Archive for the ‘Quality Of Life’ Category
Last Updated on Monday, 11 February 2013 12:50 Written by David Solie Wednesday, 5 September 2012 12:12
The best way to predict the future is to invent it.
It’s 2026. The future is here, 14 year later. We are taking a sneak peak into the lives of two baby boomer couples that are now well into their late seventies. Both couples live in Southern California. Both couples have worked hard and saved diligently for retirement. Despite the similarities of location and financial dedication, decisions each couple made in their mid- 50s have created very different futures they are now living 20 years later.
Couple number one, Linda and Ted, live in a retirement community north of Los Angeles that offers many levels of care. They have lived their lives using the “coping” approach, which meant adjusting to health problems as they arise but not venturing far from a lifestyle they chose 20 years ago. Linda and Ted stuck to what they knew and how they wanted to live their lives.
Ted has been in the assisted living unit for a couple years and would like to see Linda more frequently. Sometimes he gets depressed and cries. Ted has been overweight for over 30 years; 20 years ago he developed diabetes. Now he’s suffering from multiple complications of diabetes including advanced heart disease, poor circulation in his feet and lower legs, and poor vision. He is being transported to the hospital today for amputation of his left foot below the knee due to gangrene of three toes. Although the staff did their best to monitor his health, his lack of feeling in his feet due to his diabetes and limited ambulation due to his sedentary lifestyle allowed the gangrene to take hold of him. His vision problems caused by his poorly controlled diabetes resulted in him losing his drivers license many years ago. The demands of his poor health take almost 100% of his coping mode just to get through each day. Each day is a struggle for him depending on others for the most basic daily living activities. It takes almost 2 and half home care providers 7 days a week to assist him with his daily activities of living (ambulation, bathing, food preparation and eating, and visits to the doctor). His prognosis is poor and he is unlikely to survive another year.
In another part of the same retirement community, Linda and their kids are sorting through the couple’s belongings as they prepare for Linda to join Ted in the high level assisted living center. Linda had been a smoker all her life and after the development of emphysema stopped smoking 10 years ago. Unfortunately 80 pack years of smoking (40 years of smoking 2 packs a day) took its toll on her lungs. She has a constant hacking cough and audible wheezes with each respiration. Her face is covered in deep wrinkles especially surrounding her mouth accompanied by her raspy voice as she gasps for air in her tiny apartment. Her emphysema necessitates both a portable oxygen unit for day trips with her kids and a larger unit at her bedside. Between the emphysema and heart problems, she has to sleep with her oxygen on in a sitting up position or she experiences a worsening cough and heart palpitations. She curses those “damn cigarettes” daily. Her daily regimen includes taking seven medications and frequents visits to her cardiologist, pulmologist, and internist. She can no longer cook or take a bath unassisted. She is just too tired and out of breath all the time. Sally will follow Ted within 12 months of his death. Although good savers all their life, their health problems bankrupted both their quality of life and bank accounts.
Couple number two, Heather and Jack, live in the same house they have called home for over 40 years. They have lived their lives using the “upgraded” approach, which meant in their mid-50s they added good health as a goal for the rest of their lives. To reach that goal, they had to change their lifestyle, acquire a new set of habits.
Jack just celebrated his 79th birthday. Jack loves life. He is a deacon at their church, leads a men’s group on Wednesday mornings at the local coffee shop and walks three miles daily with his wife Heather. Heather and Jack cherish their 50 plus years together. Each morning as they walk, they catch up on their plans for the day, discuss the grandchildren and talk about various projects they are working on. Heather reminds Jack they need to decide if they are returning to the same small village in Mexico for their volunteer vacation next year. Heather has already talked to their granddaughter about house and pet sitting while out of the country. After their walk, Heather, who just turned 75 years old takes care of the dog, two cats and the household parrot. Later today, they are scheduled for visiting pet nursing home rounds at a retirement home with Winston the parrot and Carmella, their fat orange tabby cat. The staff and residents look forward to their biweekly visits. Jack and Heather bring a sparkly presence and a new story or two about the animal mischief in their household each visit.
