SLEEP NEEDS FOR OLD PEOPLE

The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

I slept in this morning until 11 which is later getting out of bed than I can remember.  Attaining this sleep record got me wondering how much sleep should old people get each night and let’s include day time naps?  I think all information known to mankind is somewhere on the web so that is where I went in my quest to find the sleep needs for old people.

Being a scientist I understand somewhat the validity of research studies such as the topic of sleep which involves physiology because I have a doctorate in physiology.  Now, I am not putting myself here as an expert on the science of sleep as it pertains to old people.  I am just reporting what I found on the web.  And, I found quite a bit there on the subject of sleep but not so much on sleep needs of old people.  I am not surprised about the lack of information regarding us old people because not much research has been done with us in any field of science including medicine.

First I found at several sites this thing called ‘advanced sleep-phase syndrome’ where old people go to bed very early so they get up early.  This ‘problem’ apparently can be fixed by adjusting the circadian rhythm with ‘bright light therapy’.  I won’t get into the specifics here because this was not what I was searching for.

I found most information concerning other problems about old people sleeping. Interestingly these concerned primarily men for some reason and included simple insomnia, sleep apnea, circadian rhythm disturbances all of which gets worse with increasing age. Well that was not good news especially when I read about many treatments for these conditions which include breathing exercise, yoga, restful environment in the bedroom, and cognitive and behavior therapy.  Once again this was not what I was looking for.

Finally I came across the fact that sleep needs vary with age.  Aha, now I am getting someplace then I read that sleep needs also vary with individuals.  Of course the question now is can these be separated?

As expected, I found lots of bad news about too little sleep which included daytime drowsiness, getting fat, diabetes, heart problems, a decrease in the ability to reason, and memory loss with an increased chance to develop Alzheimer’s .  On the other hand the effects of too much sleep, which was my quest with all of this research, are pretty much unknown.  Then I read that the average mortality increases in people with sleeping less than 7 hrs. but also in people sleeping more than 8 hrs. Now, this got my attention but as I thought about a window of just a single hour at 8 hrs. of sleep affects mortality rate I immediately questioned the validity of such a finding.

Another age-related sleep study showed that people in bed for 8 hours got less sleep with age.  That is ages 20-30 slept an average of 7.2 hrs.; 40-55 slept 6.8 hrs.; and 66-83 (hey that includes me) 6.5 hrs.  And, with age there is less Rapid Eye Movement (REM) which occurs with slow wave sleep which is the good sleep where you dream, is less in older people.

Then I came across a considerable amount of information on us old people but not our needs but more information regarding sleep habits which included: (1) it is not normal to sleep during the day even in older people; (2) role of sleep is not well understood and it is not known how much sleep people need; (3) old people do not need more sleep than younger adults; (4) old people have more difficultly falling asleep; and (5) older people sleep less.  I knew most of those things but what got my attention was (2) which made me begin to think I was on an impossible quest.

Yet in another study published in the Dec 2014 issue of AARP I read that 30 min catnaps provide an important midday pick-me-up.  On the other hand daily naps of one hour plus each day are 32% more likely to die of any cause. This information is opposite to item (1) in the above paragraph.

Finally, a breakthrough as to why old people sleep less: (1) we produce less melatonin (a hormone which puts a person to sleep); (2) we are more sensitive to the sleeping environment changes such as noise; and (3) sleep neurons in the brains of old people die off with age.  Interesting information but it did not tell me about how much sleep old people need. 

In the fall 2014 issue of AARP I did come across an article by Dr. Cohen entitled ‘Stay Well Forever’.  A rather misleading title as ‘forever’ cannot be measured in time and our lives are limited by time. One of his subtitles ‘Turn in Early’ caught my eye for it related to the sleep needs of mature people.  I write ‘mature’ because he mentions that people 50 years of age and older need 6 to 8 hours sleep each night.  Of course to get this much sleep when people are old in their 80's and generally retired does not require us to turn in early.

I am always dubious about articles like this which includes old people with middle-aged people and 50 years of age is middle age.  He does offer some sound reasons for the proper amount of sleep: (1) think better; (2) strengthen the connection between brain cells (you know think well); and (3) repair our bodies from that day’s stresses. Now this last reason makes sense and provides me clues as to the number I am looking for.  And, that number depends on several factors one of which involves our activities the day before we sleep. So, there is no magic number for it depends.

The word ‘repair’ Dr. Cohen used caught my eye.  Well, old people require more time to recover/repair from diseases and surgery.  So as I understand the need for sleep it is to refurbish the physiologic functions of the body after using them all day.  These functions get tired and need sleep to recover and in old people that takes more time.

These thoughts have been re-enforced when I came across an article published more than a year later than when I wrote this article in December 2014 which has yet to be published on my blog.  This article appeared in the March 2016 Scientific American on the importance of having a ‘clean brain’.  Recent studies have found that the brain has a drainage system unique from all the other organs.  Yes, it is this the lymphatic system but quite different in structure and function called the lymphatic system.  This system removes proteins associated with Alzheimer’s, Parkinson’s and other neurological diseases. And, it is most efficient during REM sleep!

So, with this information does it not make sense that we old people need more sleep each night to recover the rigors of our day-time activities?  Of course if there is no physical activity during the day then less rest might be required.  Still sitting around all day watching TV requires some brain activity so even a sedentary person requires sleep just to clean out the brain.  Certainly, this holds for adults of all ages.

In my case as I have written before I do daily exercises at the gym including muscle strength and aerobics.  I take three mile walks three times each week at a leisurely pace.  (Now two and a half years later, I do not take those walks and I work out less at the gym). With this much activity each day, maybe sleeping in once in a while is not all bad!  When I read articles on the web there is frequently comments by readers their take on the information they had just read.  Sometimes they add information mostly their experiences but sometimes knowledge on the subject.  During my search on sleep I came across many comments from readers noting that their grandparents or older parents sleep some 20 hrs. each day! Obviously these people are suffering from depression and have lost the desire to live any longer. 

To summarize what I found on the web about sleep in regards to old people: (1) we get less REM sleep, (2) can suffer from advanced deep-phase syndrome, (3) have numerous problems with sleep patterns, (4) more medical problems with too little sleep, (5) we sleep less than younger adults, (6) have different sleeping habits, (7) produce less melatonin, (8) have fewer sleep neurons in the brain, (9) sleep needs vary with age and individuals, and finally (10) more sensitive to sleep environment interference.

Wow, with all of those negatives regarding sleep with old people it is a wonder that we can get any sleep. So, I guess me sleeping until 11 in the morning with good REM sleep is a feat worth bragging about. Still, I was expecting a simple number for my sleep needs as an old person.  Obviously because of its complexity there is no such number for how much sleep we require. In fact I believe age has very little to do with how much sleep us old people need.  Like all humans we need as much as our body requires and that depends!!!!!

