Remember when you were a youngster dreaming of adulthood? Couldn’t wait till you were in charge of your own life. Did you play teacher? Did you imagine yourself becoming a sports star, an astronaut, a parent? How those dreams influenced our educational and early career choices. Do you remember later on how much time you spent researching and planning for your first apartment, a wedding, the arrival of a child, a trip abroad? I’ll bet most of your life has been a “do it yourself” project. So why stop now?
Warning: My intention in this and the next few posts is to get you, my boomer friends, dreaming up a more detailed vision of who, what and where you will be in old age. Do this now, while you’re a young elder, to protect your aged self from being pigeonholed (literally) by your children or (Oh my!) “the system.” We begin by taking a necessary quick peek at the required “activities of living.” Be brave. These are the tasks that let you “do it yourself.” After looking them square in the face, we’ll go on to explore the lifestyle options and growing bank of resources that allow us boomers to dream on.
The reality is that most of us can perform the required tasks of daily living with relative ease right now. This makes it easy to shake off the spectre of our own future decline, which naturally materializes when we pitch in to help our parents or older friends with what used to be easy for them. But there is a dreadful place deep inside that gets it – we know, but don’t want to dwell on, how quickly one’s independence can go into a downward spiral.
Perhaps a wobbly ankle leads to a fall that leads to a fracture that leads to a hospitalization, physical therapy, and months of recuperation. Who you gonna call? Perhaps a lagging memory and personality changes are diagnosed as indicators of the onset of dementia or Alzheimers? Then what? Perhaps you’re functioning as part of an able duo. You’ve probably known some – partner one provides the brains, partner two provides the brawn. Then one is incapacitated or gone forever. Who fills in?
You’re capably in charge of your own life now, but where will you be, what/who will you be able to count on for help when you’re 87 and can no longer do some of these priority tasks with ease?
Don’t shut down. It’s going to be alright. Just take a deep breath, picture yourself in need of assistance, and begin to imagine the who, what and where of your life’s next phase. Growing old doesn’t mean growing up. Let’s play with the future, just as we used to. Let’s dream up what we want in a new old age – ours!
Activities of Daily Living (ADLs)
(assembled by Wikipedia)
Basic ADLs consist of self-care tasks.
- Functional mobility, often referred to as transferring (moving from one place to another while performing activities)
- For most people, functional mobility is measured as the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition above is useful for people with different physical abilities who are still able to get around independently.
- Bathing and showering (washing all parts of your body)
- Self-feeding (not including cooking or chewing and swallowing)
- Personal hygiene and grooming (including brushing/combing/styling hair)
- Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)
Although not in wide general use, a mnemonic that some find useful is DEATH: dressing/bathing, eating, ambulating (walking), toileting, hygiene.
One way to think about basic ADLs is that they are the things many people do when they get up in the morning and get ready to go out of the house: get out of bed, go to the toilet, bathe, dress, groom and eat. Have you known anyone who didn’t require skilled nursing care, but was unable to perform two or more of the above? The system provides precious little help for that person living independently, especially if they fall into the so-called “middle class.”
Instrumental activities of daily living (IADLs) are not necessary for basic functioning, but they let us live independently in a community: A useful mnemonic is SHAFT: shopping, housekeeping, accounting, food preparation/meds, telephone/transportation.
- Preparing meals
- Taking medications as prescribed
- Managing money, insurance, and legal paperwork
- Shopping for groceries or clothing
- Use of telephone or other forms of communication
- Transportation within the community
You can probably see how these IADLs are more complex or challenging than the Basic ADLs, yet for us now, they still seem so simple. Not so easy when your eyesight, hearing, memory, muscles, joints, and balance are failing. A positive attitude and some pre-planning will be in our favor.
Occupational therapists often evaluate IADLs when completing patient assessments for placement. When being discharged from a hospital or recuperation facility, the judgement of an OT or a Social Worker may determine whether you get to go home to continue living independently or need a more supervised or supported placement. The American Occupational Therapy Association identifies the list below as IADLs. How many of those are part of your own lifestyle? Caring for a pet? Attending religious or spiritual services? Changing the batteries in the smoke detector? Renewing your cell phone service?
- Care of others (including selecting and supervising caregivers for self or a loved one)
- Care of pets
- Child rearing
- Communication management
- Community mobility
- Financial, medial, and legal management
- Health management and maintenance
- Home establishment and maintenance
- Meal preparation and cleanup
- Religious observances
- Safety procedures and emergency responses
If you’ve read this far, let me appreciate you for having a courageous heart. As Bette Davis said, “Old age ain’t no place for sissies.” Once we’ve honestly considered where we are today and what we may need help with in the inevitable future, we’re ready to pre-design our safety nets. (Loosely-woven, not guaranteed to keep us from falling, but at least lending assurance that we’ll hit something strong and resilient and be able to bounce back up when we do.)
In my next post I’ll provide an overview of several options available for aging independently and in community. By sticking with me and this blog, you are on your way to personal success. By commenting, you become part of an empowered community.
How does one keep from “growing old inside”? Surely only in community. The only way to make friends with time is to stay friends with people…. Taking community seriously not only gives us the companionship we need, it also relieves us of the notion that we are indispensable.
— Robert McAfee Brown