Elders 2

By Dr. Paul Campanis

This is "Elders 2," my second cable presentation on senior issues. The view is my own and I present it in a chatty fashion that attempts to inform slowly and without a lot of fancy terminology. Unfortunately a lot comes at a person who is trying to learn about Medicare, prescription drugs and the many changes that surround us today. First I will take you through a set of telephonic problems I face as a customer of health services. If you detect frustration in my voice, I hope you will understand. Then I summarize some of the issues covered in the document, "Massachusetts Bulletin for People with Medicare." It is available for your reading at the local Councils on Aging. Finally I will lay out some general findings concerning elders like you and me who are trying to keep up with the times.

1) Talking on the phone
Being old these days is terribly complicated. I wish for universal health care which would eliminate the horrors that keep me awake at night. I have my own serious problems getting adequate health care for myself and my extended family. Plainly it is a great big mess.
Bein' old is tough enough without phone menus that run five minutes. Then a voice comes on the line, maybe, to ask a bunch of questions that will determine whom you claim to be. They don't ask your waist size thank goodness, or your preference in beer, wine or other dangerous substances. They want to know several numbers that identify you. Woe and fie on you should a scrap of paper with a vital numerical sign fall on the floor and you can't find it! You have to have a personal identification number, your group plan number, the claim number of the matter you are investigating, a social security number, the pin number only you know, and maybe some more numbers, like your date of birth that those of us in the know call the dob.
Even that is tough because if you are born on September 3, 1937 as I was, you have to punch the numbers into the phone pad in a particular way. 09 03 1937 may be the way they require it.
There is always the possibility you will lose the connection and have to start over again. It may be not be possible to get a voice right away by punching in zero in the midst of all this, or it may work. Such uncertainty!
One experiences a numerical interrogation until the blessed voice comes on the line at the other end, a voice with no face, and it kindly asks, "how may I help you?"
At this point you may no longer recall how she can help you, with all the energy you have expended to get to her or him in the first place. I think, "Maybe you can't help me at all." I am exhausted by now, so I am not thinking so clearly to remember what I called about.
To me the phone is an instrument of torture. I hate phones and have spent years looking for and finding jobs where a phone was not part of the deal. I stayed clear of these monsters. Now I am totally dependent on them to make a path through the confusion that is the health care system. Sometimes I think you destroy your health in the process of trying to get health care for yourself and others.
Or you may find you are cut off completely. A buzz on the line. Don't know what happened. The other eventuality, the expected one, is you get a canned voice that tells you to wait for "the next available representative or associate." I have waited as long as a half hour to get a little voice , a living voice, from over there on the other side. What usually happens is you are on hold and every minute or so, a recorded voice tells you all the representatives are still busy. Then you listen to some music until the canned voice comes on again to reassure you it knows you are there, but the people in the office can't help you yet.
The representatives may be in India or Bangladesh or Dallas even. They may be on a break and you will have to wait. Or they are in Oshkosh and had to use the bathroom. Who knows? It is always a good idea to have a magazine and maybe some fortifying food and drink when you sit down to make a telephone call of this sort. These people you call hold life and death in their hands and they are so hard to access. What a world this is!
A number of old persons, especially the quite old, cannot handle what I am describing here. If they have no-one to call for them, they are just plain stuck. They don't get the proper service they want, need, desire. Sadly they may go without, completely. Another case of the bottom line. The insurer saves a few more dollars to pass onto the bloated ceo's, corporate executive officers, the stockholders and Wall Street, while Tom and Mary on Main Street go without. One ceo last year made 26 million dollars and at the same time cancelled his company's access to drugs Americans were buying in Canada.
Thinking about this medical system ,the medical care system as it is called, can make you mad or even crazy. We subject the most vulnerable to a maze which a young, able-bodied, educated human would have trouble dealing with. It's almost criminal, isn't it? And you know I am exaggerating only a little. So I lie awake at night to worry about medical predicaments I have difficulty solving.
Often the voice tells me it will email the information I need, only it doesn't. When I complain, a new voice has a set response, I swear she reads from a card.. that the company has no way of knowing if I received a message and that they are awfully sorry for the inconvenience. So really, why bother even mentioning it?