I suppose I asked myself this question when I slept in very late because I had some guilt going back to what my mother cautioned me when I was a teenager.  You know, ‘don’t sleep your life away’.  Oh yes I learned from my research that babies and young people including teenagers require more sleep than adults.  Hey, I think maybe I am returning to life as a teenager then I see one jog past me during my walk in the park.  I shake my head realizing that my life as a teenager can only be accomplished in bed and to make that clear, in bed sleeping.

12/14 revised 3/16

MY FOLKS AS OLD PEOPLE

The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

I never understood my folks’ feelings when they were old. They both experienced old age for many years as my father died when he was 87 and my mother when she was 92.  I guess I never really tried because I did not understand the remarkable change in people when they become old.  I guess that is one reason I write these essays because I want people to understand that being old is a new ballgame.  I guess in a sense it is like being born again but this time as an old person.

I guess one reason I had no empathy for my folks during their old age was because they never once mentioned what it was like.  They just went about their lives as best they could.  They alive together in a small house they owned in a small town in California.  I was busy with my career living in Texas so distance played a role in our relationship.  Still I visited them several times a year when I could during which times I would help them with home repairs, some bookkeeping, driving them about the town, etc.

My father suffered from some moderate form of Dementia and my mother had lost her central vision with Macular Degeneration.  But, together they remained independent until I realized that they could no longer live alone.  One big reason was that they depended on a couple, good friends of mine, who lived 10 miles away in another town.  Even though they willingly helped my folks for many years and never complained to me I knew that they were being taken advantage of so I finally moved them to live with me in Texas.

While still living at his home, one day my with some dementia father motioned for me to come close to him as he wanted to tell me something.  In a low voice, almost a whisper he said, “You know son I am going to live forever.”  That statement caught me by surprise but obviously he was thinking about the inevitable and did not like it.  But that brief statement was the only conversation I had with my folks about what it was like to grow old.  So, in a way I feel cheated as I did not get their knowledge about this part of one’s life.  I was just not prepared for this chapter in my life. 

Now I am not calling my folks cheaters for their disregard informing me about living to be old.  I am sure it just never crossed their minds that they might give me any advice or even thoughts on the subject.  And, I am not sure their experiences on the subject would have been of interest to me anyway for being old does not get much attention until one is old.

I guess I should have thought something about their lives when I was given clues at times usually by my mother.  We talked more than my father and me.  The small town they lived in was without taxi service so they were forced to drive their car much too long with their disabilities.  My father of course always drove but interestingly they compensated for each other’s problems as my father was my mother’s vision and my mother was my dad’s brain.

As my father’s mental condition worsened we visited a neurologist about his dementia.  Of course then there were no treatments for it.  But, when he learned that my father was still driving and had a .22 pistol in a night stand by his bed, he immediately told me to stop his driving and take away the pistol.

Suddenly, I had to take control of my father’s life in a way that was not fair to me nor to him.  He accepted the no driving but when he had discovered that I had taken away his pistol, he went into a rage telling me to go back to Texas for I was not welcome in his home. Of course this hurt me but I and my mother understood his situation.  Like my mother said ‘you are making his life smaller and smaller’.  And, what she said was very true.  Unfortunately, I was the only one in the position to do those things.  

When my folks moved to Texas my mother lived with me and my family, my father I put in an assisted living facility.  He didn’t want to live there and I didn’t blame him but besides his dementia he had an artificial leg which in those days was difficult to manage for an old person.  Many advances have been made in the design of these leg prostheses so today he would have been more mobile. 

The assisted living facility I chose for my father in Texas was a good one and close to my home so my mother and I could visit him.  My mother visited him every day. My father died less than a year after he entered the assisted living facility. 

A few months after my father died my mother’s health suddenly deteriorated. We made several visits to her physician before her condition was diagnosed as loss of blood from hemorrhage from stomach ulcers.  She never regained her strength so needing more care than my wife who had multiple sclerosis and I working many times in foreign countries could provide I moved her to the assisted living facility where my dad had lived.

I visited her regularly so it was a surprise to learn that she wanted to move closer to her daughter who lived in Arizona.  I accepted her decision for she was still capable of making it.  Unfortunately, the assisted living facility there was of very poor quality.  Her TV could not be used, which she loved and they did not have a recreation program.  It was just a storage house for old people.

I was not aware of this until I got a phone call that my sister had suddenly died.  Her death was a shock to me for she was 10 years younger than me – just 55 years old. Obviously, I immediately went there and brought my mother home.  I was shocked to see how she had deteriorated with the poor care she had received.  Perhaps I should have investigated the facility more thoroughly but then my sister had told me it was a good one. 

My mother’s mental capacity was nearly gone from the poor care.  She did recognize me and my family but the brightness in her eyes had gone.  She was soon put into hospice care at the facility where she had previously lived and died a few months later.  I know that if she had remained in San Antonio she would most likely have lived to be a 100 years old.

My sudden awareness that I am now my folks’ age is a bit of a shock.  Unlike my folks I take much better care of myself although I do drink a lot more alcohol than they ever did.  Still I walk 3 miles 3 times a week, do my aerobics on the stationary bike and lift weights at the gym on a regular basis so I am trying to make old age as tolerable as possible.

I suppose there will be problems being old with my son and his children living 14 hours away by car.  I am just trying to keep it as far in the future as possible.  You will read more about this as it unfolds.  Keep reading if you are interested.

12/2014

P. S: This blog was written more than two years ago.  Old age has taken its toll for now I go to the gym only twice a week and my mobility includes a cane.  More on this in later blogs.

THE EVOLUTION OF MY CHRISTMAS TREES

The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

A neighbor came over to my house the other evening and we trimmed my Christmas tree.  She like me is not a Believer so I guess I should call it a Holiday tree.  We do this every year as we have a martini.  I guess it could be called a tradition and it is great fun.  I call this Christmas tree a bottle brush tree for it is made of twisted wires all attached to a round metal tube which is fit into a three legged plastic stand.  Except for the stand the tree is covered with green plastic needle-like things.  The tree is shaped to resemble a Spruce evergreen.  It is 3 feet tall so it sits on a small wooden table I have in the living room. Of course the plastic stand is covered with a white cloth to resemble snow.

The tree lights are plugged into an electric strip with a switch which I push to bring the tree to life with its colors.  The tree lights are mostly white but the string on top has colored lights.  When I light the tree each morning it brightens my day.  And, it brings back great memories of when I was young and enjoyed Christmas so very much. 

