Ageing and confusion

'C ' is for confusion. If other people haven’t noticed this – and we try to keep it from them – we who are ageing most certainly have. Sometimes it’s just a matter of bad memory, which we’ll probably get to later, but often its just temporary mental fuzziness or a break in the continuity of thought. Where am I, we ask – even, sometimes, who am I? (A friend said to me the other day, When I look in the mirror these days I hardly recognise the face – I look more like my father than myself.) I recognise that experience. I had a struggle the other day trying to identify a fragment of memory that was nagging at me– was it a dream or had it been a real moment? (Later I was able to identify that it was real!). This can happen to anyone of any age, but as you get older when it happens you look for warning signs of mental deterioration and are in danger of finding them even when they aren’t there.

The dread of course is the fear that we are going senile or have the beginnings of dementia or even Altzeimer’s. Usually however, it’s just that we are getting older with the past often more real than the present, and our ability to adapt to changing circumstances less than it used to be. There may be other reasons – a dietary deficiency perhaps, a badly prescribed medicine that doesn’t suit us, we have become over-dependent on alcohol, or we are not keeping ourselves warm enough – unsuspected hypothermia can creep up on us, or we may even be dehydrated. Most of all it could be that we are spending too much time alone.

If the confusion becomes a more or less permanent state of mind, then it’s time to seek medical help. It may be less serious than we fear and it could be that there is a nutritional disorder or infection that can be dealt with. If you are really worried about yourself, the kindness of family or friends assuring you that you are alright really, may be a hindrance to getting to the truth of how you are. Better to consult with a dispassionate friend – or even someone going through the same experience. Twice a year I meet with a group of my old college friends, and we stagger into each other’s company still imagining the youngsters we once were but, replacing that onetime reality with the funny old boys we have become. And as we rummage in our memories for a name or an event, we watch each other, often reassured that others are ageing rather less successfully than we are! It happens, this slackening of grip on reality. In varying degrees it happens to all of us.

Perhaps the greatest antidote to confusion as we get older is to accept it, which I don’t find at all easy. O.K. – the process of living and thinking clearly is not as simple and straightforward as it once was, and we may have to devise strategies to deal with it. But when all’s done, I guess we should try not to mind it too much!

Bryan

Ageing and depression

'B' is for breakdown; a nervous breakdown to be precise. Although not a recognisable clinical term, this is still often used to describe a loss of mental stability. In medieval times it might have been called ‘melancholia’, in the early 1900’s it was known as neurasthenia and then in the 1930’s our present term was used. It describes the experience of ‘snapping’ under immense pressure, with consequent physical or mental collapse, or both. More commonly now we would call it depression.

Depressive episodes may be caused by genetic and biological factors but are often triggered by social and environmental circumstances. Moving home for an elderly person after many years in the same place can do it. A sudden and unexpected death of a dear friend can do the same. Similarly anxiety about failing powers and the fear of not being able to cope with what once would have been ordinary pressures can destroy a sense of wellbeing. Retirement for somebody whose work has been their life, can plunge her or him into a strange and unwelcoming world. Bereavement is often a cause – losing someone you have loved may mean losing your own sense of who you are. Whatever the reason (and it may not be easy to find), depression saps your energy and motivation and can leave you feeling rootless, guilty and without hope.

I had such an experience in the mid 1990’s. I was on prosac for about five months (too long I now think, but I hadn’t then the energy to argue with my doctor). I also had some counselling, saw a homoeopathist, struggled back to work which became part of the therapy, had guidance from the Irritable Bowel Syndrome Support Network, and was supported by my wife and family.

The condition can make you a stranger to yourself and it’s therefore very difficult to manage your life -just existing is no fun: the worst thing about depression is being depressed! It is very difficult to move out of the trough in which you feel you have fallen. But it is possible. So what is to be done? Drugs are one answer, perhaps too easily prescribed. Counselling is another, social support a third, a fourth someone who has had a similar experience around to tell you that there will be better times, and finally the conviction of people who love you, that you are still yourself and will recover your equanimity. Most of all you need patience.

Bryan

Ageing and aches

' A ' is for aches. Ask someone in their seventies how they are, and they’re likely to say,’ alright, but for the usual aches and pains’. As we get older, rheumatic ailments are among the most common reasons for people to go and see their doctor, and women are three times more likely to suffer from them than men. The three O’s are often the villains.

Osteoarthritis happens when the tissue that connects the joints of knees, hands, hips and spine (the cartilage) wears away, leaving the surface of the bones with less protection. Sometimes the pain disappears for long periods before returning. Regular but gentle exercise can be helpful. Acute cases may require an operation such as a hip replacement.

Osteoporosis is caused by a lack of calcium. As you get older the ability to absorb calcium from food can be reduced. The bones become more brittle and although it is mainly a painless complaint, if you fall you are more prone to fracture. There may be a loss of height with the sort of ‘shrinking’ that some older people experience. Calcium supplements can be helpful as well as a balanced diet, a phrase we shall meet many times during these articles!

Osteomalacia is a softening of the bones, causing aches and tenderness in bones, weakness in muscles and a general run-down feeling. It’s caused by a deficiency of Vitamin D. So if you are troubled by this condition, and you live in Spain you have the advantage over the rest of us, for Vitamin D is produced in the skin by sunlight. Again a vitamin supplement –prescribed by a doctor (that’s important) - can do the trick, for this condition is curable.

If you suffer from these or other rheumatic pains, here are six sensible things you can do.

• Make sure there are no safety hazards in your house
• Have regular but not too strenuous exercise
• Get out into the sunshine as often as possible (with the obvious protection from creams)
• Don’t get overweight
• Maintain a good posture whether sitting or standing
• Keep warm – and baths are probably better than showers

Bryan

Coping with Ageing

I have been asked, by the ever enterprising euroresidentes team, to introduce some postings on the delicate business of how to grow old gracefully and without panic.

The subject is dear to my heart! I am in my seventy fifth year and have been retired now for nearly ten years after an active and eventful working life. My health during that period has been good and the worst I have had to struggle with has been recurring bouts of hypochondria – my occasional fears of some terminal illness happily proving illusory!

Until recently. In the last three years I have had heart surgery and radiotherapy treatment for prostate cancer. With good medical care in this country and in Spain, together with the unfussy understanding of my beloved family, I live well but remain curious about this strange business of ageing. There are often moments when I think ‘help! What’s happening to my body’ (and mind, which of course is also body). And if that’s your experience – hello!, and read on.

As a starter I will use the alphabet as a convenience, hoping that it will be a useful framework for the things we can touch on, but then perhaps move on to other matters. ‘An ABC Guide to Health for Older People’ sounds pretentious, but that’s the rough idea. I have no medical knowledge other than I can find from the web and from books, and any ideas that emerge will only be mine and have no authority other than my own understanding and experience. Where possible my concern is to be factual and to identify experiences that belong to most of us as we age. I admire people who say ‘I am as young as I feel’, but the truth is that often we don’t feel a bit young. Being old is more than feeling; it demands a level of realism about the decline, but also recognition of the new perspectives that ageing provides.

Your comments will be especially useful to others who may read this – so please, when you feel you have something to say or share, log on. Directed to people of a certain age, I hope others too may read and share. For – sorry, but it’s true – this happens to us all!

Bryan