One hand on the reins

My mother used to call it autonomy… having none herself, she gradually sank into a pit my father later characterized as Alzheimer’s. And that may well be, but it was his tyranny, not some physical cause, that triggered it. She simply had nothing to do. He shopped, he cooked, he gardened.

We've known for some time that having choice…and something or someone to care for…enriches life experience at any age; and for people in nursing homes, even a plant to water and feed themselves is an asset for healthy living.

When others do everything for you, bathing you, feeding you, preparing your meals, doing your laundry, and someone, such as an adult child, makes financial decisions for you that you may not agree with, it helps to have one or two things you can do for yourself.

It’s about finding a balance; as with most things related to health, a mental and physical state of proportion (as the Greeks called it) or equanimity, as the Buddhists do, is critical.

A widely quoted study (summary below) concluded in 1986 that some control is advised, especially for the younger elders, but as life advances, too much responsibility becomes overwhelming with too much stress associated with it.

Like children, the very old may want to be cared for; not to be robbed of our autonomy, mind you, but nurtured, attended, considered and included. I'm not there yet, but I can relate. The other day as I was getting ready to attend a meeting at a local church I fancied myself being escorted there. I had a mental picture of being dropped at the door while someone, my husband, boyfriend or friend, parked the car. It wasn’t the chore of driving or parking that I so wished someone else would take care of, it was the attention to my well-being. Old people like that. And younger ones, too! I chuckled thinking, How can you feel like a Queen unless somebody serves you?

But we have a negative idea of service in our society. Service is something that illegal Mexicans do, and we don’t have to grant them citizenship for doing it, cheap labor to weed the orchard, wash up the dishes, or care for the sick elderly. We hire it, and we don’t even pay very much for it, unless we are very kind and rather rich. But we don’t value it.

A

I remember in the 70s when so many of us were following Indian gurus, we were trained in seva, which means, service. Our service was not considered lowly, but divine. It was our gift, our offering.

In our spiritual family, we took care of babies, including those that weren’t our own, and we tended the elder members until they died. 

Now we are the elder members, and there’s no one to care for some of us! Our society has trended back to its traditional self-reliance. You can hear the Midwestern accent, the gravelly voice saying, I don’t owe nobody nothing. Right?

Now self reliance has morphed into narcissism. It’s just all-about-us! It’s about my health, my diet, my radiant skin; my career, my healing, my self-empowerment. And I do include you in that. But I’m not going to wait on you!  

In such an environment, it’s critical to be independent; that’s the key value. We've got to make the effort to survive on our own. When true self reliance is not available to us, we are typically stripped of all responsibility and dumped in a care home.

That complete loss of control – of autonomy – is bad for our health. We need to let the next generation know that while we do love to sit down at the dining table for the family dinner, we can still make toast.

Science 19 September 1986:

Vol. 233 no. 4770 pp. 1271-1276

DOI: 10.1126/science.3749877

ARTICLES

Aging and health: effects of the sense of control

J Rodin

ABSTRACT

The relation between health and a sense of control may grow stronger in old age. This could occur through three types of processes: experiences particularly relevant to control may increase markedly in old age; the association between control and some aspect of health may be altered by age; and age may influence the association between control and health-related behaviors or the seeking of medical care. Studies show that there are detrimental effects on the health of older people when their control of their activities is restricted; in contrast, interventions that enhance options for control by nursing home patients promote health. With increasing age, however, variability in preferred amounts of control also increases, and sometimes greater control over activities, circumstances, or health has negative consequences including stress, worry, and self-blame. Mechanisms mediating the control-health relation include feelings of stress, symptom labeling, changes in the neuroendocrine and immune systems, and behavior relevant to health maintenance.

Back From Fatigue

Here I am again, after two months' absence from this page; and what a time it has been!

