I still cherish and remember fondly these dedicated people. They included Luther and Beth, retired medical doctors from South Africa; and  Mary, the 30-year church treasurer and retired school teacher who chose to remain single but assisted nieces and nephews with college expenses. They include Ida, who lived in HUD housing and at the age of 80 passed on. She was a source of sunshine though “as poor as Job’s turkey.” Upon her demise, she deeded to the church her one source of passing the time: a record player and a set of 78 rpm records.

These dedicated Christians and residents of the small community, even in retirement, brought hope to their neighbors, and especially their pastor. Also, 50% of this congregation had earned BA or MA degrees. I officiated at the burials of some of them in my eight years as their pastor, friend, confidant and counselor.

On this day, though, my pleasant memories are of how at their ages they were a blessing to both church and community. They are still my role models for productivity in retirement. In our retirement years we too can be a source of encouragement to our neighbors, family, friends, and especially grandchildren. Upon my departure, I believe my daughters and five grandchildren will be imprinted with good by my entire life, but especially with the positive things I did in my own retirement.

I have been retired from the US Army for 22 years, and from the United Methodist Church for 10 years. This phase of my life has been enriching.

How can we enrich our lives while in retirement? One principle to implement for immediate benefit is a conscientious attention to your state of health. At any cost, have regular medical check-ups; in other words, don’t neglect your health. Medicare encourages retirees toward a decision to prolong our lives. Seventy-year-olds are in need of preventive care just as much as a 40-year-old. In these closing months and years of life, it is wise not to neglect  your physical, psychological  and emotional well-being. My own program of preventive health care includes regular eye exams and dental care. Select your care providers carefully, and follow through on your appointments. As I write this I am reminded of an upcoming appointment with an optometrist for a six-month exam. Cataracts or other diseases of eyesight in aging won’t sneak up on me unknowingly.

I am also reminded as I write this narrative of our very own Cassie, a 16-year-old Pug. Over the years she has been a delightful companion and a source of joy to us. I see her health declining now; she is partially blind now. In these closing days of life she still has regular appointments with her vet, Dr. Tina Winn.

Preventive care in retirement is beneficial no matter how much longer we live.

I am satisfied with the publicity that medical care for everyone is getting from our politicians. I desire for everyone the extended medical care that I have had under Medicare and Tricare Prime. I appreciate the goal of Senator Barack Obama on medical care. He convincingly states his plan for all Americans to have similar health care to that of our representatives in Congress. To this proposal, I sing “Amen, Amen, Amen!”

More about our retirement years in next weeks’ Sunday article. Meanwhile, make and keep an appointment with your health care provider.

Cassie, our healthy 15-year-old Pug, is a supportive companion and she is challenging this ancient and trite platitude. Cassie, even though she has exceeded the age expectancy for her breed, is either an exception or the disproving of the trite saying.

Cassie, in the human equivalent of 105 years of age, is more mentally active than ever. Even in her senior years she is demonstrating an alertness, a “brain receptiveness” to new tricks, many of which are beneficial to the household. She is more effective than ever in communicating her needs to us with a bark, or by sitting in front of us and staring us in the eyes. For 14 years, she never barked except when visitors arrived at our door. Now she barks like clockwork at 10 p.m. or 2 a.m., whenever she need to go out and relieve herself. At this stage, she may have a gland problem that pushes her to more frequent needs to relieve her kidneys. Just like many of us senior citizens.

Only in the past year has she assumed the sentry mode in staring at us or following us throughout the house. She is completely in control of when she needs to be let outside and we are appreciative that her “accidents” are as rare as hen’s teeth — another axiom. She is learning to control us and get our attention with enough confidence to have us jump out of bed to assist her. She’s also learned to communicate with the neighbor’s Shih-tzu, Campbell, with a series of barks.

What can I learn from this adorable pet that speaks to me of my own aging process?

First, make the most of what I can. Maintain a measure of intellectual curiosity. In high school, I studied Julius Caesar but didn’t understand it. Reading this icon of literature was an insurmountable obstacle. I hated the class; it was too much of a challenge for this country boy. Now, 50 years later, I saw Julius Caesar at the Roxy Regional Theatre. In preparation for this adventure, I read a critique of this Shakesperean drama and carefully studied the plot. Though aging and so much older, I still have a passion to learn, cultivated over years of maturation, and know it wasn’t my fault for not understanding this play when I was in school.

