Tuesday, September 20, 2022

Vanity of Age: The Lines

 I visited New York City last week. 

I saw this giant image of Lauren Hutton.

She's 78. 

Go figure. 

I was immediately taken with the unabashed lineage of her face

Oh sure, I'm confident there's been some post-production touching up here and there, but there are lines aplenty. And, yes, she's got a good infrastructure to support the lay of her skin. 

But still. 

I bet nobody dares call her young lady

A good role model for me. 

Lauren Hutton at 78 on a banner in New York City. September 2022.
Lauren Hutton at 78, on a banner in New York City. September 2022. 


Monday, August 29, 2022

Lessons From My Elders: Bring in the Light, Clean the Counters, and Put on Lipstick

 

Light through the window. Playa del Carmen, Quintana Roo, Mexico. November 2010. Credit: Mzuriana.
Light through the window. Playa del Carmen, Quintana Roo, Mexico. November 2010. Credit: Mzuriana.

Every morning, I open my window blinds and receive the light into my space.

Every morning, in the physicality of that action, I remember my mother. 

Every morning, my mother also opened her blinds, or shutters, or curtains, or drapes - whatever the window treatment was in the house she occupied at the time. 

She also told me how important it was to clean off the kitchen counters. Even if there are dishes in the sink, she said, a clean counter makes the whole kitchen look pretty OK, and it makes her feel good, too, she said. 

She also told me how important it was to apply lipstick in the morning (and in her years of youngish matronhood, how important it was to refresh that lipstick before my father returned home from work).

So what do these prosaic actions have to do with aging? 

  • There are small actions we can take to create our own environment of ease, beauty, and dignity. 
  • We have control over these small acts; they are expressions of our self-determination. 
  • They send a message to those who enter our spaces: You are dealing with an elder Who Keeps Up. 

To each her own on whether or not to apply cosmetics when one is traveling in the Land of Age, but here are some thoughts about its power, gleaned from the Women's Health article, Why Putting On Lipstick Makes You Feel So Awesome

"... lipstick provides a reliable tonic in trying times. ...  it often serves as a symbol (however small) of health and vibrancy. 'Lipstick helps restore a normal sense of self that a patient can lose during incredibly difficult cancer treatments and help them feel like themselves,' says Bobbie Rimel, M.D., a gynecologist and oncologist...."

"[Poppy King] recalls ...  'Lipstick immediately made me feel different on the inside ... like I was capable of more with it on than I was without it.'" 

"As Audrey Hepburn so succinctly put it, 'On a bad day, there's always lipstick.'"


Thursday, August 25, 2022

Digital Journals: The Other Side of Sixty

Roasting coffee beans. Washington, D.C. May 2007. Credit: Mzuriana.
Roasting coffee beans. Washington, D.C. May 2007. Credit: Mzuriana.
 

The Other Side of Sixty, by "Wisewebwoman."

The author lives in Newfoundland, Canada. I'll call her WBW (wise web woman). 

Age 79 (as of today's writing).

WBW is very open about how she moves through the sea of age. Some days are clear sailing, a goodly breeze. Some are stormy, treacherous. Some days the sail is still and flaccid, her vessel stalled over the deep unknowable.

WBW's blog is an espresso. Black, no sugar. Flavorful.

She has visited some corners of aging that I've touched on, as well, and I find sustenance in reading similar experiences. 



Monday, August 22, 2022

Digital Journals: The 80-Something Blog

 

Judy Kugel. Source: The Art of Applying.
Judy Kugel. Source: The Art of Applying.


Rather than craft an introduction, I'll get to my recommendation: 

The 80-Something Blog by Judy Kugel. 

With a video lagniappe below, in an interview conducted by one of her sons: 


In addition to my appreciation for her content about aging as well as she can in all dimensions of our humanness - the physical, mental, and emotional - I like her writing style. It is clean and succinct. 

On a superficial note, the attire she wore in the video interview resonated with me. Classic. Ageless. 


Thursday, August 18, 2022

Vanity of Age: On Camera Filters, or The Lack Thereof

 

A selfie in Juarez. December 2016. Credit: Mzuriana.
A selfie in Juarez. December 2016. Credit: Mzuriana.


Until recently, I've felt somewhat irritated that my phone camera's app auto-"corrects" my selfies, smoothing out my lines a bit. I've searched the camera settings to turn this feature off, but the option doesn't seem to exist on my phone's camera app. 

I have now reconsidered my objections. 

I attended a community event a week or so ago. Members of a local photography club swirled about the area, capturing many photos of the people there. Some of the photographers posted their work on a social media site, where I saw a photo of myself. 

It was a perfectly fine photo, except I wish I had been sitting up straighter on the bench. 

It was a perfectly fine photo, except ..... ohhhhh ..... without the busybody filter that my phone camera has, the photographer's camera had no compunction at all about disclosing the stark reality of my facial terrain. 

I'm reconsidering my irritation at my phone's kinder view. 

 

Monday, June 27, 2022

Vanity of Age: The "Meno-Belly"

Tripe (stomach). Istanbul market, Turkey. July 2012. Credit: Mzuriana.
Tripe (stomach). Istanbul market, Turkey. July 2012. Credit: Mzuriana.

This "meno-belly" (aka "meno-pot") business has only just come to my attention. 

When I arrived at my healthy body weight (overall, a 150-pound weight loss over the course of some years), I had what they call an "apron," which is loose skin that hangs down a bit from the abdomen. 

But more recently, I have acquired the proverbial spare tire around my middle. "Recently" meaning: In the last two years, maybe a bit longer. 

I blamed it on these two things, in chronological order: 

  1. Moved from a dance-intensive area to an area where there is not much of a dance community, so I lost that good workout; and
  2. COVID, of course 
I had gotten a little loosey-goosey on my caloric intake, too, not much, but over time, enough sloppiness to spill over into some weight gain. 

