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The Dignity of Risk

Posted on Wednesday January 24th, 2018

Two Elders in my life, Eldo and Harriet, taught me about the dignity of risk – one aspect of resilience and independence that is often overlooked as people age.  It’s far too common for well intentioned helpers to pressure older adults – especially those with functional challenges – into a safety bubble. The dignity of risk simply allows people regardless of age or functional ability to continue making the choice of how to live – how to balance personal risk with safety.

Eldo’s Story

At age 82 Eldo fell off a haystack and broke his back and neck.  His friends were devastated, convinced Eldo was “done”; but when I walked into his hospital room the first thing he said to me was, “Bleep de bleep (use your imagination) I can’t believe I ruined my whole summer of horseback riding!”

I was amazed! He didn’t get the memo saying he was finished riding. He was just furious that he’d messed up his whole summer!  Next, Eldo called in the nurse to tell her the neck brace was causing him a lot of pain.  She was patronizing, “Well, you can’t expect it to be comfortable”.  He replied very directly, “I’m not asking for comfortable, I’m asking for tolerable.  Get the orthopedic on the phone”.

I knew the building blocks of resilience included optimism and hope, self-efficacy (belief in one’s ability to impact outcomes) and a sense of control. But here it was in living color as Eldo took charge of his recovery. He knew he would recover, and he knew what he needed and asked for it!  A different neck brace brought him immediate relief and a sense of control over his destiny.

Seven weeks to the day after he broke his back, Eldo was riding again. His mindset of full recovery, his rejection of negative expectations of aging, and the “dignity of risk” all played a role in his recovery. Recovery is far more than just physical and his doctor – a horseback rider himself – realized how critical it was for Eldo to live his passion. How different the outcome could have been if his doctor, family, and friends had insisted he retreat to the safety of his recliner.

Harriet’s Story

When my son Cole was born I needed part‑time childcare. Harriett was interested in the job, but I was a worried.  She had significant physical challenges; advanced osteoporosis with spinal kyphosis (the rounded upper spine people often call a dowagers hump). After making a career out of advising people to focus on possibilities, not disabilities, could I live it?  So we had a frank talk. “I’m concerned. I don’t want you or Cole to get hurt.  How can we make this work?”  With equal parts amusement and determination she said, “Oh, I’ve had a bad back my whole life and took care of my own kids. I don’t know why it would be any different now”.  Harriet was 80 years old at the time.

So we came up with adaptive strategies.  We put the crib next to the bed so Cole could climb out of the crib, onto the bed, and then to the floor – no lifting required. Harriet watched him from the time he was 4 months old until he went to school, and like Eldo she taught me a lot about the dignity of risk. In her 90’s she used a walker and lived in a second floor apartment with no elevator. People often pressured her to move to a ground floor apartment to which she replied, “I want to see the mountains when I wake up in the morning. I’ll scoot up on my butt if I have to!”  She lived there until she was 100 years old.   

 So, Harriett, frail with many physical challenges, and Eldo, out riding horses in the mountains had two very different aging experiences. Yet they shared a common trait – the ability to use the tools of resilience to live life on their terms. And they were both afforded, no – demanded, the dignity of risk.

First published at Silver Nest  www.silvernest.com 

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What's Your Vitality Portfolio®?

Posted on Tuesday August 15th, 2017

Building financial security and maintaining health are consistently listed as top aging concerns for adults over 55. Most of us know you have to plan, balance assets, and make regular deposits to support lifelong financial security. But what about your vitality?  Do you have a plan? Have you considered what “assets” you need to support lifelong vitality?

The Vitality Portfolio®, strategy encourages you to create a practical roadmap for lifelong health:

1) make a vitality plan,

2) balance vitality assets (functional, core, and wellness assets), and

3) make regular deposits

 

Making a Plan

How long do you expect to live? I ask this question during keynote speeches and people always seem to have a number in their head. In future blog posts (Aging – It’s a family affair) we’ll explore how people come up with it, but for now consider your number – and more important, consider what you want to be able to do through your 60’s, 70’s, 80’s, 90’s, and 100’s! Making a vitality plan helps you set, track, and reach your goals.

 Functional Assets

Strength, mobility and endurance are “mission critical” assets for maintaining independence; yet optimizing function through physical activity is the most underused healthy aging strategy available today! It’s easy to disregard functional changes that happen gradually, so here’s some food for thought.

Statistics don’t motivate action unless they’re personally relevant. For example: Strength declines approximately 1-1 ½% per year after about age 30. That doesn’t sound like a lot until you do the math.  If you’re not regularly challenging your strength – you’re losing it – on average about 60% by age 70 and 75% by age 80. Imagine going about your daily life carrying a backpack filled with your body weight (i.e. ½ the strength requires double the effort). Consider how difficult daily tasks would become and how many activities you would have to give up. 

Physical frailty IS common and predictable with age, but it’s NOT due to age or inevitable! Studies show even 90+ year olds can prevent and reverse loss of muscle mass and strength with resistance training.

Take charge! If you get fatigued while walking – walk more! If you’re having trouble rising from a chair, do it more; every time you sit down, stand up and sit down 3 more times. See how many knee lifts you can do during TV commercial breaks or commit to standing up and sitting down 5-10 times during each commercial break.

