Elderquette

You read a lot about dealing with elders.  Lots of advice for caregivers is out there, much of it very helpful.  Having lived with my elderly mom for six years, I am full of counsel directed at the elders being cared for, listed here in a form all English-speaking peoples can relate to - the ABCs.

A is for Abdicate

Please, elders who cannot care for yourself, abdicate your power and control!  If you cannot help growing old (as we can't) at least try to grow old with some grace.

Nobody is asking for complete abnegation here.  Just abdication from the throne of tyrannical micromanaging control.

Maybe you used to be able to do everything better than your caregivers ever will, but those times are past.

Abdicate, and appreciate that you have someone willing to do for you what you really are no longer able to do for yourself.

Yours truly, your caregivers, with apologies for bluntness.

B is for Balance

Balance is one of my favorite words.  I've always had a pretty good sense of balance physically, and it is a good thing to have.  You are less likely to trip, and if you do trip you are less likely to fall, hitting the ground and getting injured.

A few months ago at the gym I got some new exercises from a personal trainer, and the very first exercise he gave me was about balance.  All you have to do is lift up your foot as if you were marching slowly until your upper leg is parallel to the floor (or as close as you can get to it), hold that position for a second or so, then lift up the other foot.

This strengthens all your leg and ankle muscles that you need for balance, and gives you practice at keeping your balance.  Even weaker people could do this in front of their soft sofas with a walker to tighten their grip on if they lose their balance.

Which brings me to another kind of balance.

Mental balance, the one I have not always been good at and have had to cultivate - or maybe a better way to say it would be "learn to exercise!"

Elders, cultivate your mental balance as well as physical balance!  Don't equate age with the privilege of losing all sense of balance and the relative importance of things.

We caregivers acknowledge that old age can come with all kinds of potential infirmities, including mental ones.  But to the extent to which you are able, please display your balance in every way possible!  Your family and friends will love you for it.

C is for Craziness Created in Caregivers by Caching

When I went to help Mom pack for a Christmas trip to my sister's house, I couldn't find socks.  This was very odd, because the same sister gave her half a dozen pairs of black socks just two years ago.

For some reason, when my mom came back from the hospital a year ago, I only found three pairs of socks that weren't short and white.  And two of them, non-skid blue and non-skid tan, came from the hospital!

So I did a deep search in her drawers for the Christmas trip.  Lo and behold, in a plastic bag in a back corner of a drawer full of shirts, I found ten or twelve pairs of socks.  Black ones.

Unfortunately, I didn't look intensely enough for gloves.  We found only one pair, one of which somehow didn't manage to get to my sister's house.  So my sister bought my mom three pairs of gloves, a hat (which my mom refuses to wear) and a wonderful scarf.

Upon our return home, I found four more pairs of gloves.  Where?  In the shoebag hanging in the closet, of course.  So now Mom has one pair of black mittens, one pair of leather gloves, one pair of longer navy blue knit gloves, shorter slate blue ones, variegated blue ones (brand new) and two pairs of those cheap thin black gloves that humans seem to shed like hair.  Not six pairs, seven!

Don't cache stuff.  It will drive your caregivers crazy, and your hands and feet will be cold in the winter.

D is for Direct

Is ambiguity artful?

Is subtlety sexy?

Is nuance nice?

Not when you're ninety!

We baby-boomers who let it all hang out do not respond well to indirection.

Dreams are fine, dreamland is not.

If you want people to respond to your needs, please don't make a mystery of them.

Be blatant! 

E is for Elder and Equal

Elder means older.  That's all!

In spite of the fact that you older people are sometimes called Elders in a way that implies you possess more wisdom, it may not be all that true.

Sure, you have managed to survive for a long time.  That makes you smart maybe, or lucky.

Maybe you are wise, and that is wonderful.

But if you don't believe in equality yet, and feel that you are wiser than others just because you are old, it is time to join the human race.

If you just can't believe that we are all equal, pretend!  People love to be treated like equals.

F is for Friday

Sure, you are no longer in the work force.  You probably don't use an alarm any more, or even pay much attention to the days of the week.

But let Friday morning be your attention alarm clock.  How are you feeling?  Do you have pain or another condition that, if neglected, will necessitate a visit to the ER over the weekend?

Please, pay attention to your symptoms on Friday morning!  Don't hurt for two days, then decide the pain is intolerable in the wee hours Saturday morning.  It will be much easier for your caregivers to address your medical needs efficiently on Friday morning than anytime during the weekend.

