March 2025

Coping with Uncertainty

The current turmoil in the United States has significant ramifications for the nation’s mental health, affecting not only the senior population but individuals of all ages. Consider this: People often feel most secure when they have confidence in the predictability of their environments. Unpredictable events, such as natural disasters, sudden deaths, and random crimes, can occur at any time. However, most of us wake up with a sense of order, structure, and routine in our surroundings.

Viewing our environment as constant fosters peace of mind and confidence in our actions. If I study diligently, I will pass the course successfully. My Social Security check will arrive on Wednesday. Attending law school will improve my chances of finding a decent job. And so it goes; we all progress in a stable and predictable world.

Wars and natural disasters can disrupt life’s predictability, yet they often unite a nation. During World War II, the rate of mental illness in London decreased. Why? The populace shared a common goal and purpose. People rose to the occasion and fought for a cause greater than themselves.

However, leaders and governments implementing rapid change without sensible rationale can demoralize a population. Suddenly, one’s former beliefs and values seem inconsequential, and the world no longer makes sense in the same way. What I proposed yesterday is no longer an option, and what might change tomorrow?

Valley Afar

moonbeams on summer’s night,
the sound of running water,
racing to far places,
where stones lie,
where flowers bloom,
were a valley
presents a meadow of flowing gold

Passing the Baton

Arthur Brooks wrote an excellent article in a recent issue of the Atlantic. Titled Why so many people are unhappy in retirement, his thesis is as follows. Brooks describes a hero’s journey, which is well-documented in literature and film; the journey consists of several parts—the call to adventure, the ordeal, and the victory.

Think about your own life. We get an idea of what we want and pursue it, but it is often at great sacrifice and cost. We move across the country to go to school, work hard to support a family, and put up with all the frustrations and anxieties of trying to build a career. This scenario is familiar to many.

So, what’s the problem? Brooks maintains that people run into difficulties once the victory has been won and the game has ended. How often have you read about executives, athletes, and others feeling bored or purposeless in retirement? They miss the stimulation and struggle of the quest.

Later-Life Transitions:

Loss of Physical Capabilities – Musculoskeletal

In 2023/2024, the SDPA Aging Issues Committee produced six ninety minute Zoom presentations entitled Later-Life Transitions Luncheon Series. Topics covered in this series included Retirement, Loss of Physical Capabilities, Moving to a Senior Facility, Becoming Caregiver to a Family Member, Loss of a Spouse/Partner and The Final Transition. We are presenting a summary of the material covered in each of the six series presentations in installments .

The second topic Loss of Physical Capabilities was facilitated by Cynthia A. Cotter, Ph.D. and Kenneth S. Dellefield, Ph.D. on June 16, 2023 and covered vision, hearing, vestibular and musculoskeletal systems. The summary below covers the material presented on the musculoskeletal system.

MUSCULOSKELETAL

The musculoskeletal system includes our bones, cartilage, joints, muscles, tendons, ligaments and bursae. With age we experience bone loss, joint damage, bone demineralization, loss of muscle fiber/atrophy and other conditions that can negatively impact movement and independence. The most common age-related disorders of the bones and muscles are presented below with descriptions of symptoms, possible causes and treatments.

Osteoporosis. As we age, we undergo gradual loss of calcium from our bones that decreases bone mass and bone density. If bone loss is great enough, bone strength declines and we can experience pain and loss of mobility. Osteoporosis is one of the leading causes of disability in older adults that can produce fractures associated with difficulty in standing, walking, and other movement. Risk factors include female gender, White or Asian race, family history, small body build, sedentary lifestyle, low calcium intake, excessive use of caffeine and alcohol, excessive use of steroids, anticonvulsants, thyroid hormone and magnesium/aluminum antacids, drinking large amounts of carbonated beverages, protein deficiency, and excessive tobacco use. Two prevention and treatment strategies are regular exercise and drug therapy. Weight bearing exercises and walking are the most recommended. Drug therapy may include calcium/Vitamin D, hormones (estrogen/progesterone) or medications such as Fosamax, Boniva, etc. (many newly developed of this type).

Anticipation

Anticipation is an adaptive, learned trait. Think about high-functioning people. They think ahead and anticipate the future the best they can. I had a friend who always thought about excursions with her children. She brought games, raincoats, etc., depending on her perception of the future. She was successful in whatever she did.

Anticipation is not just a helpful trait, but a crucial tool for seniors. As we age, our memories may not be as reliable as they once were. This morning at my club, I packed up my things immediately after using them, anticipating that I might forget them. I also lay out my golf items the night before, knowing that I might forget some of them in the morning rush. Anticipation, in this context, is a strategy for managing memory loss, making our lives easier and more manageable.