Secondly, I am learning from Cassie that with aging there are inevitable physical changes in us. her gait is slower and her steps shorter now; she sleeps 20 hours a day and prefers staying at home to visiting grandchildren in Indiana. It takes her longer to find her food and water dishes.

Thirdly, Cassie’s physical prowess is restricted. She will not climb stairs to the bonus room where I have an office. Perhaps she’s experiencing discomfort from arthritis, or a newly developed fear of heights. She is demonstrating some of my bodily symptoms — slowing down. In the last local road race I finished near the end; I’ve never done that before. My defense mechanisms automatically blink and flashes “you’re losing your endurance.” I resist admitting that my prowess in racing is declining.

Our pets have much to teach us about living and aging gracefully and learning even as we move through our remaining years. I hope Cassie remains healthy. As long as she is she will bring a sense of encouragement, and will l serve as my teacher.

Though now a Tennessee resident, when I speak of home I still focus on Missouri, especially the Ozarks where I was born and spent six formative years of childhood.

Recently I returned to the Ozarks near Fort Leonard Wood. There for three days, I faced an epiphany, an experience of both sadness and joy. Experiences that brought me closer to reality. Something happened that was unforeseen and unanticipated, something that wasn’t on my list of objectives for this trip. The result was a new personal “awareness” and sensitivity toward my own well-being.

The Ozarks surrounding Fort Leonard Wood was where I played with my uncles and cousins. We explored caves, woods, and hills. We fished, hunted and played hide and seek in the woods and in season, climbed persimmon trees and picked the fruit when it was ripe enough to eat.

The major objective of this newest visit was to reconnect with friends, family and former members of the Newburgh United Methodist Church. I wanted to strengthen relationships with those who had been significant others in my pilgrimage through life.

On this visit, I met members of this Newburgh congregation, where I had served for eight years as pastor. One startling demographic of this 40-member church concerned the educational level of its membership: highly educated and professional leaders, some 50% of the group had earned masters degrees. We had two doctors — Lute and Beth – who immigrated to the United States from South Africa.

Newburgh 40 years ago was a bustling and financially independent railroad town, but with modernization and the scraping of the steam engine the community took it “on the nose” economically. A mass exodus of jobs and workers sent the town into a decline, dropping its population to a mere 400.

While there I made friends, good friends. On this visit, I hosted a a dinner for them at the local Shoney’s. Of this original group of dedicated church members, only a handful remained. Though in their 70s and 80s now, they remained enthusiastic and healthy enough to drive the distance for a dinner/reunion with their former pastor. The, each and everyone, still served their community and church, and shared an occasional glass of wine.

My Epiphany

So this renewal, this aforementioned epiphany, began for me. I was confronted with the knowledge that two-thirds of my friends from this dynamic church had died or moved on. The camaraderie arising from this dinner gathering strengthened my bonds with and feelings for Beth, Renata, Bob, Irene, Ruth, and Gordon. We dined on an Ozark dinner of frog legs, chicken and beef dishes. Throughout this period of fellowship, I relived some of the “good old days” we had together. The presence of these good people made me feel a better person and renewed my sense of achievement. I recognized that they had made a positive contribution to my life and had enabled me to find an elevated sense of self-esteem.

In this area, this county near Fort Leonard Wood, I still have a few aunts, uncles and cousins. Their number has dwindled since my last visit. The bell has “tolled” for a dozen of them in the last eight years. These family members from my mother’s side were supporting and accepting of me and contributed to our well-being; my mother was a single parent at age 18. These precious relatives helped raise me in an environment of loving care. Over the years, I’ve continued to express my gratitude, verbally, and with gifts, or frequent phone calls, for their daily positive confirmations of my value in childhood, especially those first six years.

Time has taken an ignominious toll on them; they are widows and widowers, having outlived their spouses. they are receiving extended medical care for a variety of injuries and diseases. Uncle Frank is 91, in overall good health but confined to an assisted living facility. There are symptoms of diseases, signs of the ravages of dementia and stroke. Individually they have had to surrender their self-determination and physical mobility to the demands of aging. For them, driving a car is no longer a comfort activity in life.

