WE SUFFER LOSSES throughout our life. During our youth, we might leave old chums behind when our family starts fresh in a new town or when we go away to college. Later, a job loss or a divorce could leave us drained both financially and emotionally. But for most of us, our senior years are when loss hits hardest.
Our body is often the first casualty, especially the face we see in the mirror each morning. At some point, the dents and dings of time take their toll on that image. My own visage is covered with sun-damaged skin and topped by silver hair. I’ve grown used to the view, but occasionally I’m startled by the realization I look old.
Achy joints and stiff muscles add another dimension to the picture. My complaints are minor, usually no more than a nuisance, but probably portend more serious problems down the road. Vision and hearing deficits have already arrived. The ophthalmologist is keeping an eye on my cataracts, and my wife says I’m overdue for hearing aids.
Meanwhile, gravity is beginning to win—again. We all start life held fast to the earth, staying put where we’re placed. As our strength grows, most of us commence to roll, then progress to sitting and crawling, until we eventually lift ourselves to our feet and begin to walk.
We may stay in motion for decades, never thinking of life without mobility. Young bodies generally do our bidding. They run all day until we drop into bed with exhaustion, then jump up at dawn to begin the race again. But one day, our strength begins to fade, or we’re laid low by injury or disease.
As a physical therapist, the core of my practice is helping folks either remain in motion or get moving again. Whether pain, weakness or some other ailment hinders movement, we join forces to combat whatever is stopping them or slowing them down. Often, we win, but many times the victory is incomplete, especially for older bodies. When that happens, we’re both forced to face the pain of loss.
As a therapist, I’m a spectator to this real-life drama. But for my patients, it can be a constant companion that haunts their waking hours and robs them of sleep.
Grappling with injury or illness is physically demanding. The cost in pain, money and time away from our lives is dear. Add to this the mental struggle, which can be even more severe, especially the realization that life afterward may never be the same. Even if we escape experiencing a single debilitating event during a long life, we may still be cognizant of the creeping loss of vigor that comes with age.
Many mourn the loss, but others seem to take the slowdown in stride. Consider a gentleman I met a few months back: He’s in his late 80s, with health issues beginning to curtail his once active lifestyle. From all appearances, he accepts his decline with grace. He’s cheerful, witty and expresses gratitude for his life. But I discovered that, underneath a veneer of contentment, he carries a different kind of burden.
When we first met, he told me of his first marriage, and of a daughter born with cognitive deficiency. He was a strong advocate for her and others like her, lobbying his state legislature for favorable laws and helping to found a special school. But she died in middle age, and his wife’s death followed several years later. He was resigned to spending his remaining years in solitude, but instead met and married a vibrant woman a few years his junior. With a beaming face, he told me, “I’m lucky I found her.” He seemed satisfied with his life.
At our last meeting, though, some of the façade fell away. He briefly recounted the family history I’d heard before. This time, however, as he brushed over memories of the past, instead of a smile, his eyes welled up with tears. I was mostly mute as he told me, in halting words, how he still grieves for his deceased wife and daughter. What words could I offer as salve for such a painful recollection?
More recently, at a chance reunion with an old acquaintance, another loss that often comes with age came up in the conversation. This man is a retired physician, age 86. I ran into him, accompanied by his wife, during a checkup at my ophthalmologist’s office. I told his wife I had good memories of him as a respected physician in our hospital, as well as a disciplined physical therapy patient in my clinic.
I could see that the doctor was getting around well, and asked if he had visited his home in India. He confirmed that he had, but that airports are confusing. “It’s dementia,” he said matter-of-factly, and added that his waning cognition also keeps him from driving farther afield than our little town. I glanced at his wife, and saw the same stoic expression that her husband wore. Though I can’t be sure, I departed our meeting feeling they both accepted his decline as just the natural course of life.
Both of these men are more than two decades my senior, and I observed at least a part of my future in them. Even at 62, I already feel the inevitable downward pull of gravity on my body. Though I still have the hardiness to dig my garden and split firewood by hand, I’m slower getting it finished. And the last hour or two of my 10-hour workday is a little more taxing than it once was.
