Aging is about change Of course we have all been changing, and aging, from the moment we were born—physically, mentally, emotionally, spiritually. There are many myths about growing older. In these articles, we strive to debunk the misconceptions and speak candidly about the most common changes of our later years.
Age is fluid
Line up a group of people who are 65 and older and you will see remarkable variation. Have them stand in chronological order and you may be surprised that some individuals in the later years will appear to have more vigor than others in the younger years. This exercise is not about passing judgment. It’s simply to show that there is a distinction between “aging” (the chronological fact of living longer) and “decline.” While the functions of the physical body do decline over time, the rate of change is different for everyone.
It helps to begin with an understanding of the normal process of physical aging. And—especially for those who are not yet experiencing them—learning how those changes affect our lives on a daily basis and in the big picture.
The normal changes of aging and the necessary daily lifestyle adjustments that go with them are easiest to see by looking at the five senses. Vision, hearing, touch, taste, and smell are how we experience our world. They greatly affect our understanding and often, our joy. Even normal changes to our senses create some risks and usually result in the need to do things differently in order to adapt.
Vision More than one-quarter (28 percent) of persons over age seventy have experienced at least some vision loss. The normal changes of aging have potentially serious effects:
Difficulty seeing up close. (Glasses or contacts can usually remedy this problem.)
Need for more light, because we don’t have the receptors we used to.
Reduced ability to judge distance. This can have serious consequences for driving, because we have trouble judging the speed of oncoming cars, making a left-hand turn, or entering the freeway.
Problems with glare. Adjusting to light and dark takes the eyes much longer than we are used to. This makes driving at night difficult and dangerous. As a result, we tend to stay home in the evenings and are unable to go out easily to nighttime events.
More than three-quarters of legally blind individuals are people over age sixty-five who lost their sight because of age-related diseases. The most common diseases include glaucoma, cataracts, macular degeneration, and diabetic retinopathy.
Hearing Nearly one-quarter of persons age sixty-five to seventy-four and half of those age seventy-five and older have a disabling hearing loss. It’s not only a matter of volume, but also being unable to hear words clearly. Loss of hearing has deep consequences.
Injury. Not hearing can lead to a greater chance of injury, particularly involving cars, when we may not hear one approaching. In addition, persons with even mild hearing loss are three times more likely to experience falls than are persons without. Scientists are unclear why. The fact that the inner ear plays such a large role in balance may be part of the reason.
Social isolation. Difficulty hearing tends to cause people to withdraw socially. We lose our relationships when we lose our hearing!
While technology aids are improving, they are expensive. Less-expensive versions tend to amplify all noises, which is not ideal. As a result, only 30 percent of older adults with hearing loss use hearing aids.
Other hearing impairments include tinnitus, an often-constant ringing, buzzing, or swishing noise in the ears.
Although the impact of hearing impairment is profound, it is frequently overlooked as a disability.
Touch The sense of touch involves not only the skin, but also our nerves and brain. As we age, our sensitivity to touch, temperature, pressure, vibration, and the position of our body changes. Reduced sensitivity can have serious outcomes:
Burns. We may not feel that something is too hot. It’s important to set the temperature of the water heater to no higher than 120° to avoid burns.
Hypothermia or frostbite. We can’t rely on our bodies to judge the temperature outside. Check an outdoor thermometer when it’s cold, and dress accordingly.
Infection. By not feeling pain as acutely, we may be unaware that a sore or infection is developing. It’s important to check the skin regularly for injuries, especially the feet.
Taste Eating is one of life’s pleasures. However, the taste buds lose their sensitivity with age, and the tongue has fewer of them. Following are some of the pitfalls:
Oversalting or oversweetening foods. As a result, older adults are often tempted to put more salt or sugar on their food than they did in their younger years. This can lead to problems for those on special diets.
Malnutrition. When food becomes less tasty, it can also become unappealing, leading to weight loss and poor nutrition.
Fortunately, taste is rarely lost completely, and texture—crunchy or chewy foods—can be emphasized for variety.
Smell The ability to perceive odors declines with age, especially after age seventy. While outwardly this might seem to have some benefits, there are definite disadvantages:
Reduced pleasure in eating. For those who relate smells to the joy of food, it can reduce the pleasure of eating.
