Achieved the milestone of becoming a senior citizen, I have been slowly letting the concept of being “old” sink in. My 50th high school reunion is this year (50th!!!). I feel like I need a plan for growing old gracefully, or maybe just growing old with intention. We seniors are encouraged to plan for retirement, write health care directives, buy burial plots. But what about everyday living? What do we do?
Here are the questions I am starting with:
- Can you teach old dogs new tricks?
- Why is there a Grumpy Old Man and Grey Hair Grumpy Old Woman day?
- Can crosswords or Wordle keep cognitive decline at bay?
- How do we avoid loneliness or living in the past as we lose friends, lose our hearing and when family grow busy or move away?
Question 1: New tricks?
We know that our brains retain plasticity—or the ability to change, to learn—even in the later years. It is true that as we age, we will experience an overall slowing in thinking, experience challenges holding attention, lose some functioning in working memory or in holding specific facts or names in mind, and likely problems with word-finding. Yet our “crystalized intelligence” or the ability to integrate knowledge rooted in life experience continues to develop into our seventies. If we keep learning our brains keep developing. Old dogs do learn new tricks (but don’t ask me to remember why I just went down to the basement).
The ability to learn, to change the workings of and healthy functioning of one’s brain means that seeking mental health counseling as an elder can and does work. We maintain the ability to change behaviors, change habits, take new initiatives, improve our health. We choose to continue to set goals, try new things, put fun ahead of fear.
Question 2: Grumpiness and aging?
Wabasha has its Grumpy Old Men festival. My favorite t-shirts include the Grumpy Old Men Club (“never happy unless complaining”) and my “Grumpa” hat (like a regular grandpa but grumpier). There are compelling reasons for becoming more irritable, depressed or distracted: chronic pain, grief and losses, ageism, and whatever the latest new fad in music is, all this can cause one to become a curmudgeon. See an odd but instructive thread on Quora as an example.
There are several developmental theories that describe stages of maturation. The best known is Erickson’s Eight Stages of Psychosocial Development. The eighth stage, which starts at age 65, poses the dichotomy of integrity verses despair. It is a time of reflection on our life, determining we are either okay with who we were and what we have done, or we are consumed with regret for things we did or failed to do.
Joan Erickson outlived her husband Eric, and so she got the last word in and at age 93 proposed a Ninth Stage of Development. It corresponds to one’s eighties and nineties, describing a time when physical health diminishes, death feels close, and isolation from the broader community often occurs. Our society rarely honors the old, their wisdom is not cherished, and so for many of us we struggle to maintain a sense of wellness and integrity. In this last stage, Ericson states we naturally relive the struggles of every one of the eight previous developmental stages, though in reverse. Mistrust of one’s capabilities replaces trust; we may experience profound loss of autonomy. The loss of competencies/functioning leads to inferiorities; our existential identity is questioned; secure intimacy is often replaced with isolation; diminished energy leads to dull routine, to stagnation; and the integrity of the eighth stage gives way to a recognition of a loss of self.
The adaptations forced upon us during this ninth stage of physical and sometimes psychological decline has been called working towards Gerotranscendence. It involves developing a strong sense of spiritual connection, a comfort with one’s future being limited, making accommodation to more limited mobility and to a shrinking of one’s personal space. It can involve accepting that death is part of life. We can grow in a sense of having a stronger physical and conceptual interrelation with others.
We can see then that there is some basis in reality to support the common stereotype of us old people being cranks. We know that old age is not for wimps. Yet surveys regularly show that a majority of people in early old age are happier than younger groups are. On top of this, most senior citizens develop a stronger positivity bias that sees and fosters the good and discounts the negative.
So then, are we foreordained to become crotchety cranks? There is choice involved, using perspective to maintain a positive attitude. Counseling during the early senior years can help one shift from despair/regret to integrity. It can help improve self-forgiveness and establish greater acceptance or even a redefinition of who we are becoming. Counseling can help look beyond one’s day-to-day existence to focus on our spiritual connections and how we have left our mark with the people in our lives.
Question 3: Can Wordle defeat dementia?
I keep Sudoku and crossword books in my house, play Wordle and Spelling Bee online. What I know beyond a shadow of a doubt is that they are great aids for procrastination. But are brain puzzles preventative mental health? Must cognitive decline be inevitable?