Jack has a little arthritis in his back and hips but otherwise is in good health for an “old guy”. He continues his annual birthday health screening visits with his physician. Together the couple enjoys a high vegetable, fruit, and whole grain diet with small servings of animal protein. Both Jack and Heather maintain normal weights and blood pressures.
When Heather was age 60 during her annual health screening an early breast cancer tumor was found in her right breast without lymph node involvement. A lumpectomy and short round of chemotherapy put her into remission now in its 15th year. Heather’s biggest current health problem is her diminishing hearing. She just visited the audiologist as part of her annual check up and is excited about a new hearing aid that is almost invisible but will provide near normal hearing.
Does this example sound too extreme? Are we overstating the poor outcome of Linda and Ted? We wish that were the case. The fact is that these stories reflect what really happens in the journey from 50-something to 70-something. They portray the uncomfortable and painful truth about quality of life: you either define it or it defines you. That’s what happened to these two couples. Over 20 years ago they set off on very different paths as they invented their future in their mid-50s. Linda and Ted opted for the coping approach to embrace their senior years because they did not want to change the way they lived. Although they worked hard and planned for retirement, long term planning to preserve health and minimize disease was, in most cases, left to chance. Jack and Heather chose the upgraded approach as part of their planning for the second 50 years of life. It required change. It required dedication to a new direction in the utilization of health care, diet, physical activity and exercise, community activities, their spiritual life, and their attitude towards the stress of everyday life. These changes did not happen overnight. They were the end product of a series of “baby steps,” small but ultimately profound changes in key areas of their lives that paid huge dividends in the quality of their life today. Nor was it all smooth sailing. Despite a few detours along the way, it is clear they are experiencing a better quality of life than 20 years ago. And that is payoff, the key to even considering upgrading or reinventing our futures.
Both couples had satisfactory lives in their mid-50s. They had success and hope for the future. But their future was actually in the midst of a profound transition, one in which there would be little room for error, few if any second chances. It is hard to believe in our mid-50s that such an intense and unforgiving storm is just around the bend. But it is. Linda and Ted saw it one way. Heather and Jack saw it another. Both couples made choices and set out to live their choices. 20 years later those choices point out two crucial elements about quality of life beyond 50-something:
1. The individual has immense power to reinvent their future.
2. Modern medicine is has limited power to reinvent a poorly structured future.
Quality of life is not based on cosmetic surgery, new drugs or the latest medical procedures. The clinic cannot save us from bad choices or poor game plans. It all starts with us, but we need a plan. That is where many of us get stuck. When we look for a plan, the choices are overwhelming. Do I eat organic food and meditate? Should I sign up for a marathon? What are the good “carbs?” Should I take St. John’s Wort to handle stress? Did I need a body scan? Just finding a plan more proves more complicated than just doing what we have always done. Surely not all of the thing we have been told to do for our health, our quality of life, can be right? How do we know what is right? What’s the plan?
We have asked ourselves this question for many years, both for ourselves, for family member, for friends and for patients. What plan is simple, easy to work with, offers realistic baby steps and, most importantly, actually works? By works, we mean, a plan that has been around long enough to validate its effectiveness, meaning real people have used it with great success. For a long time we used a variety of approaches, a mix and match approach to our own health and the advice we gave others. And then by chance we discovered a plan by the most successful group of people to ever use them. We discovered the centenarians. The centenarians are people who have lived to 100 and beyond. Who better than those who have actually lived the journey with good health and great engagement to provide us with insights and strategies to obtain both quality of life and the potential for longevity? We were intrigued, but we wanted to know more. Here is what we found.
Currently in the US, we have 58,000 individuals who are at least 100 years old, a number that will increase to 1,000,000 by 2050. Some of the centenarians are fortunate enough to have longevity genes (usually evidenced by a family history among family members of long lives), but many have achieved long lives by a healthy lifestyle, even in the face of major medical problems. How did they do this?
The how is what this book is about. Not about the “how” to live to 100, but rather the “how” of their game plan that took them through the passage from their mid-50s through their 70s and 80s. This is the most likely passage for the majority of baby boomers. Some of us will get to 100, but most will get to between 70 and 90. This is our focus. How we can get to 70-something with the best quality of life.