So I've tightened up the daily caloric envelope to see what happens. 

You'd think an esteemed institution such as the Cleveland Clinic would have something insightful to offer here, but it doesn't. Just the usual stuff: Weight, exercise, diet, blah, blah, blah. I can get that in a so-called "women's" magazine. Or The Enquirer. The Mayo Clinic isn't much better

However, there is a possible tiny hint of what might have contributed to my meno-belly - which by the way - did not emerge until well after I'd passed through menopause: 
  1. A reference to sleep apnea in the Cleveland Clinic's article; and
  2. A reference to breathing problems in the Mayo Clinic's article. 

Because "breathing problems" are a function of sleep apnea, it's possible that as the treatment of my sleep apnea progresses, my meno-belly might contract. 

I wonder about this possibility because I noticed a change in my sleep patterns after I moved to Tucson. And it was during my Tucson sojourn that I began to notice the belly change. 

We'll see. 

Thursday, June 23, 2022

Lessons From My Elders: New & Improved Is Not Always Better

Cars on a table. Missouri. January 2006. Credit: Mzuriana.
Cars on a table. Missouri. January 2006. Credit: Mzuriana.
 


My mother bought a new car when she was in her mid-80s. 

Her old car didn't have a back-up camera.

It made sense for her to buy a car with a back-up camera, yes? Safer for her! Safer for the people around her when she backed up! Right? 

Well, maybe not.

A back-up camera can make backing out of a space more treacherous unless you master the new quirks the camera requires of the driver. While you're looking down and to the right at the back-up video screen on or below your dashboard, you are not looking at what's coming at you just out of view of the back-up camera:

  • A shopper who is about to walk directly behind you
  • A car in the parking lot lane approaching your egress path. 

We've still got to look up and into our rearview mirror, over our shoulders to the rear, over to the right to the passenger side mirror, over to the left at our side mirror, turning to look in the rear window. All of these movements we are accustomed to do. 

Adding a new visual point to see what's in the camera screen in front of us - adds a complication in both the passage of chronological time and mental processing time.  

The lesson for me, as I peer into my aging future, is this: Sure, try the new thing out before I get rid of my old thing. Maybe newer will be better, but maybe the ease and comfort of the old will actually be safer, or if safety isn't a factor, maybe more satisfying. 


Monday, June 20, 2022

Lessons From My Elders: Exercise Bands

 

Resistance bands. Credit: Mzuriana.
Resistance bands. Credit: Mzuriana.


When my mother, "Joanne," was in her late 80s, there was a day when she had what I can only call a system crash. Joanne acquired some sort of infection that, like a malware program, brought her down both physically and cognitively. It was scary, and after doing some hospital time, she passed additional time in a rehab center. 

It's my mother's experience at the rehab center that taught me two lessons that I have onboarded for myself: 

  1. Get a set of stretchy exercise bands for strength-building at home, the same bands that the rehab center's physical therapist had Joanne use
  2. Actually use them


I did buy a set of bands.

I do actually use them. Almost every day. 

I can get some benefits of a gym without having to go to a gym. The bands are inexpensive and they take up virtually no space. 

I can build and maintain strength and muscle. I'm going to need both as I continue to grow old. 

Thursday, June 16, 2022

Literature: The Fountain of Age

 

"Half old chicken" at Asian market. Toronto, Canada. June 2016. Credit: Mzuriana.
"Half old chicken" at Asian market. Toronto, Canada. June 2016. Credit: Mzuriana.


Betty Friedan is best known for The Feminine Mystique (1963), published when she was 42 years old.

Three decades later, at age 72, she birthed another pivotal book: The Fountain of Age. She proposed that we replace the view of aging as a process of decline with a view that aging "opens the way to a further dimension of 'personhood.'" 


p. 20

"In the months that followed my sixtieth birthday, I grimly forced myself to study age, head on. .... I took a fellowship at Harvard ... I would immerse myself in state-of-the-aging art: medical, clinical, physiological, psychological, social policy. .... 

"Looking around the paneled room at my first Harvard meeting on 'Ethical Issues in the Care of the Aged,' I realized that, aside from my own, there was only one white head of hair. It belonged to a man who was a pioneer in the study of age and was about to retire (it seemed gerontologists must also retire at age sixty-five). These bright young turks of the new aging field were mostly men who maybe started out in psychiatry, doing post-docs in 'geropsychiatry' ..., and a few women staking out new turf as legal-medical 'ethicists.'" ....

 

"I grimly forced myself to study age, head on ..." 

Well, I feel neither grim nor forced, but otherwise, I'm with Betty on an exploration of the Land of Age. 

It's my big new country of residence, after all, and I want to see what's what. 



Monday, June 13, 2022

On Mortality: The Trench

 

In the Trenches, World War I Museum. Kansas City, Missouri. January 2010. Credit: Mzuriana.
In the Trenches, World War I Museum. Kansas City, Missouri. January 2010. Credit: Mzuriana. 

My mortality. 

I've been thinking of this, of late. 

Neal Stephenson, in Fall (or Dodge in Hell), described the process of such thoughts for some of us.  

"He saw life as a trench in the First World War sense of that term, dug very deep at one end but becoming more shallow as you marched along, gradually ramping up to surface level. 

Early in your life you were so deep down in it that you didn't even know that shells were bursting and bullets zipping over its top. 

As time went on these became noticeable but not directly relevant. 

At a certain point you began to see people around you getting injured or even killed by stray bits of shrapnel, but even if they were good friends of yours, you knew, in your grief and shock, that they were statistical aberrations. 

The more you kept marching, however, the more difficult it became to ignore the fact that you were drawing closer to the surface. 

People in front of you died singly, then in clusters, then in swathes. 

Eventually, when you were something like a hundred years old, you emerged from the trench onto open ground, where your life span was measured in minutes. 

