Louisville Medicine Volume 66, Issue 6 | Page 37

REFLECTIONS Reflections TRANSITIONS Teresita Bacani-Oropilla, MD R etired life rolls merrily along for many. Pushing 80 or 90 is a happy time for most. Still able to drive, we attend meetings, reunions and family events, are prized as con- sultants, and do charity and church work. We travel. We are treated with love and deference, deserved or not, because of our ages, who and get free rides of joy. All must take advantage of and enjoy, because these privileges can change in a week, maybe a day, or in the twinkle of an eye! So fragile have some bodies become that a little mishap will stop us in our tracks. One member of a conglomeration of body systems that got along perfectly well before, suddenly balks. Like the legendary straw that broke the camel’s back, this literally happens as when one of the osteoporotic cracker thin vertebrae in one’s back gives up and collapses! Aaaauuughhh! Then pain exacerbated by any movement ensues. Getting out of bed or walking to the table to eat become excruciating chores. Workups are followed by general anesthesia, surgical proce- dures, rehab to restore weakened muscles, and assisted living because one is now unable to care for oneself. The house of cards has fallen flat! A broken femur, a mild cerebral infarct, a leaking heart valve, a urethral stone, a mild case of the flu, even a foot wound can start a cascade - nay, an avalanche - of woes that one never imagined. It could begin the transition to another way of life. In a country like ours, where extended families have broken into nuclear ones, and older members are living longer lives, the care of the latter has become a dilemma for all. Once vigorous self-supporting elders, still clear of mind, full of enthusiasm and not really ready to give up on the business of life, unfortunately, are not safe to live alone. It is not lack of love or caring, nor even lack of sustenance funds in many cases. It is lack of time. Many couples or singles in assisted living are there after careful deliberation of all concerned. The sandwich generation of active working children and grandchildren have to maintain precarious schedules themselves that definitely cannot include daily time-con- suming routines of checking in on elderly, suddenly handicapped relatives. It is painful for all. It can entail the necessary breaking up of an ancestral home where now adult grandchildren had their own “blankies” hidden in some closet, the giving up of rare one-of-a-kind treasure collected from travels in foreign countries, the trophies and mementos of retirements from prestigious positions, or the folded flag given to a widow at her husband’s military funeral. When transition comes, these have to go, and to where? We hope it will be a safe and comfortable place, maybe a room with an alert bell around one’s neck if we fall or cannot get out of bed. The assisted living homes and staff that inherit these newly “displaced” try their very best to preserve the dignity of their new charges. They are assured safety, reminded if they forget meals or to nourish themselves, helped with self-care, entertained so they don’t get bored, and exercised so they maintain physical skills. It is indeed a transition, a choice among many others. It is something to think about, plan for and be prepared for. It also takes the courage of the brave to go through and accept it. But who says old people are wimps? This is just another bump in the rocky road of life, on which we are already veterans! We will get over it! Dr. Bacani-Oropilla is a retired psychiatrist. NOVEMBER 2018 35