Growing old is not a passive thing, as though it were merely happening to us. It is indeed growing – it is the
act of growing old. And just as we tell our children to act their age, so we must remind ourselves that we are constantly
becoming, spurred on by acts of the heart, mind, body and spirit – acts of courage, acts of will, acts of strength or
acts of faith: Each is a part of our becoming, our growing old. Perhaps never is this more obvious than when we see such an
act, a courageous response to one of life’s random, shattering challenges.
Take the case of U.S. concert pianist Byron Janis, now in his early 60s. He was 45, his career a rising cresco, when
he noticed redness and swelling in one of his fingers. To his utter dismay, in a matter of months, the symptoms had spread
to all his fingers. Janis had developed psoriatic arthritis. Despite medication and therapy, the joints in nine fingers gradually
fused.
By rights, that should have been the end of the musical line for Janis, who had studied with Vladimir Horowitz and made
his Carnegie Hall debut at 20, but he refused to call it quits. He adjusted his technique, changing his fingering and hand
positioning – and continued playing. “I learned to utilize what I had,”he told Newsweek last March. “I
had a total passion for music. It was my life and I had to pursue it. I have arthritis – but it doesn’t have me.”
A remarkable story, decidedly. Exceptional? Only in the details. To take another example: An Ontario woman in her mid-90s
was reduced to near-immobility by inactivity and arthritis – not age – but a month after taking up an exercise
program under the supervision of a physiotherapist, she was up and walking, albeit with a walker, and her entire outlook had
changed.
Then there was the 62-year-old Manitoba woman with one arm already in a sling. She was warned to prepare for the slow
onset of arthritis – and a future of relative immobility: Six years later, she is the flexible and energetic leader
of a growing t’aichi class.
There are more people over 65 than ever before, and they’re “younger” than any previous generation
of so-called elderly people – scaling mountains, running marathons and surfing, spearheading social-action groups, taking
up dance and writing books.
Besides age, what these active elderly have in common is exactly that: activity. Healthy or not, they share a practical
appreciation of a natural law that can be summed up in a simple dictum: Use it or lose it. In nature, wings atrophy if a bird
no longer flies; idle machinery rusts and falls into disrepair; so, too, are our minds and bodies diminished by disuse.
As most people grow older, they become less active – with good reason, of course. Physically we’re in a slow
decline from our 20s on; as we age, it gets harder to be active. The peripheral nervous system that sends sensory cues begins
to attenuate, and we gradually lose our ability to respond quickly to stimuli. The muscles and bones begin to thin as they
lose cell matter, and we are weaker, less resilient, and less able to perform physical activity. It also takes longer to recover
from illness and injury.
Even worse, we don’t seem to be as mentally acute. The brain starts to lose cell matter and synapses – the
connections between neurons – and it becomes harder to learn things and more difficult to retain them. For every mentally
agile artist, scientist or court justice in his or her 70s or 80s, there are countless people of that age who have difficulty
comprehending, or remembering names and words.
On top of all that, there is the shrinking social world of the increasingly elderly; as friends and family become fewer,
the incentive to stay active collapses. There are fewer people to see and fewer dates to keep; in any case, the discomfort
and pain of arthritis, often combined with other chronic illnesses, make it more difficult to get up and get out, and one
is increasingly inclined not to try. Yet with each outing we forgo, each activity we give over, our energy for endeavour –
mental or physical– seems to shrivel. But that’s the bad news.
The good news is that getting active – mentally, physically and socially – pays measurable dividends. And
it’s never too late to start: Anyone, no matter what his or her condition, can – and should – get involved.
Let’s start at the top.
Many people say their greatest fear in growing old is “losing their edge,” becoming less mentally astute.
That fear is exacerbated by the widespread misconception that older people are not as bright as younger people. But, says
neurologist Dr.Richard M. Restak in his best seller, “The Mind”: “psychological testing of the elderly
reveals no change, and, in some instances, even improvements in what we call crystallized intelligence: vocabulary, general
information and comprehension. The ‘wisdom’ of the aged is an everyday recognition of the fact that the observations
and experiences accumulated over a lifetime can count for a great deal – one of the reasons our Supreme Court justices
on the average are in their 60s and 70s and not their 30s or 40s. Only fluid intelligence – memory span and the ability
to process information rapidly –decreases significantly with age.”
Restak recounts a study conducted by Dr. Ellen Langer at Harvard University on the residents of a nursing home. “One
group of patients was told in essence, ‘It’s your life and you make of it what you want.’ Members were urged
to try to change things they didn’t like and pretty much make up their own minds on various matters...the second group
was told things like, ‘We feel it’s our responsibility to make this a home that you can be proud of and will make
you happy’.”
As might be expected, the group urged to assume responsibility“ became more alert and more active, were happier
and healthier, participated in more activities, even lived longer. In general...people did better in a reasonably demanding
environment that encouraged them to make use of their cognitive abilities.”