Richard still had decades to go before it was like that, but he'd seen a few people around him buy the farm, and looking up that trench he could see in the great distance - but still close enough to see it - the brink above which the bullets flew in blazing streams. 

Or maybe it was just the music in his headphones making him think thus."


With both of my parents now dead, I'm at the head of the line. A sobering thought. 

Until very recently, my goal was simply to enjoy a good quality of life for as long as possible, and as independently as possible, without placing an unrealistic burden on my descendants. 

But a few days ago, I thought to put a number on it. 

If I look at the longevity of both my maternal and paternal parents, grandparents, and blood-related aunts and uncles - plus my generation's better nutrition, access to health care, advances in health treatments, etc. - I had a vague assumption that my early 90s would not be unrealistic. 

Some of that is magical thinking, to some extent, because my father died in his mid-70s and his mother died in her 50s. 

I thought to put a number on it because I wondered: How many years do I have left, really? 

And if I put a number on how many years I have left, how will that guide my allocation of time and other resources to: 

  • Achievements I still want to accomplish? 
  • Experiences I want to have? 
  • Relationships I want to nurture?
  • Relationships I need to let go?
  • New relationships I want to find? 
  • For my descendants, leave a legacy of love, a current and past family history, connectedness, memories, and investments in their and their descendants' futures, whether tangible or intangible. 


So I've applied the WAG method to come up with a concrete number for myself. 

86 

So if I make that 20 years from today, that's June 13, 2042. 

42. 


 Oh my gosh. 

42. 


The answer to the question in Hitchhiker's Guide to the Galaxy

What is the meaning of life? 

42. 


It is poetic. 

Inshallah

Thursday, June 9, 2022

Elder Barriers: Non-Adherence vs. Non-Compliance

 

Toilet instructions. Antigua, Guatemala. April 2016. Photo credit: Mzuriana.
User-friendly toilet instructions. Antigua, Guatemala. April 2016. Photo credit: Mzuriana.


Definitions: Adherence versus compliance

From a 2019 article in Medscape

"Noncompliance Versus Nonadherence

".... there is a difference between the two terms. ....

"Generally, 'noncompliance' describes patients who deliberately refuse to follow a treatment plan.

"'Nonadherence' is the behavior in which a patient unintentionally fails to follow a plan.

"Although the resulting behavior might be the same (e.g., unfilled prescriptions, missed appointments), the causes can be very different.

A noncompliant patient could ignore a plan for several reasons, whereas a nonadherent patient might intend to follow physician orders, but be unable to do so. ..."


It is self-serving for providers to default to patient "noncompliance"

It's expedient for healthcare suppliers and insurers** to blame their patients or end users for not following their prescriptions/instructions for:

  • Medication 
  • Equipment 
  • Exercise routines
  • Diet

**Includes researchers, pharma/device developers and designers, process developers and technical writers, administrative and regulatory bodies that oversee approval of products, those who prescribe the meds, equipment, processes, etc. - In short, every entity in the chain that leads to the end user. 

In the case of Medicare, patients are financially penalized for not following instructions for things such as CPAP machines and their accoutrement, as Medicare will not pay for the equipment cost unless there is documentation showing the patient is using same. 

On the surface, Medicare's punishment follows a logical "if this, then that" algorithm. 

But the blame-the-patient model ignores certain realities of working with a cohort of patients who are in the Third or Fourth Ages. 

As groups, each of these two Ages is much more likely to live with a constellation of common compliance barriers, including those related to memory or cognition, than patients who are under age 65. 

So, for the nonadherence definition, I would change it thusly: 

"Nonadherence is the behavior in which a patient unintentionally fails to follow a plan or is unable to consistently follow a plan because adherence requires a certain level of:

  1. Visual acuity (e.g. to read instructions, liquid measurement levels); 
  2. Motor strength (e.g. to handle or carry DME or the parts thereof); 
  3. Finger and hand dexterity (e.g. to apply eye drops, open latches and lids); 
  4. Time management or impulse control (e.g. to prioritize the timing of doses over the calls of hunger/thirst, such as for meds that must be taken 30 minutes before or after eating);  
  5. Financial resources to implement the plan; or
  6. The ease and speed with which they can access technical support to answer questions or troubleshoot problems ... 

.... you get the idea. 

Some thoughts on adherence and compliance in these articles: 

But even these articles focus almost all of their attention on how to influence the user


It is time for the healthcare suppliers and insurers to feel the spotlight's heat

There seems to be scant attention on those who: 

  1. Develop the products, 
  2. Design the products and their packaging, 
  3. Develop the usage protocols and treatment processes, etc. 

If low adherence to a treatment is common, then a spotlight should shine on the provider (developer, designer, manufacturer, supplier or prescriber) first, and not the patient. 

Note: By "products," I mean: 

  • Equipment
  • Medications and delivery methods of same (e.g. eye drops, ointments, special timing of medication consumption)
  • Prescribed actions, such as exercises designed for strength-building, range of motion, motor skills, etc. 


The USAID story

The focus on the end users instead of the product providers (et al) reminds me of a story that an Ethiopian university instructor told me in the mid-80s:  

In Ethiopia, as land was handed down to sons by their fathers, their descendants - subsistence farmers - owned smaller and smaller pieces of land as it was divvied up with their brothers. The plots of land were becoming too small to support cattle, the traditional livestock of choice. 

Some smart people from the US, perhaps with USAID, had a great idea: 

Encourage the subsistence farmers to switch from cows to goats. The goats provide meat and milk like cows, but take up less space and consume fewer resources.

Upon hearing this story, I said, "Hey, that is a great idea. Creative!"

The Ethiopian professor said: 

"No, it's forcing the farmers to do all the changing. 

The oligarchy doesn't have to change anything. 

They keep their wealth and vast properties. 

What needs to happen is land reform."


What needs to happen is ..... 

.... pressure to remove adherence barriers at the front- and back-ends instead of more pressure at the user end. 


