregiver. My Coworker and I discussed the husband’s reluctance to provide needed information to access services. She pointed out to me that they were African Americans from the deep South and may be fearful of outsiders, based on past experiences with systematic racism. I then realized that so many old wounds are being opened with the recent public demonstrations of white supremacy/white nationalism. Older people are reliving the racism of the past.
Here is a great article with information we can all use. You don’t need to be a full time activist, but all of us ordinary people need to DO SOMETHING!
Everybody has a different reaction to health problems, but one response I consistently hear is, “why me?” A fair question. Life isn’t fair.
Another person recently stated over and over, “I’ve fallen apart, mentally and physically”. When he learned that his assets were depleting, he told his friend and POA, “just take me out back and shoot me.” I told him we could do a LOT better than that for him while thanking him for his service and explaining the publicly funded long term care available to him.
Another visit comes to mind when I was talking with a woman in a nursing home who just had her leg amputated. I saw her staring at my feet, exposed due to the sandals I was wearing. I was suddenly aware that I was reminding her of the leg she will never have back. Why me, she seemed to be thinking.
Then there was the individual I called to remind of some needed paperwork he had not submitted. “You have no idea what it is like to be disabled”, he stated. There is no response to that statement.
There is no place to hide when discussing matters of such importance with people. It is a part of being human myself and acknowledging the humanness in others. Again and again, I am reminded of how fortunate I am and how I must come across to people, many of whom are isolated and have little contact with people other than care providers. It is at these times that I realize the significance of this type of work, even though it is not very glamorous.
One of the most wonderful parts of seeing clients in their homes and connecting older adults with long term care programs is supporting individuals and families in home settings. Along with keeping families together, it allows older adults to have their pets around, improving quality of life for all involved.
One of the most memorable pets I’ve met is Terry the cat-a very large grey cat. His owner, Marie, lives alone and has a limited support system. She told me that he comes running when she calls him Baby.
On one occasion a few years back, I brought my puppy into my workplace, which was an adult day center. One frail woman fell to her knees when she saw the puppy and held the dog with tears in her eyes. “I used to have a dog just like that and I miss her so much”, she said.
In the book, “A Man Called Ove”, there is a heartwarming subplot about his relationship with a stray cat. When Ove peacefully passes away, the cat curls up on his chest.
Pets help us to live in the present moment. It’s important to remember even when someone may be older, possibly ill or have a dementia, animals will likely provide the joy and feeling of connectedness.
I hope you enjoy this slideshow that outlines specific reasons why animals are wonderful companions for older people.
In this article, Gawande describes a different way to look at treatment of chronic health issues. The approach is based on slow and steady progress and the realization that complete cure is unlikely and that progress can be slow and incremental. There is rarely an immediate remedy and expectations are lowered. Doctors partner with patients to measure the problem and work through plans of escalating remedies. It involves continual measuring and adjusting. Medical practice can at times convey an “aura of heroism”, like a surgeon operating just in time to save a life. Data, however, shows that Primary Care (opposite of a specialist) is the area of medicine that has the greatest impact, including lower medical costs.
This approach emphasizes the importance of prevention and maintenance of health, as well as coordination among specialists for problems that have already been diagnosed.
Perhaps this approach resonates because I grew up in a household with a dad who specialized in Internal Medicine, who I believe practiced this type of medicine. He seemed to know his patients as individuals, many who were fiercely loyal.
I have also seen this approach work well in my 20 years working in the PACE model. This model sets up long term relationships between interdisciplinary health care professionals and individuals with multiple chronic health issues.
An incremental approach also would address the rapidly rising costs of health care.
It is also related to wellness, defined asis an approach to health care that promotes the prevention of illness rather than treatment of disease, or health as an actively pursued deliberate effort.
It definitely is a challenge however, because it goes against the fast pace of rapidly developing technology. Perhaps that’s the point.
I went to a training this week and was reminded of the importance of listening to what people tell us about what is meaningful in their lives. The presenter sang a version of The Rolling Stones You Can’t Always Get What you Want, but instead he sang “You get what we think you need”. The takeaway here is that people tell us all the time what they need from us, yet we let our assumptions distract us from the real message, and we make quick interpretations and assumptions.
I think this applies to all of us-we all need to be better listeners, in particular to Older Adults. What makes life meaningful for them? How can we keep those things intact when people need support from family friends and formal service providers.
A recent conversation with my Mother in Law, an expert family cook who now has her meals provided by her assisted living, reminded me of this. She lit up when discussing the special glaze she made for her ham loaf. We discussed how much we enjoyed it at holidays and provided an opportunity to ask her how she made the glaze. I saw the same spark of interest when she discussed the way she prepared rhubarb, which she has often called “the Spring tonic”. Here is a photo of her preparing her own rhubarb sauce where she resides.
I read an article published by Next Avenue for Older Americans Month in May that talks about the need to establish the shared value of healthy aging. It is never too late to address the importance of exercise, nutrition and social engagement.
Also, it is important to have a good understanding of what parts of the aging process are normal and what are some common myths. There are two myths specifically to look at-changes in memory and mental health.
When are memory problems part of normal aging and when should others start to worry? A little bit of forgetfulness comes with age related changes to the brain. Alzheimer’s or dementia is not normal aging. If you see confusion, personality changes and disorientation over a period of time, you can ask for a memory workup. There are specific things to rule out that can mimic dementia that are reversible. It is important to try to get a specific diagnosis for dementia because it may help to know the course of the illness and it can allow time to plan for the future.
People experience grief and sadness as normal reactions to losses associated with aging. When do you know if an older adult is in need of extra psychological or psychiatric help? If you see a person isolating themselves and expressing feelings of helplessness and hopelessness more than a year following a loss, you can pursue a psychiatric evaluation. There are treatments for depression and also a medical doctor can rule out other causes.
I picked these two areas in particular because in my experience, they are the most often misunderstood aspects of aging. Society in general, including some in the medical field tend to not address changes in memory or changes in emotional wellbeing, often attributing these changes falsely to the aging process.
While I am a social worker not a medical professional, I have met many older adults taking 5 or 6 or 7 different medications on a daily basis. There are risks and side effects and interactions that come along with polypharmacy. Doctors may not catch these things without patients stopping to ask.
All older adults deserve to optimize everything they can to live a full life! #ageoutloud #oam17