Another event that occurred recently is that the voice quotes a policy manual in a case I am involved in. Only it is a change in the policy, different from the policy in the manual I have. The new policy supersedes the one you are going by, but you didn't know this because no-one told you. Or the web site has a policy that contradicts the printed one in your hand and when you try to get the benefit that the web site policy promises, the voice tells you that that policy is inaccurate and the right one is the one in the hardcopy policy in your hand.
An important insurance issue, involving thousands of dollars, may be just impossible to clarify. It may take many calls and involve erroneous information by the provider before you get a letter promising this or that. And then the next month out of the blue, you may receive a new letter negating much of the previous letter's promises of service. None of this is fictitious. It happens.
Then the hr department, the human relations department, tells you to call the company to whom they have outsourced the bulk of their day-to-day maintenance of health policy. To get an answer to a question you call and find quickly that the phones are manned by persons who may be well-meaning, but just don't know much or give you wrong answers. If you make two calls, the two representatives give you different answers. So what do you do now?
What is human about a human relations function that cannot help you accurately and in a timely fashion with a modicum of human concern? Instead they apologize a lot for an error or for keeping you on hold for five minutes, while they look up an answer to satisfy you and get you off the line.
I have never been apologized to so many times since I started calling insurance companies and hr departments. Only you can't take apologies to the bank or to the mail order pharmacy to get prescriptions filled.
Worst of all you can never get the same person twice, so you have to start over again with each one when you call a second time for clarification or a new question. If the issue is complicated as many issues are, this is hard to go through time and time again. Some persons on the other side of the phone line are competent, others ill -informed. It may take days to get a straight answer you think may be reliable. It is a kind of phone roulette. You just wish you could find someone you know is skilled whom you can return to, if you forgot to ask something, or need clarification.
My findings are a composite of the many attempts I have made for myself, or for other old persons, to help them get help on often pressing issues.
The system needs to change, mostly because it hurts people who cannot maneuver around these problems of communication. Accurate information becomes victim to the complications I have mentioned here.
When I took my granddaughter to gymnastics this past Saturday I read this litany to Brenda, one of the mom's whose child was in a class. She said," look, they ask you first whether you do English or Spanish before you face the awful menu. Why don't companies say, " do you want to speak to a living voice or do you wish the menu?" That would get you to a person right away and would make me a lot happier. Maybe this is a possibility. I will mention it to one of my state legislators who is sympathetic to us old ones.
Often one is referred to a web site on the internet to sign up for the next year's offering in the health plan. Or it is necessary to check on line whether a drug is generic or on a preferred or non preferred list. The non-preferred may be a good deal more expensive than the preferred brand name drug or the generic. The formulary, the list of drugs on the internet, is often complicated to follow and understand. If the old person has no computer, that is a problem. If the individual has one but can't use it well, he or she may not get the information that is needed. I have often found older persons are not skilled in using the computer.
What bothers me far more than anything else though, is that these old people get themselves so upset. It rains on an otherwise tolerable or rather good day. They get so upset; they worry; they may cry. They do, you know, because they are alone and have few resources to call on. All I can say is, be thankful for our Councils on Aging, the folks at the other end of the Medicare line, the SHINE and other support networks without which we would be in serious trouble. SHINE is the federal and state volunteer program that helps people answer medicare and other health questions. It is just traumatic for older people or anyone else for that matter, to have to live like this.
It bothers me so. I don't get mad. I don't try to get even. I just want service for myself and others who have been productive in this society over the years in often difficult and trying jobs. They retire and get treated like this. It is hard for them to get basic services they are entitled to and need.
It is not just a matter of getting a prescription filled or checking out a bill one gets in the mail. It may not be a life and death thing, but it often is an issue of a person getting better health service or worse health service. It is the worse health service that bothers me. The prescription is not filled, or a bill is paid by a senior that shouldn't have been paid. The person scrimps elsewhere in the food or heating part of his or her budget.