 

Toilet instructions. Antigua, Guatemala. April 2016. Photo credit: Mzuriana.
User-friendly toilet instructions. Antigua, Guatemala. April 2016. Photo credit: Mzuriana.

 

Monday, June 6, 2022

Elder Barriers: UI and UX Generalized


Red berries in winter. December 2006. Credit: Mzuriana.
Red berries in winter. December 2006. Credit: Mzuriana.

Heheheheheh, "elder barriers" ......... "elderberries."  I like that. 

Perhaps I will some day self-identify as an "elderberry." Hopefully, that's not too close to dingleberry. 

But I digress. 


What are UI and UX? 

UI and UX refer to the "look and feel" of a website, application, or device (such as a cell phone, tablet, or laptop) for the person who uses it. 

UI = User Interface. UI refers to the:

  1. Buttons,
  2. Toggles,
  3. Icons, and other visual elements 
  4. That you interact with when using a website, app, or other electronic device.

UX = User eXperience. UX refers to the entire interaction you have with a product, including how you feel about the interaction.


UI and UX generalized

We can apply the terms UI and UX to almost everything around us. 

About UI

  • Is a store or community center or park or health care facility visually appealing? Does it draw me in or does it repel me? Does it create a vibe? Does the design give me information about its target users? 
  • Does the appearance or presentation of a product or service seem friendly to use or does it seem daunting to use? 
  • Is there good signage that tells me where to go and where I am? 


About UX

Is it relatively simple to access the facility, product, or service? Can I afford it? If there are barriers, are they relatively easy to work around? Is there help available when I experience problems? 


UI and UX and elders

As I age, my abilities will change. I'll be somewhere on a spectrum of typical changes in:

  1. Abilities, 
  2. Disabilities, and perhaps
  3. Inabilities

I want products and services and processes with a UI and a UX that respect the most common ability changes that occur as we age. 

The Americans with Disabilities Act (ADA) and its associated entities (Department of Justice, Access Board, ADA Network) already have laws, regs, guides, technical support, training, and enforcement remedies in place to ensure access to products and services provided by: 

  • Health care providers
  • Health care facilities
  • Assisted living, rehab, and skilled nursing care facilities
  • Website designers
  • Software applications
  • Durable medical equipment operations, cleaning, and maintenance
  • Drug packaging designers
  • Pharmaceutical delivery systems (times of day, frequency, before/during/after eating)
  • Eye drops
  • Cell phone designers

There's also the World Wide Web Consortium (W3C) Web Accessibility Initiative (WAI) - with accessibility standards since 2000. It's now in its 3rd draft. 

But the execution of all of these wonderful UI and UX measures? 

Not so great, I'm thinking. 


In the meantime, I need to check my own website for accessibility. 


Thursday, June 2, 2022

My Inspirations: Long Journeys

 

Old Mines Trail, Big Bend National Park, Texas. September 2017. Credit: Mzuriana.
Old Mines Trail, Big Bend National Park, Texas. September 2017. Credit: Mzuriana.

In addition to saving the world (ahem), I've dreamed all my life of taking a long trek. Usually by hiking. Well, walking. There was a time when I devised a plan to walk from the Arctic Circle to the southernmost tip of Tierra del Fuego, in Chile, when I turned 50.  That plan evaporated when I read the story of the hiker who, unbeknownst to him, had a bear tracking behind him. A driver who passed by alerted the hiker. 

Ernie Andrus is the oldest person to have run across America. It took him three years. He was age 90 at the start and 93 at the finish. 

Nimblewill Nomad,' 83, is the oldest to hike the Appalachian Trail

Nan Resinger is the oldest woman to hike the Appalachian Trail, doing so at age 74. And, hey, her hike partner, also a woman, was no yowwen at age 67. 

Emma Gatewood, at age 67, was the first woman ever to complete the entire Appalachian Trail alone in one season (and this was back in 1955). (Do note that her trail name was Grandma Gatewood, tying her to her uterus, versus the character-rich trail name of "Nimblewill Nomad" in a link above. 

From the Amazon page of the book, Grandma Gatewood's Walk: The Inspiring Story of the Woman Who Saved the Appalachian Trail

"[Emma] Gatewood not only hiked the trail alone, she was the first person—man or woman—to walk it twice and three times. At age seventy-one, she hiked the 2,000-mile Oregon Trail."

 80-year-old Yuichiro Miura claims new Everest record. Mr. Miura is also the oldest person to ski (and, er, tumble part of the way) down Mount Everest - at age 70. There's even a movie about his descent: The Man Who Skied Down Everest



Note: "[S]ix Sherpa members were killed during the expedition, as well as a Japanese member who died of a heart attack." Source: Wikipedia  What is recreation for a few is a means to support one's families for others


Monday, May 30, 2022

Walkable ADA-Compliant Communities for the Third Age, A Second Look

 

Bywater Crescent Park, New Orleans, Louisiana. March 2021. Credit: Mzuriana.
Bywater Crescent Park, New Orleans, Louisiana. March 2021. Credit: Mzuriana.

The plan

I already wrote about it here. Today's post is a second pass. 

Currently, my lifestyle is such that I move to new cities regularly. But in a handful of years, my plan is to choose a so-called final residing place so that I can plant a garden of mutual support in a community. 

In my perfect world, the criteria for that place are:

  1. Walkability
  2. Affordability
  3. Mild weather
  4. Diversity of age, complexion, cultural heritage, history
  5. Cultural activities


Walkable communities

In one of my past lives, I was introduced to "walkable communities." The community where I lived brought in Dan Burden, the premier evangelist of same at that time. 

What a revelation! New language and new ideas for me: 

  • Traffic calming
  • Mixed use zoning - not only residential-and-commercial mixed use, but socio-economic-level diverse housing
  • The downsides to cul-de-sacs
  • The counter-intuitive rebound effect of too many stop signs or stop lights
  • Traffic circles versus traditional four-way stops
  • Food deserts

I was further enlightened by the engrossing (and sometimes humorous) book, Traffic: Why We Drive the Way We Do, by Tom Vanderbilt. 

