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Lifelong participation: Coursework for Re-thinking aging

Currently, I am participating in an massive online open course (MOOC) from the University of Melbourne on the topic of Re-thinking aging:  are we prepared to live longer?

The free course is offered through Coursera; it started the last week in April and runs for 5 weeks. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/ageing/home/welcome

We were encouraged to keep a journal or blog about our journey through the course, particularly to note where our opinions and ideas have changed from the beginning of the course to the end. I thought this would be a great opportunity to share the course information and my opinions with you – a little something different than my usual posts 🙂 As such, this will be a work in progress over the next 5 weeks.

Week 2:  Lifelong participation

Week 2 of this course is focused on lifelong participation. It dives into the physical and psychological changes that are more common in later life and how the gains in technology advancements enable people to be active, independent and socially connected to support lifelong participation.

Q. What does “ageing well” mean to you?

A. To me, aging well (yes, I go back and forth between how to spell aging) means growing into advanced years in relatively healthy physical, mental and social health. When I think of a person who is aging well, I think of my  mother. She has regularly exercised, chosen healthy food options, has actively been involved in her health, and participates in her community and social groups. She is young in her 60s, full of life, energetic, able to move and participate in the activities she chooses and enjoys, and shares her knowledge and experiences with others. Another important element of aging well which I think my mom exemplifies is that she has thought about her years ahead, what may happen with her health, independence, finances, etc. and has shared her opinions on these with her family and loved ones. We have a pretty good idea of what she would want if she was no longer able to independently function and we definitely know what she would want if she would need heroic measures or life support in order to continue living.

Q. Identify themes from these quotes (related to healthy aging).

ageing well according to experts

A. Themes in these quotes include physical health, independent functioning, mental/cognitive health and self-determination, meaningfulness of and engagement in enjoyable activities.

Q. What do you think you will be doing when you are 80?

A. When I am 80, I hope that I will still be physically and mentally active every day. I hope that I can still enjoy walks in the park, reading, and my hobbies (painting, crochet, arts and crafts stuff, learning, writing). I hope that I will be nearer to my family (living on a different continent than them now) and to regularly engage with them. I also hope that I have social ties in my community and friends I enjoy spending time with.

However, a more honest look at me at age 80 likely includes some arthritis, declining vision and hearing, and other possible physical and cognitive impairments when compared to my current 34-year old self. I hope I live in a community where services, such as cleaning, yardwork, public transit, accessible walkways etc., are available to me.

Q. How can you act now to best prepare yourself for the mental health challenges of aging?

A. I can strengthen my social ties and actively engage in social activities more often. I tend to be a bit of a homebody and really enjoy my alone time, but I also know that this hinders cognitive health and development and can negatively impact my quality of life. I can also get more strenuous exercise. I typically do yoga for exercise, as well as get daily bike rides and walks to work and the shops in my neighborhood, but this is just barely meeting daily requirements for activity. I think it is also a good idea to self-reflect more and really learn from past experiences, to start practicing that art of reminiscence and bigger picture thinking.

Q. What can you do now to prepare yourself for a role as a care partner with someone that you love that may live with dementia now or in the near future? (I changed the wording of this question a bit. I found the original to be insinuating that being a carer is reduced to doing something for someone with dementia, but in reality, it is participating in the daily life of someone living with dementia – it is typically a series of progressive losses, not just suddenly suffering and no longer living life.)

A. I could have a more set daily schedule for myself, as schedules are quite important to set the structure of the day for an individual living with dementia. As I tend to go with the flow, my days have a loose structure with changing sleeping and eating times. I could also increase my physical strength to prepare for some of the hands-on tasks which could be involved. If there were a person in my life now with a dementia diagnosis, I would be wise to start having the (difficult) discussions on what they value in their days, what they fear and do not want, which types of health and social care they would accept and how they would want that carried out – to get to know their wishes so that I could do my best to be their advocate.

Q. What is the sentiment behind Therapeutic Nihilism and why is it a challenge?

A. Therapeutic nihilism is a type of ageism found in health and care settings. Doctors and other health professionals erroneously think that older adults cannot recover or be rehabilitated the same as younger patients could. It also encompasses thoughts that older adults are less deserving of and are less in need of health services that would be offered to younger patients. Basically, therapeutic nihilism occurs when health professionals think (and act on) that older patients are simply “too old” to be treated and should be left to nature’s course. Because of this ageism, older adults are not provided with or even offered treatments available to them which may be therapeutic.
This is a problem because a large (and growing number) of individuals are not being offered the care they could benefit from. The even larger challenge is the ageist way of thinking and how that attitude carries over into healthcare. And when health professionals state or act on these misguided attitudes, patients, families, and the general public notices and begins to think along the same lines. It is stigmatizing, ignorant, and negligent (indeed, a form of abuse).
There were also 2 videos on technology and aging, which I was particularly looking forward to. They were informative, went over current trends and schools of thought around technology and aging. But, I found it to be quite a broad overview and didn’t really discuss the tangible benefits or uses of technologies for aging or for aging adults. I have seen this several times in courses and lectures, where they highlight that they will focus on gerontechnology (technology for and to benefit aging adults), but then give a thin overview and don’t really go into the topic. I hope this changes sometime soon!
Finally, there was a 5 question quiz on mental health and aging. I ended up with 4 out of 5 correct, but couldn’t access the review page to see which question I got wrong. I have a hunch it was #1 because there were multiple factors which could be selected, the other two being intelligence and luck. While education level can influence how well one ages, intelligence is different than educational level…
  1. Which factors can influence how well a person ages? (Personality)
  2. Which of the following is the most significant risk factor for Alzheimer’s dementia? (age)
  3. Which of the following groups have the highest rate of completed suicide? (men over 80)
  4. Which of the following are likely to be experienced regularly by carers of people with dementia? (exhaustion, frustration and anger, grief)
  5. Which of the following is NOT true regarding effective management strategies for aged persons with psychiatric illness. (psychotherapy is generally unhelpful for persons over 80)