The history of this tree is interesting for it involves the person I bought my house from several years ago.  She gave it to me because she did not want it anymore probably because it looked cheap and ugly.  So, when she moved to a larger more upscale house she bought a very expensive artificial tree which must be 10 or 12 feet tall.  I never considered this tree to be ugly for it is no doubt an early version of artificial Christmas trees.  Consequently because of its age it can now be regarded a ‘collectable’.

The decorations for this tree consists of four strings of tiny lights, strings of white plastic pearl like beads strung around the tree.  Decorations consist of many small plastic or wooden figures, many decorated balls some made of plastic and a few thin glass colored ones mostly small.  A long thin colored glass decoration adorns the top of this tree.  Now this tree top decoration with the glass balls remind me of Christmas trees when I was just a young boy.  But then these types of thin glass balls were larger hung from the tree branches by a wire hook. Today they are hanging from the tree with plastic hooks.

But, not all of the glass balls were simply round.  I remember some were larger and somewhat elongated with an indentation on the side of a different color.  A particular ball I remember had the indentation colored bright silver. The rest of the ball was a dark red.  Those special balls were handled with great care and when the tree was taken down these fancy balls were wrapped and carefully stored away for next Christmas.  

My first Christmas I remember was when I lived in South Dakota in the late 1930s.  I was about 6 years old I guess.  The tree was a real one which my father found someplace and cut it down.  I remember it to be rather tall but then I was short so it might not have been quite so tall.  It was adorned with a couple strings of various colored lights.  These lights were much larger than the lights used today and since they were wired in series instead of parallel when one light burned out the entire string did not light up.  How frustrating for my father who had to replace each bulb until the lights came back on.

What fun it was to throw the thin silver metal like ice cycles on the tree to make them look like ice cycles.  Of course the large glass colored balls were placed in strategic places on the tree to give it a nice symmetrical look.  Those balls made out of thin glass were very delicate so when one was dropped it usually broke into several pieces.  And, most every Christmas at least one was accidentally dropped to the sorrow of everyone in the room.  We all felt bad especially for the person who had dropped it.  Instead of the plastic stings of beads we strung popcorn on a thread using a needle. 

Making this rather large tree stand upright always required a rather detailed engineered

Stand made out of wood which my father built.  Large nails driven through the stand into the base of the cut tree trunk held the tree to the stand.  The tree would be place upright on the wooden stand and hopefully it would not tip over.  I remember the first metal tree stand in which the tree was simply placed in it and with screws held upright – no fuss, no muss.  But in a way some fun, even a little excitement and a certain amount of skill was lost with that invention. 

Of course this real tree gave off a pine-like smell which I vividly remember and I miss with my plastic tree.  Soon needles would begin to fall off as the tree aged.  Hopefully it would stay fresh long enough to last until New Years.  Obviously, as the tree dried it became a fire hazard. So, when to buy the tree was always a dilemma for if you bought it too soon it would not last the season.  But, to buy it too late meant less selection to find the perfect tree.

One year I could not find the perfect tree so I cut off some of the base to provide me some limbs.  Where the tree needed a branch I drilled a hole in the trunk in which I inserted and glued a limb. Suddenly I had the perfect tree.

I don’t remember each Christmas tree through the years but I do remember it was always a real tree.  And a real tree would be cut down. Of course, in those early years artificial trees did not exist so it had to be a real one.  Still, even when plastic trees became common my folks insisted on a real tree which they cut down as did I for many years when I became a father. 

For several decades the shape of the tree light bulbs remained the same.  A great improvement was the redesign of the tree light string so that when one bulb burned out the string remained lighted. But recently the tiny lights have become the norm.  They give off a bright light and use much less electricity which now days is an important factor.

But as I aged I began to buy real trees already cut down from a local tree stand.  For some reason that never seemed to be the same as when I would venture to a tree farm and cut one down.  Picking out the right tree was always a difficult job for it had to be the perfect tree and there were many trees from which to choose.  The perfect tree meant that it had to be precisely symmetrical with even the smallest limb in place. After finding and buying the perfect tree was the hassle of getting it into the car to take home.  Some how it was managed and the process of putting it into the metal stand and decorating it began with great anticipation and family enjoyment.

But, as artificial trees began to look more realistic and the realization of killing those thousands of spruce trees each year for no other reason than to decorate a home for a few weeks, I bought a very nice artificial tree.  Still, it was just a tree and not one with lights built into it.  That was just going too far.  As times past and the family has gotten smaller so has my Christmas tree which I described at the beginning of this essay.

Oh yes, I still enjoy my little artificial Christmas tree and Christmas holiday but in a way it is quite different.  Now the joy is mostly memories. We tend to forget the bad memories so all of them are full of joy.

12/14

I DON’T LIKE CHANGE

The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

Unfortunately for me, change has become the norm in most everything I do and I don’t like it!  The other day I clicked on my Yahoo web site courtesy of att.net and the format had changed.  Then I checked my email and that had changed. And, as I was writing this essay, I clicked on my monthly bank e-statement and it is much different than last month’s e-statement. Give me a break.

I have a hard enough time just doing the basics with this e-stuff and then to have it changed on me several times a year is very frustrating and it makes me angry.  I remember when change was something which happened only once in a while, like once every few years.  That frequency of change I could handle for it made me feel like I was being kept up to date – you know becoming more ‘modern’.

I guess my hatred of change is supported by the adage ‘Can’t teach old dogs new tricks’.  Certainly, I am an old dog alright still I can learn new tricks but having to learn them every few weeks is ridiculous.   I can imagine some geeks sitting around in a rubber room chatting about changing something because there must be change or they will lose their high paying jobs.

The latest change to my email now involves Twitter and Face Book.  I have heard of these things but I don’t use them.  My son has attempted to get me on Face Book as he uses it quite frequently and seems to like it for reasons I do not understand.  His mother and he use it.  But, you know if you want to communicate with someone you email, snail mail (new name for postal mail), or phone them.  Oh yes included in all of this e-stuff is texting. 

Texting is something else I do not do and in fact I have blocked it from my cell phone.  Every now and then I would get a text message from someone I did not know nor did I want to know.  And, it costed me money!  I do not understand the advantage of texting someone unless it is to commit a type of subterfuge which I have unfortunately witnessed with my granddaughter.  I have written about this before but it bears repeating.

I was asked by her father, my son, that it would be nice to take your granddaughter to lunch so you could chat and get to know each other better.  I could not have agreed more about the latter thoughts for I live several hours away and see them a couple of times a year. So, with that threatening reminder of what I should do as a grandfather I did just that and I was looking forward to it.