How do we equip ourselves for the losses that inevitably come our way? Prudent financial planning is part of the answer. Life insurance won’t take the sting out of a loved one’s death, but it can replace income that’s vital for the family that remains. Likewise, disability insurance can mitigate the financial pain of illness or injury. In the retirement years, a robust cushion of savings can remove worry and cover practical solutions for the challenges that come with aging.
But money can’t replace companionship. It also won’t buy a cure for the heartbreak that comes with dementia. And what about dealing with the reality of our own physical decline?
I’m no expert on the subject. As I indicated above, I’m a spectator to a drama, with my patients occupying the stage. Perhaps a more accurate metaphor is player-coach, sharing the same hazards and headwinds we all face as we try—usually unsuccessfully—to make it to the end of the game with all parts of our life intact.
Despite a picture that may seem bleak, there’s plenty of space for hope. When life is harsh, we humans seem to draw on a resilience that can handle all manner of misery. And those with religious faith know the comfort and strength it can offer. We don’t know what troubles tomorrow will bring, but there’s no profit in worrying about them today, though I sometimes do. That said, I pray we realize our turn will eventually come and that, when it does, we’re given the grace to face it.
Ed Marsh is a physical therapist who lives and works in a small community near Atlanta. He likes to spend time with his church, with his family and in his garden thinking about retirement. His favorite question to ask a young person is, “Are you saving for retirement?” Check out Ed’s earlier articles.
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Well Ed, we are exactly the same age, and I live in a small community north of Atlanta. I echo your sentiments entirely. Especially gardening and splitting wood! lol. Not as fast as I used to be. My joints hurt, going up and down the stairs in my home has me dreaming of an old 4 sided brick home with a carport and CONCRETE patio…no more wood to stain and care for. My wife is a certified dementia practitioner and geriatric care manage, so mention of the doctor really hits home. It is in our dinnertime conversation every night while discussing the days events. Hang in there brother! It is all we auld pharts can do.
I have real concerns about my 70+ and 80+ year old friends still riding bicycles. Can’t seem to convince them they are a nanosecond away from serious injury which will drastically alter their mobility. The risk reward ratio is not on their side.
At 79 mobility is extremely important to me. I walk in our community botanical gardens 5 miles 5 days a week. Yeah it’s not near as much fun as Mountain Biking or Skiing was , but gives me a lot better chance of being mobile for as long as possible. I should be in the Gym too , but I hate the smell so there’s some hypocrisy there.
Thanks Ed; I’ve been a reader of HD for longer than I can remember but yours and Jonathan’s articles this week are about as good as it gets for reflecting on the past and the future. The same fate awaits us all, so the better to make preparations now.
Any day I’m included in a compliment with Jonathan is a good day–thank you for the kind words.
I am 76 and, like many of the comments you have received, am cogniscent of the toll of aging. I gave up running at 40. Stopped playing tennis at 70. And, a serious crash ended my cycling at 72. However, I am in the gym or pool 7 days a week, plus walking and a Tai Chi class.
My body hurts and I don’t have the stamina that I once had but I console myself with the reminders that: 1) I have outlived many of my peers, and 2) I am in far better condition and more mobile than many of my peers.
Small consolation perhaps, but it beats the alternative.
So many of these comments, including yours and those of Boomerst3 and Jerry pinkard below, stress the importance of accepting our present limitations as we stay active in mind and body, and being thankful for what we have. HD is full of great examples for living life well.
Good points here. I’m 73, had a knee replacement 9 years ago because of a college sport injury, have a partially torn rotator cuff and the typical joint pains from arthritis (thankfully not too serious). I go to a F45 gym 3-4 times a week, which is 45 minutes of Functional (the F in F45) movements. It includes cardio, weights and body resistance. Some call it HIIT. I am by far the oldest in the gym but because I have always been active, I can do it. I modify some exercises because of the rotator cuff injury, and you can go at your own pace. As many others here say, staying active as long as we can will definitely help us as we age. We may not be able to beat aging, but we can try to slow it down.