It may even be possible as Restak surmises in his earlier book, “The Brain: The Final Frontier,” that there
is a survival value inherent in the stimulation of novelty, that novelty is itself rewarding. A study conducted by psychologist
David Hebb, using laboratory rats in a maze, may not exactly replicate the rat race most of us run, but the results are nevertheless
interesting. They suggest, says Restak, “that the opportunity to explore is in itself rewarding.
Prior exploration allows an animal to develop new patterns of responses that can later be used to meet future demand
situations – e.g., finding food.”
Certainly “making everything old new again” can have a remarkably rejuvenating effect; people often say of
a challenging new activity that it makes them feel “ten years younger.” That’s part of the rationale behind
Creative Retirement Manitoba (CRM), a fascinating seniors’ program profiled by David Suzuki’s CBC-TV science series,
The Nature of Things last spring. Basically CRM is an educational program, with health promotion as a major component, that
began in response to seniors ’requests for flexible and affordable education programs.
“If people retire early,” says CRM executive director Farrell Fleming, “say, at 55, and they die at
100 – that’s 45 years, and there’s a lot they’re going to want to learn in that time if they’re
interested in life.”
The other part of the mandate, says Fleming, “is to put the wisdom, skills, experience and knowledge of older people
to workin the community in an educational role.” The result is alot of older people taking part in teaching and/or learning
activities. There are workshops and lectures given to seniors all over the province (including a home-bound learning program
specifically for shut-ins), in addition to lectures to school children on everything, says Fleming, “from aging to narrative
and oral poetry and what you need to get and hold a job.”
There are classes for seniors on the art of massage and t’ai chi (where the mid-60s arthritic instructor, mentioned
earlier,“makes the young people gasp”) and art, history and being older. And out of the classes have come several
service groups: Viewers saw the massage team and the barbershop quarteton The Nature of Things, but there’s also a choral
reading group called The Phoneticals, says Fleming, “who came out of a dramatic reading course and work mostly in schools.
There’s a drama group that at its height did 90 shows; there’s a ‘philharmonica band’ that came out
of the harmonica classes and a recorder ensemble that came out of the recorder classes. So, part of it is learning the stuff,
but the other partis putting what you’ve learned to use.
“Use it or lose it,” says Fleming. “We talk a lot about that, because it’s true for everything.
It’s true in the emotional realm: You use your sensitivity, empathy, friliness, your interest – or you lose them.
It’s true in the intellectual realm: Use the mind or lose it. It’s true in the physical realm – it’s
true in any realm you want to talk about. The law of life seems to work that way, so it’s very much one of our messages.”
The message seems to be working. People are regaining skills and interests they thought they had lost, while other people,
says Fleming, “come to things for which they never had the opportunity – they were too busy raising kids, too
busy making endsmeet, a lot of them. Suddenly they get an opportunity to fly, and some of them do. Some of them really start
to soar.”
But even for those whose disease makes them feel too earth bound to soar, the message is the same – use it or lose
it; get involved. The easiest place to start is with your own body.
Of course, a life long pattern of exercise is ideal, says an associate professor in the Department of Health Studies
at the University of Waterloo (Ontario) – “for developing flexibility, muscle strength and bone mass in young
adulthood.” But, she says, “the nice part is that you don’t have to ‘use it or lose it’ all
through life:You can resume exercising or start it late in life. It’s never too late to begin, so people in their 60s
and 70s can start,as long as it’s appropriate to their state of health.
She believes that “low-intensity exercise that’s good for older people is good even for people with osteoporosis
and arthritis; it’s very helpful in retaining and improving flexibility, mobility, general range of movement, and obviously
it’s very important to mental attitude. There’s no reason why a person with severe arthritis couldn’t do
some exercising. Obviously they’d have to do only as much as they could and build up slowly, but I would say flexibility
exercises – everything from the hands and shoulders to the legs – would be appropriate and would certainly should
show some benefits.”
A properly trained physiotherapist's will also encourage people to be as active as possible,within the constraints of
their disease, and in a supported way. They teach people exercises that are appropriate to their type of arthritis. They will
create an exercise program tailored to each patient’s needs, and they try to make it interesting for them so they’re
motivated to continue it on an ongoing basis.
To some patients, of course, the idea of using mind and body inactivities not specifically goal-directed – in the
form of work, say – is a foreign notion. For these industrious people, exercise was what you got while working. When
they retired, regular activity all but ceased. But staying active, is acutely important. And it’s anymore important
for elderly people than young people to have an attitude toward life that involves activism and being involved and giving
to other people and giving back to the community and keeping active physically, mentally, socially, sexually and soon. The
bottom line is, all that should be part of life.
And if it’s true that the less you do, the harder it is to do anything at all, it’s also true that the more
you do, the easier it is to do more. No segment of the population derives greater benefit from exercise than seniors. In young
people, exercise can improve physical function by only about 10 percent; in the elderly, exercise can boost function by as
much as 50 percent.
Staying active is especially important for anybody with arthritis. Obviously when you have pain and inflammation in a
joint, you’re reluctant to move it, but when you don’t,in a short period of time, the structures around the joint
will stiffen and become less flexible, and the muscles that move the joint will become weaker.
