by Gary Fenstermacher
The last three columns of “Caring for Our Elders” explored the need for, features, and cost of long term care, particularly in facilities that provide such care. In this last column it seems appropriate to conclude with some thoughts on what elders can do to avoid the need for long term care-at least for as long as possible.
Let’s begin with what you already know: Don’t smoke, do exercise, eat healthy, avoid stress, and get sufficient sleep (so quick and easy to write, yet often so challenging for many elders). Because we read or hear this advice incessantly, in newspapers, magazines, and on radio and TV, let’s not belabor it here. I’ll simply remind you that these are among the proven ways to preserve quality of life and thereby delay or eliminate the need for moving to a long term care facility.
What is probably just as important for maintaining the good health of elders, but which we hear or read about far less often, is the following: Immerse yourself in activities that bring satisfaction, nurture the mind with thoughtful reading and listening, cultivate relationships with persons that bring delight, and consciously express gratitude for the things that occasion joy, awe, laughter, insight and calm. There are also huge gains in well-being from staying connected to family, friends, and neighbors. For elders, connections that cross generations can be especially fulfilling.
When the need for medical help does arise, find a primary care doctor (or nurse practitioner) you can relate to, then pepper her or him with questions about how you can improve your health and take better care of yourself. It is often helpful to ask about alternatives to any proposed remedies (for example, pills are often the first response to physical ailments, but physical therapy or chiropractic may be a better long-term solution). If referred to a medical specialist, do not just listen and leave. Ask questions the same way you do with your primary care person. Because the American medical system is complex and difficult to navigate, patients need to take charge of their own healthcare. Elders should not be shy about doing so.
Exercise, eating right, sleeping well, and reducing stress are indeed ways to forestall, perhaps even eliminate, the need to move to long term care. However they are far more likely to be beneficial when combined with meaningful activities and projects, nurturing the mind, ennobling the heart, and spending time with treasured others. And do not underestimate the power of gratitude. Find ways to express it on a daily basis.
In concluding this series, I want to express my gratitude to Lucretia and Jared Free at The Vail Voice for the opportunity to share the last five months of columns with you. In addition, heartfelt thanks to two remarkable nurses, Candace Tucker and Judy Ingall. They guided many of the words that composed these columns, though they are completely blameless for what I did with their guidance (well, almost . . :-).