So we got in the car to go to the restaurant when immediately she pulled out her I-phone and began to text a message to her boy friend. Well so much for our conversation as we drove to the restaurant.  But, I thought when we got to where we were going to eat the promised conversation would begin.  Wrong, she texted with her phone ‘hidden’ under the table as if I did not know what was happening.  I am old but I am not completely stupid about these e-things.

So back to Twitter and Face Book oh I forgot another one named Linkedin.  Linkedin is another social network e-thing which I did not know existed until a friend contacted me using Linkedin. My friend who is of mature age, not really old, was using it and she wanted to contact me, so why not so I clicked on.  I saw her the next day and she told me that this Linkedin thing was a mistake.  Well, too late I was suddenly bombarded by Linkedin informing me that all these people some were friends wanting to contact me, of course using their social network.

I felt used and abused because my privacy was invaded by some communication network I did not know anything about.  I suppose I should have responded to each of my friends who were so excited about contacting me but I just deleted those messages. And, all future messages from Linkedin was flagged to be placed in my spam folder where once a week or so I delete them with a big smile on my face.  Oh yes the word ‘folder’ in this e-world always amuses me.  To me the word ‘folder’ is some hard brown paper thing used to hold more paper things on a subject in a file cabinet.

If someone wants to contact me then give me a phone call.  All of those names which I recognized have my phone number. Just give a call, I’m usually home or leave a message on my answering service or try my cell phone.  I have a cell phone but I rarely use it.  I try to take it with me when I go someplace but I usually forget it.  But, I must admit the cell phone is a great invention if it is not abused such as talking on it while driving. 

Certainly everyone knows that using these e-things while driving is a dangerous habit, especially texting.  Many times I have been following a car which is obviously under less than optimum control.  In fact, sometimes I think the driver is drunk!  As, I pass cautiously for they are driving rather slow I always try to look at the driver who is either on a cell phone or looking down as they are texting.

My son uses the cell phone while he is driving, in fact I don’t think he can drive if he is not using it.  Regarding these practices some states have them illegal.  Even Texas which is just emerging from the Dark Ages of social norms has cell phone use in School Zones illegal.  This law is based on the known facts that driving is compromised while talking on a cell phone.  So, why isn’t it illegal to use a cell phone all of the time when driving like many states such as California and New York?  I guess the answer is we don’t want to kill kids but adults are fair game.

Something else has interested me about a change which occurred within the last couple of decades.  It is a change but not really for it was around when I was a little kid in the 1930's.  Yes, it was ordering things via postal mail you know using the Sears Roebuck catalog. In fact there were two catalogs, the other was Montgomery Wards.

On my, what a God send those catalogs were to my family.  We lived in the northwest corner of South Dakota near a little town called Newell.  It did not have any department store so when you wanted something like that you had to order it from a catalog.  I remember getting my first bicycle through one of these catalogs for Christmas one year.  It was in the late 30’s so I must have been about 7 years old. The one my folks had ordered cost $15 but they were out of that model so they sent me a larger fancier one which cost $25 at the same lower price. My dad had to put wooden blocks on the pedals so I could reach them.

Suddenly ordering by mail disappeared and we stopped getting our new annual Sears (someone got rid of Roebuck) or Wards (Montgomery had been dropped) catalogs.  Now we are doing the same thing but over the web and it is a new convenient exciting major retail format! Everybody is buying stuff over the web!!! Why is the web so different from a printed catalog? So how things change but in many ways not really.

I close this longer than usual essay with my surprise today to find a new format for my bank e-statement.  I hate bank e-statements.  I know it is supposed to save paper (‘go green’ is the sign on the bank wall which is good for the environment), but does it really?  I guess the envelop it was mailed in is not used but the e-statement I print at home is like the one that was printed by the bank, so where is the big paper savings?  Oh yes, the big ‘green’ saving for the bank is the cost of postage!

Unaware that I have a new format to conquer with my bank e-statement I type in the ‘user name’ and my ‘pass word’.  Of course what pops us is ‘what is the name of your best friend?’ So, I type that in and it comes back that the name I used is incorrect.  I am puzzled for I use the same name for years.  But, what irritates me the most is why have the ‘user name’ and ‘pass word’ if what it really needs is my best friend’s name?

So, I am puzzled that it did not accept his name.  I am confused and angry for I know that is the correct name.  I think of other names but none make any sense.  Once again in desperation I retype in his name and there is my e-statement!  What had happened?  Had I somehow missed some case-sensitive thing?  Now there is another irritating thing some idiot dreamed up and that is this case-sensitive requirement – oh but not always!!!!!

Now I have my December e-statement in front of me but the format has changed.  What should I do to simply get my bank statement to appear on my computer screen so I can print it out and balance my check book? I click on several icons attempting to get my bank statement to magically appear.  Again, I am frustrated for there are no instructions on using this new format.  Finally, I click on the number of the account and there it is on my computer screen waiting to be printed.  I now print it instead of the bank.  Wow…

12/14

.

NEVER TOO OLD FOR CHEMO

THE OLD RUSTY MAIL

An e-journal for old people

Russell Burton, an Old Person

I ran across this article in the December 2014 issue of the journal Scientific American.  Even though the title does suggest some nasty thoughts, my take was quite the opposite.  No doubt age especially old age does limit us as to our medical options.  I understand that when a person reaches the age of 80 organ transplants are no longer available.  Now this restriction may change as the population as a whole ages.  In a way I hope so because at my age of 82 soon to become 83 I feel like a major medical option which could save my life has suddenly disappeared.  In a way one of my life boats has been cut adrift.

In fact this article reports exactly that age-limitation are changing with us old people in regards to aggressive medical treatments such as chemo therapy.  Simply physicians are attempting more aggressive treatments on old people with advanced cancer.  And why not for Americans are living longer lives.  I read the other day that half of the babies born now will live to be 100!  For me that is not hard to believe for when I was a young person my hope was to live to see the turn of the century.  In the late thirties and early forties life expectancy was 68 years old and being born in 1932 to see 2000 arrive was not a sure thing.

Of course now, life expectancy is something like 78 for men and 81 for women so in 100 years yes it could well be 100 years of age.  Life expectancy of course means that half of a population will reach that age.

This article had a different take on this increased aging thing using cancer as an example.  Now, half of all cancer patients are older than 65 and by 2030 70% over 65 will get cancer.  That is the increase in old cancer patients will have increased by 40% in just 15 years. Three reasons were given why old people have so much cancer: 1 – we have accumulated more exposure to things that cause cancer, 2 – old cells are more vulnerable to cancer and 3 – our immune system which is our primary biological cancer fighter is slowing down.