Our research on the centenarians demonstrated that as a group they share common traits that impact the quality and length of their lives. Despite their diverse backgrounds and experiences, their lifestyles follow a common path, a common set of habits that offer a plan, a road map that is both profound and yet surprising simple in design. We call their common traits the “centenarian markers,” the unique building blocks that account for their impressive quality of life. Taken as a group the centenarian markers offer up a game plan that is both an assessment tool and a coaching tool. It can tell you what’s working and what can benefit from an upgrade. It offers the global view we need to see the big picture as well as the practical coaching tips we need to make changes. It addresses life, as we know it.
It is easy to forget with the avalanche of health messages we get from the popular media that we are more than blood pressure readings or cholesterol levels. Our lives are embedded into a complex landscape that has children, grandchildren, older parents, challenging jobs, marriages, and uneven health. Any road map that does not give us the tools to manage the whole process, life as we really live it, can’t help us. We don’t need a diet as much as we need a clear view of how the physical and psychological issues of our lives either work for us or against us. This is the value of what the centenarians have to teach us.
The goal is to upgrade the quality of our lives. Knowing the whole plan makes upgrading the parts so much easier. Why? Because we see how they are connected together in way that makes sense to us. Because we see how even a small step in one area yields huge results in the other areas. Because we see that one part of the plan does not replace or overshadow the other. Because we finally see that no doctor, no diet book, no fitness program can provide us with the invaluable perspective from the end of the journey, the advantage of looking back at what worked and why. This is the centenarian’s gift to us, the one they lived and now pass on to us to help us invent our future.
We wrote this book to provide you with a clear understanding why the centenarian markers are so crucial to quality of life and how they provide a clear road map that anyone can adopt at any age to upgrade the quality of their life. Knowing the centenarian markers is one thing; putting them into practice is another. The value of the book lies in its common sense approach to incorporating, most of the time in baby steps, this wisdom into our lives. It is not the big decisions that influence our lives so much as it is the small, determined decisions that yield profound influence over what we become. We are big on baby steps.
So as millions of baby boomers navigate 50-something, they are traveling through a critical period of time that will determine their future, the last major 20-year segment they have to invent a different outcome to their health story. For a larger portion of baby boomer population, this is a wake up call, like it or not. Which brings us to another important aspect of this book. It offers a plan that allows anyone to upgrade the quality of their life, on their own time schedule, in the order that suits them best, and in the manner that reflects who they are. Like we said, we are big on baby steps. Just choosing one new habit, one new goal from the nine markers we outline in the book can have a dramatic impact on the individual and those around him or her. This is what happen to Alan.
Alan heard us give a presentation on the centenarian markers. He can up afterwards to discuss a number of issues. Alan was looking for an upgrade in many areas of his life. Where to begin? What is the one step you can take in the next 90 days we asked him? Maybe a health check up he suggested. He was 55 and was long overdue for a physical. He decided to take that baby step and get a check up, colonoscopy and all. To his relief, everything was normal. He was relived and inspired. He opted for another small step. He began to test ways to get better connected in his community. Baby steps, piece by piece, building an upgraded future, on his own terms, piggy backing off of one goal after another, using the centenarian road map for keeping on course, remembering how the whole game was meant to be played.
While this book incorporates the wisdom of those who have lived to a 100 and beyond, it is not about longevity. Life is not a contest to see who last the longest. This book is about quality, about a balanced life that is more meaningful and satisfying. We won’t promise you that following the wisdom of centenarian markers will get you to 100, but wouldn’t it be wonderful as you approach 80 years of age and older to be like Jack and Heather? That is the purpose of this book, to provide you with a set of tools and strategies to minimize the development of future disease and to preserve good health, to upgrade your life to the highest quality you can have, for yourself and for those who are connected to you.
David and Janet Solie
Tags: aging, aging parents, Boomers, Booming On, caregiver, centenarians, Communication, David Solie, David Solie's blog, depression, diet, disability, exercise, Health Coach Advantage, healthy aging, How To Say It To Seniors, Janet Solie, middle age | Posted under Boomers, Health, Quality Of Life | No Comments
Last Updated on Monday, 11 February 2013 02:07 Written by David Solie Monday, 1 June 2009 05:38
My wife Janet shared with me a very moving article about end of life conversations from a doctor’s perspective entitled: Talking Frankly at the End of Life. Here is the link.