It may happen that elders don't schedule a doctor visit because an anonymous voice has given them a copayment figure that is too high and erroneous. The voice just got it wrong for a change and the person may not have the funds for the wrongly stated high copay cost. Such mistakes are common.
I have seen these problems. They are not fictitious. On a positive note I have also seen good information move through our support staff to a client who visits a local Council on Aging. But I also know a number of folks never make it there for help. They may be too sick or discouraged or upset. They may be unable to fathom the tragedy in which they are the central character. They may just be used to being alone and never asking for support and help from strangers.
So, many do not get service. They are the ones who are victim to the troublesome maze called our health system.
Sorry to lay this on you but you gotta know. And to those in their fifties, it will sadly happen to you soon. Many such wonderful citizens in their fifties are caring for their parents, aunts, uncles, and others in a tender fashion, so they too know what I am talking about here.
Please reach your state representative, and state senator. Connect to federal officials as well, congresspersons and senators. I have found them receptive and concerned with senior issues. We old ones vote. Vote and consider my words. Also I hope you will care about how I feel.
I don't know much about national health services and what is called socialized medicine, but I do know anything short or no coverage is better than this. And we are the lucky ones with coverage. What about the forty two million persons who don't have any medical coverage, in the US? The system is really flawed and seniors, elders, pay a high cost.
2) Policy
I am speaking here for myself and not as a SHINE volunteer. SHINE is "serving the health information needs of elders." It is a most valuable federal and state program which assists elders in the US. I represent Dover and Sherborn, meeting some terrific elders in my daily rounds of life. I advise them on Medicare and Medicaid which latter in dear old Massachusetts is called Mass Health.
Change is a constant today. I will refer to some developments here and perhaps make things in this health maelstrom a bit clearer. National political figures also refer to major health issues and it behooves seniors to keep up to date on the debates. C-span is a good source of news on the cable as is the state's Department of Elder Affairs, and AARP, the American Association for Retired Persons.
Remember a large cohort of close to eighty million persons is about to enter the ranks of those of us over 60. They will have a lot of health needs and issues to learn about and then address. The stressful lifestyle we live, the sheer busyness, the unemployment, the high cost of everything, the vulnerability that plagues the nuclear family, alcohol abuse,.. all these facts add to the illness that would normally come with age and these so-called baby boomers may not be a terribly healthy age cohort when they join us. Their needs will be great. The system creaks some and they too will pay the price. They too will have to become the intrepid navigators some of us already are.
In Dover almost a third of the fifty-nine hundred persons living here today are over fifty years of age. The population figure includes children and young adults, so if you think of heads of house, it is clear that the town has many older citizens who shoulder sizeable financial responsibility.
I attended a Halloween Social in Sherborn recently and was reminded that a growing number of elders are over 75. As one who is 66 years old, I am in the middle, between the many about to reach 60 and those over 75. I am trying to render service to the newcomers as well as to the old, old.
Medicare is not hard to get a grip on. People on Medicare receive a publication from the federal government yearly. It is called " Medicare and You. 2004." It makes a promise on the cover that "Medicare is here for you 24 hours a day, everyday." If you believe these words as I do, it is not daunting to call and have a good phone experience. The people who work for Medicare are indeed there on the phone and are most often very helpful indeed.
The number is 1-800-MEDICARE. A web site is also listed. The times I have called I have found the voice well-informed and polite, always. I have experienced the horrors of long menus followed by voices of insurance representatives who did not know much of what they had been hired to help people with. Medicare was not that way. The representatives I spoke to were kind and knowledgeable, which all was a surprise to me.
For younger people who do not get the federal Medicare book sent to them, locate one in your library or at the Council on Aging. It is quite useful and well written.
The best book I have read on Medicare is at the Dover Library and at other locations in the Minuteman system. It is called "Medicare for the Clueless," by Conklin, call number, 332.024. I was clueless when I first read it. I was at the large Newton library, trying to figure out what Medigap meant. Medigap is supplemental insurance that buttresses traditional Medicare A and B. I was totally confused, looking through their large selection of materials. I sort of gave up in despair. When I get that way I change departments at the library and leave the boring medical care stuff and feast on books that have to do with art. So I headed over to the 750.9 section on the second floor of the library and got lost amid the huge trove of art books with lots of pictures. I became quickly refreshed and went back to the Medicare books and found the Conklin volume. It helped me understand Medigap some and then I made an appointment with SHINE in Needham. It was explained to me in a way I could understand. Medigap is good to have if one can afford the monthly payments.