When I wrote about moving to a new location in the county where I had once lived for 16 years, I was focusing on the necessary exercises we go through after a move -- establishing routines, learning directions, and creating new social networks. All of this is good for the brain, unless, of course, it's too much for the brain -- too much effort, too much stress, and, as a result, too much fatigue. Just too much everything!

I just became completely exhausted. Do you remember staying up late night after night, cramming for final exams? It wasn't until it was all over that you finally collapsed. I'm an active person, but last month if I closed my eyes after lunch, I fell asleep.

I started to worry that I had some unbearable illness; but if I do, doctors haven't found it. Of course I'm relieved, but then I start to worry. Maybe the doctor is missing something? Doctors here seem to be very upbeat and cheerful. Does that mean they're not paying attention?  I remember a doctor I had in Santa Fe. When I had a pain in the chest, she wouldn't see me unless I went to the ER to have all the tests for heart attack. Another time she ordered a full pulmonary panel because I told her I coughed once or twice when I woke up in the morning and had been a smoker. She was extreme, but you could be sure she left no stone unturned. She would find something even if it was just a pebble.

My physician is conscientious enough. When something is bothering me, she goes after the easiest explanation first. The last time I went to see her it was about my fatigue. All my recent blood tests had been normal. I asked her whether the move could have just wiped me out and she agreed we should explore that possibility. She didn't really have any suggestions, although she did applaud one of mine.

This is what I did:

At my local supplements store, Pharmaca, where you can find natural medicines as well as purchase your prescriptions, the helpful sales associate suggested a form of B-12 that is easily absorbed. It's called methylcobalamin. As we age, he told me, we become less able to derive B-12 from foods. Just one or two raspberry flavored sprays into the mouth, and in a few days you should be feeling better, he said. And I did.

Another thing I picked up was a formula for adrenal support. Constant stress wears out the adrenal glands located on top of each kidney; they release the adrenaline that triggers the rise of cortisol which is useful in an emergency but sustained high cortisol levels "destroy healthy muscle and bone, slow down healing and normal cell regeneration, co-opt biochemicals need to make other vital hormone, impair digestion, metabolism and mental function, interfere with healthy endocrine function and weaken your immune system," according to Marcelle Pick, OB-GYN nurse practitioner. Wow. I certainly did not know that cortisol can destroy muscles and bones! I've had lots of problems with weak muscles and bones. The Adrenal Support formula, a combination of several Ayurveduc adaptogenic hers, has been helpful.

Lastly, I decided to go to acupuncture. That's the idea my physician encouraged. Are you familiar with the People's Organization of Community Acupuncture? It's a great thing! POCA was created to make acupuncture available to working class people and others with limited incomes who needed to have regular treatments for chronic illnesses -- people like you and me, trying to "stay alive" after 60.

In Community Acupuncture clinics, which you can locate at the POCA website above, patients stretch out on recliners in a large open room. The practitioner visits each in turn, talking briefly, inserting the needles, then moving on to the next person. Relaxing music plays, and patients doze off or just enjoy a little quiet time while the needles do their work. It's so pleasant, and it's affordable! The clinic that I visit, in Petaluma, charges $20-40 sliding scale.

The supplements, the acupuncture, and taking a little more rest have helped recharge my system, though when I'm feeling good I tend to overdo, the way I did yesterday and the day before. As a Capricorn, I'm always trying to be productive; but as astrologer Rio Olesky recommended in his monthly horoscope for October, this month was a good time for Capricorns to find other ways to spend their time.

I just didn't listen. I've been trying all day to get out to the Community Farm where I do some volunteer gardening, when all I really felt like doing was going back to bed. Oh well. There's always time to go back to bed! At least I've updated my blog -- and in the process, I've remembered that I'm still recovering from adrenal fatigue. According to Marcelle Pick, recovery can take as long as four months! I'd better build up my strength before I start running around town again.

After I do this load of laundry . . .

Those Old Country Roads

Returning can be risky!