Not surprising most clinical medical research is done on younger people so how well old people will respond or even tolerate aggressive treatments are not known. Apparently, this situation is changing as medical research studies are beginning to include old people.  This mind set is not surprising as it is just common sense that old people are supposed to die. Well not so fast…

Finally, physicians are beginning to understand that all old people are not alike, that is chronologic age is not as good an evaluator of well being as what is known as physiologic age.  Yes, physiologic age differs greatly among old people.  And, I might be one of those lucky ones who is ‘aging’ slower than many old persons.  I say that because of the following experience I had a few years ago when I had major surgery on my leg which I have written about before in this blog.

I was examined by a young anesthesiologist resident a few days before my surgery to get a handle on my physiologic age although she did not call it that.  Still she wanted to know how old I was other than being in my late 70s.  You know ‘was I going to die on the operating table’?

To begin when she entered my room she exclaimed “You are 78?” asking in a voice exalting amazement. She was even more dumfounded when she learned I had all of my original teeth and I was taking only two meds each day. Simply, she had discovered my physiologic age not my chronologic age and she was astonished.  Clearly, she had not been around very many old people.

On the other hand my geriatric physician understands physiologic aging although she never gave it that name.  The other day she mentioned to me that I was in very good health.  Then she let me know that many of her patients are in terrible health.  Clearly the bar I had just crossed was not very high.

In this article I mentioned earlier, physicians have attempted to measure this physiologic age thing using a Comprehensive Geriatric Assessment.  This measurement takes into account a patient’s strengths and weaknesses which include such things as chronic diseases, medications, cognitive abilities, nutritional status, social support and probably most importantly the ability to perform ‘activities of daily living’. 

Now, we all know what the last assessment includes thus revealing how multiple biologic systems are working together. Now understanding that is a measure of a person’s health which of course is a predictor of how well a person will tolerate the rigors of an aggressive medical treatment. A specific assessment chart has been devised just for patients who need chemo therapy and involves 11 specific questions with a resulting risk score of 0-100.  A high score of course suggest a less aggressive treatment is in order.

Of course age enters into the meaning of this score as a young person might care to undergo aggressive treatment because they potentially have many more years to live than an old person.  Certainly ‘quality of life’ means a great deal to an old person with not much life left to live. You know enjoy those years while you can rather than suffering through aggressive medical treatments just to gain a few months of being sick.

Still old people may want to take the side effects of an aggressive chemo therapy as documented in this article.  The author’s father-in-law who was 91 decided to give it a go which included 35 radiation treatments but after 20 months he is a survivor.  And, at 93 he is doing quite well.  I am not sure I would have taken his route.

Certainly as the article concludes ‘…having lived many years in no way disqualifies you from gunning for more time’.  I could not agree more!!!!!

11/14

PS: I am now nearly 85 years old and in those 2 years I have aged considerably. That is my physical capabilities are more limiting and I have poorer balance all of which compromises my ‘activities of daily living’. So, regarding this article I am beginning to understand what it means to be ‘too old for chemo’.

SMELL AS A PREDICTOR OF DEATH

The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

This title is the title of an article on a research study a friend gave me the other day which got me thinking about a previous blog in which I wrote about an interesting physiologic finding that old people smell differently than younger people.  The smell was characterized not a real odor but a different smell.

But, I had forgotten about that smell reference and when I read this title I thought of two other smells.  Certainly, the one which came first is yes when a person dies the corpse if not disposed of properly will put out a pretty heavy odor.  And, an odor I might add is rather distinctive.  Years ago when I was director of a research group at the USAF School of Aerospace Medicine, one of the scientists who worked for me was tardy for work.  As he was a responsible young physician I was concerned.

I phoned his address several times and without an answer I decided to drive over to his apartment and see if there was a problem.  I asked another physician employee, a Lt. Colonel to come with me.  It was a short drive.  When we knocked at his front door and did not get an answer we got the apartment manager to let us in.  When she opened the door she started to go in then she quickly closed it saying he was taking a shower. 

My physician friend caught an odor which had come out of the slightly opened door and told the manager that we had better go in for he suspected something was wrong.  And, indeed something was wrong for the person we were looking for lay dead on the bathroom floor with hot water running from the shower.  The odor was unmistakable and hard to describe but the physician picked up on it with only a slight sniff.

But when you think about it the smell of a dead person is not a predictor of death it is an identifier of death.  Something quite different so that left me with but one smell left which is the inability of old people to detect any odor, fragrance, scent, aroma, whiff, or stink which of course is our sense of smell. Better had the author been more explicit in her title like “Sense of Smell….’.   

The title of the study reported on by Smitha Mundasad of the BBC News was ‘Science of Smell May Predict Lifespan’.  Once again why was the ‘sense of smell’ not included in the title? Anyway, this study on the ‘sense of smell’ was a survey of 3,000 individuals in which 39% with the poorest sense of smell (4-5 errors) were dead in within 5 years compared with moderate smellers 19%  and good smellers (0-1 errors) only 10% had died.

She noted that this study accounted for age, smoking habits, poverty, nutrition and overall health all of which are difficult to control for but I guess it was done. Unfortunately those details were no included. Now when an important detail such as that is left out I begin to wonder about its credibility.  Still, it was fun reading and did relate to us old people so here goes my take on it.

The odor of the oranges was the first to go so I guess a good habit would be to each morning cut an orange in two and catch that fragrance if you can.  If you can’t better begin to write you’re Memoirs, Living Will, and the real Will.   Oh yes, decided what you want your survivors to do with your cold dead body.

And, something else, you might want to consider what kind of memorial service you wish to have, if any.  I write ‘if any’ because I am not sure I want one.  To begin with they tend to be morbid by definition.  Now I have been to some where the theme was along the line of a ‘celebration of that person’s life’.  I have always had a difficult time with that title with celebration in it for somehow a celebration does not seem appropriate.  Still, I understand the attempt here is to cheer up the occasion because morbidity, a natural occurrence, does need more smiles and less tears.

Back to that study which found some 39% dead within five years after the sense of smell was no longer considered up to par. Of course you must realize that 61% of the time you will be wrong.  In fact those 61% still alive might have out lived the good smellers. Oh well…

In that regard my mother lost her sense of smell when she was a young girl probably when she had a serious case of pneumonia.  In those days without antibiotics any case of pneumonia would be considered serious.  Besides losing her sense of smell the disease resulted in her having a residual lung disease which required surgery to correct it which she did in her late forties.  No her sense of smell did not return.

Still her lack of smell did not prevent her from being a rather good cook for I understand that taste and smell are closely related. Now for me as a late teenager living at home her inability to smell was welcomed when I would come home at night after drinking a few beers.  Yes, she could not smell alcohol on my breath!