Medicare A and B cover hospital and doctor bills respectively. There are places in the system where the citizen has sizeable liability in copayments and deductibles. The Medigap fills in here.
Part A has no monthly premium. A person signs up at the Social Security office when he or she reaches the blessed age of 65. Part B has a monthly premium that next year will be 66.60 per subscriber. This figure comes out of one's Social Security payments automatically. Of course one has to notify Social Security that one wants Part B and then find out when enrollment is possible.
The enrollment procedure is straightforward but one still must notify them when the time comes. Calling Social Security may be a problem if you wish to reach a particular office, so I recommend a person show up in Norwood, for instance, and take a ticket. One waits a while among a bunch of persons and then one can speak at the window to a clerk. In Norwood I found government representatives knowledgeable and willing to take the time to help.
Your local Council on Aging has a document for you to fall back on. It is called "Massachusetts Bulletin for People with Medicare." I have added a few other sheets to it and it allows one to get a good handle on the whole matter. The bulletin has many phone numbers that will connect with all the relevant agencies that assist in Medicare access. The material I summarize here is found in the bulletin that is available at the Council on Aging offices in Dover and Sherborn.
Medigap Is costly but that's the way it is. In Massachusetts we have only two providers, both private companies, and only a few options, so the matter is quite simple. The coverage is most worthwhile.
One plan is by United Health. Membership in AARP is required. The other is a Blue Cross plan called Medex. Both are comparable in price. United Health's plan mirrors the Blue Cross product. The Medex product offers three standard options I will summarize briefly. There is now available a fourth coverage called Core Plus. I will deal separately with that one which is offered as a rider. It is brand new and addresses part of the need for prescription drug coverage.
The three main Medigap options are Core, Supplement one, called Medex Bronze and Supplement two, Medex Gold. These Medigap plans I will discuss briefly now. Remember Medicare A covers mostly hospital expense, Medicare B the doctor's bills and Medigap fills in to cover expensive deductibles and the inevitable copayments that Medicare does not cover.
Core Medigap coverage is basic protection and will cost 84.34$ a month per subscriber as of March 15,2004. It is 72.76$ now. It pays for some expensive hospital copayments and pays the twenty percent for doctors' bills that Medicare does not pay for.
Most people I know use Supplement one, or Medex Bronze. Enrollment in Bronze in the last year was almost 115,000 people in the Commonwealth, in Gold, 36.000 and Core, 3700 or so. Medex Bronze has no prescription drug component and until now people have often combined it with the state drug plan called Prescription Advantage. Unfortunately we don't now know if the latter plan will be available in January. Still Bronze is popular because of what you get for the price. It costs 124.42 a month per person and covers important items Core does not. In March of next year Medex Bronze will cost 139.01$ a month per person.
Medex Bronze covers the following. The 876 dollar deductible for hospital stays under Part A is covered. The Skilled Nursing Facility costs, days 21 to 100, which are 109.50 a day and not covered by Part A are also covered. The 100 dollar Part B annual deductible and a few other things are covered too. I do think Sup 1 or Bronze is good if you can afford it .
Core Plus is going to be 157.24$ a month as of the first of the year, offering some modest prescription drug coverage. Roughly comparable in price with Medex Bronze, it is a kind of tradeoff. Core Plus offers some drug help and Bronze covers largish deductibles and copays that Core Plus does not. Bronze has no drug benefit.
Those many who take Medex Bronze in Massachusetts need to consider other ways to cover drugs if Prescription Advantage does not open to new members in January. CVS has a monthly plan now which is worth looking into. Drug companies offer discounts. Many are income based. Some are not. There is Canada still and other ways as well to influence how much you spend for prescription drugs. The most obvious is, of course, the use of generic prescription drugs whenever possible.