G is for Grooming

Maybe when you get old, time passes so quickly that life seems about nothing other than washing your hands and brushing your hair.

Well, do it anyway.  G also stands for germs (otherwise known as bacteria) and good grooming will keep them to a minimum.

Oh, and something I didn't know when I was little.  Bacteria travel!  They can move!  So wash plenty and far!

(And I'm pretty casual about this stuff.  If I am telling you to wash, well just do it!)

H is for History and, um, Honesty

Really want to be helpful?  While you are in the mode to remember ancient history, write it down!  If you have difficulty putting words to paper, recite into a tape recorder.

By the time your busy children are inclined to start asking questions about the past, it may be too late.

This does not have to be politically significant history.  True domestic stories are fascinating in revealing how we used to live, and personal stories can really open up to the younger ones exactly where they come from.

How about joining the National Geographic genographic project?  That respects the history both of you and your children, but also adds to the knowledge of the whole human race!  Too cool.

Your medical history could be invaluable to your descendants down the road.  When I hit fifty I tried to find out how old my dad was when he got colon cancer.  He and mom couldn't remember, and from a distance it was just too difficult to get medical records released.  (This was the kind of paperwork my parents just couldn't be bothered with, and I don't blame them!)  Write down your medical history as it comes.  And be honest!

And I will do the same.  Very soon... tomorrow, maybe...

I is for Incontinence (my son's idea, snicker) Interface (my idea) and "I" (everyone's idea!)

Interface can loosely be used in a number of contexts - the interfaces between people, parts of your brain, biological membranes, computer programs - stuff like that.

The concept of interfaces is really interesting.

Think interface, not "I".

No man is an island. 

Make the interface between you, the world, and all the other non-islands out there a higher consciousness, not a liquid!

J is for "Just One More..."*

There is a psychological syndrome which I like to call the "just one more push!" syndrome.

I don't know what makes it persist into adulthood, but it seems to be ubiquitous.

When you try to pay for a product with a check (not that I do, anymore - haven't for years! because) if you have a brand-new check with no address or phone number, the clerk will ask you for a phone number.  Okay.

If you have a check with address and phone number, the clerk will ask for another "work" number.

Does this make any sense?

My 91-year-old mother has taken to a variety of this syndrome I may have come across in my catering days, but which you have to experience multiple times to identify as a "just one more push!" syndrome.

No matter how many utensils I put at her place, she will want one more.  She won't ask for it, though.  She will laboriously push herself up by the edge of the table, slooowly walk around to the silverware drawer, struggle with it until it finally opens, and extract the desired implement (if she can find it) and slooowly return to her seat (hopefully not falling on said implement (hopefully not a knife)) where she sits down heavily.  She doesn't seem to notice that before anyone else can let out the breath they've been holding so they can take another bite, she must navigate her journey safely.

A moon landing couldn't be more fraught with nervous tension.

I could give my mom a dinner fork, a salad fork, a knife, a steak-knife, a soup spoon and a dessert spoon and she would feel it necessary to rise to the occasion of searching for a pickle spear.

Maybe it is Mom's daily exercise.  I don't know.

Clerks and my mom aren't alone in playing "just one more push", though.

Other seemingly adult people will do this with - anything!

They make so many requests, one piggy-backing on the other, that I begin to feel like the last domino in a very long line of unstable on-end playthings.  A line of dominoes that ends at the edge of a cliff.

My tormentors, adult children playing, "Just one more push!" hanging around waiting for me to snap and fall over the edge.

*Originally written in Rumilluminations July 2010, the appreciation of this piece by a childhood friend was the inspiration for Elderquette.  Each admonition was originally meant to be humorous, but unfortunately that kind of consistency is not to be expected from me!  EP

K is for Kitchen

Yeah, you know, that most ordinary of rooms which, when you were younger you couldn't wait to get out of when the meal was over, leaving the kids to do the dishes?

The kitchen, that room which, aside from the all-too-short time spent in the consumption of food, is probably the most symbolic of labor in the whole contemporary house?

The room the floor of which is hardest to keep clean?

You might find you are banned from it now.

Maybe you leave the stove on.  Maybe your eyesight is failing and you can't see well enough to clean.  Maybe you can't smell tainted food.

How is it that older people cannot remember the days they used to long for escape from kitchen chores?

Your caregivers probably sometimes long for that escape themselves.