Like most clinical studies this one really raises more questions than provide answers to why the sense of smell would be compromised with age which in turn predicted the occurrence of death.  One explanation put forth was that it indicated that replacing olfactory cells in the nose is slowing down an indication that replacing other cells might also be on the decline.  Now, slowing down cell replacement growth with age is not an astounding discovery.  I bet most all types of cells are being replaced at a much slower rate.  You know all of our bodily functions are slowing down which is sometimes referred to as physiologic aging.

Still this was an interesting study which might have some implications as a clinical tool to ‘identify patients at risk’ of dying within the next few years.  Of course, when we get to be old we are all at considerable risk of dying. That is, a good clinical tool is simply to look at our birth date and at what age did our parents die will give one a pretty good indication of life expectancy a subject I wrote about several blogs back.

This smell thing has peeked my interest.  I think I will go to the kitchen and cut open an orange. Oh my I don’t have any in the house.  So, I will go down to the grocery store and buy some and list the bill as a medical expense on my Income Tax.

11/14

A BEAUTIFUL DEATH

 The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

Aside from the morbid title this is an interesting blog which I consider to be an uplifting one especially for us old people.  By that statement I mean, it takes the morbid thoughts of death and translates them into a more pleasant experience although not something a person wishes to rush into.  What follows are excerpts taken from an article ‘A Beautiful Death’ from Consumer Reports, a magazine I have subscribed to for many years.  This magazine as the name implies is concerned primarily with testing and recommending a multitude of consumer products ranging from cars to wine.

As a lengthily subscriber I was surprised to read an article which has absolutely nothing to do with consumer products.  Death is not a product which neither needs testing nor recommendations for it is free for all and will be tested and consumed by everyone.  Still, the article is an interesting one I believe worth my take and worthy of your thoughts.

The article centers on a man who is dying of cancer at the age of 86 who refuses medical treatments such as radiation and chemo.  In fact he does not want to return to the hospital, an experience he had lived through a year earlier.  Oh my, I could not agree more about his dislike of hospitals.  My most recent visit involved staying over night after surgery on a major leg artery.  I could not get out of there too soon.

Like he expressed why go through chemo to live a few months longer when I can live a few months with a decent quality of life.  Chemo is a recipe for a drastically poor quality of life.

Of course he involved Hospice Care to be used when the time had come and he did it in a timely fashion that is not waiting until the last few weeks.  I question their take on what they consider to be a timely fashion.  I know of friends who lived a good quality of life until just a few days/weeks before Hospice Care was needed.

It was interesting that he was more willing to die and felt more comfortable going through the process than some of his family members.  One daughter was upset and argued with him about his decision to stop taking one of his meds which was designed to have him live a little longer.

Much of the article involves the thoughts of the Hospice physician as he cares for this dying person.  His job as he explains is the fact that “We’re all going to die and it is my job to make sure that people do so in as calm and beautiful a manner as possible.”  I am not sure that the word beautiful works here but I understand the sentiment.

One family member at the end of the article expressed her thoughts “Dad always told us that he wanted to teach us how to die…And what a great teacher he was.”

It is a beautiful article which is found in the December 2014 issue of Consumers Report and I urge all of us old people to read it.

Another thing I found interesting in this article is the side-bar with statistics from a survey conducted by Consumer Reports regarding death.  As a retired scientist, I love data so I am always drawn to these kinds of numbers:

• 86% wish to spend their last days at home. Where does the other 14% wish to be when they die – in a hospital?  If that is their choice their home-life must be Hell.
• 50% prefer pain management and comfort care over other types of medical treatments.  I assume ‘other types of medical treatments’ includes heroic attempts to keep us breathing a few minutes longer.
• 61% had never heard of palliative (Hospice) care.  This fact surprises me but I suppose these questions were asked of people of all ages.  Certainly most of us old people have heard of Hospice Care but then we have more interest in it.
• 47% have completed a ‘living will’.  I am surprised about this low number but to think of it I had better update mine.  Yes, updating this thing is important.  I remember when my father was near death, I was asked by a physician if he had a living will.  When he learned that his Will was many years old he thought it was invalid as it had not been updated.  Oh well…
• 42% had provided end of life care for a friend or relative.  I assume this means that a person has helped a friend die. 

I have ‘helped’ with the death of two of my close friends.  One was a friend who I had known for nearly 50 years. I went with him alone from the hospital in a panel-type car to a Hospice Care hospital.  This move had been postponed several hours because of bad weather. Upon our arrival at the Care center he was immediately taken to a room on a gurney and moved to a bed.  His breathing was labored and erratic.  The nurse was alarmed about his irregular breathing, we both realizing that he was dying. 

The nurse wanted to give him oxygen to prolong the life which resulted in an argument when I said ‘no’.  I had been told by my friend and his wife that he wanted to die.  He had struggled with his first serious stroke for many years and this one was much worse.  In fact, he had now been in Intensive Care for some ten days!  Yes it took that long for the hospital to give permission for him to be moved to this Hospice facility.  The medical cost for those ten days was $110,000! I guess they didn’t want him moved because he was a ‘cash cow’.

My second experience was when my very best friend, who I had first met in college, was dying and I spent his last night of living sharing the bed with him.  He was in a very deep sleep, possibly a coma so I doubt if he knew I was there.  I continue to think he knew, at least I hope he knew.  The next morning I left the room for a few minutes.  When I returned his breathing was irregular so I notified the family members who all came to be by his side as he died.  I held his hand.

In a way I enjoyed helping my close friends die of course not in a morbid sense but in a loving way as I remembered all of the good times we had together.  And, those ‘good times’ seemed like they happened yesterday.

But us old people all have those memories of many years past remembering them as they had happened but a few days ago, until we suddenly know better.

This blog was written two years ago and as I read it now before I publish it, my thoughts have not changed.  Quite to the contrary, death is now two years closer for me but interestingly it becomes less important. During those two years, I have given a copy of this article from Consumer Reports to friends who were dying.  They found comfort in it so I recommend it to all us old people, especially those of us nearing death.

11/14

   

 

LIFE TRIBUTES

The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

My local newspaper the San Antonio Express News continues to make changes in an attempt to make it more appealing.  This makes sense for newspapers are in a fight to remain profitable as they compete with several different venues which offer news. Many of these changes are strictly cosmetic in order to appear to give the reader a feeling of experiencing a more advanced approach in getting the news.  You know a feeling that this old mode of delivering news is keeping up with the many TV news channels, Web news on computers, and I phones all of which provide news streams which include instantly everything that can be called news.

