My Old Friends

I have yet to meet an elderly person who has stated that they want to be lonely and poor. My job requires that I complete home visits to assess senior citizens' (age 60 plus) health, living conditions and needs. Most of us envision retirement as a time in life filled with family, travel and doing those things you've always wanted to do. Maybe it's just my line of work, but there are a lot (A LOT) of people who aren't "living the dream." My husband says, "Remember, you're seeing worst case scenario." Maybe. But, I live in a town where poverty really isn't in the forefront. We're a resort town...people come here to vacation. We're fine. Buy some t-shirts. Retire here. Raise your cute family here. We're good at that.

We have a little work to do when it comes to aging and poverty.

Most of my people (my elderly clients) fall in that awful gray area. They don't qualify for Medicaid, they can't perform what is known as "activities of daily living" (bathing, dressing, toileting) on their own and their money is disappearing for various reasons.  They want to live independently in their home. A few, however, would really like to live in assisted living, but they certainly couldn't afford it.

Truly, I wonder how many did not consider conserving finances in their youth. I have no idea. As a nurse, my job is not to judge my patients (that's not my job as a human), so I have to put that aside. I wonder how many have alienated family members. It's not that I can only see their loneliness, I can feel it.  Sometimes it comes out as endless tears and other times it comes out as a fist banging on the table while shouting,"I hate being so alone!" For others, it is evident through the cookies and tea they've set out prior to my arrival. The table is set for a complete stranger. All I have to go on is what they tell me, what they show me. I can't dig into the past and decide whether or not they are worthy of love or finances. My goal is solely to help them, but truthfully, I end up loving them, too.

I lost one of my favorites in August. This person was a giant in their younger years. They were an athlete and caught they eye of others based on charm and good looks. Their blue eyes twinkled as if they were the only thing left over from a youth. In those eyes I saw an energy enslaved by a deteriorating body that just was not worthy of that spirit inside. I met them early in the year and as the months progressed, so did their maladies. Soon their happiness and joking, became buried under anger and frustration that is all related to the ability to observe one's own physicl aging. I had to dig and dig to find the person that I met. They were still there, I just had to work more to unleash the humor and lightheartedness. This person told me, "Ivonne, I think I'm going to stop taking my medications. I can't live like this anymore. I've had friends with illnesses like the ones I have and once they were diagnosed, they didn't last long." My friend was right about this. The illnesses were terminal, though you won't necessarily hear a physician say that. Docs will medicate you because, naturally, that is our instinct: to live. At some point, however, we know that we can't win this one. No one comes out alive. Yes, I encouraged them for a moment to take their medications as prescribed and then I caught myself. I was not going to say anymore about it. It's their choice. It truly is. How can I tell my friend to prolong their pain and suffering after having lived a long, fulfilling 80-some-years on this planet? I can't because I loved them too much. So, I gave one sentence of "nurse-speak", "You SHOULD blah blah blah" and that was enough bullshit for the both of us. Whenever I left, I felt it was the last time I would see them. We never left without mutual "thank yous" and I was the grateful recipient of  weak, but heartfelt hugs and a kisses on the cheek. I drive by their home often (not because I'm a stalker), but because my daily life takes me by. The home has it's blinds drawn and life has continued it's usual hum, but their home doesn't have a heart. It's more like a dark cave now - no charm, no personality - just an empty space.

In a geriatric assessment, two things are very important: Maslow's hierarchy of needs and identifying if a person can perform their activities of daily living or ADLs. In Maslow's hierarchy, which you probably studied in school, the foundation of a person's motivation and ability to fulfill other needs is based upon their ability to fulfill basic needs. Basic needs are food, water, breathing (physiological needs to ensure life). From their, you move on to shelter, resources, employment. And just above that is when things fall apart for my patients: love and belonging. Interacting, socialization, intimacy, family, friendship...they don't have these. Some have absolutely none of these.  Then again, going back to ADLs (which include: bathing, toileting, self care), some can't perform these either and these functions fall into Maslow's basic needs category, the foundation. These people, generally, have to employ someone to come into their home to assist them with self care. It's not cheap. This service will generally cost you anywhere from $15 to $25 per hour and most services require a minimum number of hours to be met.  Hopefully, these seniors find a caregiver who truly loves their job and cares about those they help. Wiping bottoms, bathing, changing linens...sounds like motherhood: it's not glamorous, but the reward can be enormous. Imagine doing all this for someone unrelated to you.  It's a sad and beautiful interaction all at once. These basic needs can be addressed and believe it or not, it might be the easiest part of this puzzle.