But back to my epiphany. As a result of this renewal with my friends and family, I have experienced a wake-up call. I am now one of the older generation in our family, and in 2008, I could become one of the few survivors of our clan. Thisfamily visit introduced me anew to my own mortality. Tearfully, I say that I am going to miss my uncles and aunts upon their demise. A comfort for me, though, will be my recognition that I “loved them now” while they are still with me. (Presbytarian hymn).

Mullings and Musings

A source of inspiration and spiritual boldness as I begin my 7th decade s the book Mullings and Musings by Clarksville’s own Charlotte Marshall, in which she gives comforting advice from decades of life through her gift for story telling. In one emotional and insightful story, she says:

“Then the purposelessness and fragility of life bound together as an ephemeral gift camae into sharp fears as to make me weep. Why have I been so dull, so unaware, so taking-for-granted the treasures given me? Never again will any of life be taken cavalierly.”

After my abbreviated time with my family in the Ozarks, I’ve returned to Clarksville withb a renewed sense of dedication “to set my house in order.” I have been more generous and have vowed not to be so cavalier in daily living.

A few concluding observations from this experience: Such confrontations are not joyful happenings, but are ones I can, with God’s help, use productively in the time I have remaining. Being Methodist, In hope to live as long as our founder, Rev. John Wesley, who left this earthly test at 86 years of age.

Also, as we say in the Ozarks, “I;m not allowing any grass to grow under my feet.” I’m busy sharing, doing good, and planning for my future, with it’s five or 20 years.

At the beginning of this new year, I am appreciative of my heritage and lineage. I am grateful for my family, especially the uncles and aunts that immeasurably contributed to my life, not with money but with affection and acceptance.

Happy New Year to all.

Author’s Note: Mullings and Musings is available at Trinity Episcopal Church for $10. It is an excellent gift for any and all occasions and a tool for anyone interested in spiritual growth.

The other day a young person asked me how I felt about being old. I was taken aback, for I do not think of myself as old. Upon seeing my reaction, she was immediately embarrassed, but I explained that it was an interesting question, and I would ponder it, and let her know.

Old Age, I decided, is a gift.

I am now, probably for the first time in my life, the person I have always wanted to be. Oh, not my body! I sometime despair over my body, the wrinkles, the baggy eyes, and the sagging butt. And often I am taken aback by that old person that lives in my mirror (who looks like my mother!), but I don’t agonize over those things for long.

I would never trade my amazing friends, my wonderful life, and my loving family for less gray hair or a flatter belly. As I’ve aged, I’ve become kinder to myself, and less critical of myself. I’ve become my own friend.

I don’t chide myself for eating that extra cookie, or for not making my bed, or for buying that silly cement gecko that I didn’t need, but looks so Avant Garde on my patio. I am entitled to a treat, to be messy, to be extravagant.

I have seen too many dear friends leave this world too soon; before they understood the great freedom that comes with aging.

Whose business is it if I choose to read or play on the computer until 4 AM and sleep until noon? I will dance with myself to those wonderful tunes of the 60&70’s, and if I, at the same time, wish to weep over a lost love … I will.

I will walk the beach in a swim suit that is stretched over a bulging body, and will dive into the waves with abandon if I choose to, despite the pitying glances from the jet set.

They, too, will get old.

I know I am sometimes forgetful. But there again, some of life is just as well forgotten. And I eventually remember the important things.

Sure, over the years my heart has been broken. How can your heart not break when you lose a loved one, or when a child suffers, or even when somebody’s beloved pet gets hit by a car? But broken hearts are what give us strength and understanding and compassion. A heart never broken is pristine and sterile and will never know the joy of being imperfect.

I am so blessed to have lived long enough to have my hair turning gray, and to have my youthful laughs be forever etched into deep grooves on my face. So many have never laughed, and so many have died before their hair could turn silver.

As you get older, it is easier to be positive. You care less about what other people think. I don’t question myself anymore. I’ve even earned the right to be wrong.