Of course one change in my newspaper which continues unabated is the fact that it gets smaller.  A while ago I noticed the Bridge section had disappeared in the section entitled my SA.  In fact this section is reduced to only three pages.  With double-sided printing I guess it could be called six pages.  Another loss was the physician’s column which attempted to make diagnoses that had been missed by physicians using hands on examination with multiple medical tests of the patient.  I always considered that quite a feat of medical skill coming up with a better diagnosis using a small paragraph of symptoms as described by the patient.

This section also contains the comics which have also shrunk considerably.  Still the Sudoku and Crossword puzzles remain for without those features subscribers would leave by droves.  Luckily for the printed news these games can not now be accomplished while watching TV or your computer.  You noticed I wrote ‘not now’ for I am not sure what the future holds in regard to these e-things.

Now that I have established that my newspaper is getting smaller and as it attempts to modernize it has focused on the obituary section.  Well that was what it used to be named but now it is Life Tributes.  And, with this change comes much larger individual life stories now with much larger photographs of the deceased frequently one as a younger person and the other a more recent shot.  I guess this approach makes some sense as I have written before in this e-journal entitled ‘Obituaries’. 

Of course when a person dies at a relatively young age the photographs appear to be bothers or sisters staring at the reader.  Another thing I have noticed is that the older picture is not always that recent which makes me look at it again when I read how old that person was at death.  As an example today I saw a picture of someone in their early fifties who was born in 1921!  Come on that person died at the age of 93.  Certainly a more recent photograph would be in order.

I have a feeling that these obituaries as they appear to be more modern looking are actually taking up much more space.  I assume that this kind of ‘news’ is much cheaper to obtain so why not make it larger thereby making the newspaper appear that it has not shrunk more than it actually has.

I suppose Life Tributes is a more modern title for this section and perhaps more fun reading when the reason for this section is death which of course is really an obituary.  Now I looked up the obituary word in my computer dictionary to find exactly what obituary means.  Well it is (1) announcement of death and (2) recording death neither of which has the word Life in it. Now in the first description listed above it does note that it may contain a short biography of the dead person.

So with the title Life Tributes the newspaper is making the real reason for this announcement of death secondary to the biography section of an obituary.  Strange because the main purpose here is the death notice.

I suppose this all goes back to the fact that people do not like to think about death or dying nor do they like to read about it each morning as they face a new day in which one’s death is possible.  So, now when I read the obituaries in my modernized newspaper my mind is not about that person’s death but more about how that person lived and their contributions to society.

In this section there is always one person singled out with a much larger life tribute found at its beginning.  In fact, it takes up nearly half of the page.  This tribute written by the newspaper staff writers begins with a large bold printed title announcing some reason for this extra tribute.  As I look at the other life tributes which follow I find some of those who have died to have accomplished a great deal perhaps even more than the person who is the headliner. So, I ask myself how does someone suddenly escalate to a celebrity in death.  Who decides which person gets the star treatment?

Oh well life goes on and being chosen as a headliner for the Life Tributes section is of no consequence to those people whom I believe would have preferred this tribute to be acknowledged before they had died.

Yes, when a person dies it is difficult to imagine that person enjoying any tribute which announces some good things they did in life.  Of course if you believe that this person is looking down from Heaven and enjoying this recognition then it does make sense.  But, that is another story.

This specific article on life tributes was prompted by a Wednesday edition of the newspaper – really nothing special until I noticed the title of a short column entitled ‘Notable Passing’ next to the large headliner four-column spread I just wrote about.  It read ‘Dropkick Me, Jesus among Craft’s hits’. Now there is a headliner.

10/14

Please note that the date which appears at the end of these articles is when they were written.

LET’S DISRUPT AGING

THE OLD RUSTY NAIL

 AN E-JOURNAL FOR OLD PEOPLE

         Russell Burton, an Old Person

The title of this article is from the title of a piece written by American Association for Retired People (AARP) CEO, Jo Ann Jenkins in the October 2014 issue of that publication.  The author having been President of this organization before becoming its CEO I would peg her age in late 50s or early 60’s guessing from accompanying photograph. Of course published photographs can be misleading but her article indicates that she is somewhere in that age bracket.

AARP membership begins when a person reaches 50 years of age so I suppose she could not have started those careers before she was 50 assuming you must be a member of AARP in order to hold those offices. On the other hand, AARP doesn’t ask for IDs so I suppose someone if they so chose could become a member of this organization at the ripe old age of 49.

What is interesting about AARP is that it is a group formed in support of retired people as its name implies.  Now, people have been known to retire in their 20’s but of course the vast majority of retirees are late mid-life to being old like me.  Still, I did retire when I was in my late 60’s and like I have written before, that decade is a piece of cake regarding aging.  In fact, being old could not have been further from my mind.

This takes me back to the intent of the title of this article.  Of course for someone in their early 60’s to talk about aging is like a physician telling sick people how they feel.  At that age, I was at the apex of my career and aging really never crossed my mind.  I assume being CEO of such a large corporation as AARP is probably the pinnacle of Ms. Jenkins’s career.  So, why is she thinking about aging? Well she is in her AARP article.

AARP because of its intent has always struggled to identify with really old people who need the most help with the symptoms of old age.  Certainly youngsters in their 60’s and even in their 70’s are perfectly capable of living with much less support.  And, that is too bad because we old people do need a strong advocate as we deal with this 'disease' of old age. 

So, Jo Ann is beginning to struggle with this age thing as she is determined not to be defined, as she named it, with one’s age.  As if when someone reaches the ancient age of 60 they are thus identified as being old.  To be exact we are always identified with our age.  You know first I was a baby, then a child or adolescent and then a teenager too young to legally drink alcohol and vote in a national election.  Then I became a young adult and suddenly without warning, I was middle-age which depending on one's view point can continue into the 70’s.

Yes, I said the 70’s which I learned when I was told of a study conducted by an expert in management dynamics.  You see I worked for the Air Force as a scientist for nearly thirty years.  During that time I was sent to several management classes in order to sharpen my management skills.  I must confess that my management skills did need sharpening.  In fact, I had too few management skills to sharpen as I later learned.

None the less, there I was deeply engrossed in my management class much of which I do not remember except this one tidbit of information.  The instructor told us that during one of his classes several years before he took an ad hoc survey on those people present about whom in his class considered themselves to be middle aged?  Most everyone raised their hand including a man in his 70’s!  Certainly age was not going to define him.

Jo Ann goes on to explain that this disrupting aging thing begins by feeling good about where we are in life.  Well, I hope she feels good about herself with her lofty position. Still, I could not agree more for when I was in my 70’s and retired and after some struggle with my loss of purposefulness I really felt good about where I was in my life but then I had no choice.  My goodness, I feel good about where I am in my life at age 84 + because I am still alive!  That alone is sufficient to make one feel good.

