By Annamarie Fuchs, Creator, Partners in Health | Conversations.
Aging is an extraordinary process where you become the person you always should have been.
David Bowie.
I recently visited my best friend in person for the first time since COVID arrived on the scene in the spring of 2020. She is older than me – in her 80’s – and a warrior. She has fought and won battles with two primary cancers and recovered from a stroke while continuing to write, and to serve as a grief counselor and spiritual guide for so many people. She’s truly my hero and has been for nearly 30 years.
Despite her challenges, she remains one of the most independent, thoughtful, and compassionate people I have ever known. During our conversation, she talked quietly about a series of recent events that have led to her decision to give up driving. She’s one of those people who has always seemed indestructible to me, but that day offered a stark reminder that she, like us all, is aging. Driving is a key source of independence for most of us but in jurisdictions where people live outside of cities or towns, losing that freedom only works when you have a network of people and services you can rely on. Such is the case for my friend and thankfully so, or she would not practically be able to continue living at her rural, lakefront property.
As we continued talking about how our lives have changed since COVID and particularly since her decision to stop driving, I started thinking about what my life will look like in the not-too-distant future when I am in my 80’s. I wondered what I need to do to better prepare my own environment, my social network of friends and family, and learn what I need to learn about how the health system can support me in maintaining my own independence.
When I discuss aging with friends and family, it’s remarkable how many people believe that most of us will end up in some type of facility-based care once we reach a certain age. The fact is that while seniors make up 19% off the entire population, most Canadians will remain independent throughout their lives. In fact, in 2012[1] only 7.1% of all seniors over the age of 65 lived in care facilities of any kind. And despite the fact that Canada’s population is rapidly aging thanks in large part to that ‘baby boomer’ generation I belong to, only 1/3 of those over the age of 85 currently live in residential care settings.[2]
Between 2011 and 2016, the number of centenarians in Canada grew by 41.3% Among those 100 years or older, women outnumber men by 5:1 all of whom represent a very small number of those living in residential care. The largest group of older adults who do live in various types of continuing or long-term care in Canada are those who are between the ages of 85 and 89 years old.
So, what are some of the risks associated with aging that might challenge our ability to remain independent into our 80’s and beyond? We can easily point toward the effects of chronic disease, sub-optimal nutrition, social isolation, and falls as key contributors to our loss of independence.[3] Nevertheless, the research is telling us that we essentially have a great deal of control over many of these factors. Most chronic diseases are preventable or manageable with diet and exercise. Fall risk can be mitigated by remaining physically active, by walking each day, and instituting fall prevention changes in our homes. And finally, social participation can help to prevent loneliness, depression, and even some forms of dementia. Belonging to social networks, attending church services or belonging to faith groups, and establishing relationships with neighbors are all examples of how we might prevent the social isolation that can come with the onset of aging.
While there are no guarantees that we will maintain our independence, here’s what I’ve learned from my dear friend, from a few decades working in health care, and from my own experiences of aging to date.
Michael Pollan has written extensively about the food industry and nutrition. I’ve read some of his books and eventually had the opportunity to see him in person in Scottsdale in 2019. Pollan advises people to “eat (real) food, not too much, mostly plants.”[4] The emphasis is mine but, in many interviews, he points out that ‘eating food’ means to eat real food which includes vegetables, fruits, whole grains, and to avoid the temptation to eat food-like substances which include virtually anything your grandmother wouldn’t recognize as food.
He also suggests we stop worrying so much about our dietary health, explaining that in North America, …”we are a people who worry unreasonably about dietary health and yet have the worst diets in the world.”[5] I would agree. In fact, over the years I’ve learned that we place far too much time ‘thinking’ about food and getting fit. Like many of you, I’ve wasted time and money buying and reading diet books while consuming buckets of vitamins and so-called super foods. I’ve joined gyms, exercise classes, and more. But over time and with age I started looking for solutions that made practical sense; solutions that would correspond more easily with my values and my lifestyle. Michael Pollan’s work has resonated with me for many years as has Dan Buettner and the ‘Blue Zones’[6] phenomenon.