So, to answer your question, I like being old. It has set me free. I like the person I have become. I am not going to live forever, but while I am still here, I will not waste time lamenting what could have been, or worrying about what will be. And I shall eat dessert single day. (If I feel like it)

Editor’s Note: I have stumbled across this item a dozen times in the past few weeks, but nowhere (so far) has the author’s name been posted. I’ve contacted quite a few individuals who have posted this online, but none of them can claim authorship. It falls into the realm of Harriet Jacob’s “Be An Outrageous Older Woman” and Jenny Joseph’s “When I Am An Old Woman I Shall Wear Purple.” Thus, I have culled it for this site, because I believe you, our readers, especially those approaching “a certain age,” will enjoy and appreciate it. Anyone who might know the source is encouraged to contact us. — Christine Piesyk

Since turning 70, I am analyzing my situation,and have made the following observations:

• I am still maturing
• I still enjoy sports
• I’m dedicated to a high health standard
• I still appreciate exercising
• I recognize the brevity of life more than ever before
• I’ve enjoyed the World Series and the weekly Titans game
• I enjoy serving as a board member on several dynamic community organizations
• I continue to discover the security, peace and direction of my faith and appreciate my spiritual resources
• While this litany could continue, I find myself pondering and reminding myself of my legacy. Not what it will be, but rather, what it is now.

It’s there, and I accept cognitively and emotionally that “it is appointed once to die.” So what is my legacy? I quietly assess my behavior and attitudes:

For me, at this stage of maturity, my legacy includes how I will be remembered in that first year after I pass. My present behavior and attitude testify to my values that will hopefully leave an impression, especially on my grandchildren.

How will my five grandchildren remember me? I ask myself and model my life so as to have a positive effect on their development. My legacy to them, even at this time, is to help instill the values of generosity, affection, forgiveness, enthusiasm, diligence and a dedication to education and spirituality.

What is my legacy to my 15-year-old Pub, Cassie? If she remembers anything, and I think she will, it will be that she has received tender loving car, the best of medical care, daily exercise, 25 pats on the head and our moments of play, which are seldom now with the increasing in aging (hers more than mine). She isn’t a puppy anymore.

One unit of my present legacy is the habit of being proactive. This is an accurate image which portrays long term planning for the future. I am persuaded that my present values and characteristics are surely impacting others, especially the grandchildren. We leave our mark on others; that is our legacy.

In the Upper Room Devotional Magazine [10/9/07], Tom of Utah shared poignant remarks on this subject, one such assuring comment being:

“Whether I realize it or not, I influence those around me each waking moment”

Each day we are building our legacy.

Josiah was a political leader in the old testament. For 31 years he gave guidance and brought security and economic stability to his small nation. Daily he built his legacy of doing “what was right in the eyes of the Lord.” [2Kings22:2].

Each day, we are building our legacy.

“One morning I found I simply could not get out of bed. The simple action of pushing back the sheet was too hard. I had nothing left…”

“My mother’s brain is gone, but her body is like the energizer bunny. Keeps on going and going and going … and I can’t keep up. I’m so tired I am getting sick all the time…”

“Dad keeps sneaking out. How can someone who remembers nothing be so clever … he’s an escape artist…”

For the millions of caregivers tackling the challenge of caring for someone with Dementia, most commonly in the form of Alzheimer’s disease affecting a parent, spouse or sibling, things like exhaustion, stress, declining health (their own), anger, rage, guilt and other emotions and issues are “normal.” It’s what happens when otherwise healthy people are suddenly confronted with the 24/7 reality of care-giving. A kind of care-giving measured not in days, weeks, or months, but years.

As Alzheimer’s reaches near epidemic proportions and is affecting ever increasing millions of people who are living longer (if not always better), and the pool of available caregivers shrinks, the pressures are mounting. And caregivers are crumbling under the weight of their complex responsibilities.

At one time caregivers were told were told “it’s all in your head” when they complained of fatigue, and all these other mental and physical issues. That great multipurpose line implied that not being a person of superpowers and extraordinary coping skills was a reflection on one’s competence in dealing with life.

The professionals were wrong. It’s not “in your head.” It’s real, and it has a name: Caregiver Syndrome, the technical name now being applied to the basic stresses on body, mind and spirit that care-giving for someone with Dementia can cause.

Dr. Jean Posner, a Baltimore neurologist, who has studied the syndrome and the symptoms, calls it “a debilitating condition” triggered by “unrelieved, constant care” of someone with dementia or other chronic illness.