She goes on making herself feel good about growing old with the following statements: we face different challenges (you bet) and have different goals (staying alive is one big one); we are motivated by different things; we see the world through a lens shaped by ups and downs and gained wisdom; with age I am more ‘purposeful’ because of my experiences and wisdom; and, looking forward to the years ahead not looking back.

For some of us really old people we have to look forward because we can’t remember much when we do look back.

Her use of the word ‘purposeful’ intrigued me so I looked up the meaning in my Webster’s New World Thesaurus.  Essentially she means one is more focused when we age.  Now, I certainly disagree with that because before I retired I was extremely focused on my job as she must be.  When I retired I struggled for years trying to find my focus because in retirement I had lost it.  One day I was Chief Scientist of an Air Force laboratory and the next day I was a retired nobody obviously without a purpose.

So, I wonder how someone with a challenging job like she has as CEO of a multi-million dollar organization can understand what the realities of retirement are much less the challenges of being old.  Now I am quite certain that I will not live long enough to ask her about purposefulness when she is retired and living in the 80’s age bracket (if she is lucky) because I would be over a hundred.  Thoughts about living that long boggle my mind and I would not classify them as being in my hopes, dreams and aspirations.  

Yes, she can talk about the fun of growing old, because for her it is probably 20 + years from now and as I have written before, humans think about the future differently than they do the present.  And, the future has a nasty habit of suddenly becoming the here and now.

Still I like what she is trying to do by making aging a fun game.  Unfortunately it is not a game and it is not that much fun.  Still aging is a privilege which us old people must realize because not understanding that it is indeed a privilege would make being old a very depressing experience.  In that regard, I guess I am disrupting aging and living a relatively pain-free life is purposeful.

10/14

WANTING TO DIE AT 75 YEARS OLD

The old rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

The other day I saw Dr. Ezekial Emanuel, a practicing physician, affectionately called Zeke on public television (PBS).  He is the oldest and considered the smartest of the three rather famous Manuel’s including one of his brothers who is mayor of Chicago formerly Chief of Staff at the White House under President Obama.

During his interview he was most emphatic about his desire to die when he reached the young age of 75 years.  I note ‘a young age’ because as I look back several years when I was 75 I recall asking myself what is so difficult about this growing old stuff?

Then a couple of years later I began to notice a difference in my physical abilities including balance and the tendency to fall down with greater discomfort than I had previously experienced.  Another problem I acquired was a severe pain in my right leg as I walked even short distances. 

As I have written before, I put off seeing a physician for a couple of years as I thought it was somehow related to the minor drop foot I had acquired prior to this leg pain. You know the pitfalls of self-diagnosis.  But, when I did go for an examination I found that they were not related and that the leg pain could be treated with surgery.  Following the four hours of surgery and my rather rapid recovery and rehabilitation I was able to walk without any pain even one of longer than an hour.

The drop foot caused by a nerve disorder could have been treated with surgery when it first occurred.  Unfortunately, I had waited too long.

When Zeke was pressed by exactly what he meant about dying at age 75 he hedged his statement with the caveat that ‘well he was not going to kill himself but would not seek any medical care after he reached that age’.  When I heard that statement I remembered my leg surgery and how my quality of life was substantially improved because of it.

Zeke went on to note that there are so many disabilities associated with being old that the smart thing to do is just die.  You know he mentioned Alzheimer’s disease, reduced physical capabilities, chronic joint pain, and lack of creativity, just to name a few.  Well welcome to old age Zeke but I am not about to die and I have lived seven years plus passed your magical age of 75 and I am doing pretty well.  Oh sure I’m no 75 year old but I don’t want to die right now.

I was particularly upset about this ‘lack of creativity’ nonsense.  I hear this frequently that an old mind is not creative.  No not ‘as creative’ but dogmatically ‘not creative’ anymore.  Well I published a fantastic mystery novel ‘Mary’ of over 80,000 words which is available on Amazon Kindle for $5.99 when I was 79.  I started writing this Blog on old people when I was 80.  In fact I could not have written about being old starting at 80 without being 80!!!

Now he did concur that there are some ‘outliers’ who are doing pretty well regarding all of his listed infirmities like I am a rarity you know one in a million.  Well not so fast.  I play bridge on a regular basis with three ‘old people’ two of which are older than me, one of which is 87 and she is very capable at the game.  I have written about my uncle who is 92 and he is no mental cripple by any means not to mention the pleasure he has with his Scotch on the rocks each evening.

So what does Zeke mean by outliers?  In fact, I have monthly luncheons with my retired friends and except for one person all of us are mentally alert and physically capable of living a productive still interesting life.  Well some of them never did live a real interesting life even when they were in their prime.

Now Zeke is about 57 years old so 75 is a long way in the future and like I wrote about people are not good at thinking far into the future.  We evolved thinking about the here and now for several reasons one of which is survival.  We have in our DNA the desire to survive at all costs and that involves reacting to the present, not something several years down the road.  Simply, the future can not be appreciated in the present so it is caste off with only casual thought.

But the future has a nasty habit of becoming the present. And, the present must be dealt with now not in the future which takes us back to quality of life. 

Like I have written a good quality of life is just about everything in old age.  And, a good quality of life for old people requires hard work.  When we retire we too often think now I don’t have to do anything I don’t want to do.  You know, my whole life has been filled with requirements many of which I disliked so now that is all gone.

Well, doing some form of physical exercise most everyday is work but it must be done!  Stimulating the brain with mental gymnastics requires effort but it must be done!  You know the old adage, ‘use it or loose it’.  A few years ago a common saying was, ‘a brain is a terrible thing to waste’ but even worse is ‘a brain going to waist is a terrible thing’.   

So, with that very clever turn of words, I close with the thought growing old is interesting but being old is damn hard work yet still interesting Zeke.

PS:

In the October 2014 issue of the Atlantic magazine Zeke wrote an article expressing the same sentiments under the title ‘Why I Hope to Die at 75’. I was intrigued by the correspondence from readers of this article published in the next issue under the heading ‘The Conversation’.

Many of my above views were echoed especially from the older readers.  And like my take the overwhelmingly majority of 74% of all ages disagreed with his ‘Hope’ (and dreams?) of dying at that age.  Of course quality of life was noted many times, simply living just to be living for most readers was not an option.

Of the several letters published many from older readers, not one mentioned that living to be an old person is living another role in life’s journey with many challenges but still very interesting if one’s quality of life remains at an acceptable level.  Half of the population does not have the privilege for they have died.

I liked one letter best recalling his 85-aged grandmother answer when asked who would want to live to be 100?  She replied ‘Someone 99’.  Simply, Zeke does not know what he is writing about until he lives to be 75 then he will probably want to live to be 76, then 77…

12/14