I discovered the Blue Zones in 2005[7] when their ground-breaking article was first published in National Geographic. I noticed the issue, particularly the cover picture, on the magazine rack when I was out shopping one night and picked up a copy. Those precepts have been with me ever since and except for my failure at transitioning to a fully plant-based diet (although I do consider myself plant-centric), my husband and I follow the Blue Zones concepts.
The Blue Zones are 5 places in the world where the world’s longest living people enjoy health and quality of life well into their elderly years. Those zones include Sardinia Italy, the Nicoya Peninsula in Costa Rica, Ikaria Greece, Loma Lina California, and Okinawa Japan. However, while it might be nice to live in one of those places, we don’t need to move to a Blue Zone to enjoy a healthy and active retirement. Essentially, as Buettner pointed out, when you look at older adults who live in those 5 places, you’ll notice some common themes he calls the ‘power nine.’[8] For example, they move naturally. You won’t see them joining gyms or running marathons. Instead, they live in such a way that their day-to-day lives require them to continue moving without conscious effort. They grow gardens, walk to various places instead of drive, and engage in physical work. They develop and nurture a sense of purpose which by the way, is worth up to seven extra years of life expectancy! They know how to down shift by finding ways to manage stress, and they apply the 80% rule at the dinner table where they eat until they are 80% satisfied. They eat plant-based or plant-centric diets with a focus on greens and legumes. Meat of any kind is eaten only on average about 5 times per month in small quantities, and almost as a condiment. They drink red wine in moderate amounts every day, particularly with friends except for the Loma Linda group who do not consume any alcohol. They commit to and enjoy a social network or what they call ‘belonging to the right tribe’ where healthy behaviors are largely part of their shared norms and values. They engage in regular spiritual practices which add 14 years of life expectancy and they put families first. They commit to a life partner (which can add 3 years of life expectancy) and invest time and energy into their children and other family members.
Our health systems across Canada and North America also offer a tremendous range of services and supports. Tip sheets about healthy eating, how to ‘fall proof’ your home, and how to remain active as you age, are available in most jurisdictions or online. “Active Aging Canada”[9] also provides a range of resources. Another great resource I personally take advantage of on occasion is “Zoomer Magazine.”[10] Beyond the magazine subscription itself, Zoomer also offers a wellness e-newsletter, book club, and other resources that can help you educate yourself and stay connected to people in your demographic who share some of your values.
I also believe that establishing a relationship with a family physician is fundamental to any wellness strategy. I have been blessed to have relationships with only 2 physicians in the last 35 years. My first family doctor retired after 25 years and I was able to meet a new physician 12 years ago who has supported me and my husband ever since. In Canada we are blessed with strong primary care systems. If you don’t have a primary care physician, find one. Get to know that person. And make a commitment to work with that person as a partner in helping you navigate the system and to enable you to make decisions that are right for you.
In the last 20 years, my husband and I have been simplifying our lives more and more. We move more now than we did in our 30’s and are eating more ‘real’ food. We have developed an interest in gardening and last year prepared a spot for a much bigger garden in 2022. We purchased a green house. Our interest in plant-based living has admittedly evolved slowly over time and more recently has been triggered by the awareness that we need to do more to address our own challenges associated with aging. Didn’t Hippocrates say, “Let food by the medicine and medicine by thy food?” Well, that’s a value we’ve been trying to implement for some time. We been plant-centric for years but in recent months we have been transitioning to a nearly vegan way of life where we avoid eggs and dairy and eat very little meat.
We are part of a close-knit immediate family but in the last year we’ve also become part of a community of people who embrace many of the same values we do. They are rapidly becoming part of our own tribe where we socialize, share food from our gardens, drink wine together, and look out for each other. That transition to becoming part of a new tribe was precipitated by the purchase of a tiny lake-front home in a community of like-minded people where we share everyone’s garden bounty, help each other with jobs that need tackling, and share any opportunity to stop and socialize. Recently, we sat around the fire at one home, bundled up with our winter gear on, while we laughed at each other’s stories. Even our faith in the last 10 years has evolved. We now embrace creation-centered spirituality where our way of demonstrating our faith is grounded in original blessing, acceptance, sharing, love and wonder rather than fear, separation, and judgement.
