Life After Dementia

Life After Dementia

BLOGGER: MICHAEL FRIEDMAN, L.M.S.W

I am afraid of developing dementia, the most common form of which is Alzheimer’s disease. The possibilities are horrifying — the ineluctable loss of memory and other cognitive functions; dependency on others to dress me, to feed me, to change my diapers; slipping into a fog, where I cannot recognize even people I love.

But is dementia inevitably a cruel, distorted end of a human life?

When I was younger, I thought so.  I had no doubt that I would prefer death to living in a demented state; that I would want to take my own life; and that, if I missed the timing and could not act on my own, I would want someone else to do it for me.  “Just shoot me,” I said to my wife — knowing, of course, that she would not and could not, but hoping that she would act swiftly as my health care proxy to have any kind of life support — including food and water — removed when I was no longer myself.

As I have become old (I am now 68), my thinking has changed.  When the time comes, if the time comes, I may want to live — even if I cannot engage in witty conversation; even with the need for someone to help me hobble on a walker to get out for a breath of air; even with the indignity of someone cleaning me after I mess my diapers.

What we expect and want for ourselves changes over time.  That is the fundamental insight of developmental psychology.  When I was a child, being a child seemed right.  When I became a teenager, I fought against being a child.  As a grown-up, my adolescence was an embarrassing memory.  I am happy now not to be driven to succeed at the work, which largely and happily defined my existence as an adult.  The low-stress life I am fortunate to have now feels right to me.

What will feel right when I am very old?  Will I care if I can no longer analyze public policy?  Will I be deeply distressed if I cannot write or teach?  Will I suffer if I cannot tell a joke or have an informed conversation about politics, world events, and the fields of knowledge and activity that have been central to my life?

Or will a visit from someone I like make my day?  Will my daughter and grandchildren (if I have them) be a source of constant interest?  Will watching world events on the TV with only faint understanding be enough?  And when the time comes, if it comes, will the feel of the sun on my face be enough for me to want to live?  Will a caring hand on my shoulder, the taste of French fries, the sound of jazz, the sight of a beautiful painting or sunset be enough?  I do not know the answer.

I do know that dementia unfolds in stages.  Although many people in the early and mid-stages are devastated by the growing loss of important abilities and develop mood or anxiety disorders, others have “full” lives that include the pleasures of friendships, love, and sex; the satisfaction of participation in social and communal activities; and even the discovery of new interests.  In fact, some experts on dementia (see, for example, John Zeisel’s book, “I’m Still Here“) maintain that diminished cognitive functions result in the release of capabilities that have been suppressed by the very cognitive abilities that are now in decline — particularly the willingness to take creative risks and the openness to human affection and intimacy.

There are, as we all know, people with dementia who become depressed, frightened or angry — some so angry that they are abusive to people who try to care for them.  There are some people with dementia who wonder why they are alive, or wish for death.

But there are also people with dementia who experience pleasure, who feel love, and who are at peace.

So, even though I still fear developing dementia, I no longer say with any sense of certainty, “Just shoot me.”

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Sex and the Sixty: The Coffee Shop

Sex and the Sixty: The Coffee Shop

BLOGGER:  RENEE FISHER

Before reading, if you haven’t read the first three blogs in the series, you can click the links below:

Sex and the Sixty: Online Dating

Sex and the Sixty: Susan Gets Online

Sex and the Sixty: Not a Good Match

When Susan agreed to my rules about coffee only/60 minute maximum, she decided it would be a good idea to knock out (well, not literally) as many men as possible on a daily basis, and thus began setting up two coffee dates per weekend day, one per hour. The venue was a local bagel bakery in a crowded suburb of DC.

On one especially lucrative day, Susan managed to schedule three men, back-to-back.  She set up a 10:00 a.m. date, went in, got a cup of coffee, sat innocently at the table in a bright chartreuse shirt (easily identifiable so that no man would ever mistake another woman for her), and waited for her date.  Enter Date #1.  He found her, they chatted.  After approximately 50 minutes, she walked him out the door, said good-bye in the parking lot and then headed back into the bagel place.