There is good reason to explore these matters at the library or on the internet. The Councils on Aging can help as well as SHINE and your medical professionals. The information is not that hard to understand. It is a matter of learning a new vocabulary of sorts and meeting up with people who can help you.
Mass Medline, the state phone help system can help a lot. These people advise free, on drug choice for all the citizens in the Commonwealth. Call them and go over your medications. They will advise on possible alternatives and choices you can then talk over with your doctor or nurse. Prescription Advantage still has openings for people in mitigating circumstances, and is still in force for those now in the plan. As I said earlier, accessing the Medicare system by phone or internet is helpful as well. Information is all around us. Further, SHINE offers lectures on hot topics of interest that you can find out about at your local councils on aging.
Another fine source of news having to do with Medicare is the tv. C-span, CNN and other stations keep us up to date on the national medical scene, as it plays out in Washington and in our states and cities.
So read up on Medicare and Medigap coverage. Give serious consideration to Medex Bronze. It is so popular in Massachusetts for good reason. The fact that it does not cover prescription drugs can be dealt with by getting information and counsel from all the fine sources at one's disposal.
The third plan in Massachusetts offered by Blue Cross is called Medex Gold and will be 476.01$ a month per subscriber next year. This year it is 417.56$ It is a good choice for those with very high drug expenses. It pays for an unlimited amount of outpatient prescription drugs ,with nominal copayments, after a 35 dollar deductible per quarter.
The new plan, Core Plus which starts next year, will be 157.24$ a month per person. With Prescription Advantage, the state plan, in considerable difficulty, Core Plus is certainly a welcome addition. There is no deductible. Retail purchases of drugs are covered at 50% and the insurer, Blue Cross, pays 70% of the cost of mail-order drugs. There is a 150 dollar cap per quarter on brand name drugs. That is, you can only spend 150 dollars every three months for brand name drugs but the good news is that there is no limit on the amount of generics you buy. That is very good indeed and a further reason to explore the use of generic drugs with Mass Medline, the state drug phone service and with your doctor. Core Plus may thus fill a sorely needed gap if Prescription Advantage does not open for new members next year.
Two large Councils on Aging are found in our area. One is the Callahan Senior Center in Framingham, next to the main library there. There is sheltered parking next to both buildings and spaces are always available. It is a large, though antiquated facility with many programs and activities for seniors . It is ably managed by Mary Parcher. The SHINE program there is run by Assistant Director of SHINE, Dorene Nemeth. The address is 154 Pearl Street.
The other is the Needham Council on Aging located next to the ball field and playground in back of Walgreen's in Needham Center. Its director is Sharon Lally. .Ken Levy, regional director of SHINE is there as well. The address is 83 Pickering Street.
Another center in our area in Wellesley is active and useful. There I use the services of Cecilie Godderidge. In Dover Karen Tegelaar is our director and is available the first three days of the week with Sue Sheridan working Thursday and Friday. Sherborn is led by Shawn Hilton. Both of our local centers produce newsletters that list events and programs in the area.
Chief Sheridan is the outreach person in Dover. Carol Kelley in Sherborn. Both have many years of experience . They are very helpful to our seniors.
In Massachusetts we are lucky to have Mass Medline, a phone advisory service that specializes in information about medical drug use. The staff are pharmacists and other medical professionals. I have heard them speak at meetings and lectures, finding them helpful and informed. There is no axe to grind with them. They have one's best interest in mind at all times. In a time of sham and cheats it is good to have a safe harbor when inquiring about prescription and other medications. Mass Medline is a fine and free service. It is easy to reach a human voice and the people there are polite and kind. Brochures are available at local councils on aging.
Companies used to offer hard copy formularies one could carry to the doctor's office when discussing alternative drug use. Now this appears not to be the case. They refer you to the internet and the formulary may be confusing to follow and too long to copy . At least that has been my experience. I am finding it harder now to locate generic equivalents to the drugs I use.