Great article Ed. Thanks for sharing.
I recently turned 80 and am all too familiar with PT. I had major knee surgery (torn MCL and ACL) when 36 and have had numerous issues with back, hip, rotator cuff and other joints since then. But fortunately I have avoided surgery for any of them so far. PT can do wonders to heal us.
I maintain an active life with exercise, walking, golf and gym, along with maintaining my 2 acre heavily wooded lot. I have slowed down but refuse to stop doing what I can, and grudgingly but realistically accept my limitations. I feel very blessed by the Lord to be able to do what I am able to do at my age.
As we age, I think it is really important to take as good a care of ourselves as we can with a proper diet, exercise and mental attitude. Whenever (not if) a serious illness affects us, we will be in better shape to handle it.
Ed, thanks for a great article and for your work as a physical therapist. I’m a fan of PT as an alternative to other treatments (surgery) when possible. When I was younger (30’s & 40’s), it was for sports injuries like rotator cuff. As, I’ve gotten older (now 70) PT for knee replacement and to help with loss of strength due to RA joint damage. My attitude is to impact those things I can and not to worry about those I can’t. PT helps with those things I have some ability to affect.
That’s a great summary–to stay in action and out of worry.
Ed, thanks for an interesting and insightful article. Like many other commenters, my wife and I have experience with aging parents, and are on that journey ourselves. Like much of life, I think the challenge is finding the right balance of raging against the dying of the light, and graceful acceptance of life’s realities. My mother was a good example of this when she fought brain cancer. She endured 6 hard months, including brain surgery, chemo, and PT. After an initial respite, the cancer came back with a vengeance, ravaging her brain. When it was obvious there was no alternative, she gracefully accepted her situation and allowed her family and friends to help her. She had helped many family members and friends during her life. They, or sometimes their children, lined up to help her in her time of need. It was a big help to my wife and me, and our family. I realized that it was her last gift to the people she loved, a chance to give something back to someone they cared for. It was humbling to see how good people are. The lesson I learned is that sometimes allowing people to help us is a gift to them, rather than a burden.
Thanks, Rick. My father also had recurring brain cancer. The first surgery gave him over a decade of normal health, but the second treatment left him with years of dementia. Your last statement is a true test of humility. It takes a lot of it to let go of our independence.
This insightful article points out many challenges that I see often in our 55+ community. There are many here, who are over 80. They make every effort to be active, and accept health decline with grace.
However, many don’t have a plan in place if they are disabled or unable to take care of themselves. When that happens, their children will have to bear the burden. That would be sad.
Sundar, I see the situation you describe on a regular basis, and I’m living it myself.
So many words of wisdom and encouragement here! Something I’ve tried to do, encouraged by many HD articles and comments, is to give away more of my prudently saved, and inherited, resources. I’ve been sending a money order at Christmas for several years to an impoverished relative-by-marriage. I’ve known her since she was 16 (she’s 70 now, and in poor health). She’s had none of the advantages that I’ve had and many more difficulties. This year, I overcame my ambivalence and also sent a money order to a much closer relative who did have the same advantages but also more challenges. I’ve lost patience with this person so many times, but as we age, why not let bygones be bygones?
You are both kind and generous!
A sobering and thoughtful article, Ed.
Re: your reply to Jeff’s comment below…..you need to get off that roof!
Happy New Year!
Andrew
My wife agrees with you Andrew!
Ed, these issues are on my mind all the time. I am 63, soon to retire physician. I have been very athletic in my life, and have been pretty well successful accepting the change in my physical abilities. More challenging is living with the reality of my fam history: father died of a sudden death event age 70 (presumed cardiac), mother currently in memory care with advanced and worsening dementia. Very much focused on the gift of today. Any of our lives can change in a heartbeat. Onward, Happy Holidays – and thanks again.
I had a long conversation with my cousin about our shared family health history a couple of nights ago. He’s worried about decline, but what can we do other than fight against the risk factors, take care of practical issues and make the most of today? Thanks for reading!
Very thoughtful article, Ed, and one I can strongly relate to. One of the greatest pleasures in life is the ability to move. I was always in motion in my younger days and always doing something.