Potential to get sick from spoiled foods. A weak “sniffer” can cause problems because it’s more difficult to tell if food has gone bad.
Greater likelihood of injury. It’s harder to smell smoke in the case of a fire. Or a gas leak. It’s important to be sure that smoke and carbon monoxide detectors have fresh batteries and are tested regularly.
There is no one explanation of aging. More than 300 theories exist to explain physical decline. Some relate to environmental factors (exposure to air pollution, or things that we do, like drinking alcohol and smoking tobacco). About 25 percent of aging can be attributed to cellular changes that are more genetic in nature.
On the cellular level, the simplest explanation is that aging occurs as components in our cells wear out over time. This process begins in our twenties.
The cells in our body are constantly being replaced. Over the years, those cells don’t reproduce as accurately or as quickly as they did before. Our cellular repair systems don’t cull out dead or misfiring cells as effectively. Bodily processes become less efficient. Healing takes longer. Everything slows down.
Whether it’s a blood cell, a bone cell, a nerve cell, a digestive cell, a muscle cell, etc., all cells and systems are affected. Our immune system becomes weaker, and we are unable to fight disease as effectively. Our digestive system doesn’t extract nutrients as well as it used to. You get the picture.
And this doesn’t count the cellular impact of our lifestyle choices or environmental exposures.
Such changes are not noticeable in younger people. But as the years accumulate, so do those little changes. The inefficiencies become more obvious. And they have consequences.
The changes in the five senses—smell, sight, hearing, taste, and touch—for instance, are part of the normal process of aging. The cellular errors of aging, however, can also open doorways for mutations (cancer), infections, or other chronic conditions.
We are living longer!
Only one-hundred years ago, the average person lived to their mid-fifties. Now the average life expectancy is in the late seventies. According to the Social Security Administration, if you’ve made it to sixty-five already, there’s a 54% chance you will see your ninetieth birthday if you are a nonsmoking healthy female (43% chance for nonsmoking healthy males). For smokers, those numbers are 35% for females and 23% for males.
Are we living well?
Although we are living longer lives, many of those years are spent managing multiple chronic conditions. Diabetes. High blood pressure. Congestive heart failure. COPD. Alzheimer’s and other dementias. It is these chronic conditions that can profoundly affect our daily experience of life.
And it’s our daily lived experience that creates our quality of life. The joy in our days. In this sense, “living well” is not about our material belongings, although financial worries do diminish quality of life. “Living well” tends to be our satisfaction or pleasure in our ability to do what we want. It’s our relationships, our autonomy for making decisions, and our feeling of purpose or meaning in life. Ultimately, “quality” can be defined only by each of us personally.
Living well—and therefore aging well—is a balance between quantity and quality of life. This means having enough health to do what gives us joy, and the time to engage in those pleasant, meaningful activities.
Lessons from centenarians (people who live to be one hundred)
While our lifespan is of course affected by genetics, it turns out that is only 20%–30% of the picture. A pioneering international study looked at cultural and lifestyle habits of five communities around the world—in the United States, Greece, Italy, Costa Rica, and Japan. These communities were special because they had low rates of chronic disease and an extremely high proportion of people who live well into their nineties and even one hundreds. Dubbed “blue zones,” the communities shared nine qualities across four domains:
Movement
Move naturally. Ideally, physical activity would be just a natural part of living. Rather than going to the gym, people in blue zones walk a lot. They garden, and participate in other physical activities over the course of their daily chores and interactions. Other research suggests at least 75 minutes of vigorous activity or 150 minutes of moderate activity per week will add to health and longevity.
Diet
Eating food in moderation. Rather than eating until full or stuffed, people in blue zones tend to “leave room” by stopping when they feel 80% sated, not 100%. Along similar lines, their smallest meal is in the late afternoon or early evening. They refrain from eating at night, essentially fasting until breakfast. Other studies demonstrate that eating slowly and chewing longer can reduce hunger and increase feelings of fullness sooner.
“Plant slant.” Meat is eaten only five times a month or so. Instead, the vast majority of foods eaten in blue zone communities are from plant sources: Legumes (beans, peas, lentils), nuts, whole grains, and vegetables. These foods provide protein, fiber, vitamins, and minerals. They also provide unsaturated (good) fats. Together they promote heart health, a healthy gut, and reduced chance of metabolic syndrome (prediabetes).