She then touched up her lipstick, rid herself of the cup of coffee, and checked to make sure her mascara was still in place.  I’m not sure why Susan felt that the act of drinking coffee would damage her mascara, unless the coffee were so hot as to make her make up evaporate, in which case, it would also have been suitable material for a lawsuit.

She then procured another cup of coffee and waited for her next victim (oops, date).  Date #2 entered, and he and Susan went through the same scenario.  In 45-50 minutes, Date #2 was out the door.  For her third date, Susan re-entered the bagel bakery, and she was handed her third cup of coffee.  As she walked away from the counter to pay for it, she overheard one of the cashiers whisper to another cashier “Ah, here comes the Bagel Hooker again.”

I can relate to this.  For a couple years before I started dating my second husband, I met all of my internet dates at a diner that was directly across the street from my office.  That way, I could, at whatever moment I desired, announce, “Wow, gotta get back to the office!”  Unlike Susan, I didn’t schedule dates back-to-back.  But Susan has always been much more efficient than I was about men.

Unlike a coffee or bagel shop, this diner had a hostess who would seat people.  Each week I had one or two meetings with men.  Each time I would say to the hostess, “I’m meeting a man here but I don’t know exactly what he looks like.”  Then, after an hour, we would leave together.  After several weeks, I noticed that whenever I came into the diner, the employees would stop what they were doing, watch me, and shake their heads knowingly.

Then one morning, I met my friend Crazy Debbie for breakfast at the diner. Debbie is nothing if not memorable.   It was a weekend morning, and the diner was very crowded.  I arrived first and got a booth at the far end of the room. About ten minutes later, Debbie swept into the diner wearing a nightgown, fur boots, and a tiara.  She had a purple oval painted on her forehead.  When the hostess asked if she could help her, Debbie replied in a very loud voice, “I’m meeting my lover here!” scanned the room, located me, pointed in my direction and announced, “And there she is!”

From that moment on, I morphed from a mere call girl into a genuine celebrity in the eyes of the diner staff.

I think I’ve covered all bases now leading up to relating the actual live meetings between Susan and Her Men.  That, depending on how long this friendship lasts at this point, will await that time until either Susan accumulates more stories or until she remembers the ones that were so traumatic that she has temporarily blocked them from her memory.

Renee Fisher is a Realtor and writer who lives in the Washington, DC area.  She is the co-author of two award-winning books about life after 50  www.invisiblenomore.com and is the DC Boomer Humor columnist for  examiner.com DC-Boomer-Humor-Examiner.

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Resisting An Age Phobic Culture

Resisting An Age Phobic Culture

BLOGGER:   JESSE MENDES

There are some people in this world that approach every birthday in their later years with a sense of dread; an unwelcome, God-forsaken, doomsday event.

One of those people is my mother. Every year I try to remind her of the level of self possession and appreciation for life that she has now, that continues to grow as she gets older, and that she never had when she was young. Every year I point to her the strength, the beauty and the wisdom with which she perceives life now, that defines her day to day experience, and that only came with age. Every year, she admits I am right. My mother is an extraordinary woman with extraordinary depth, and a capacity for love and sheer delight that most people can only dream about. And yet despite her treasures; despite her sanctuary of a home and her beloved cat creatures and her rich social life and her back yard of magical forest fauna, every year, she fights me. Every year, as I implore her to remember who she is and how she inspires me, she clings to her disgust about age, insisting that I won’t understand until I reach her age.

Perhaps she is right. Except that I believe we all have, to some extent, a hand in how we experience, or respond to, the inevitabilities of life – and our emotional responses are shaped, in part, by our attitudes. And I don’t want to dread growing older. Maybe I can’t control that. Maybe there is some genetically-pre-disposed, universal experience to getting older that I’m oblivious to. Or maybe we’ve all been sold a bill of goods; an ideology so utterly devoid of virtue or any morsel of humanity – that to age is to become undesirable, impotent, irrelevant and disposable.