A formulary is a list of generic, preferred brand name, and non preferred brand name drugs offered by a drug purveyor, such as a mail order company. The insurance company you use may offer a three tier plan, with generics the cheapest, next brand names the company offers at a reasonable price, and then nonpreferred brand names that they charge a lot more for. The difference in my plan between a preferred drug and a non preferred drug is 30 dollars for a ninety day supply. Why one drug is preferred and another nonpreferred may be a mystery, one could never solve. Except it is safe to say that drugs slip back and forth from one category to the other on a regular basis. It is important to check, though, as nonpreferred drugs may cost a lot more than generic or preferred plan drugs.
I really need a printed formulary I can study at my leisure and take to my doctor when I go for a visit. I get the feeling that it is not readily available anymore from mail order houses and other sources. I am now using a library book available in Dover, at least. It is a huge tome one can borrow at will called, "Complete Guide to Prescription and Nonprescription Drugs," a 2003 edition, .by H. Winter Griffith. I found it easy to use once I figured out how it was set up. It took a while but I managed to locate all the drugs being used by me and other family members. So far I have been able to use generics , except for the arthritis drug I use, Vioxx, which is somewhat new and not available in generic form.
Generics save a lot of money and with a doctor's blessing can really help in these hard times. Mass Medline is always a good resource for information.. The mail order company phone line I use is also helpful to me, the people always kind and informed. If one requests, a pharmacist is available and the times I have spoken to them, I found what I needed to know. In my case the doctors at the Beth Israel Deaconess in Boston have been supportive in my attempts to save money by substituting generic drugs for brand names. By using the community resources available to you, some cost and worry can be avoided. The people and information needed to make informed choices are available.
The larger problem is that today is very different from what tomorrow will look like. Almost daily, changes are coming along that alter the medical landscape.
The costs just keep going up and one can not be blamed for hiding one's head under a blanket. The situation is difficult at best, but with a bit of luck and some kindness from others in the local and national medical delivery system, we can make it through another quarter, another year.
3) We Old Ones
Successful older people I know are tied into networks that support their interests and activities. There are simply marvelous and vital people who serve others in varied ways. It is a pleasure to work amid them and add my little bit to the mix.
Illness related to age is a constant for many of us. Pain may be a companion to every day. We still get out to rake leaves, walk or shop. Discomfort is simply something one has to get used to. There is only the alternative of taking pills to block out the pain or putting up with it with no medication.
Active communities have a lot going on. A regular reach-out function operates for elders. Care is available and easily at hand.
Old people have some advantages. The knowledge that comes of time and living. A kind of weary wisdom that is pretty good a lot of the time. This often allows them to survive comfortably and with grace. The world is ever hard but seniors have a way of carving out a spot in this harsh old world.
One negative characteristic I have seen in elderly persons concerns me a great deal. The state of self-absorption is a terrible way to be. Some folks are into themselves totally.
They leave active contact with the outside world more or less, often more. The individual cares only about his or her needs and problems to the exclusion of others. It may not seem a bad way to be, but let me explain that when a human is thinking only of the self, then concern and care for others does not occur. The person becomes isolated, lives alone, very alone.
The exemplary elders I see are selfless. They don't make a big deal of it. One person in my acquaintance offers a sewing class. She and her mates have a fine time and she quietly makes sure they have what they need, encourages and praises them and their handiwork. It is done quietly and unobtrusively. She is just there, positive and kind. I find it so interesting to watch her work. She is a silent servant in the process of offering an activity her students look forward to and enjoy greatly.
It may be half-baked psychology on my part, but this is how I feel. One's psyche has to be guided forward out of the lazy self that is part of the customary personality many of us have in us. We are all a little neurotic, crazy, foolish, lazy and all. These are the parameters amid which we live . To beat the system, one has to do an end around one's personality and psyche, to put one's good self to work. There may be our bad self and the good one. The trick is to emphasize the latter. When one reaches a hand out to anyone, to a person, a plant, a tree, an animal, that is a true positive. It gets one out of the shell of the self and allows for good things to happen.