I loved the interplay in the book between the (wrong) common wisdoms against the counter-intuitive facts. Examples: Why the drivers of new cars, SUVs, and pick-ups are more dangerous than drivers of older cars and smaller cars. Why it's hard to "see" motorcyclists, some bicyclists, pedestrians, and people coming at you the wrong way on the road. 

Mr. Vanderbilt's explanation that what we see in traffic depends on what we expect to see (and other factors) fascinated me. 

There was also a memorable Washington Post article (circa 2000?) about a tragic pedestrian-vehicle encounter, in which it was pointed out that sometimes it is safer for pedestrians to jaywalk than to cross a street at an intersection. Thus far, I haven't been able to re-surface that article, but a 2001 Washington Post opinion piece, Pedestrians in Peril, explains the thinking on the idea.

Note: I have personal experience. One day, as I walked across a busy road at an intersection with traffic lights, where I had the right-of-way at the time of crossing, a car turned onto the street from the cross street, and struck me. As the Pedestrians in Peril author states:

Newspaper accounts of pedestrian accidents [and law enforcement, car insurance companies, and people who hear about the hit] always make a point of reporting whether the victim was using a crosswalk. This should be perhaps the third or fourth question asked, after:

  • "Was the driver speeding or breaking other traffic laws?"
  • "Was he or she paying enough attention to avoid an accident?"
  • "Is the road -- including crosswalks and traffic signals -- designed for reasonably safe crossing?"

In my case, the driver had been distracted, trying to use his cell phone while making the turn. 

Intersections are, by their very design, pain points. The left-hand turn at intersections is the most acute pain point. And that's exactly what the driver had attempted to do when he hit me with his car. Although I had the right of way because I was crossing a street at a time when that street's light was red, the driver who hit me had a green light, which meant he could legally turn left at the intersection IF a pedestrian was not in the perpendicular crosswalk. 

I never crossed at that intersection again. Instead, I jaywalked to get to the opposite side of the street. It was safer because I could gauge the traffic oncoming both ways, not only on that street, but from the intersecting street. 

On one hand, the jaywalking versus "legal" crossing argument above is a bit of a detour in today's post. 

On the other hand, when I say I seek a "walkable community," I see that this is not good enough. 

As I write this, I live in a gorgeous neighborhood with sidewalks on both sides of every street. 

But the sidewalks are unsafe for people who:

  • Use wheelchairs or walkers or push strollers
  • Have depth perception challenges
  • Have gait irregularities that compromise balance

.... because the roots of trees or sidewalk-invading (yet lovely) plantings heave or obscure too many sections.  


"Walkable" is not good enough

The older we get, the more likely we will acquire mobility, vision, or hearing disabilities. 

We may: 

  • Walk (or wheel) more slowly than younger folks when we cross a street, for a variety of physical reasons
  • Have slower reflexes when confronted with sudden traffic events (i.e. an oncoming vehicle or a bicycle that is passing us from behind)
  • Experience differences in assessing the distances between us and oncoming vehicles

So the community I seek needs to be ADA-compliant. It needs to be a community that embraces universal design. The Department of Justice offers user-friendly guides for communities: 


"Livable" communities

The AARP uses the term "livable communities." The criteria for a livable community are: 

AARP Livable Community poster. Credit: AARP
AARP Livable Community poster. Credit: AARP

 The AARP page, AARP Livable Communities, is fat with good information. 


Thursday, May 26, 2022

The Fourth Age: Quality of Life

 

Aztec Ruins in Aztec, New Mexico. April 2013. Credit: Mzuriana.
Aztec Ruins in Aztec, New Mexico. April 2013. Credit: Mzuriana

Remember that the Fourth Age is the time when our bodies, and perhaps our cognitive functioning, have begun the process of shutting down shop.

I have questions about the Fourth Age

Who decides if a 4th-ager is enjoying a rich quality of life? 

What does a rich quality of life look like when one is in the Fourth Age? Is the definition equivalent to that of someone under age 60 who:

  • Is in hospice? 
  • Has physical, mental, or cognitive disability that requires accommodations of some sort? 

Or do we segregate 4th-agers into a special category that allows us to lower the quality-of-life standards that younger people enjoy, thus contributing to:

  • Infantilization
  • Denial of rights to self-determination (including the right to make mistakes and stupid decisions sometimes), and 
  • Learned helplessness? (Or perhaps, more accurately put: taught helplessness)

Must the definition of a rich quality of life for 4th-agers be relative and not absolute? In other words, does it require the qualifier "for her age,"  as in: Life kinda sucks, but it sucks less than the lives of most people her age.


Again I must circle back to: What is the definition of the Fourth Age?

From the 2018 article Self-perception during the Transition to the Fourth Age in the Czech Republic are these thoughts (which I've chunked for easier readability): 

"A definition proposed by Gilleard and Higgs describes the fourth age as the period:

  1. When individuals are seen as no longer being able to manage their everyday life, 
  2. 'When they become third persons in others’ age-based discourse, within others’ rules' [Gilleard and Higgs, 2010: 122], 
  3. Which in turn results in a process of 'othering'—i.e., of becoming the other, who is discursively associated with alienation, vulnerability (associated with frailty), and a state of abjection [Higgs and Gilleard, 2014]. 

Othering simultaneously becomes part of a person’s identity:

  1. Not only in terms of self-perception, 
  2. But also as a dynamic relationship between self-perception and how one is seen by others, 
  3. As well as the approach of institutions and practices that are anchored within wider cultural frames. 

The sense of identity of fourth-agers is described as being continually renegotiated ....  leading to a radical form of othering that increasingly separates the older adults and infirm from the rest of humanity [van Dyk, 2016]." 