Last Saturday I drove out to the West County, where I used to live, to attend a CodePink Peace Camp at Ocean Song Farm and Wilderness Center -- and got caught in a web of nostalgia that almost tripped me up.

Ocean Song is a 350-acre property west of Occidental, the village that is the centerpiece of the rural community in which we lived, where five roads intersect in a little valley nestled between two ridges. When we first moved up there from San Francisco, the main street, which is only two blocks long, wasn't even paved.

The area was settled by Italian families around the turn of the last century and adopted by hippies fleeing the city to put their feet back on the ground and make their gardens grow. They became some of the first organic farmers in the country; and of course, they also grew magnificent pot.

Coming from the southeastern part of this sprawling county, where I now live, I chose not to drive through town. I was trying to be efficient, but perhaps I was also trying to avoid the seductive trap of recollection and regret that was lurking around every turn, ready to draw me in.

But as it turned out, the alternate route was just as reminiscent of my life here. Driving along Bodega Highway, I remembered taking that road every morning during the two years I worked for a newspaper out on the coast, Bodega Bay Navigator, after my marriage split up.

When I turned onto Joy Road, I was joined by other presences, whispers from those former days, as if I were again accompanied by two or more children chattering and laughing in the back seats on the way to the beach, or someone's sleepover, or perhaps the monthly mother-daughter potluck that Amy and I attended when she was in Middle School; or the time we hit a deer coming home from an event at the coast and didn't stop because my husband was certain he saw it get up and run off into the woods.

It wasn't always a merry good time. The kids might be fighting over the choice of radio station, someone might be yelling or moping and crying, I might have been irritable or tired of settling arguments and negotiating demands, but despite all that, I loved being a mother, and I loved the person I was then (most of the time); and in retrospect I loved her even more.

These roads, like old houses, seem to mirror the tracks memory carves in the brain. The landscape is quite distinct from where I am living now. Around Sonoma, the hills are molded and firm like young breasts, covered with golden oat grass that resembles blonde fur when the wind sweeps through. But around Occidental the hills are mostly obscured by forest and scruffy shrubs, a mix of various oaks, madrone, bay laurel, willow, pine and a few redwoods, and the sides of the road are cluttered with an effusion of native plants (aka weeds) and wildflowers. This is the land that fought off the developers and chose to remain as it had been. The old farmhouses are unpretentious and homey, set back from the road, some with fences beginning to cave and porches starting to sag. But they are comfortable, settled into the land, like the families who have lived in them since the 70s, raised their kids and stayed. They may have divorced and remarried, but they haven't left the community, and their lives are intertwined with the land.

Unlike mine! From poignant reminiscence my mood shifted to one of deep regret. I hadn't had to leave and hadn't really wanted to, but it's what I did, and there's no turning the clock back. Nor will it help to listen to the voice in my head that is getting ready to scold me for not working night and day in order to keep my cottage in the redwoods. There's plenty of fault to find, no question; but a scolding is not going to bring it back. I lost my house and my settled country life because I needed a change. I didn't realize how difficult it was going to be to come back.

As I made the turn onto Coleman Valley Road, I began thinking, I am still not home. I have to find a way to move back where I belong. By the time I reached the gate to Ocean Song, my mind was still locked into a few words repeating themselves like the sounds of a train on the track. I have to come back, I have to come back, clicketty clack, I have to come back where I belong!

But then I paused to breathe in the astonishing view spread out below, the rows of blue green hills, the fog bank spread out between them, the far distance sea, and awe took the place of my repetitious chatter.

People move on. It's what happens. Had I not left, I would have missed the many great experiences I had in New Mexico. Had I not returned, I wouldn't be having this experience of revisiting the life I had here and linking it up with the one I am making now in a very different setting. In Sonoma, a Wine Country "destination" known all across the country.

Rebecca Solnit says it well:  "The self is also a creation, the principle work of your life, the crafting of which makes everyone an artist. This unfinished work of becoming ends only when you do, if then, and the consequences live on."