My favorite hobby was figure skating. I started out as a freestyle skater but gave up performing axel and toe loop jumps as I grew older. Instead I found ice dancing—just as difficult in its own way—executing intricate steps on the edge of a skating blade, like choctaws and twizzles; but less dangerous than falling while flying through the air, at breakneck speed. However, still graceful and exhilarating.
The secret to maintaining motion is, as you’ve said, to keep on moving to the extent we are able and to be grateful for what we still can do.
Your great attitude is just as therapeutic to your patients as your therapy in helping them improve mobility and lessen pain.
Marjorie,
I grew up in Hanover, NH in the sixties and seventies. A classmate of mine parents, Michael and Lois McGean, were the national ice dancing champions in 1950 and 1952 and won the World/International Ice Dancing Championship in London in 1950. They started a figure skating club in Hanover.
Above post is correct
How interesting, David. The McGeans made ice skating history.
So interesting, Marjorie. I don’t remember reading about your ice skating. A lovely early-80’s couple I know met as teenagers when they were both competitive roller skating dancers. They continued until just a few years ago, more because of the difficulty finding rinks than because of their own physical issues. They hung up their skates but continue ballroom dancing at least weekly. They’re frequent cruise travelers with their choice determined by the availability of ballroom dancing – even if they’re the only ones on the floor 😊. Hope I get to watch them sometime.
I also loved ice skating on local ponds in winter. Nothing like outdoor skating on a cold, sunny wintry day. See my response to Ed Marsh below.
Marjorie, I don’t recall reading about your skating before now. You are still graceful in your writing, and gracious with your comments. Thank you.
Ed, although I never wrote about it, the information is in my bio. I was accredited by the USFSA – United States Figure Skating Association. I only skated at the amateur level but met the standards for ice dancing, and have certificates for the standards I met. Ice Skating incorporated everything I loved – music, dancing, artistry and skating. Thank you for your generous compliments.
Great article, Ed! It’s better to be seen than viewed!
True! Thank you.
Thank you, Ed. This was a great article and timely for me with things going on in Spouse’s family for dementia and ALS issues. I was also reminded of the therapy I had 2 years ago when I needed some help with my vision issues. You are right that there is much we have to accept with grace. I also try to remember there is always something to be grateful for. Chris
Thanks, Chris. In The Great Divorce, George MacDonald tells the author-narrator that different people will look back at their life on Earth as having already attained either Heaven or Hell. It takes a lot of grace to accept everything in life that comes our way.
That’s a favorite C.S. Lewis book of mine. Entertaining and thought provoking.
Ed – I think all of us have some of both, heaven and hell. Thankful for the heavenly moments.
I think the key word is “acceptance”. If you don’t accept that at some point you will at least cut back if not retire completely you won’t make the necessary financial plans. Equally, if you don’t accept that you may not be able to live independently at some point, you won’t figure out how you will get help. And, just as important, if you don’t accept the reality of death you won’t take the practical steps – will, POAs, DNR etc. – never mind the emotional steps, to be at least somewhat prepared. I’m about to sign up for a course based on Katy Butler’s “The Art of Dying Well’, although I have already done much of the practical work.
You are wise to make plans, Kathy. Many of us have trouble with that first step of acceptance, as you say.
Excellent article as usual Ed.
Being a retired orthopedic Physical Therapist I know the prescription for delaying physical decline as long as possible as do you. Exercise, both aerobic ie lower intensity longer duration exercise such as walking, bicycling, hiking, kayaking, etc; as well as strength training, and balance exercises.
Despite working out six days a week year round I still find the number of hours I can work in the yard steadily declining (though my wife says I get more done in an hour than most others do in 1/2 a day). I always ask myself how do people that don’t work out fare doing the activities I’m currently engaged in?
