AFTER attending my lecture on “Enjoying the Later Years,” a 65-year-old man approached me and asked if I could visit his 85-year-old mother. He thanked me for opening his eyes regarding the aging process and he realized they have been neglectful of their mom. Curious of how the mother was, I willingly obliged.
Neglect is true, unmanaged is what I would describe his mom when I saw her. She was clearly malnourished, thin to the bones, very dry open mouth, in an almost flexed and rigid position with a number of bed sores on vulnerable areas.
The daughter told me, “My mother is not sick, Doktora. I think she is just old. We just give her what we think she can manage. I don’t think there is a need to bring her to a doctor.”
Ooooh…quite unusual. I see parents brought to me by their children because they want to know if there is any way they could help their parents!
There is a need to understand our aging parents.
Let us start from the basic changes that we, too, will experience as we age.
The cognitive process slows down because of brain shrinkage. We do not become demented as we age. Only our facility to process information becomes slow. Hence, when talking to the elderly, we have to be more understanding. We don’t ask questions one after another. We wait for them to process the first question before we move on to the next. This is also one reason when a lot of people are talking, they become irritable.
Our vision starts to get dim. We experience glare and difficulty adapting at night. Our peripheral vision narrows. Hence, in order for us to see what’s at right or left, we will always turn our head in those directions, making us vulnerable to dizziness and vertigo.
Our taste sensation changes with the predominance of the salty and the sweet. This preference, perhaps, is a consequence of the decrease in our taste buds. An 82-year-old patient of mine once told her daughter while inside my clinic, “Better kill me and let me die than feed me those tasteless food.”
Our heart starts to work harder, especially if some arteries are clogged with cholesterol. Blood pressure is higher when we become old because of the characteristic changes in our arteries and veins.
Our lungs are no longer as flexible as before, making us catch our breath more during long walks. This explains why at 70, climbing up the stairs and our usual exercise tends to be more difficult.
Our skin becomes thinner, resulting in cold intolerance. Skin changes are perhaps the most obvious. Skin and capillary fragility accounts for easy bruising.
Our kidneys become smaller. Our ability to filter drugs and other substances is compromised.
Our ears decrease in hearing acuity. We have difficulty discriminating sounds. When talking to an older person, it is best to look them in the eye, make sure their attention is on you and talk in your most normal audible voice. Shouting at older people is not proper. They will always perceive the shout as anger and hopelessness. In old age, we become more sensitive. Self pity and depression is very common.
Our muscles lose strength and the bones become brittle. The muscles become weak and these actually decrease in size and function, making us vulnerable to frailty. The apparent weakness will disable an older person and may even cause hospitalization. Functional limitations become a risk factor for malnutrition and if not properly managed, will have debilitating effects.
These physiologic changes should not be a hindrance to a happy life in old age. The secret is to help our parents accept who they are, maintain a healthy lifestyle, engage in worthwhile activities, join and be with a group of friends, and enjoy a quiet time to be with themselves.
It is never too late for them to embrace the aging process and enjoy the later years with their own friends. It is never too late for them to start building new relationships, to find new meaning in their lives. It is never too late to engage in worthwhile activities.
Going back to my patient, I educated the children on the proper way to take care of their mother. I spent time explaining. I was told that the next day, this 85- year-old patient got up in bed, enjoyed her food and is hopefully on her way to full recovery.