Only a decade ago, when the realities of the AD explosion became a visible, talked about and increasingly debated growing reality did health administrators, doctors and government officials start taking a good look at who is going to care, not only for the patients, but the caregivers. And how will that be accomplished?

The statistics are intimidating: one in every four families now cares for someone over the age of 50. In 2000, some 35 million Americans were over 65; that number, augmented by the post World War II bubble of baby-boomers, will hit 71 million — double — by 2030. The numbers are staggering and threaten to collapse the system of medical and elder care.

Caregivers, those unpaid, committed souls working from a sense of love and responsibility on the frontlines of home health care, are most commonly affected by depression, anxiety and anger. But these emotional stresses also translate into physical conditions of high blood pressure, diabetes and deteriorating immune systems and even progressive memory loss — mimicking the symptoms of those they care for. The older the caregiver, the higher the risks, and some it is now documented that over 60% of caregivers will experience at least some combination of these symptoms. Prolonged and elevated levels of stress hormones are triggered by prolonged care-giving, which usually dovetails with self-neglect. Caregivers are so busy caring for someone, they fail to care for themselves. Caregiver stress can be the match of Post Traumatic Stress Disorder.

It’s not just the physical care-giving; watching the decline and the certainty of the progression of dementing illnesses is literally watching someone die. Not a single age-related death but a lengthy decline that may last for years, accompanied by an ongoing sense of loss triggered in small increments: one function, one memory at a time evaporates. Each one constitutes a loss. And the losses are relentless.

After not just months but years of coping with these periodic losses, after this “staging down” or chronic deterioration has drained the caregivers and left their charges little more than shells of their former selves, after a thousand small deaths within the human brain, these caregivers are KO’ed by the reality of physical death. In the aftermath of a death from Dementia, the caregivers collapse. Some are relieved, but too many are simply unable to reclaim the time, energy and vitality expended in the relative isolation of multi-year care-giving.

Caregiver Syndrome is acknowledged among providers of care to the terminally ill — and make no mistake, Dementias are terminal illnesses — but it has yet to be acknowledged in American medical training and literature. So doctors miss it.

Many years ago, families took care of each and their aging and infirm relatives. it was simply the way things were handled. Nursing homes and assisted living sites were anomalies.

In the high pitched rapid fire pace of 21st century lifestyles, less value is placed on the efforts of care-giving, and the attached responsibilities are more often seen as ongoing burdens. Our society simply does not place adequate value on its elders or the people who care for them, creating an isolation and lack of peripheral and direct supports that affect many who give care. These unsung heroes become shadows figures in a world that is passing them by.

The American Academy of Family Physicians and the National Center for Care-giving are lobbying for the implementation of stress and depression screening for all caregivers, and urging those who feel overwhelmed by the pressures of giving care to speak candidly with their physicians (and social workers, if such professionals are involved in a dementia case). Respite time, social supports and improved training in care-giving and coping skills may go a long way to relieving the impact of care-giving on the human body and its overstressed mind.

Caregivers often feel as if they are going crazy. They are not. And now there is a name attached to what they feel. Caregiver Syndrome. It’s not just all in their heads.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Editor’s Note: Local Councils on Aging, the National Alzheimer’s Association, local hospitals, mental health agencies and senior service providers all offer assistance and information at varying levels to caregivers in need of assistance. One phone call can make a difference in the quality of life for both the caregiver and the person being cared for.

If you need information on Alzheimer’s Disease or how to provide care for someone with Dementia in any of its forms, call the National Alzheimer’s Association 24-hour hotline at 1-800-272-3900.

The U.S. Administration on Aging also offers an Eldercare Locater Service. Call 1-800-677-1116 Monday through Friday from 9 a.m. to 8 p.m. eastern Standard Time.

Today these caregivers were told by the Supreme Court that they can still work overtime, but they are not eligible for overtime pay. They don’t count. Their work — caring for millions of stay-at-home elders and disabled people — isn’t worthy of the extra pay. The balance of the court once again tipped away from family values and the rights of the common folk.