Despair, drugs, depression, that awful depression, alcohol, mindless tv, compulsive behavior, constant noise from a radio, all allow a person to withdraw. The healthy elder is not that way. She or he will dress up, engage, and get involved, go out and meet the world. Get into a course, a political activity of a local or a national sort, a sewing class, a lecture, a lunch at the senior center, a coffee hour, a trip to the bank, a visit to a sick friend, a jaunt to the local school for a visit. Something. Anything that can get one to meet the world, to interact in a creative and meaningful way. There is so much that is fun to do and often elders, especially those who feel poorly , avoid this civic immersion to their own detriment.
Obviously volunteer work is useful if one has the energy and the drive. Seniors get so much from such work and give back so much to the community. They have deep experience to offer.
Many elders get out of touch. It is not a good thing to do if one wants to understand what is going on, but we who are old have only so much energy . Pain and illness take their measure on mind and body.
Some people keep up with change, with new films and tv shows, with the latest appliances at Best Buy. Unfortunately I cannot manage to do so but I have others like my wife, son and daughter who do so . I fall back on them for understanding and help when change overwhelms me. This condition is common with me. It makes me dizzy.
I do read constantly. It is my crutch, my joy to read the nonfiction I borrow at the Dover Library and other libraries in the Minuteman network and in Sherborn. I do not know much about mobile phones and atm's but my reading on social changes registers in me and I pass along to family and friends what I am learning about the world, here and abroad. Latest findings in childrearing I pass to my kids as they raise my grandchildren. What I learn about senior health I use in my volunteer work. Politics in our country are a constant responsibility to keep up on. The war, the economy, the trade issues , the relationship of the US to Europe and the far east. I read history books, works on photography and art which I love.
All these books and the joy of having the access to them! Magazines that I borrow for a week in Dover educate me so. I just know things from what I read and engage those I meet all the time to hear what they know and think. It makes me attuned and engaged. It works for me.
A number of older people read novels. They devour them, I should say. That is also a good way to stay alert and active. Library-centered book clubs are also a good way to connect people to one another and to relevant and vital reading.
I have met remarkable older people. The best of them are not into complaining much. They go about their daily lives, nicely set out to master their world. They look after kin and neighbor a lot. I am amazed at how much elders help one another.
Going with a person to the doctor or the hospital. The woman next to me at the eye doctor's wore a patch, had a cataract taken out. Miss Hill's companion was an old woman who accompanied her and drove her to the appointment. Her role was to help. They spoke to me. Old people talk to one another a lot. I just say hi and ask for peoples' news and get it that way. The woman left with no patch. Arm in arm, they left the hospital to go home to Medford, a local suburb. You see that often. Older people help each other. Of course the young ones with kids do too, swapping off services all the time. It is just a smart way to be. Get help. Give help.
I sense that successful older people have some overarching philosophy that is positive. Religion, a political belief, a dedication to human kindness, a drive to change things for the better.
It is something you have to scratch the surface to find, but it is most often there in my experience. Maybe it is a passion for some activity or a hobby or an activity from childhood that has stuck around. Maybe it is just a desire to stay in the human sphere in an active way. Often it is a religious philosophy.
Some do their lives alone and others in groups. A writer who is old or a painter or sculptor needs to be solitary while most of us go forward with others. The sense exists that life is worth living fully amid other people and the community; that a bigger force makes that all possible and easier to enact.
Older people need a deep system of beliefs, as their lives are full of loss. A loved one dies or gets sick, the eyes are going, one cannot any longer bend to do the garden. Loss is the constant in age and then death occurs, the big, big loss. I seldom hear elders say they fear death. Illness yes, but not death. They may kid about it but I do not have the feeling it is fear but rather a simple resignation that the time may be near for death. So they may say, so what? And go on with what they were doing.