There it is. The elephant in the room. Well, hardly. Common attitudes about aging in North America are nothing short of pathological, and yet somehow, they make up most of the propaganda we all willingly participate in every day. My mother is one of many victims of a mass media marketing machine, peddling warped ideals of an age phobic culture. How will I fare? Will I succumb to mainstream dictum?

Not if I can help it.

Jesse Mendes is a writer, editor and journalist who is deeply committed to helping to change how older women are perceived in North America, and to dispeling the stigma around aging. Her blog can be found on the Blogroll on this web site, and on the link on her Twitter page, where she goes by the name SeptemberMay.

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WHEN I AM 64 WILL I BE HAPPY? II

When I am 64 will I be happy? (Part 2)

BLOGGER:  PAUL GRIFFIN, PHD

Does happiness change with age? Although the difficulties of the aging process coupled with negative stereotypes about the elderly lead many to think that a decline in happiness is inevitable, in my first post I argued that some research contradicts this popular belief. A number of studies find that those who are 64 are more likely to report higher levels of happiness than those who are 34 or 44. These findings are revealing, and certainly they point to reasons why we should be somewhat optimistic about our “golden years.” But in this post I would like to add a note of caution. Although some have used these compelling findings to definitively conclude that happiness increases with age, I think this general conclusion is problematic for two primary reasons. After discussing these problems, I will try to keep the reader happy—especially the baby boomers–by nonetheless arguing that there are still considerable reasons to be optimistic about getting older, even if the future of aging presents a number of pressing issues for society as a whole.

The first problem with concluding that happiness increases with age is that findings on this subject vary according to how happiness is measured. This brings us to an issue that has perplexed greater thinkers throughout the ages: What is happiness? On the surface, this is a rather basic question that could be answered by most anyone. We have all experienced happiness, and, therefore, we all believe we know what it is. Yet because happiness is a subjective experience, a standard definition remains elusive. We all come to our own definitions of what happiness is, and subsequently use this definition to answer the question, Am I happy? Therefore, even with the understanding that people can be wrong about their own emotional states, most research on happiness is based on directly asking the people being studied to provide the answers themselves. The most basic way of doing this would be by asking a single global question like the following: “Taken all together, how would you say things are these days—would you say very happy, pretty happy, or not too happy.”

Some—particularly in psychology– approach the question of happiness a little deeper by more precisely trying to define the components of happiness. Since they often still take a subjective approach to answering the question, the term that is often used interchangeably with happiness is “subjective well-being” (SWB). Fancy terms for common words are often a part of academic disciplines, and it might be true that in many cases such substitutions are a way for people with PhDs to feel a wee bit smarter (and, thus, a bit happier). In this case, however, I think the use of the term SWB is way to arrive at a more precise definition of happiness. The three broad components that make up people who are high in SWB are characteristics typically associated with happiness: high life satisfaction, high positive affect (more likely to experience positive emotional states), and low negative affect (less likely to experience negative emotional states). Reliable multiple-item questionnaires have been created for all three components and used in hundreds of studies.

Now what is interesting is that when you take a close look at the research on aging and happiness, you find certain differences depending on how and what component of happiness/SWB is being measured. For instance, the single item question described above (“Taken all together..”) has been used in a number of large studies comparing thousands of people of different ages. Some research of this types indicates that happiness is high in people in young adulthood—in their 20s—and then shows a decline until one reaches their late 40s to early 50s, whereupon we once again see increases. Other research, using components of SWB, finds other results. For instance, considerable amount of research on life satisfaction does not often show the early dip in middle-age, but rather a gradual rise from individuals in their 30s to the early 70s. Also, research on negative affect often indicates significant declines in the experience of negative emotions as we move from young to older adulthood, but the research on positive affect is less conclusive, with some research indicating no change with age, other findings pointing to small increases, and yet other research finding gradual declines. Please note that even when these mixed results are considered, it still does not suggest that happiness is highest in young adulthood.