The more difficult need, to me, to fulfill is that of belonging, socialization, friendship. To feel that you are loved and important doesn't happen easily. All of us have felt this need unfulfilled in our lives. As a senior citizen, it's very easy to remain isolated with minimal interaction with another human since many feel they are a burden. I have met people who haven't been anywhere except to their physician's office in years. I've met someone who has not been outside in a year. I met someone too embarrassed to go out because they can not put on nice clothes, only clothes pants with elastic and maybe a t-shirt. Another recently told me that if she did not talk aloud to the picture of her deceased husband, she would lose her mind (this is an intelligent, educated woman who is absolutely aware of national and world events and who has an opinion). How fortunate I am to have met each and every one of them. Each has a unique story that I'm afraid will vanish. But the thing is, they want to share their life, their stories - with people like you and me. We are utter strangers and they WANT us and maybe even NEED us.

So, what do we do, my little town? How do we change this? We do what hundreds of other communities are doing: we include them in our daily life. We build places where young and old can coexist safely. We plan residential areas where it's easier for us to keep an eye on each other. We transform existing structures into affordable, safe housing and gathering places. Even easier, you develop programs that connect young and old. We create an daily routine of checking on our elderly neighbors. You open your mind and your heart and you fill them both with the friendship from a source you may consider unlikely.

*If you live near me, I would encourage to research Williamsburg Faith in Action (http://wfia.org/). It's the best thing going. Volunteers fulfill the needs of our local senior citizens. This is not rocket brain surgery. No one is inventing something new here - kindness, generosity, community - existed long before you and I did. Faith in Action "simply" does all the organization and planning that you and I try to avoid.

http://www.greatbigstory.com/stories/a-retirement-home-for-young-and-old/?xrs=CNNAPP#
https://www.facebook.com/aimediaAUS/videos/10153953588224220/
http://www.nytimes.com/2016/09/06/health/lonliness-aging-health-effects.html?_r=0
http://blog.csa.us/2016/05/green-houses-alternative-to-nursing.html

Truthfully, we are all headed in the same direction as the people I mentioned. My wish for you and for me is that we find ourselves in a different situation. Maybe we should get to work..

Misadventures in Camping

I've camped all of my life. I have been feeling particularly grateful to my parents for introducing us to camping when my sisters and I were young. My parents, I don't believe, camped a lot when they were younger. My dad was a Boy Scout, so maybe he had some camping adventures. Mom grew up on a farm, so I'm assuming she like the outdoors and has adventure in her spirit. In any case, they came to the U.S. from Puerto Rico and before too long, we had a camping trailer.

Our trailer was  Prowler brand trailer. I remember plastic throughout and retro/Brady Bunch upholstery. It was an innovative piece of engineering. The beds magically appeared from nowhere. The beds that were up high were actually folded down from the wall. Two slides from the hinges, and voila, you had beds above your head. I felt like I had won every time I got to sleep up there. Each of those beds had a tiny window next to it. I could crank open my window and peek out into the night or discover the weather in the morning. I was always happy up there.

We loved camping at Solomon's Island where there was always a flock of kids on bikes headed to the pool, putt putt, bowling or roller skating. We stayed up late at night crabbing. At the time, the crabs were enormous. We'd take the crabs back to the site, cook them and eat them well into the night beneath a starry sky.  My family and I also traveled to West Virginia where I learned to love rock hopping in rivers. What great memories my parents created!

Then again, I don't remember dealing with the gray water or actually setting up the camper. Not my problem. As I got older, the perils of camping became a little more evident.

Let's revisit camping in Shenandoah with my two sisters. I have older sisters and like good sisters do, we decided to bond up in the mountains of our incredible state, Virginia. I drove my minty green Toyota Tercel to a trail where I met my sisters. They had driven there in my sister's (Jo-Joy) Isuzu Trooper (the big, old boxy kind). We were incredibly prepared and even donned matching, beige safari hats. During our three hour hike, we stopped at rivers to chat and watch the water pass us by and we "helloed" fellow outdoors-people (who probably thought our matching hats were awesome). Things were peachy until the three hour hike became four. We were out of water, we were out of food and we were lost and we were starting to get punchy. Nevertheless, we flipped the map over and rerouted and continued. One hour later we felt we were making progress. Jo-Joy, however, was not necessarily loving the situation. She's the type that gets...how do you say?? Hangry. Hangriness was pulsing through her veins. Syama and I tried to appeal to her senses, but she was too far gone. She had legitimate reasons. In the fifth hour she seemed to hallucinate and babble about granola and water and that was exactly when a sign appeared:

 

She started to run. Never mind that the lot was still miles away - she ran and ran hollering about food and water and stupid hikes and female bonding. She ran. It was an hour or so before we saw her in the parking lot. Jo-Joy was disheveled. Her face was dirty, she was sweaty and barely "hanging on" and laid out on the gravel lot.  When she came to her senses she confessed that she had tried to break into the cars in the lot to find food and drink in order to survive. She resorted to these measures because my other sister, Syama, had the key to her Trooper. Thankfully we survived and chowed on nuts and berries like every good trailblazer and squirrels do.