That's what it comes down to: designing a life, learning its lessons, growing all the way to the very end.

I made my way down the hill to sample the delicious California country buffet and connect with old friends.

Old Brains in New Places

Is moving beneficial for people our age? Applying the principles of new brain science seems to suggest that it can certainly help us stay young and sharp.

Moving, especially to a different part of the country, forces us to change some of our habits. Old people are “set in their ways”, a quality that psychologist Ellen J. Langer calls “mindlessness”. It's not just a feature of age; most people, she says, live their lives mindlessly, on automatic pilot; but those who choose to become “mindful” stay youthful longer.

A woman in my women's group who just moved here from Tucson asked, "Isn't it too late to get established in a new place?" Not at all! Brain research in the last twenty years has shown that the brain’s ability to change, called “neuroplasticity”, persists as long as we live. It’s never too late to change!

The brain creates neuronal connections that are reinforced by habit, like those well-worn pathways in the carpet created by repeated trips back and forth to the kitchen or bath; these connections are reinforced by habit. But we can change the imprints if we choose.

It’s a case of use-it-or-lose-it. Just as muscle tone rapidly deteriorates when we don’t exercise, a brain that relies on ingrained or “mindless” behavior is an under-utilized organ, and little by little it stops producing new neuronal tracks. People who sit home in front of the television, endlessly repeating old behaviors, are letting a good brain to go to waste.

This is why we are advised to learn something new every day, like a new language, or how to play a musical instrument. Neuroscience has shown that stimulating mental activities with lots of repetition are just what we need to keep our brains healthy. Now that we are living longer, pushing back the 70 forms of dementia that confine more and more elders to nursing homes is a primary goal for most of us.

Age provides limitless opportunities for new kinds of activities, ones without the stress associated with jobs and child-rearing. The trick is to choose a challenging activity, the more difficult the better. Diane Ackerman writes in her book, A Hundred Names for Love, which is about her husband’s aphasia (brain damage resulting from a massive stroke): 

“A colossal number of brain cells (hundreds to thousands) are born each day but most die within weeks unless the brain is forced to learn something new. Then more neurons revive and sprout connections to their brethren. The harder the task, the more survivors.” 

Ackerman's husband, Paul West, an accomplished writer, lost the ability to communicate; but with constant daily effort to write and to speak, and his wife's constant support, he regained many of his verbal skills. In the five years after the stroke, he actually published three books and dozens of articles! 

You have to try. Moving to a new place challenges us to adopt new habits, but without application and repetition, we’ll simply transport the old ways to the new location.

We have to think to change the pathway, and that’s the whole idea. The more attentive we become to what we are doing, the more the brain benefits from the effort.

Yesterday in an aquatic yoga class that I enjoy, one woman alluded to her “challenged directionality.” It’s like a kind of dyslexia, she said. She can’t follow directions that rely on left and right because her brain can’t figure them out.

I don’t have that problem exactly, but I definitely have a poor sense of direction; and if I come to a dead end and have to turn around, I sometimes can’t figure out how to get back where I was going.

Living in a new town, driving into new areas to shop or attend an event, requires a fair amount of effort on my part. I have to look up the directions, study the map, print out the steps I’ll need to take; I have to allow enough time so that I don’t get into a panic; and then I really have to pay attention to where I’m going.

When I go back a week later, I have to review all these pointers, and pay careful attention to landmarks along the way. When I recognize that I am going the right way, I'm proud of my success. 

I did live in this region before, so it’s not completely overwhelming, but one place I now visit frequently, Santa Rosa, I now approach from the opposite direction. Instead of coming from the west, I now arrive from the southeast. At first I was totally confused. 

I could not figure out how to get to one congested, busy street, Santa Rosa Avenue. I had to get on the freeway! But last week, when I visited the Peace and Justice Center on Sebastopol Road, I saw where Santa Rosa Avenue begins. Suddenly the pieces fell into place. Of course! This is the way we used to go to Toys R Us! Now I know how to get to all the Big Box stores that we don’t have in Sonoma.