Moderate wine consumption. With the exception of one community (which abstains completely), people in blue zones drink one, perhaps two glasses of wine per day. Other research suggests that red wine is associated with heart health and a longer life. This may be because of the antioxidants found in red grapes.
Social network
Strong social and intergenerational connections. Persons dedicated to a life partner benefit with three additional years of life expectancy. Having elders nearby who interact with children also seemed to be beneficial for all. We are social beings. The COVID-19 pandemic taught us that feeling connected—that we belong and have meaningful relationships—is important to well-being.
Belonging to a faith-based community. Meeting weekly with others who share a spiritual focus seems to add four to fourteen years of life expectancy. One theory is that the sense of awe or transcendence—meaning beyond the self—is a contributing factor. Other research seems to indicate that the social connection is helpful. Also, that people involved in faith communities typically have lower rates of depression.
Healthy friends. Good habits are contagious. Ideally, those in your social network support the type of healthy living you believe in.
Approach to life
Rest and relaxation. People in blue zone communities allow themselves to sleep until they feel rested. They have active strategies for setting aside worries during some part of the day (for example, prayer, naps, a social hour). This is confirmed by other research, which suggests seven hours of sleep at night and a short daytime nap (thirty minutes or less) are beneficial for both the heart and the brain.
Purpose. Having a sense of purpose, a reason to get up in the morning, provides seven added years to life expectancy.
With a focus on social, spiritual, and physical well-being, elders in these communities seem to have found a balance that allows them to live long and well. One doesn’t have to adopt all the habits to feel the benefit. Some will be easy or appeal more than others. Learning to age well is about making informed, conscious choices that feel right for you.
It can be hard to accept, but at some point the physical challenges of aging will become unavoidable. Each of us will have the experience of losing our abilities. Eventually we will succumb.
It may be a crisis that lands us in the hospital. Or a terminal illness that allows us to die at home. It could be a heart attack. Or we could die because our organ systems gradually shut down and simply can’t function anymore.
The last few days
On the day we die, we will usually have been in and out of consciousness for a week or more. Unlike in the movies, very few people are awake, aware, or talking. The person may seem to be seeing or reacting to people the rest of us can’t see (hallucinations). Breathing will have become erratic and take on a gurgled sound, sometimes called the “death rattle.” Hands and skin will be cold to the touch. Eventually, the heart and lungs will find it too difficult to continue, and one breath will simply not be followed by another. The heart will stop.
The three pathways Of course, everyone hopes for a quick and painless death. To die in our sleep, perhaps.
It used to be that most deaths were the result of injury or disease. They tended to be quick and often unexpected.
With modern medicine, things have changed. Now we tend to die with multiple chronic conditions that have been managed more and more aggressively over time. Eventually, one condition overpowers the body and becomes the actual cause of death.
Sometimes it helps to know what to expect.
Dying is actually a process that goes on for months (even years, depending on the condition). There are three general pathways or patterns of decline:
Episodes of crisis with adjustments in between. In our older years, most of us manage well enough. We adapt. Then something happens. There’s a fall. A sickness. A surgery. We bounce back, but not to the level of health and vitality we had before. We find a new normal, and cruise along. Then something else happens. We dip down, and we recover. Again, just not back to where we had been. As a rule, over time, these dips occur more frequently, and the bounce back is lower each time. This is a common pathway for people with CHF or COPD, for instance.
A short and rather steep decline. Some of us will get a disease, such as cancer. If it is not the kind that can be cured, it has a relatively steep (short) decline.
A gradual decline. Some of us reach advanced years with few chronic conditions and very few crises. This pathway is a bit different. One simply becomes more frail. We lose weight and become easily fatigued. We walk more slowly and become less active. That doesn’t mean we are unhappy. It’s just that the physical body sort of dwindles. Usually it is an infection, such as pneumonia, that finally tips the scale. As an example, this gradual decline is the general pathway for Alzheimer’s disease.
We, Touching Hearts at Home, work with Inspire Care frequently. We receive client referrals and work closely with them to give the client the best care. Inspire Care staff are available, helpful, and compassionate. They continue to grow and add services. Touching Hearts is grateful to work with them
Becky and her team are amazing. Marybeth is the most wonderful and compassionate caregiver, her weekly visits with our Mother were truly inspiring and gave us such peace of mind.