The mental/spiritual part? That I’m not very well suited personality wise to handle. 🤷♂️
I probably don’t do most of the physical activities that you do, but to keep up with the things I do need to do, walking (and not even close to 10k steps) seems to keep me going, and a weekly Silver Sneakers Zumba class. I know more would be better, but so many of my friends who have been dedicated to working out seem to have needed various joint replacements. Maybe there’s no connection but I wonder …
Hi Linda,
Just as a FYI regarding your last sentence. A research study years ago showed no correlation between runners and knee arthritis.
FYI I had both of my hips replaced before I was fifty and still stationary bicycle >1 K miles per year (one hour at a time) and can leg press 380#, so keep pushing! The more you can do the better your odds of maintaining your physical abilities.
PS Lindsay Vonn just returned to the World Cup skiing tour after a partial knee replacement at 40 years old.
Thanks for the info on the research study. David. Sometimes we (I) jump to incorrect conclusions based on partial information/observations. And I agree that maintaining our physical abilities is worth the effort.
David, we’ve seen both kinds of folks–those who handle the decline well and those who don’t. And everything in-between. Don’t we first try to help patients understand the reality of their starting point, as well as the realistic potential they can hope to achieve? I’m trying to take the same approach from a mental standpoint. Loss is bound to feel lousy, but–hopefully–we’re left with enough will to keeping finding joy in what we have left.
Thanks for this synopsis of the variable life process. I’ve written in the past of things I no longer do: aggressive whitewater rafting and climbing tall ladders. It’s not without regret, but these changes mark an acceptance of what is real in my current life experience.
Happy New Year to everyone.
I’m teetering atop that decision ladder, Jeff. I still climb on the roof for cleaning, but already thinking about how to pass the job on to someone else. My wife has already dropped out of rafting. She says she’ll stay at the lodging with a book or hit a dry-land trail while my daughter and I enjoy the water. I wondering when my time will come.
Well, Ed you are right of course. I’m 81 and feel the fading energy, but fight it every day, Connie is 85 and spends free time at PT trying to deal with back and related problems.
The fight for independence never ends.
But Ed, now you have me depressed starting the new year. As my 80 something buddies say when asked how things are “I’m still here.” They say.
I’m not in Jail.
I’m not in the hospital.
I’m not in the ground.
Today is a good day.
Yesterday I saw all the kids and Grandkiddies. It was a wonderful day.
Someone said to me recently: “Any day I wake up is a good day”.
I have a patient who tells me he’s happy he “made the wake-up list today.”
Dick, I don’t yet know how it feels to be 81, either physically or emotionally, but I’m getting flashes of insight. You’ve documented the challenges you’ve faced at each stage of your life, and of your fight to do your best each time. You have a cadre of fans here that hope you continue to do so.
Compared to animals, humans have a big brain which gives them the gift of intelligence. With this intelligence most of us come to understand (but not necessarily accept) our mortality. With life, comes the certainty of death. However, we don’t know what the trip will be like between the two events.
Will our trip end with a sudden painless event in our sleep some night? Or might we face the long, long gradual diminishment of our health and intellect to the point where we live on in misery and loneliness wishing to die but still stuck with the living, or something in between..
And, we all live our lives with the fantasy that we can control what is happening, at least to some degree. Or, we might lean on religion or mysticism to help us cope with how our trip is progressing. Some just pretend that it isn’t going to end.
Like everyone else, I am just trying to cope. I used to be able to walk 4 miles in under an hour, now I feel good doing 3 miles in just over 70 minutes. However, this is just one more little thing (along with my pacemaker) slapping me in the face saying I’m not the man I used to be. And, there is really nothing I can do to significantly change what is happening.
My one year old grandson and his parents are flying home today after a holiday visit that my wife and I really enjoyed. It is events like this that still make my life enjoyable regardless of all the little aches and pains. I just have to hope that the pluses continue to out weigh the negatives.
It is commonly said that cowards shouldn’t grow old. Unfortunately, they, like the brave, aren’t given that choice…..
You’re right, we often don’t have a choice. I had a conversation Christmas Eve with man who retired five years ago at age 70 and has since continued to stay busy with regular exercise, education and service work. I said he plans to “stay active, helping myself and others.” He knows he doesn’t have ultimate control, but he has the desire to keep moving and make the most of each day.