 

Bellies satisfied, we hopped into our cars and headed to our tent camping site. We each had brought  gear to get us through what was sure to be a starry date-night with nature. My trusty waterproof tent was up, we made some food, and settled in for the night. All three of us cozy in my tent. Just like when we were kids...laughing, telling stories. This closeness with my sisters was all I could ever want.

 

Eventually, we slept peacefully side by side - until the rain came. My "waterproof" tent was, apparently, water resistant. Jo-Joy scrambled to her Trooper. Plenty of dry space in there. Syama and I held firm - no way were we going to bail out on our camping adventure. The torrential downpour continued in the tent. Syama caved - another one lost to the Trooper. I could see them staring at me through the foggy window. Waving. Laughing. I peered out from my sleeping bag like a turtle in a shell. "Troopers are for sissies,"  I told myself. It was a stare down. In the movies, the equivalent would have been a shoot out in the middle of town, hands near holsters and a squinty eyed, piercing stare that was enough to kill your enemy. No. I had to resist. Whatever... I didn't and I jumped in the Trooper after kicking my stupid tent. Ah, the Trooper - it smelled like a dirty swamp and the air was damp, but it wasn't raining inside. Now, because I am the youngest, I always give in to my sisters' demands. There is no way around this. Submit! Or, you will be beaten into submission. I had to sleep on the wheel hubs. My head was propped up and my feet were propped up while the rest of me sagged between the firm lumps. Perfect. That night, sleep was intermittent at best.

 

The next day was the closing ceremony of our adventure. How sad to see it end! We gathered our drenched belongings and prepared for our reintroduction to civilization. Because Jo-Joy wanted to look nice for her return, she pulled out the blowdryer for her hair. The white flag had been waved.

 

Years later, my husband and I were fortunate enough to live in the Pacific NW where we often hiked and camped. The United States has and impressive landscape not to be missed! On one particular adventure with friends, we backpacked in to our campsite. The hike itself was incredible, but our camping spot was surreal, a clear green lake surrounded by mountains and pines. I've never seen anything like it and would escape there if my mind needed calm - but I can't, because I can not shake the trauma of it all.

Green Lake in Oregon. It is now known as Brown Lake.

 

Tents were pitched and lovely evening had by all. Once again, we settled in to sleep under a starry sky - until the rain came. Really? Again? This time, however, our tent was indeed waterproof. Michael and I had a very small tent, cozy for two. I call it, "the coffin". It's best that you really enjoy your companion if you are sleeping in this tent.

 

On this misadventure, we had our loyal dog, Gus. She was a brown, furry Lab/Chow mix. A sweet dog, a well trained dog (we didn't have kids then, so all of our attention went to her - the exact opposite of our current two mutts). Gus started to bark and cry during this intense storm. Lightning lit up the sky and claps of thunder left our ears buzzing. Soon enough, we had no choice but to begrudgingly "welcome' Gus into the tent. Needless to say, the coziness factor was lost, but it's all relative. At least we were dry and our little family was together. We managed a few blinks of sleep (as is the norm with most of our camping experiences).

 

The next day, we woke to a majestic sunrise over the mountains with clouds burning off at their peaks. The clear lake reflected the scene making it doubly alluring. But, all good things must end. And that indeed was the end as Gus ran away. She had a fierce longing in her eyes - like she must go into the wild and discover something that was out there. She did indeed.

 

If you are backpacking, you know to bring a small shovel. The small shovel is used to create your toilet. There is a standard depth you are "required" to dig to create your toilet. This was a slight oversight to a camper, but not to Gus. She found the non-toilet and rolled and rolled and rolled until she was completely satisfied and dizzied with excitement. She was the drunk girl in the bar. She trotted back gleefully - matted fur and the air around her was unmistakable. Green Lake would never be the same as my nauseated husband washed her fur with cautious intensity.

 

Did I mention that we were ticketed by a Park Ranger for camping too closely to another camper?

 

 20 years is STILL not enough time for Michael to label "that camping trip to Green Lake" as "fun". My recommendation is to never mention it to him.