Studies about quality of life of people over age 85

This study was a meta-survey study of other research that asked "older people" how they define quality of life. 

The researchers used these QoL (quality of life) domains (categories): 

  1. Attitude and adaptation
  2. autonomy 
  3. Emotional comfort
  4. Financial security
  5. Health perception
  6. Home and neighborhood
  7. Relationships
  8. Role and activity
  9. Spirituality

Table 1 shows the ages of the subjects. Unfortunately, the ages of the subjects in some of the included studies begin at 60. Furthermore, all of the subjects lived at home.

 On the bright side, I like Table 2 for showing the criteria the researchers used to measure each of the domains. 



Another wrinkle. So to speak. 


"As we have already mentioned, quality of life and life satisfaction are different concepts, but at the same time, they are complementary.
Life satisfaction represents an indicator of quality of life ....  focuses on moral, cognitive, and affective aspects, on the tasks carried out independently, and on satisfaction with social support received and, in general, is related to life expectancy.
On the contrary, quality of life is ... linked to ... the ability to be independent in their daily activities. .... improving self-esteem, satisfaction with functioning, a sense of independence in daily life tasks, and a sense of participation, which are important components of the whole structure that makes up the standards of quality of life of the elderly.

Alas, this was another study with an age threshold of 65. And, yes, a person age 65 can be in the Fourth Age, depending on their health status, but generally speaking, age 65 is toward the beginning of the Third Age. 


Can my 4th-age quality of life measurement be absolute or must it be relative? 

By this I mean, do I use different QoL scales depending on my residence:

  • In my own home (alone? with a mate? with a roommate? with a caregiver?)
  • In an assisted living situation (with communal dining? with my own kitchen?)
  • In a nursing home
  • With a family member (in the same home? in a casita on the same property?)
  • In a shared-housing residence (a la Golden Girls)
  • In hospice (at  home? in a hospice facility?)
Do I use different QoL scales depending on the nature of my disabilities (if, by definition, a person has at least one disability in the Fourth Age):
  • Cognitive impairment?
  • Memory impairment?
  • Nature and extent of mobility impairment?
  • Pain management?
  • Complexity of health management, such as for diabetes, cancer treatment (or palliative care)
  • Vision impairment
  • Hearing impairment

I don't have answers, clearly. 

At a certain point, however, I'll need to define my personal measures for quality of life. Doing this will help me:
  1. Fashion a Plan A, Plan B, and Plan C for my 4th age, dependent on various typical scenarios
  2. Have SWOT conversations with my descendants about the Strengths - Weaknesses and  Opportunities - Threats to my (our) plans for my 4th age. 

In the meantime, I continue to watch and learn from both positive and negative role models in their aging process. 


Monday, May 23, 2022

Eyes: Eyelid Hygiene: Who Knew?

Yellow eye, artist unknown. Missouri. February 2006. Photo credit: Mzuriana.
Yellow eye, artist unknown. Missouri. February 2006. Photo credit: Mzuriana.

The 3 take-aways from this post

  1. The older we get, the more likely we are to acquire blepharitis and dry eye.
  2. Good eyelid hygiene prevents or helps manage blepharitis and dry eye. 
  3. We should cleanse our eyelids at least once per day whether we need to or not.

 
Until this year, I never thought about eyelid hygiene. I washed my face. Showered. Wore eyeliner and mascara

But apparently, the careful cleaning of our eyelids is a thing we should do. When I say eyelids, I mean along the lash lines. When I say careful, I mean not a slapdash, close-enough-for-horseshoes swipe with a soapy washcloth across the lids, but mindful back-and-forth strokes. Not too soft and not too hard. Assertive. Not aggressive.

I did not know about eyelid hygiene until after an ophthalmologist diagnosed me with blepharitis and dry eye in April. 

He handed me two pieces of paper as I left his exam room, accompanied by a meager crumb or two of explanation: 

1.    A list of products from one brand's line of: 

  • Tea tree oil eyelid wipes to cleanse my eyelids
  • Microwaveable heat compress mask
  • Preservative-free lubricating drops
  • Night time ointment

2.   A prescription for Restasis (which would have cost me $500 for a one-month supply out-of-pocket if I had filled it)

This post addresses the eyelid cleaning only. 

I watched a score of youtube videos by eye doctors, and I read a ream of online articles and subreddit posts on the subject. With the exception of the feral, entirely anecdotal subreddit, I used written sources that I felt were most reliable, such as the high-reputation Mayo Clinic and Cleveland Clinic. 

What do we use to clean our eyelids? 

There is a lot of chatter out there about these cleansing products:

  • Wipes (and the pros and cons of tea tree oil formulations)
  • Foam scrubs
  • Diluted baby shampoo
  • Dandruff shampoo
  • Cleansing sprays

This is not a medical blog and I'm not an expert, so I'll wish you well on your personal quest for the perfect product and technique.

But below is my personal journey, which is in its early days still. 

What I chose 

I bought two eyelid cleansers: 

  1. Tea tree oil wipes - because I didn't know yet if I had an overpopulation of demodex (mites) or not - and tea tree oil formulations seemed to be the go-to for subduing the mite population; and
  2. OcuSoft Lid Scrub Plus - because I could use my finger to apply it and it was more cost-effective than the packaging-heavy and very expensive wipes

At first, I also bought a travel-size bottle of baby shampoo and diluted it, but my subsequent research pointed to newish concerns about this, so I've suspended its use as an eyelid cleanser for now. 

What I will choose next 

I've had a follow-up visit since my first diagnosis and I now know that I do not have an overpopulation of demodex (mites). I do have scurf and scales, which translates to dandruff flakes in my lashes and along the lash line. 

Therefore, I will not buy the tea tree oil wipes again. Too expensive. Too much packaging.

I will buy the OcuSoft Lid Scrub Plus Platinum next time (instead of "just" the Plus). In addition to the qualities in the Plus product, it also reduces inflammation.


