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.

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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 . . .