Dover Library just concluded a display of books about older artists. Michelle Sampson of the library and I presented this offering. Those of you that missed this exhibit will be interested to know of some of the artistic geniuses who did great work late in their lives. Of course Picasso, Braque, Monet and Goya never stopped. Samuel Rosenberg was experimenting with his style late in life after his first serious heart attack in 1967. Joan Mitchell, despite illness and loss, stayed vital and exciting to the end. Another American painter whose inventiveness and productivity did not slacken, Grandma Moses. began painting at the age of 78. Alex Katz has been a joy to appreciate over his long career. The very old Louise Bourgeois is working hard in a remarkably fecund career. My great favorite, the west coast artist, Wayne Thiebaud, just keeps on truckin', changing focus and style in dizzying fashion and always leaving me breathless. What a great, great artist! Louise Nevelson, the sculptor, enjoyed great success and recognition in her later years.
Having their art books displayed at my local library gave me such a kick. I nagged my friends to visit to see what these creative people did through their lives. Obviously those my age and those younger have so much to look forward to, as they reach their sixties with a chance to bring it on home. Older age sure gets your attention. It is a wakeup call. Time to do the work while there is still a chance. The sense that time is finite or running out often brings the best out of us. It did with these artists.
If you missed the display at the Dover Library, it is up already in Sherborn. The staff quickly mounted the display. My thanks to Elizabeth Johnston and Donna Bryant. I walked in last week and there it was. "Artists of Age", it is called. Please try to visit the library and browse a bit. One can also see a marvelous display of local artists" paintings adorning the walls.
Age is like anything else. It can be met wisely or it defeats one. The choice is often ours. Some poor folk are too sick to fight the battle of active aging. To them, I offer prayer and support as I can muster it. But for those that are ambulatory, have memory and consciousness, can see, walk and hear, I ask them to come on out and play and work and have some fun with the rest or us who plug along.
Last summer the French went on vacation in the midst of a heat wave and several thousand elders expired. A lot of them were alone. Their bodies piled up in refrigerated trucks. Elsewhere in Europe neglected old people died of the heat. CNN reported on August 27 that a "Europe heat wave may have killed 20,000." The figure turned out a bit high but it got the French to think of giving up one of their many national holidays to put some money toward solving this terrible problem of isolated elders who just died from neglect. Where is the family one may ask? On vacation it seems. The head of a French welfare rights group said the victims were "frail, often isolated elderly people who were very vulnerable." He added ," families needed to take more responsibility for caring for elderly relatives."
This tragedy occurred recently. In these troubled times of war and unemployment elders have to face the reality of being left to die alone. It is sobering and reminds all of us, old and young, that we have to care so this won't happen to us here in the US. Europe has the same high standard of life we do but look what happened there. What a horrible way to die, alone, in great need. Unable to get the help to save one's own life.
We must continue to support all our people. A society is judged by how it looks after its young, its old, its parents alone raising children, its poor. I am concerned we not forget the old amid us whom we may not recognize as needy.
Society ages up, so to speak. A third of Dover's population is over 50. This total population of 5900 includes children and young adults, so one can see the number of older elders in the town who are heads of household is high indeed. The ones between fifty and sixty often have older relatives to look after, so they too are in the process of dealing with issues of age and illness. The whole community, Sherborn or Dover must look after providing help and information and connection so we may all benefit and grow through our total life cycle. It is only proper to look after one another living in the little place we occupy.
I never resist when I get on my high-fallutin' pedestal to recall a poem, of course, a Greek one. By Konstantine Kavafi called "Anna Dalassini."
It is an encomium by the king to honor his mother. It ends with the line in Ancient Greek, "Ou to emon e to son, to psyhron touto to ryma, errythy."
This means, mother, his mother, "never uttered those cold words, `mine' or `yours.'" That is the ultimate complement King Komninos offers to her .
Won't you reach out to me and others in our two wonderful towns? Old, young, what's the difference?
Don't do "yours" or "mine." The world is too full of that. Do "us" and "we." Together with the diminutive genius, the fabulous one, Konstantine Kabafi, we will move forward to a happier future.
Anna Dalassini
In the royal decree that Alexios Komninos
put out specially to honor his mother-
the very intelligent Lady Anna Dalassini,
noteworthy in both her works and her manners-
much is said in praise of her.
Here I offer one phrase only,
a phrase that is beautiful, sublime:
"She never uttered those cold words `mine' or `yours.'
"Ou to emon e to son, to psyhron touto ryma errythy."