Seniors must overcome diminishing memory to avoid frustration and accomplish goals. Lists, day planners, watches, and reminders from a spouse can all help. In addition, it is easy to catch Capeitis in retirement, as my father used to call the condition that people who retired on Cape Cod tended to “catch.” They tended to drift into a space where obligations faded away, and the present became all-important. A day timer was a clock to measure a cooking egg, and commitments were a musical group from Ireland.

Pesto Pasta with Lemon

Jim and I stumbled on this recipe and it turned out to be wonderful! It is extremely simple and foolproof to prepare and there is a jolting blast of fresh lemon. A perfect quick entree for guests!

1 pound DeCecco spaghetti No. 12
3 large lemons, zested and juiced (6 Tbs. juice)
1 cup pine nuts toasted
1 large clove garlic
1 cup fresh basil packed (preferably “in vivo” basil)
1 cup finely grated Parmigiana-Reggiano cheese
3/4 cup extra-virgin olive oil
Kosher salt and freshly ground black pepper to taste

Toast pine nuts in a small dry frying pan being careful not to let the nuts burn. Shake pan while toasting.

Pulse lemon zest, pine nuts and garlic in a food processor until finely chopped. Add the basil and Parmesan and pulse a few times. Then, while pulsing, drizzle in the lemon juice and the olive oil.

Fill large pot halfway up with water and salt and bring to boil. Put in entire box of spaghetti and cook 10 minutes. Drain the pasta reserving some pasta water.

Add the pesto to the spaghetti and toss to coat. Add some reserved pasta water, salt and pepper and additional lemon juice to taste.

Serves four. Leftover pasta was great heated the next day.

Dominoes Falling…

Besides the usual childhood illnesses, I grew up with an intact body. The kids in my neighborhood and I played all the sports in summer and winter. We even had an indoor basketball court in the hayloft of my family’s barn. My outdoor athletic activity continued until the first domino fell around age 40.

I had to get glasses, but so did everyone else. No big deal! The second domino fell some years later when painful walking led to a hip replacement. The recovery was a successful challenge, and I continued most of my usual activities. Then came another hip replacement and a “heart incident,” as the ER doc referred. Some stents later, I was back out there.

Now it seemed the dominos were falling faster. The time between medical problems was growing shorter. Hearing aids and cataract surgery were in there somewhere. Initially, I was able to treat these problems as isolated problems that needed to be solved. More stents followed along with spine surgery and significant arthritis.

At some point, I realized I couldn’t stop the falling dominos. My mind felt young, but my body was aging and falling apart. Did this mean I would give in to these falling tiles? No, of course not! I had a team of able-bodied docs ready to go into combat. My insurance company was a go, and I was prepared to battle. However, I knew my mind needed to be clever.

I understood I had to pick activities I could do within a growing list of limitations. Could I hike? No, but I could ski. Could I be outdoors as much as I once did? No, but I could work on my computer and spend time with friends. I couldn’t stop the dominos of aging, but I could outwit them, at least for a while.

To Move or Not to Move…

…that is the question.

Here we were, living in beautiful Del Mar in a perfect house overlooking the Pacific Ocean, thinking we would never move again…that the only way we would be leaving this house was feet first!! That was then….this is now — now we live in beautiful Boulder Colorado, in a magnificent, brand new 5 star retirement community, in an apartment almost as large as our house was, looking out to the Rockies! How did this happen??

Our decision to make this monumental move came about from the accumulation of many little and not so little things. While we loved our house, it seemed like even minor repairs were feeling like responsibilities we no longer wanted to deal with. Del Mar, and San Diego in general, had grown exponentially in the 20 years we lived there — the traffic and congestion were becoming frustrating. We were growing older (in our 80’s) and we began asking why not make our lives easier by giving up the house and going someplace we would learn to love just as we’d grown to love San Diego. We were northeasterners for the first 60 years of our lives and, unlike so many of our friends, we’ve moved around a bit. The idea of living in a new place held a sense of excitement for us.

La Bonne Table

Hey, San Diegans! Would you like to eat at a quaint inn in France that serves fine food and offers personalized service? Of course, you would, but twelve hours is a long time to travel for a meal. However, I have good news!

On a Saturday evening, drive to an area on 5th Avenue in Hillcrest, where parking is ample, and claim your reservation at La Bonne Table. The small and intimate dining room features an old wooden bar that occupies part of the space. The staff is friendly and knowledgeable. Don’t be smug or try to show off your wine or food knowledge; it won’t play well in this welcoming environment of capable people. Are the staff friendly? Yes! They make you feel as if you are a guest in their home.

The restaurant offers a limited wine list and menu, but everything is excellent. It works well! On my last visit, I had steak with fries and was very happy. My martini was great, and the glass of Bordeaux I had was superb. The restaurant has a soothing effect; the food, service, wine, and ambiance create a relaxing and satisfying culinary experience.