I work for NBT Bank and Becky has worked with one of our clients for many years now. Her and her team go above and beyond the call of duty everyday to help her clients achieve the best quality of life possible. From coordinating doctor appointments, cleaning and repair services, making emergency visits, and assisting with many various tasks that have come up in the past several years. The team members truly take an interest in their clients lives and build a true relationship with them which makes such a positive impact. The exemplary and dependable service Inspire Care provides has greatly improved the quality of life of our mutual client and I'm sure of many others as well.The opinions and advice offered within this account are my own and do not reflect that of my employer NBT Bancorp or any of its primary business units.
Completing the Life Plan by Inspire Care has given me and my spouse peace of mind. The content is well organized and thorough. They've thought of everything! There is even the option of completing the Life Plan in a digital version. The "Plan" is divided up into user friendly and manageable sections including financial, medical, legal information and "end of life wishes." We now have all of our important information in one place. We also appreciated the in-person meetings (via zoom) that provided opportunities to share our progress, ask questions and receive lots of positive encouragement. Now completed, it will be easy to review and update. We highly recommend this program!!
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I recently had to go through the incredible difficulty of sorting out my aging Mother's complicated financial picture as her power of attorney. I decided then, that I also had to find a much better solution for organizing the complexities of my own life plan. I needed to do this not only for my wife, if she survived me, but for our children in the event of our passing together. We were blessed to come upon the "Life Plan" program by Inspire Care of Central New York. The plan book and online program offered us the perfect solution for our situation. We completed the plan together and now feel extremely comfortable that we have all the pieces of our finances and life wishes in place. This program is a must have for anyone interested in finding simple, organizational solutions for their life plan!
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Becky and Inspire care has been an absolute blessing with our Mother who is suffering from dementia. Not only the in home care provided but the guidance given helped us to navigate the process to move her to into a long term care facility where she is now thriving. We absolutely could not have done this without the care, help, and guidance from Inspire.
Provided an immediate, and long term, in-home care solution for our beloved relative—and eventually spearheaded the skilled nursing facility admission process. Provided highly professional and compassionate service and advice from start to finish.
Inspire Care was so wonderful to work with in my mother's final years. Becky was with us from the early days when we were looking for someone to share a few meals and leave a few in the fridge for our Mom who lived alone but was showing early signs of dementia, through a broken hip and eventual 24x7 care.Having an experienced team in Inspire Care to help us navigate was SO helpful during stressful times. They helped us find and work with agencies and businesses that we would have struggled to navigate without their experienced guidance.
We have cultivated such a wonderful partnership with Inspire Care. Becky, is extremely thorough with much attention to detail thatperhaps one thought wouldn't matter. The Inspire care Team leads with such professionalism and have such compassion for their clients. We value & embrace the partnership we have created the entire team .
I have known Becky Auyer and Inspire Care for over 10 years. I have recommended her to many friends and families.About 7 years ago, I hired her to help me with my parents. (I recall thinking I was a super hero, and I could do this well all by myself!)Early on, she helped me to navigate both of my parents getting off the road. That was a tremendous hurdle for our family and much needed for everyones safety.She helped us in the house with safety measures, meds, doctor appointments and check ins when I was away on travel.In 2017, my parents moved to senior apartment living. She helped us with that process, as well as helping us with mobility issues that both parents now had.Over the last 5 years, with COVID, my mother suffering numerous falls, rehab, and several hospitalization, Becky and her staff were always a phone call away. Becky, Gwen, Sharon, Deborah and Cheryl, all pitched in with daily treatments, showers, physical therapy, and sometimes taking turns at the hospital. This gave me so much comfort knowing they could help me in so many ways.During the 1st 6 months of 2022, both of my parents died at home with hospice, family, and the Inspire Care team helping us every step of the way.In a lot of ways, these last 12 years was the toughest job I ever had. I don't regret it, but I know I couldn't have done as well as I did without Inspire Care by my side until the end.
Inspire Care of CNY cared for both of my aging parents in the final stages of their lives. Becky and her team were FANTASTIC. We faced many challenges--moving my parents out of their house and into a retirement community, and then confronting various issues as their health failed. I don't know how we would have survived that phase of life without their patient, kind, and knowledgeable support. The support was for my parents, but also for us, their adult children. I wish I could give more than five stars!