I will try to make sense of these discrepancies in a moment. But let’s take up the second problem, which is that a considerable amount of the age and happiness research is composed of populations that often do not include many people in their 80s and beyond. Not including such age groups might have made sense several decades ago, when they made up smaller amounts of the elderly population. But that is not the case today, and it is likely that “late life” for increasing number of people in the future will not mean late 60s or 70s, but the decades beyond. Therefore, this is an important population to consider, and when we begin to expand our research pool to include these age groups, the picture of happiness and aging becomes more complicated. For instance, while SWB research comparing samples of people in young adulthood and middle-age (30 to 50) to older adulthood (60 and 70s) often indicate higher SWB in the older populations, when we look at groups beyond their 70s, declines are more pronounced. My own longitudinal research with a sample of 1500 men found that while negative affect showed a significant decline between middle to older adulthood (from 40 to 70 years), these declines began to flatten when they reached their early 70s, and then the experience of negative emotions showed a gradual increase as men moved into their 80s. Therefore, while it is true that a number of studies do find increases in happiness with old age, many of these studies fail to define “old age” with individuals beyond their late 70s. Studies that do focus on the very old (>80) often find reductions in SWB with age.

What are we to make of all of these discrepancies? First, it seems that if we want to get a more defined picture of how happiness changes across the lifespan, we need to fully consider what aspects of happiness are being measured. When we consider the different components of SWB and how they show different changes across the lifespan, rather than think of these findings as inconsistencies we might instead want to consider how they reveal the different ways that aspects of the happy life manifest themselves across the lifespan. A more complete picture of happiness requires us to move away from a global and singular answer to this question. Different changes in different indicators of SWB might point to the varied ways we adjust to the aging process.

Second, recent research that finds declines in happiness in very late life make it clear that we should be careful about coming to any general conclusions about the direction of SWB across the lifespan. Although it is now more common to find headlines—in both academic and popular outlets—claiming that happiness is highest in later life, I think this optimistic picture of aging is incomplete. Yes, there is considerable amount of research that indicates that people are quite happy at 64, but we know considerably less about this question when we ask those who are 84. And while 64 years of age might have once produced the iconic image of the later years of life in a song written several decades ago, this picture of late life has shifted and thus must our conceptions of what it means to get old. Recent research indicating declines in happiness in the very old (>80 years) should be reason for concern. They probably point to the many stressors of the aging process as increasing difficulties accumulate.

Yet before you say I don’t want to be 80, consider a couple of points. Several longitudinal studies on SWB find a significant degree of variability in how people change across the lifespan, even in these later years. This is another way of saying that while a considerable number of people might show decreases in happiness in very late adulthood, a considerable number do not. Yes, people are still flourishing, even in their 80s and 90s. Why? What predicts differences in the ways we cope with the aging process? This is an essential question that I will address in a future post. The important point to consider now is that there is no reason to believe that such declines are inevitable. This leads me to my next point, which is that not so long ago our perceptions of aging and what was to be expected of those in later life were considerably different from today. Ageism and common negative stereotypes of the elderly remain, but consider the more sedentary lives of those in their 60s and 70s a half century ago, and compare that with the active lifestyle many in this same age group are practicing today. This profound cultural shift can be attributed to a variety of factors, including greater amounts of social capital, better health, and expanded life expectancies.

One of the most influential researchers in gerontology and positive aging, Paul Baltes, once wrote, “The greatest invention of the 20^th century is old age.” In saying this, Baltes was saying how none of the changes we described were inevitable. If people live longer and in some cases better at later ages, it is because of the significant contributions made by society to cause these changes. But Baltes’ comment also points to the tremendous strain that such an invention places on society and individuals. If getting older is to continue to mean getting better for a significant portion of the population, it will also require considerable effort and sacrifice. When you consider that whatever the age of the person reading this post, it is now more likely than ever before in human history that he or she will spend more years at advanced ages of life, such commitment and sacrifice will be an essential part of ensuring a happy populace now and in the future.