Justice Stephen Breyer wrote the decision, a boon to the companies, the employers and insurance companies and HMOs whose payrolls will not sag under the burden of fair wages for hours worked, and a growing burden to the hundreds of thousands of caregivers on the front lines of in home health care. It’s a profession with a 40-60% turnover rate. Long hours. Hard work. Burnout. Nobody’s getting rich here. Well, no one on the front lines.

The ruling was made in the case of Evelyn Coke, a 73-year-old former caregiver now in need of such care herself. In the 1990s, the Clinton administration was working toward the goal of providing overtime pay to these unsung workers, but the onslaught of the Bush regime quickly set about opposing the plan to pay overtime to home health care providers.

Think about this:

While I was both a full time midlife student, first a journalist and later a non-profit employee, I was also a home care provider. Once. Twice. Three times. Sometimes overlapping. I was one of the millions of Americans who are FREE labor in the health care field. I took care of my dad, a multiple-stroke victim, a lung cancer victim, and amputee. My mother, with my perennial and perpetual support, cared for my dad at home for 15 years. We both cared for her brother/my uncle, a former WWII POW with a brain injury, post-war mental health issues, eventual Alzheimer’s and other major health problems. We cared for him at home for 18 years, before it became necessary to institutionalize him. Even then, I continued on as his free legal advocate, medical advisor, paper pusher, fiscal conservator and legal guardian for another nine years. Unpaid. My mother suffered from Alzehiemer Disease, four years in the “invisible” Stage I, another five in the advancing stages. With the exception of 15 months when she lived in assisted living, I was the on call, round the clock caregiver.

There are millions like me who do this work out of love, a sense of responsibility, and a feeling that if can, we take care of our own. What would mom and I have earned else? What would mom and I have earned had we been paid for this undervalued work of caregiving? And what if we had stepped away from this work, as we could have chosen to do, and left it to the state? Or the feds under Social Security? Let the state and insurance pay for nursing homes and assisted living and legal services for three people for the better part of 30 years…

Now think about this:

• The population is aging, people are living longer, Alzheimer Disease and other illnesses that prey on aging populations are spiraling toward epidemic levels even as the generation that follows is shrinking and dissipating to the far corners of the country, the continent, the planet earth. People don’t stay where they grew up anymore. They move out and on. There’s no one left to give care.
• Caregivers are good, loving, hard-working people who are burning out in outrageous numbers  and not making anywhere near enough money to constitute a true living wage. They aren’t making enough to save for retirement or personal medical savings accounts touted by the current administration.
• If professional caregivers are burning out at the rate of 40-60% a year, who will take their place? The money is not enough of an incentive to lure many young people into this kind of work.
• And what happens when those of us who are “free” caregivers can’t do it anymore? We are, after all, aging ourselves. We are the baby-boomer bubble moving to whatever will be left of Social Security.

The fact is, free caregivers in the form of family and dear friends are so burdened with trying to stay afloat fiscally while burning out physically that they are becoming ill and emotionally burdened at younger ages than the people they care for. They may well need care of their own at younger ages.

Caregiving is not just an act of love: it is a profession no less worthy of solid wages and OVERTIME, incentives and bonuses than Licensed Practical Nurses and Registered Nurses.

Opting to deny overtime to professional caregivers is a slap in the face not just to them but to the people they serve.

Our Supreme Court judges, our government, our President with his so-called agenda of family values, needs to think about building warehouses for the aging baby boomers speeding toward seniority, a kind of orphanage for old folks without caregivers, unless he plans to let them die in their homes, unattended, because no one can afford to care for them without a realistic paycheck. A few billion shifted from the Iraq War budget would go a long way to funding programs for elder assistance via caregiving, but taking money from the war machine for public health might be considered anti-American. Anti-Bush. But then, Bush doesn’t have to worry about things like this; his family fortune and his presidential perks will care for him for life. I bet that somewhere in his future, his caregivers, at least, will be making exceptional wages based not just on medical skills but security clearance. And our tax dollars will pay for that.

Meanwhile, the rest of us will just have to take our chances. Or stay healthy ’til we drop.

~  ~  ~  ~  ~

Note: I earned my individualized Master of Arts in this field, with a book-length thesis entitled Daughter of Dementia, which addressed caring for elders with Alzheimer Disease and coping with caregiver burnout.

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