When COVID-19 struck in early 2020, our gym memberships were useless. In the months prior, we had been talking about whether we would renew our memberships for the coming year when the decision was made for us. COVID forced us to do more walking and appreciate the outdoors more than we ever had. We’ve always walked, hiked, camped, and while we love the outdoors, we soon discovered that we also love kayaking. Over time as the gym memberships lapsed and the pandemic persisted, we also began learning yoga to ensure flexibility as we age. And, on days when I have time to slip away from the office for a longer lunch, we walk across town to a nearby restaurant, order and sit outside or inside (depending on the weather) and stop at the post office to collect our mail before walking home.
I could go on but the point I’m trying to make is that getting healthy and staying healthy is a work in progress. It is much more about living more authentically and moving our bodies than creating designer eating plans or joining a gym. If you belong to a gym, good for you. But if you don’t, consider purchasing a bicycle or getting out for a walk – every day.
Final Thoughts
My best friend moved out to her family home when she was in her 50’s. The home has been in her family for more than 70 years. It is a secluded retreat on lake with walking trails, flowers, bird houses, bird feeders, a deck, and places to sit and meditate. As she’s aged, the house has continued to meet her needs. Her bedroom, bathroom, and kitchen as well as access to the deck are all on ground level. Her door is almost always open and unlocked because members of her tribe stop by to share a cup of tea or coffee and engage in conversation. Her favorite chair is next to a window where she can see the lake and watch the birds enjoy the bounty that she keeps on hand for them year around. A stack of books, a nearby fireplace, a spot to place her cup, and a few house plants all give rise to a setting that is truly a retreat for her.
Over time as her life has unfolded, the changes she made 30 years ago have allowed her to carve out a life of independence and meaning with a social network of beloved and supportive people around her. For my husband and I, the changes we started making 20 years ago have been relatively painless to implement. And over time, the effort to make these changes has strengthened our own relationship and allowed us to engage in authentic conversations about aging and how we also intend to live independently in retirement and into old age.
If living independently in retirement is an objective, then don’t wait until you’re 70 to start making changes! The bottom line is that by the time we reach retirement, most of us will have established deeply entrenched patterns of behavior and attitudes that will dictate to a large extent how the final 20 – 30 years of our lives unfold. That said, if you’re already 70 or older and realize you’ve got work to do, it’s never too late to get started on a path toward being more active and making the changes necessary to increase the likelihood that you can indeed remain independent. There are stories of people who took up yoga and other exercise programs or started eating right at 70 and beyond and who have become much stronger, healthier, and more resilient.
There is an ancient Latin saying, “Memento Mori”[11] which means ‘Remember you must die.’ That’s not meant to instill fear. Instead, it’s meant as a call to action. By reflecting on and accepting our own mortality, we are more likely to live more deliberately, authentically, and independently.
Like my dear friend, I intend to live purposefully, to make decisions that are right for me and for my family, contribute to my community, and finally, to simply accept and embrace the experience of aging. Life is short. Life is precious and I for one don’t intend to spend any of it looking out a window at a world I didn’t choose and can’t participate in. The ancient philosopher Seneca declared that the “one who puts the finishing touches on their life each day never runs out of time.”
[1] https://bcmj.org/news/statistics-canada-almost-5-seniors-long-term-care
[2] https://www12.statcan.gc.ca/census-recensement/2016/as-sa/98-200-x/2016004/98-200-x2016004-eng.cfm?wbdisable=true
[3] Statistics Canada. Table 13-10-0466-01 Healthy aging indicators. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310046601
[4] https://michaelpollan.com/
[5] https://www.webmd.com/food-recipes/news/20090323/7-rules-for-eating
[6] https://www.bluezones.com/articles/
[7] https://www.bluezones.com/wp-content/uploads/2015/01/Nat_Geo_LongevityF.pdf
[8] https://www.bluezones.com/2016/11/power-9/
[9] https://www.activeagingcanada.ca/
[10] https://secure.zoomer.ca/ZTW21MGBQ?utm_source=Adwords&utm_medium=cpc&utm_campaign=802331936&utm_term=%2Bzoomer%20%2Bmagazine%20%2Bcanada&content=&gclid=Cj0KCQiAweaNBhDEARIsAJ5hwbdll2rK0kqLRQ_l3mx1f8mv-qzmDPZDmTSOUNzOMzfKRA4TtKZUXuwaAm_xEALw_wcB