Why I care about pushing my blepharitis into remission

I'm very, very lucky. My blepharitis is not at a stage where it causes a fiery swelling of my lids, redness of my eyeballs, or pain. I had no idea I even had this blepharitis thing. 

However. What I have experienced is intermittent blurriness in my vision. Blepharitis (and dry eye) often does this. And that matters to me, a lot. 

Also, blepharitis can lead to or exacerbate dry eye. Dry eye is another suspect in intermittent blurriness. 

As we age, compromised vision - especially at night - can affect our ability to drive safely. Being able to drive safely as long as possible is a major quality-of-life indicator. 

So I'm gonna clean my eyelids. 

Thursday, May 19, 2022

Out Damned Spots!

 

Purpura on arms. Source: American Osteopathic College of Dermatology. Photo credit:  Jere Mammino, OD.
Purpura on arms. Source: American Osteopathic College of Dermatology. Photo credit:  Jere Mammino, OD.


"Out, damned spot! out, I say!"

Lady Macbeth


From No Sweat Shakespeare, is this reference about the famous quote from Macbeth: 

As [Lady Macbeth] walks she rubs her hands as though washing them, trying to get rid of the blood. The spot she’s referring to is a spot of blood on her hand. She’s rubbing it, trying to erase it, but cannot. “Here’s yet a spot,” she cries, desperately rubbing. “Here’s the smell of blood still.


So as we age, some of us find, in addition to other dermal indignities, that blood spots inexplicably appear, then disappear, then appear, on our arms. 

In addition to wrinkles, these small lesions are blaring horns of aging. No, not just aging, but of agedness completed. Of OLD PEOPLE. And we are not an Old Person yet. We cannot be! Are we? Are we? 

To add insult to injury, a common name for these lesions is senile purpura, although there are more neutral names available: 'actinic purpura', 'solar purpura' or 'Bateman's purpura.'


I can't go back in time and do a better job of protecting my arms from sun damage, but I can do a better job of protecting it from additional damage with:

  1. Sunscreen (instead of just on my face)
  2. Long-sleeved tops
  3. Sun sleeves

I didn't know sun sleeves were a thing until I saw a friend wear them for his walks in the desert. 

These damned spots piss me off. 


Monday, May 16, 2022

Vanity of Age: You Look Like Sisters!

 

Mural, Segundo Barrio, El Paso, Texas. November 2016. Photo credit: Mzuriana.
Mural, Segundo Barrio, El Paso, Texas. November 2016. Artist credit: Los Dos, Ramon and Christian Cardenas. Photo credit: Mzuriana.


My mother was 25 years older than I. 

There was a year, when she was in her late 70s, and I in the first nickel of my 50s, that she and I took some travel excursions together. Several times in that year, people - strangers - upon learning we were mother and daughter, exclaimed, "You look like sisters!" 

My mother, of course, was quite pleased. 

I was not as tickled. 

Was it because my mother looked so youthful? Or was it that I looked older? 

In Kansas City, I asked this of the sales person who made such an exclamation. She merely side-cocked her head, raised her eyebrows, and lifted her shoulders in a Gallic shrug. My comeuppance.

A puzzle never solved. 

I admit: It rankled. It also made me laugh; it still does. 


Thursday, May 12, 2022

Accessible Communities for the Third Age

 

Toronto Islands boardwalk. June 2016. Credit: Mzuriana.
Toronto Islands boardwalk. June 2016. Credit: Mzuriana.


In my perfect world, in four years +/- two, I will settle down in a city with these characteristics:

  1. Population size: 300k to 750k
  2. Demographics: Diverse in age, complexion, ethnicity, language of origin, and socio-economic status
  3. University campus (for its cultural events open to the community)
  4. Mild climate
  5. Historical interest
  6. Library system
  7. Diverse and well-dispersed food markets and parks
  8. Widespread, universal design for pedestrians, wheelchair/walker/stroller users, cyclists, and alternative-motorized vehicles, such as golf carts


#8 is very important for me. I envision a time in which I'll need to retire my car keys. When that happens, I'll want to be living in a walkable community. An accessible community. 


What is an accessible community? 

Here's how Canadian Rick Hansen (a wheelchair user) defines it (emphases mine): 

An accessible community is barrier-free and doesn’t limit anyone’s participation in everyday life.

In accessible communities, people with disabilities can be active participants. Ensuring that such communities exist — and thrive — is important because both people with disabilities and their neighbors benefit. Accessible communities:
  • Allow for the interaction and engagement of all members,
  • Reduce social isolation and improve mental health for people with disabilities,
  • Increase economic gains for local businesses, and
  • Improve physical health opportunities and outcomes for all.
Mr. Hansen's definition above focuses on people with disabilities, but the beauty of accessible communities is that it benefits all of us, including, for example, caregivers of children in strollers and folks who may not have a disability in the strictest sense of the word, but who, for example:
  • Move more slowly or carefully than more able-bodied people
  • Have limited stamina to walk far without frequent rests at well-spaced benches

Tied in my mind to accessible communities are: 
  • The broader concept of universal design
  • Walkability, i.e. curb cuts, sidewalks, traffic calming, cyclist lanes, etc.
  • Robust, affordable public transportation system that can include buses or vans, Uber/Lyft, or in the not-too-distant future, driverless cars that one can "call up" for errand-running
  • Pathway design for alternative personal vehicles such as golf carts, bicycles and adult tricycles, and motor scooters
  • Avoidance of food deserts
  • Good street lighting (that also conforms with Dark Skies)
  • Green spaces equally dispersed throughout the community


Good lighting versus bad lighting. Source: FAU Astronomical Observatory.
Good lighting versus bad lighting. Source: FAU Astronomical Observatory



AARP's website has a section devoted to "AARP livable communities" and "age-friendly communities." It has a lot of depth to it, including free guides for individuals and community leaders. 