Suppose you’re having problems with a particular joint – the shoulder, say. Therapista might look at ways
of relieving pain in the joint prior to exercise, so you’ll be able to exercise in a more relaxed manner. A morning
shower to help relieve some of the morning stiffness might improve the circulation and relax your muscles.
They may devise a routine to develop flexibility, stretching all the joints within acceptable pain tolerance, to attain
maximum range of motion and strengthen the muscles. And it doesn’t stop there: Depending on patient mobility,they
might encourage you to register in a hydrotherapy program and see about getting you involved in an aquafit program, where
you’re doing general exercises with other seniors in the community.
Social activity helps keep the mind measurably more active. A nursing-home study that found ,even meeting for an hour
or so a week to do nothing more than reminisce about themselves and their families increased health and happiness, and even
improved memory in about 40 per cent of the participants.
As some experts say, the main benefit of exercise may be in the mind – in another way, as well: Arthritis leaves
many ofits victims feeling helpless; exercise helps them to feel more in charge. People who do exercise consistently feel
better about themselves physically and are much more able to cope with their disease. By doing their exercises, they’re
monitoring how their disease is progressing, able to keep their doctors informed about any changes taking place in their bodies
and to recognize when they need help from the doctor. They actually have mo re control in helping themselves stay well.”
And don’t worry: No one expects you to throw yourself headlong into the fray, or, once given over to it, progress
in leaps and bounds.
A therapist,would look at very small slices, set some very short-term goals. One aspect of that, is dispelling some of
the myths about exercise: It used to be thought,"no pain, no gain," that you really have to make it hurt to have a beneficial
effect. That’s not true at all. And it used to be thought you had to exercise every day for several hours. Thats a no
no. You really only have to exercise for 20 or 30 minutes or less, three times a week, which makes it more acceptable.”
An exercise program – even if it’s only general breathing exercises can be designed for anybody, depending
on what your needs are. If they’re wheel-chair dependent, they can exercise in bed or sitting in their chair. Even if
they’re simple exercises, the increase in oxygen intake and improved circulation will help their well-being.
Sally a therapist has seen the results of activity and involvement again and again, but no one struck her so forcefully
as the woman in her mid-90s, suffering from severe osteoarthritis, who responded so completely. “I was overwhelmed,”
she says. “She was barely walking with a walker, and I gave her some heat treatments and exercises. Because she’s
doing them regularly, she increased the mobility in her knees. She was able to decrease the amount of pain she was having,
I think because of the increased mobility and the improved strength in her thigh muscles. She was very encouraged, and I feel
she’ll be able to keep walking, rather than being totally dependent on a wheelchair.
“She saw herself deteriorating within the space of a year, and her exercise program has put a stop to the rate
of deterioration. She feels she’s not going to keep losing her mobility, that perhaps she’ll be able to keep walking
with her walker. What it’s done is made her feel more optimistic about the rest of her years.”
The idea, the therapist says,is not so much exercising to try to add years to one’s life; “it’s more
along the idea of adding life to years and adding enjoyment to life.”
Certainly if you feel better,if your body is functioning better – you’re not as constipated, your appetite’s
better, you sleep better, you move better, you can do more of the things you enjoy – then,for most people that would
mentally lift their spirits and, again, improve things like confidence. There’s no one-to-one relationship here, but
for most people it’s related to a sense of well-being.
Patients can't count on miracles from activity, but they’ll probably feel better, and feel fitter and more able
to participate. If you look at most people who live into their 90s and 100s, they’re either people who never did anything
bad – never smoked, drank, had sex or anything – or they were real hellraisers. But the common denominator is
that they were usually pretty active.
There is an case of an elderly grandfather who just turned 100, as a primary example. Still tall and erect, with sharp
blue eyes, he left Ontario as a teenager to become a businessman in the West. An avid curler, he was inducted into Canada’s
Curling Hall of Fame as a “Builder,” and he may be the only golfer in the world to have shot five holes-in-one
since his 80th birthday. He finally gave up the game, at age 97.
He is still active, though he limits his gamesmanship these days to competitive bridge. He told friends on his birthday
that he still enjoys the odd drink and a good party, “but everything in moderation.”
On his birthday, he advised friends, “You know, you have to stay active.” “He never ‘exercised’
a day in his life,” says his grandson, “but he chopped wood, hiked 50 miles – things like that – but
he never did anything he would have called exercise. It was always sport for enjoyment or just darn hard work.”
The grandfather is lucky; despite his age, he has only a touch of osteoarthritis, which makes staying active admittedly
easier. For those with more serious arthritis, it’s probably even more important, because muscle strength is protective.
But even if you can’t be physically active, you still have those whole other realms of activity, which are social activity
and mental activity. You can accentuate the positive.
One of the things the grandfather said on his birthday was that he thinks you really have to put your disappointments
behind you and just go on – don’t dwell on them as an approach to life. And for anyone who has a chronic illness,
I think that’s good advice