Week 2 assignment:

Complete your personal International Classification of Functioning, Disability and Health (ICF) assignment (using the five domains and guidelines below). Your word limit is a maximum of 250 words. Remember that each of these domains influence other domains and all influence the body system and functions. The five domains are:

  1. Personal – what are the facts about you that influence your health status – consider your age, education, occupation, cultural background. Also, items that influence how you spend your day and your level of physical activity.
    • I am a 34 year old female of German and Scandinavian descent, grew up on a small farm in Midwest USA and moved to Denmark in 2005. I have a PhD and enjoy learning new things through lectures, online courses and community education events. I work at a large, intergovernmental health organization with an excellent physical environment and awesome colleagues. My work is primarily desk work, but we have desks we can adjust so that we can stand while working. There is also a significant amount of walking and stairs at work as well. At a minimum, I do at least 20 minutes of yoga each day, sometimes twice a day and now running, walking and cycling more now that the weather is getting nice. I average about 9000 steps a day without trying to reach a goal, so I know I could be more active. I am generally a positive and optimistic person, am married to my long-term partner, and have a few close friends in my city.
  2. Environment – reflect on your physical environment that acts as an enabler or barriers to physical activities and healthy behaviour. Does your environment encourage you to be sedentary or active?
    • My physical environment encourages me to be active and promotes healthy behavior. I live on the 3rd floor of our building with several shops within 10 minutes walking distance and 2 lovely parks within 15 minutes walking distance. The city center is about 15 minutes away by bike and I primarily bike or walk as my mode of transportation. I work about 2.5km away from my home, so cycle to work every day. My office is also right on the harbor, so I get plenty of fresh sea air. My work, as I mentioned, is primarily desk work in a large building. While I do stand up most of the day and use the stairs and bathrooms far away from my desk, I don’t think I get enough daily physical exercise (or at least heavy exercise).
  3. Health conditions – please include the ones you are comfortable with anonymous sharing with others. These can be conditions that are well controlled or ones that you need to get better control over so that they don’t negatively impact your body function and structure, activity and participation.
    • Hmm, this is a tricky question. While it would appear that I am healthy as a horse, I have had several health problems in my 34 years. I have pain in my knees and hips since adolescence (diagnosed as tendinitis), but this is largely well controlled for pain and mobility. After working as a carer for several years, I had a herniated disc in my back which led to several years of disability, about 1 year of that being severe and included several weeks in the hospital. It took years to rehabilitate myself, but now is well managed. I had a borrelia infection 2 years ago which hit me quickly and hard. Luckily, I started treatment within 8 weeks of showing symptoms so have made a nearly full recovery. I still have some neurological issues, heart flutters and the occasional flare up of knee pain, but otherwise feel it is behind me. In general, I have low blood pressure, good eyesight, a BMI on the lower side but still healthy, and eat plenty of fruits and vegetables.
  4. Function – Consider cardiorespiratory function and musculoskeletal function. Are they optimally functioning? For example, Louisa has noticed that all her systems are functioning, but slower that they used to be due to her sedentary lifestyle.
    • Definitely I could increase my cardiorespiratory functioning AND my musculoskeletal functioning. While they certainly get me through the day, I know that I do not exercise my lungs and heart with strenuous activity as much as they would like. Even though I walk them 5 days a week, I still get winded after 3 flights of stairs. I used to lift weights and run regularly, but that got derailed with the borrelia and then winter and I am now working back up to that. As I am in my mid-30s, I know it is still important to have strength training to prevent osteoperosis. I also notice I lose muscle mass more quickly than I did just 2 or 3 years ago, so have to regularly make sure all major muscle groups are getting a work out during my yoga sessions.
  5. Activites and participation – Consider your daily activities and how you participate socially with friends, family, and at work. Are you able to do all of your activities in smooth, well-coordinated fashion or are some of them more complex to handle? What is your level of interaction with others – the types of ways you connect? Would you like to participate more or less in the future?
    • I am most social at work, where I spend much of my days and see the majority of people that I meet on a daily basis. I also see our downstairs neighbors (couple with a 10 month old) several times per week and enjoy talking to them or stopping in for coffee and a chat. As far as other socialization, I am not so active – not as active as I would recommend other people to be, at least. I tend to like my alone time and need to recharge my energy after spending all day talking with colleagues, so go out and engage in other social activities (meeting friends for a coffee or a day in the park or for drinks or a night out) maybe 2-3 times per month. I know that I tend to feel more comfortable in smaller groups of people and in low-key settings, like dinner at someone’s home or meeting for a picnic in the park rather than large parties where there are a lot of people I don’t know. I know it would be good for me to learn how to carry myself/manage myself in these larger social situations. I also spend time texting or skyping with my friends and family back in the US, at least 2-3 times per month I call/skype with someone for at least an hour at a time. I would like to do more of these social activities that I enjoy in the future.

 

That wraps up Week 2 of the course. I would really enjoy your opinions and insights in the comments, please share what you think!

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