Monday, May 9, 2022

A Woman of Age for Reproductive Rights

 

Women's March in El Paso. January 2017. Credit: Mzuriana.
Women's March in El Paso. January 2017. Credit: Mzuriana.


I am unabashedly, unreservedly, enthusiastically pro-choice. 

Being pro-choice means I support a woman's right to choose how she responds to an unwanted pregnancy:

  • Not be pregnant → choose abortion
  • Not parent → choose to make an adoption plan
  • Parent

A woman does not need to justify, argue, defend or explain her decision to me. 


Why is this relevant to being a woman of age? 

Because people who vote skew older, it is incumbent upon voters who live in the Land of Age to protect the rights of women younger than we are. 

These recent assaults against abortion access are assaults on women's rights of self-determination, civil rights, and human rights. 

We need to protect the rights:

  • We once had, when we were of child-bearing age. 
  • Our daughters once had during their most vulnerable years of unwanted impregnation. 
  • Of our granddaughters. 


Declaration of Independence

The Declaration of Independence, which the Constitution incorporates, states that all humans have three intrinsic rights: Life, liberty, and the pursuit of happiness. 

About that right to life? That's my right to life. Your right to life. 

My right to life and your right to life subordinate that of a potential life in a uterus. The potential life in a uterus does not have more legitimacy than mine or yours. 


Adoption is not an alternative to abortion

Supreme Court Judge Amy Comey Barrent has allegedly stated that adoption is a viable alternative to abortion, therefore abortion is unnecessary. I get why she and many other folks think this way. 

But it is inaccurate reasoning. 

Adoption is an alternative to parenting

Abortion is an alternative to pregnancy

Furthermore, as someone who worked with a pro-choice private adoption agency, I can tell you that women who make adoption plans receive strong-arm pressure from family and friends to change their minds. This is what they hear:

  • "How can you give away your flesh and blood?!
  • "You will regret this!"
  • "How can you give away my grandchild?!
  • "Your child will hate you!"
  • "I'll help you raise your baby!" Note: Although said with the best of intentions, the help has a shelf life of about three months post-delivery. 

Adoptive parents tend to both vilify and feel grateful to the birth parents who chose them to parent their infants. 


There are pro-choice Republicans, but the Republican Party has been hijacked by fundamentalists

From this wikipedia entry on the now-defunct Republican Majority for Choice organization: "In 2017, Gallup released polling information showing that 36% of Republicans identified as "pro-choice" and 70% agreed that abortion should be legal in some (56%) or all (14%) circumstances."

Pro-choice Republicans have gone underground, forfeiting the field completely to a minority, fundamentalist core. Our current situation is the culmination of decades of the Three Bs messaging espoused by effective fundamentalist strategists: Babies, Bullets, and the Bible. 


Venerable organizations that advocate for women's reproductive rights

Remember them? 

  1. NARAL, founded circa 1970, by Bernard Nathanson, Betty Friedan (author of Fountain of Age), and Ernesta Drinker Ballard.
  2. NOW, founded in 1966 by Betty Friedan, Shirley Chisholm, Pauli Murray, and Muriel Fox.
  3. Planned Parenthood, with roots going back to 1916, by Margaret Sanger, Ethel Byrne, and Fania Mindel.
  4. Women's Political Caucus, founded in 1971, a multi-partisan organization with national, state, and local affiliations, by Bella Abzug, Shirley Chisholm, Betty Friedan, Fannie Lou Hamer, Mildred Jeffrey, Jill Ruckelshaus, and Gloria Steinem. Mission statement: NWPC is a national, pro-choice, multi-partisan, grassroots membership organization dedicated to identifying, recruiting, training and supporting women candidates for elected and appointed office.
  5. ACLU (American Civil Liberties Union)
  6. Religious Coalition for Reproductive Choice, with the motto: Pro Faith, Pro Family, Pro Choice


For those of us in the Land of Age: We dropped the ball. We became complacent. 

We allowed the proverbial camel's nose to get under the tent. And the tent is about to blow away if we don't catch it. 


Thursday, May 5, 2022

My Inspirations: Peace Corps Volunteers of Age

 

Adelita to the rescue. Juarez, Chihuahua, Mexico. Source: Museum of the Mexican Revolution. February 2017.
Adelita to the rescue. Juarez, Chihuahua, Mexico. Source: Museum of the Mexican Revolution. February 2017.

Youthful fancies

Since adolescence, one of my dreams has been to serve in the Peace Corps (or similar). When I was young, it combined all of my fairy-tale fantasies (not kidding):

To be a princess-heroine who travels the world incognito, overcomes tremendous challenges, saves tragic souls in dire circumstances, and who reaps acclaim for her bravery, good deeds, and wisdom. And a prince.

Indeed, in my youth, my fantastical mindset probably epitomized the cliché of a white savior, except for the white part, as my hubris was not focused on the unsolicited salvation of people with a particular complexion or geographic origin. I rescued my exclusively white suburban classmates numerous times from kidnap (a favorite theme) in my imagination. In that fantasy world, I also traveled back in time, where-when I drew upon my modern-day knowledge of stuff to save the day for imaginary damsels and swains in distress. 


Now being older

Eventually, I right-sized my fantasies of heroic derrings-do, but the dream of serving in the Peace Corps or something similar, remains. 


Role models for me to consider

  1. The first was President Jimmy Carter's mother, Lillian Carter, who joined the Peace Corps when she was 68. Learning this back in the 70s planted a seed: That the Peace Corps welcomes older volunteers.
  2. Peace Corps page for prospective volunteers over 50: Volunteering and Retirement
  3. In Blue Ridge Now: Joining the Peace Corps After 60
  4. A series on Not Exactly Retired: Older Peace Corps Volunteers
  5. From a 2016 NPR piece on an 87 year-old volunteer: Peace Corps Volunteer Values Staying Active in Old Age