Seize the opportunity!  Don't envy others their kitchen privileges.  Enjoy your own liberation from the kitchen!

"Go out and play!"

L is for Love

Hate to be predictable and trite, and maybe love is too strong a word to be a part of an etiquette for anyone, but why do so many older people seem to think that love is no longer relevant to their lives?

Has the world let you down that much?  If so, do you want to be part of the world that lets down others?

I had a friend that excused her parents with, "That's just age talking."  How much more wonderful it would be if she could have said, "That's lovetalk for you!  Aren't they wonderful?"

Well, look who's talking.  It's easier to see the failings of others than my own.

Still, love as much as you can!  It will help keep you alive and connected and from a selfish perspective, your caregivers will love you right back!

M is for Morning and Mommy

You aren't anyone's mommy anymore - give it over.

Morning is a sensitive time which should receive a modicum of respect.  Calling your caregiver before an agreed-upon time is sometimes necessary, but should only be done on an emergency basis.

What does not constitute an emergency?

Finding a bookmark for your reading material.

Washing a dish.

Finishing up any routine chore you decided had to be done at 5:30 in the morning.

Breaking into another's morning hours for such things puts you at grave risk of appearing senile.  Don't do it!

The same goes for the nighttime hours.

N is for Night

Night - a difficult time for many.  Things that go bump in the night are scary, but it is even worse when it is you!  Be extra careful trying to get around in the dark - or better yet, use light.  Your family would rather hear a little noise and see a little light than hear a big bump and wind up under the bright lights of an emergency room!  And so would you, I bet.

Nightmares make you appreciate companions and caregivers.  Last night my partner woke me up from a nightmare which was inspiring cries of fear from me that sounded like the wavering descending call of the screech owl.  I thanked him for saving me from my dream and we settled down to go back to sleep.

Just minutes later I heard the same cry coming from my mother's bedroom downstairs!   She too was having a nightmare.  I felt bad about the amount of time it took me to get downstairs and once with her, to loosen the grip her dream had on her.  Any time spent in nightmares is too long!

My mom expressed appreciation for my coming down and waking her up.  You are welcome, Mom!  Kudos to you for your nighttime elderquette!

O is for Ornery

Enjoy playing the curmudgeon?  Do you enjoy the appreciation you get in public for your rebellious spirit and feistiness?  Good.  Play it up in public where people think it is cute.

When you get home, please drop the ornery act.

And God help your caregivers if it's not an act!

P is for Pressure

They say pressure can be a good thing.

The pressure of a deadline can speed up accomplishment in some people.

Well, there is no deadline like death, so do as much as you can on your feet!

Why?  Well, for one reason it is healthier.

And because for some reason, our feet don't develop pressure wounds!

Why?

I'm not sure I can answer that!  I guess evolution gradually made sure that the soles of our feet got the musculature and padding necessary to withstand all the pressure of our vertical weight.

Feet get callouses, yes.  Pressure wounds, no.

Unfortunately, our derrieres, unlike the soles of our feet and burros' backs, are not designed to callous.  They get bruised, stressed, and broken open by too many sitting hours.

(Other parts of the body are not exempt from this, of course.  Lying down can cause pressure wounds, too.)

Are you modest?  Do you dislike exposing your private parts to other people?

Then release them (and your caregivers) from unpleasant pressure!

Q is for Quizzical

Think you know everything because you are older than everyone else?

Don't!  It is much more appealing to others if, in your old age, you can be quizzical!

Wonder about stuff.  Have qualms!

One reason people have so much trouble with elders, is that they are so know-it-all.

Think you attained old age because you are smart?

Maybe it's luck - or your genes.

Remember to stay quizzical!

R is for Reality

"Reality sucks?"  "Reality bites?"  "Reality is for the birds?"  "Idealism is better than realism?"

Whatever your generation's favorite opinion about reality, reality is all we have.  (How you want to define it I will leave up to you.)

And reality isn't usually all that bad, especially if you try to keep up with it.

Take your preventive health care tests as the time for them comes, and maybe reality won't have such nasty teeth three years from now.

Be real about what sucky exercise you need to do now, so you can still get around pretty well in five or six years.  Better to be sucking up air doing aerobics than sucking air to get out of your chair.

Don't be idealistic about letting God take care of you, or the time when you can't take care of yourself will come upon you all too soon. 

Reality is for the birds, like God takes care of sparrows.

S is for Stress

See all those white hairs appearing on your children's heads?