Increasingly in the mental health field we help people work towards a concept of wellness that emphasizes strengths, as opposed to a focus on fixing what is wrong, a focus on specific problematic symptoms. Wellness involves a broad definition of self-care. It includes developing skills to manage the moment, to do the best we can with the varying challenges of each day. Wellness can and does co-exist with ongoing and variable mental health symptoms.
A focus on wellness is essential when we consider that aging always means significant changes in brain health, physical health or daily functioning.
“I don’t let my age define me, but the side effects are getting harder to ignore.”
—Unknown
The National Institute on Aging website has useful and information and guides that define brain health and list the steps we can take to maintain or increase the functioning of our brain. Actions include physical activity, healthy eating, managing stress and keeping one’s mind active (including playing games). Learning, creating activities, dance, reading all help prevent cognitive decline, improve quality of life, and enhance brain functioning. Many elders have gained a comfort level with knowing who they are and less reluctance to speak one’s mind. Play ought to become a priority again. A search on the MeetUp site found these groups: Mexican Train and Bocce Ball, Dog Hike and Brew, Aging but Thriving with Mental Toughness, Group Sing, Blogging Group.
“Old age is an excellent time for outrage. My goal is to say or do at least one outrageous thing every week.”
—Maggie Kuhn
The CDC reports that half of us believe we will develop dementia as simply a part of normal aging. The true incidence of dementia is 10%. Regular forgetfulness is common and no more than an annoyance as our memory naturally changes due to aging. Knowing the difference between forgetfulness and dementia or Mild Cognitive Impairment is important. See here and here for how to recognize the differences. Asking your primary doctor for a referral for a baseline cognitive screening may ease one your worries.
Talking with trusted people about any concerns with changing memory or cognitive functioning is a first step. Therapy can help here with screening for cognitive impairment, and for addressing broader concerns about aging. We can develop coping skills for managing new challenges.
Question 4: Is isolation and loneliness inevitable?
Many of us seniors find ourselves feeling lonely or socially isolated. Leaving employment reduces social contacts. Limited mobility may make it hard to get out and about. Death of friends or people moving away robs us of connections. Hearing loss can be impactful when socializing in groups, in noisy places. Sometimes we fear we will have nothing to say. A lack of drivers for medical transportation companies or other types of transportation might leave us with fewer options for socializing. To counter these or other conditions, we many need to consider new options for making connections.
Minnesota, and especially the Twin Cities, has a wealth of resources for seniors for recreation and socialization available to us than do other areas. Senior and Community Centers offer recreation programs, fitness programs, education. The White Bear Lake Senior Center offers social groups, dominos, Mah Jong, and woodcarving weekly, for example. There is also the Silver Sneakers program for most people on Medicare; the program offers health club memberships or specific classes for free. Seniors can take regular courses at the U of M or other MNSCU programs for $10/credit.
The Senior Linkage Line is an online or phone service for connecting seniors or caregivers with a variety of resources, support, and information specifically for seniors.
Friends and Co. connect volunteer phone companions, visiting companions for seniors in the twin cities. This organization also has resources page with a wide array of links to food programs, specialty medical info, and even a link to adaptive bicycles.
Everyone needs someone who will call and say: Get Dressed. We’re going on an adventure.
Seeking mental health counseling for social isolation can help you identify and reduce barriers we have constructed that get in the way of our true need for human connection. Humans are meant to be social animals. Maintaining social support—even relatively casual social support—is a core element of wellness.
Making plans, setting goals, continuing to create life
We grow old simply by continuing to wake up each day. Yet passive aging will likely lead to unhappiness, to becoming the grump, to feeling like a victim.
An overall helpful description or guide for addressing the challenges of aging is from England: How to Look After Your Mental Health in Later Life. (Note that several of the links are to specific resources in the United Kingdom).
As a society, we tend to fear and resist old age, to separate ourselves from the elderly. The number of elderly living with extended family has dropped from close to three-fifths in 1900 to about one-fifth now. The overwhelming majority of us are aging in place in single family homes until our 80s, when assisted living or nursing care becomes necessary. Especially when living alone, we need to take responsibility for maintaining our mental wellness.
Overcoming the indignities and losses of old age requires entirely new and out-of-character actions: we are forced to adapt to physical and cognitive changes. As another of my favorite t-shirt says, “I don’t know how to act my age: I’ve never been this old before.”
Taking fearless stock of who I am today (not who I was) will guide me in making the bold steps I needed to—more successfully—act my age.
Exploring the power of neurofeedback in modern therapy