To maintain the gift of mobility gently stretch and move your muscles and joints through every range of motion. Embrace cardiovascular exercise to help your heart, lungs, and blood vessels deliver oxygenated blood throughout the body. Endurance activities bathe your brain in oxygenated blood so are also closely linked to brain health! Get out and move briskly every day; walk, swim, dance, or even do seated exercises that elevate your heart rate – toe touches, heel pressed, knee lifts, low kicks, marching in place all with arm swings. For simple downloadable movement programs visit http://www.kayvannorman.com/professional-products/

Age is not a diagnosis so confront functional challenges with physical therapy intervention. Consciously invest in lifelong functional independence.

Core Assets: Ageless Thinking and Resilience

Attitudes and expectations directly impact aging. Engage Ageless Thinking by consciously rejecting negative expectations of aging. Activate Resilience by embracing adaptive strategies to overcome challenges – regardless of age.

Thirty years ago people with disabilities were often institutionalized with no expectations or opportunities; and outcomes were bleak. The disability movement changed attitudes and expectations and literally transformed lives. Now young people with profound disabilities are given resources, tools, and encouragement to overcome and live fully in spite of challenges, and they accomplish astonishing things!

Unfortunately, attitudes haven’t changed much for adults who face physical or cognitive disabilities later in life. They most often receive resources, tools, and support to cope with disabilities.  There’s a profound difference in mindset between coping and overcoming – resulting in profoundly different outcomes. If you’re facing a challenge take age out of the equation, embrace adaptive strategies, and insist on pursuing the fullest recovery possible.   

Wellness Assets

Visualize the six dimensions of health: physical, social, emotional, intellectual, spiritual, and vocational as spokes on a wagon wheel. Consider how many deposits you regularly make into each dimension (spoke) and then draw your Wellness Wheel. Are some “spokes” large (carrying most of the load) while others barely exist? Are you missing an entire “spoke”? It takes conscious effort to balance wellness assets across the body, mind, and spirit.    

Don’t leave your vitality to chance! Make a plan, balance your assets, and make regular deposits into lifelong vitality.  Visit www.kayvannorman.com for a FREE downloadable Vitality Portfolio® tool-kit to get you started.

First published at Sixty & Me www.sixtyandme.com

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Possibilities vs. Disabilities

Posted on Thursday August 25th, 2016

I’ve spent my career promoting lifelong vitality and have learned that great information and even programs don’t motivate action until people, of any age, first believe in their ability to change their circumstances. It’s absolutely proven that loss of function can be prevented and even reversed with resistance training and other exercise interventions, but many people don’t take advantage of these proven programs.

Part of the problem is negative expectations of aging – i.e. “it’s normal to become frail as I age”. But it’s simply not true. It’s very common. It’s very predictable. But it’s not normal and it’s not inevitable. And even if something challenges your functional independence it’s important to embrace a mindset of possibilities, rather than focusing on deficits or disabilities.

Young people with disabilities are given tools, resources, and encouragement to overcome challenges and live life fully in spite of them – and they do! But older adults faced with functional challenges are most often just given tools to cope with challenges. There’s a profound difference between the mindset of overcoming versus coping– resulting in profoundly different outcomes. Take age out of the equation and look at challenges through a lens of resilience. Actively support self-efficacy, self-esteem, optimism, purpose, mastery and control – the building blocks of resilience. Embrace adaptive strategies to live fully rather than coping strategies that create a smaller world.

Rejecting stereotypes and believing in possibilities will move us away from the – when in danger or in doubt, run in circles scream and shout approach to health challenges, and towards environments where people feel competent and compelled to live fully in spite of challenges.

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Helicoper Childrening - it's impact on Resilience

Posted on Monday May 18th, 2015

A recent newspaper article really gave me pause. It described technology solutions for keeping track of aging parents but also revealed both ageist expectations and what my friend Teresa calls “Helicopter Childrening”.  Family members described this technology as both comforting in the short term and as a tool to know when it’s time to step in and take over: notice NOT IF – when.  A parent “under surveillance” also described how her daughter lectured her on staying up too late at night.

I applaud adaptive strategies that help people live where they choose to for their full lifespan, and technology monitoring daily activity against a pre-determined “norm” for an individual can be a helpful tool.  But strategies to support safety and security must be balanced with a commitment to also support the building blocks of resilience like self-efficacy, self-esteem, mastery and control, optimism, and hope. 

Consider some low-tech solutions too!  Instead of watching and waiting “until”, employ the research proving functional loss can be prevented and in many cases reversed and create a family plan to maximize functional ability. Adult children who feel compelled to comment on a parents choices during the day (staying up late, sleeping late, etc.) need only to consider how much they would personally appreciate that type of interference in daily life. 

Take a cue from the disability movement and prioritize an individuals feelings of self-efficacy, autonomy, and mastery and control over their own life – regardless of challenges. Employ the concept of the “dignity of risk” to avoid creating a culture dominated by illness management.  Some risk is preferable to hovering, second guessing decisions, and trying to parent your parents. Take age out of the equation and use technology in a way that helps create a care partnership and culture of “whole person” well-being.

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Heart Health Critical to Brain Health

Posted on Monday March 16th, 2015

A new study following 1,000 older adults for 11 years revealed that poor heart health increased the risk of dementia by two to three times.  Do your brain a favor (and your heart) by embracing cardiovascular exercise and healthy eating.

http://consumer.healthday.com/cognitive-health-information-26/alzheimer-s-news-20/good-heart-health-may-help-stave-off-dementia-study-says-697127.html

 

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