When you were younger you blamed your white hairs on your children.

Now your children can blame their own white heads on you!

The stress involved with making decisions on behalf of another adult is mighty - especially if that adult is a parent.

Siblings who all feel that their brothers and sisters don't do enough, no matter how much they are doing, are a major source of stress.

My orphaned mother and her sister did not speak for fifty years after their caregiver's death.  She was their aunt, and the stress and anger created by her old age, death and its aftermath led to an all but permanent split.

Nowadays people are living for so long that your survivors might not have decades to repair the damage done by your failure to do your share in keeping family relations friendly, stable, and functional.

Think your children are all grown-ups?  Well, how grown up have you been acting lately?

T is for Trust, and

When you are frail and dependent on others for help, it makes it easier for everyone if you have faith in them and trust them,  especially if they are family members.

If you can't bring yourself to trust your family, then you will have to trust strangers.

Hmmm.  From what I hear of seniors these days, maybe trusting strangers might lead to trysts!

Might not be a bad thing.

U is for Under-

Please, respected elders, wear underwear!  Appropriate underwear.  Nowadays they make diaper-identical protection for people who are bedridden.  There are underpants-styled undies for people who can still get around but can't maybe get there fast enough.

There are even quite saucy bikini-style Depends now, I notice!

So don't eschew underwear, celebrate it!  Who knows, maybe they will even start producing colored and comical underwear for the elderly young-at-heart!

I'm undertaking the attempt to convince you that your wearing proper undies will reduce your caretakers' stress exponentially.  They deserve that consideration.  You can understand that, can't you?

V is for Volume

"Could you please turn that down a little?"

Ha ha ha ha ha ha.

Fat chance!

V is for Values

Remember the values you tried to drum into your children's heads while they were growing up?  They are probably still good for elders, too! 

W is for Willful

No, I'm not talking about a big fat will chockful of goodies for your heirs.

I'm talking about the more usual kind of will - the kind that comes from within.

There is good will, and that is okay.  Wonderful.

Willful is not great.  Willful is something we most associate with children around the age, say, of two.

If you need exercise you can get it by hefting your books, a can of soup or a one-pound barbell.

If your caregiver asks you to "please" leave your dishes where they are, why not comply? 

You do it all the time in restaurants, so we know you can!

As for insisting upon emptying your bedside potty chair yourself, the consequence of that "good" intention can be unspeakable!

A good rule for that kind of willfulness is:  if doctors advise you to use a walker, avoid carrying stuff - especially refuse - even if you refuse to follow doctors' orders.

Hey, there's another W word!  W is for walker!  Use it!

X is for X-Ray and Xenophobia

Age and X-rays go together like... hmmm... I never have felt that hugs and kisses should always be intermingled, and I have eaten many a wedge of apple pie without longing for a piece of cheese, even if it is good for your teeth.

But you get the idea.  In this wonderful country we routinely give elders x-rays if the symptoms warrant it.

The health care system is rich in people of other races and cultures, so don't be a xenophobe!

Just hope that your caregivers and technicians aren't gerontophobes!

Y is for You and You of Yore

If your condition is such that you need care, the care is for you.  As long as you don't feel you need care, it can be difficult to believe that other people's assessment of your condition may be more correct.

However, if you are already in a situation in which you are getting care, the chances are that you need it.  Now.

So don't live in dreams about what you used to be able to do.  My partner was trying to convince my mother that she couldn't do everything that she used to be able to do.  He picked up the TV remote and hopped up and down on one foot and said, "I can do this now.  Maybe I won't be able to when I am ninety."

My mother got a humorous but determined fire in her eye, and laboriously rose to her feet to show that she could do that.  We humored her (not requiring her to hold the remote) and stood close by just in case she lost her balance.

She made a big heave, and her whole body seemed to rise.  At first I thought she was actually succeeding!  Then I looked down.  Her left foot - her strong foot - had not left the floor.

Be realistic about what you are capable of doing.  You aren't going to magically walk to the polls on election day if you struggle to attain the halfway point during the last week of October.

Yesterday is okay.  Yore is a bore.

Z is for Zeal.

As you get older, you must have zeal for your own health and your own healthcare.

Be a zealot for espousing life - your life!  If you don't care about the quality of your life, why should anyone else? (to paraphrase that song from my youth that says the same about love.)

If you can't summon up adequate zest to do what you need to do to maintain your health and life, z is for zed.

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