To find out more about Dr. Griffin, click his photo below.  All links for Dr. Griffin will be listed below his bio.

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Facebooking at 40…

Facebooking at 40

BLOGGER: DEBORAH HEISER

So…I finally broke down and joined Facebook.  After all, it’s one of the most popular sites for people over 40.  How could I resist?  I was hesitant, I have to admit–I even poo poo-ed it.  At first I just went through the motions of joining (leaving off my picture of course – so no one would know I joined).  Then I started trolling the site.  Punching in names.  Looking at pictures.  Punching in names.  Looking at pictures.  It was a secret obsession.  The first few days, every time my husband came in the room I’d click on something else so he wouldn’t know I’d been trolling around on Facebook (FB as it’s referred to by us insiders).  I would act like I’d been busy working on something important  (like backing up my hard drive or something).  But the obsession didn’t wane.

I uploaded my picture and started responding to   “friend requests” from people I hadn’t heard from in decades.  Hit by a wave of nostalgia and curiosity, I continued on – staying up late and procrastinating on other work so I could continue with my new obsession.  It was fun to remember grade school antics with old friends, see pictures of them with their children and husbands and pets.  See the guys who lost their hair and gained a gut, the girls who stayed remarkably good looking, and to read about how the “wild girls” had tamed down and were now caring moms and wives.  It was a sense of relief to see how so many people had moved away and went on to do interesting things with their lives.  Plus, with the click of a button to request a friend, I could reconnect with people and chat online as though decades had not passed.

Now that a couple of weeks have passed, I have to say that my initial curiosity and obsession has started to wane and I’m past the point of needing to log in several times a day.   I think it is because there is still a superficial quality to the site .  And I just don’t quite “get” some of the aspects.   I can’t understand, some of the “poke”, “super poke” and flutterby (probably have that one spelled wrong), or the gifting and getting drinks for people.  I keep screwing them up.  For example, someone poked me to “go dancing” and I couldn’t find a response other than “throw a sheep” or “give a hug” or “chest bump” with the person. (It turns out there are other choices but I couldn’t figure out how to find them).  Anyway, I chose to “chest bump” the woman–I guess it is okay to be socially awkward as long as it is online.  Right?  Someone else got me a dog award ribbon.  Should I have been offended?  And, when someone gave me a “drink” I thought it was cute, but was confused about how to accept it without giving it out to 20+ other people.

Anyway, here’s the thing: I think these pokings, giftings and other things are okay, but what I really wanted was to go beyond the “super-poking” and fake gifting.  I wanted to find out what people were actually up to.  And not on a screen where everyone else could see everything I wrote.  After all, what if my co-workers were also secretly trolling FB and found out I’d had such a blast in high school going out drinking and doing all kinds of wild things I like to pretend I never did.  Or, what if they found out I chest bumped with a woman or threw a sheep at her with a super poke?  Please, how seriously would anyone take me? Now that I’m 40, I have a need for more than online sheep throwing.  If I’m going to continue staying up late, I want it to be for something more than curiosity clicking on the internet. 

As a developmental psychologist, I realized that what I was doing (well, not the secret trolling and awkward “poking”) was actually in keeping with the developmental milestones of midlife.  As we age it is normal to shed some of our superficial friendships and concentrate on more “intimate” or fulfilling relationships.  This is often because we have families and hectic work schedules that make it impossible to maintain a large network of relationships as we used to.  So over the course of our 20’s and 30’s we weed out the less meaningful friendships, or spend less time with them, so they just fade away.  We concentrate on the relationships that are most satisfying, and most meaningful.  After all, time is precious when you’re exhausted from work and raising children.

After realizing that I was on the right developmental trajectory for my age (phew!), I asked myself… What did I take from my FB experience these past couple of weeks?  I now know that I can reach out to my “friends” from past and present.  There are more people out there than I knew I knew.  It is like an online security blanket.  But what if there were a place to chat with those “friends” about topics that are current?  Maybe a blog? …..

What are your thoughts?   

To read the bio for Deborah Heiser, click here.

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