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Aging Well – a personal perspective

04 August 2020 - Dr Jan Orman

COVID 19 has increased everybody’s awareness of the vulnerability of old age and many people in my life are being extra cautious. Those friends who still have parents are anxious for them and taking great care around them, but some of my friends are actually in the vulnerable age group themselves. This has left me doing a lot of thinking about how people generally come to terms with the aging process.

Up until recently I have found denial a very effective strategy. I work with a great team of young people whose respect I have chosen to put down to my superior skills and experience rather than just plain old respect for their elders. Being around them is great for me. Unfortunately, COVID has kept us all out of the office and I am no longer in daily contact with those bright young things with busy minds and positive attitudes. I really miss them and feel older without them. There’s probably a lesson in that for me isn’t there?

I had parents who did not age well. My mother succumbed at 61 to her appalling cardiovascular inheritance and my father developed dementia at the same time and spent his last 5 years in a nursing home, gradually disappearing. As I was still at high school when all this was happening, I was, like any teenager, not interested in their struggles. I had no opportunity to observe whether they had adopted any strategies to help them through this period of their lives. So, I’m looking around now to see what I can learn from others who are facing the challenges of aging with grace and good humour.

One of the problems, of course, is that aging is such a distasteful subject for most people. If you thought menstruation was a poor dinner table topic try talking about aging to a group of people of mixed ages and see what happens! It’s making it hard for me to get the information I need.

Nevertheless, I’m ploughing on with my research and I intend to find out, not what keeps people fit and healthy – everyone knows they need to keep active, eat well and get enough sleep, have regular check-ups and take their medications when they need them – but what is it that keeps some people positive about life, even as it approaches its end? All the things listed above certainly help but there’s something more, something that some people find easy but others just can’t manage, something that stops people from shrinking into tiny little people with tiny little worlds, something that allows them to let go of little worries and concerns and enjoy what’s left of their lives.

Here’s what I’ve learnt so far about what I need to do:

Learn to manage anxiety

I come from an anxious-worrying family. I have noticed that, as they get older, anxious-worrying people tend to become more anxious and worry even more about more and smaller things. Getting older does make you frailer and you naturally get more concerned about your physical and mental capacity to deal with things if they go wrong. This anxiety makes you afraid of change, more rigid and often more difficult to get on with. It also makes you unhappier.

Apart from ensuring you maintain as much capacity as you can for as long as you can, the lesson in this for us all is to learn some techniques to manage your anxiety as soon as possible. That way you have an anxiety management skill set to fall back on when you need it and you can be more confident about managing the inevitable challenges of aging.

Learn to look outward and take an interest

Old people often get fixated on their health. Old people who flourish do not seem to be like that. Even if your health is bad you can still take an interest in what’s going on in the world around you – in the news, in your family, in your neighbourhood. There are much more interesting things to occupy your mind with than your joints and your bowels and if you are interested in others, they will be interested in you. Their interest will make them want to be with you and share things with you and that is likely to leave you less isolated and a happier person all round.

Learn to accept the present for what it is

So much distress comes from wishing things would go back to the way they once were. Every generation must deal with the linearity of time and the inevitability of change. Yes, we’ve had a difficult time of it because change has been so fast in our lifetimes, but what’s done is done and things will not revert to the way they were no matter how hard you wish for them to do so.

The internet and social media are not going to go away, the population of our cities is not going to diminish, the roads will not get less congested, effective contraception is here to stay, the multicultural nature of our community is unlikely to change, women are not about to stop being educated and leave the workforce and men are not going to go back to opening car doors. (For most of that I personally am very grateful)

Learning to roll with change is an important life skill. Learning to accept what we can’t change is key to personal survival. That means accepting the changes in our bodies and our minds as well as the changes in the world. That doesn’t mean being complacent – it just means being realistic and making the best of the new world we find ourselves in, changing the things we can change and accepting the things we can’t.

That’s what the happy older people I know are doing. We can all practice that skill too, no matter how old we are, so that we have it up our sleeves for future use.

Learn to let go of regret

Everyone has a list of things they wish they’d done or wished they hadn’t done before it got too late. I wish I’d studied harder, had more babies, travelled more, lived in the country, lived in another country, not given up my ambitions to be a writer …… the list goes on.

Some people make that list as short as possible by trying to do everything they can before it’s too late. Others, through no fault of their own, see opportunities to fulfill their dreams pass them by, or never get those opportunities in the first place. It can be very sad but dwelling on those unfulfilled dreams can seriously interfere with life in the present.

The happiest older people I know are the ones who accept that our dreams are bigger than our lifetimes and while the dreams function to spur us on, not all of them can be fulfilled.

Learn to enjoy the memories

One of the good things about getting older is that we amass a huge collection of memories. Not all of them are good memories and not all of them are easily accessible but it’s nice to be able to pull out the happy memories when you need them. The inability to do this is part of the tragedy of age-related memory loss.

It helps to have stories and someone to tell them to, photos to look at and share and people from the past to talk to about the stuff that happened back in the day. If you are trying to help an older person get on top of their sadness it can be very helpful to talk to them about their positive past experiences and draw out the richness in their lives that they themselves may have forgotten about entirely until that moment.

Learn to be flexible

Flexibility in thinking is key to emotional survival, irrespective of age.

I’m sure you’ve encountered the increasing rigidity of thinking that affects many people as they get older. There is some neurobiology behind that phenomenon. We know that neural pathways we don’t use regularly grow over, so to speak. We shrink back to familiar patterns of thinking and behaviour if we allow ourselves to do so. The familiar is warm and inviting but it is also a little bit dangerous. Those old slippers may be the best thing you ever put on your feet but if you don’t ever take them off they’ll get smelly and eventually so worn that you won’t be able to go outside.

To prepare our brains for old age it might be helpful to practice being flexible in our thinking before we reach those big numbers. Practice looking at things from other perspectives, thinking about things differently, trying to understand other people’s attitudes and points of view. Those skills will help right now – you don’t have to wait until you get old to benefit from them.

Sure, we can do number puzzles and cryptic crosswords or learn a language or a musical instrument to keep our brains working, but we also need to train ourselves to interact with the world around us with flexibility and agility.

Don’t shy away from new experiences

Some older people’s refusal to engage with new technology springs to mind when I say this. I find it very sad to see older people becoming increasingly isolated because they have been reluctant to learn to use technology. I see them becoming increasingly isolated as the world moves on without them.

Having new experiences, whether it’s as simple as meeting new people or a more complex task like learning as new skill, is good exercise for the brain and exercising your brain is as important as exercising your body

How will I know when I’m old?

I was musing about aging recently, wondering when I would officially cross over into old age, when my husband commented that aging was an analogue process that began at birth – it’s going on all the time. There is no actual line that you cross over that gets you from one period of life to the next. For some reason I found that very helpful.

Everyone ages differently but we can all do something about how happy we are with the process just by adjusting our mindset.

If you know an older person who needs a little help with this dilemma, there’s a great online program designed to help older people who are struggling with their emotional wellbeing. You can find it at the Mindspot Virtual Clinic.

The only problem I have with the MindSpot Wellbeing Plus Program is that it defines “older adults” as being 60 years and over. I’m just not ready for that I’m afraid!

Dr Jan Orman
Dr Jan Orman

Jan is Sydney GP, private psychological medicine practitioner in Sydney’s inner west and a GP educator for Black Dog Institute.

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