As I tromp into the kitchen to get a glass of water and reach – again! -- for the wrong cupboard, I notice that if I pause to remember where the glasses are, I can feel my mind come into focus, with improved results. Like an absent-minded professor, I’m always thinking about something else. I have to pay attention to what the body is doing, to remember where the glasses are now. 

Like absent minded professors, many older adults are not necessarily senile; they are just focusing on what they are doing. Langer’s research has shown that even very old people can behave more youthfully if they practice paying attention in this way.

Moving to a new place is more disorienting at our age; but it can have this unexpected benefit. It forces us to be more mindful of what we’re doing, carving new pathways into old brains grown lazy from habit. We can do the same thing without relocating, just by taking a new route to the library, or even rearranging the furniture.

Either way, we have to be willing to try.

[NOTE: This blog is the second in a series about my recent move from Santa Fe to Sonoma. To read them in order, start here]

To Move Or Not To Move

Moving to a new location is challenging at our age. I know. I just moved from Santa Fe, New Mexico, to Sonoma, a medium sized town in Northern California. Even though I used to live on the other side of this county, and spent 36 years of my life in the San Francisco Bay Area, it's been quite an upheaval.

Of course it has not been as challenging as when I moved to New Mexico in the first place! The two places are dramatically different. I had never lived in the desert, and I missed water so much I literally cried when I stepped up on a viewing platform on Sandia Mountain and saw a little watering hole that I couldn't approach!

California is a big, busy, bustling state with the country's largest population, and New Mexico is a big state with very few people. I had been living in the country; now I was in the middle of New Mexico's biggest city, Albuquerque, an appallingly flat town with six-lane avenues criss-crossing its sprawling breadth, and an unvarying bright blue sky that produced very few cloud formations, certainly none of those thick coastal fog banks, or buckets of rain all winter long. What passed for cuisine was almost always meat with chili and a pile of unsalted pinto beans, and there was no such thing as medical marijuana. California, the vanguard of America, is on the cusp of the future, while New Mexico cherished its history and seemed to cling to its lingering past, even though it's riddled with colonialism, racism and poverty.

But the biggest challenge was my state of mind: I was at my wit's end. My children were both embarking on lives of their own. Real estate values were about to plummet and I was afraid my house would end up under water. I had lost my job as editor of a small paper and there were no new jobs around. My life had hit a wall and it felt like I was about to die if I didn't do something else.

So, I went to New Mexico, with a very unclear picture of what I was going to do there. During the first months I longed for everything about my old home: my kids, my house, my dog who had passed away, the cats I had left behind, the friends I had known for forty years.

It was strange that nobody knew me, not even a clerk at the grocery store. I didn't like the feeling of being unknown and uprooted, and many mornings I cried.

When I moved to Santa Fe, things picked up a bit, but then my health fell apart. I stayed in the City Different for six years, much longer than I had anticipated, always thinking I needed to go back where I came from and somehow being stopped. Suddenly last April, everything came together, and in May I had an apartment all approved. I had only to -- shudder, shudder -- dismantle my life and leave. Yikes! What had sounded great was suddenly overwhelming. I would have welcomed any excuse to stay put, but the gods seemed to beckon me west. It would have been ungrateful to refuse.

This move was a return, not to the same house or even the same town, but back. I had roots in this land -- I remember when I grew them, but that's a story for another time -- and the land of golden hills had not let go of its hold on my heart, no matter how much Santa Fe had become a cloak that well suited me.

It was hard. Some people called me "courageous." It was nice to hear, but on some deep level this wasn't about courage. It was something I had to do. Leaving after so many years was hard but it was definitely good for me. I'll tell you more about it in my next post, which by the way you can also view at my new blog, Moving Right Along, at wordpress.com/ as soon as I set it up.

Wherever you are, have a great day!