One of the most important aspects of the article is the issue of telling the patient the truth about their medical condition. “Am I doing more harm than good?” the author asks from her physician point of view. She cites a recent study in JAMA that asked 300 terminal patients “if their doctors had ever discussed care at the end of life.” As important, after the patients died, the researchers looked at the type of care the patients received prior to death and then interviewed the caregivers six months after the death to see how they were adjusting.
The results indicated that the patients who discussed care at the end of life were more likely to have a better quality of life at the end of their lives. They were not more depressed. They had less aggressive medical interventions. They went to hospice earlier. As important, their caregivers fared better.
What we want to know at the end our life is a personal choice. We all want some version of the truth but in different degrees and different doses. The key is being offered, more than once, the opportunity to hear it from the person who holds so much sway over our lives: the doctor. It is a natural part of our leaving, the slow dance we all take to step away from this life, preserving our dignity and saying our final goodbyes. Ironically, to do this we may need to remind the doctors who take care of our aging parents as well as ourselves, it’s okay to talk about the end, more than once…
Last Updated on Monday, 11 February 2013 03:42 Written by David Solie Thursday, 6 December 2007 11:31
The journey between middle age and old age is a complex zone of developmental currents that are demanding and confusing yet unavoidable. Knowing the mission of where you are coming from and where you are going is essential but not enough. Even with this knowledge, all of us are going to get off course time and again trying to get to old age in good shape. We need something else. Part of that something else is “navigational thinking.”
Navigational thinking involves using questions that have the unique ability to get sixty-something adults back on track and keeping them there. The questions are simple and yet profound, and can be used in any situation to initiate and sustain a course correction. Their effectiveness lies in their uncanny ability to redirect the emotional intensity of transition currents into useful thinking. It is a similar process that pilots use during an in-flight emergency. They resist the natural response to panic by focusing their attention on a set of predetermined questions that lead them to useful thinking about the best course of action to save not only their lives, but also the lives of the passengers who are counting on them.
Navigational thinking helps redirect our natural tendency towards “problem fixation” through questions that help us focus on new insights, choices, and possibilities. The questions have no right or wrong answers; they are not a test. They simply offer a starting point for a new internal conversation about an experience, circumstance, feeling, or problem. Like all cognitive strategies, they are more effective when written down, annotated, reconsidered days later, and possibly shared. Here is an example of a navigational thinking question and how it is useful:
What is the big picture?
Between middle age and old age it is easy to lose sight of the big picture. There are just too many disorientating events pouring down on our lives. Once things take a turn for the worse, the big picture narrows or quickly vanishes. The “big picture” question offers sixty-something adults a way to hit the cognitive “reset” button and recover a more useful perspective.
The big picture of the “in-between” zone reminds us that it is a demanding, complicated, confusing, and stressful passage. The normal response is to feel disoriented and get easily knocked off course. But this is only half of the story. The big picture also reassures us that we will recover and get back on track. This is not wishful thinking. We have personally witnessed numerous cycles of setbacks and recoveries in our lives up to now. Some of them we deeply believed we would never get over. But we did. The big picture reaffirms that our “in-between” passage is just another version of this familiar though not always pleasant process of change. Given time, we will adjust to these unfamiliar currents and become surprisingly adept at navigating the uncertainty and ambiguity of being “in-between.”
Big Picture Take Home
Do not overestimate your capabilities to handle the transition currents. For most of us, they are impossible to navigate alone. False heroics only lead to bad outcomes. Partner up at every opportunity to increase your “collective capacity” to find successful course corrections as well as the invaluable comfort of family and friends.
Identify unreasonable expectations for what they are: unreasonable. The transition currents pile on wave after wave of complex demands. This is a terrible time to insist on perfection. Life is messy; allow yourself to have messy, totally human moments.
Accept the transition currents as “time in the wilderness” where there are no immediate answers or directions. Remember that life’s breakthroughs are always preceded by turbulence and doubt. You have done this before and you know that over time resources and solutions will emerge.
In my next blog I will look at other “navigational thinking” questions that are especially useful for being “in-between.”
David Solie Updates
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