In the popular jargon of the day, my father-in-law was a good guy. Bob was good natured, welcoming, fair and gifted with humour and generosity.
Like some, he was a bit of a worrier about his health and subscribed to the Harvard Health Letter of the day — one issue of which stood out. In it, one expert claimed that when you retired at 65 years, you could probably count on good health for 10 to 15 years.
And so it was with Bob. His wife, Eve, inherited a small fortune, and they used it to good effect by happily travelling to spots all over the world and sometimes invited us along — good for us and them.
Following the Newsletter’s script, in his mid-to-late 70s, Bob developed a series of medical problems. Angina was followed by transient ischemic attacks and a stroke, which I’ve written about before because his case was written up for a medical journal complete (with an MRI scan of his thalamic stroke).
Following this, oddly enough, his hypochondriasis was gone, just in time for the bowel cancer which, a few years later, killed him.
His history was common enough: good health for 10 to 15 years following retirement followed by one health care problem after another in his late 70s, followed in his case by death at 78.
When I was a medical student in the 1960s, most people didn’t make it past their early 70s because of cancer and cardiovascular disease for both of which there were no good fixes in those days.
There were exceptions of course — outriders who lived well into their late 90s, still mentally sharp but most experiencing increasing trouble getting about without assist devices.
There was nothing like the many game-changing interventions we now take for granted.
Joint replacement surgery, effective drugs for a growing list of autoimmune diseases and cancers (capable of turning what were miserable, even fatal diseases into manageable problems) and a growing array of interventionist tools, which cardiologists and cardiovascular surgeons deploy these days to fix problems in the heart and arteries. All transformed health care in the last several decades.
What we can’t stop are what I see in long term care facilities– progressive degenerative diseases affecting the brain such as Lewy body dementia, fronto-temporal degeneration, and most common, Alzheimer’s disease, vascular dementia, and other diseases such as amyotrophic lateral sclerosis, better known as ALS.
What changes in our 80s through to the end of our lives are the compounding effects of multiple challenges such as impaired hearing, limited movement, pain in this or that joint or region, impaired balance, forgetfulness especially for names and appointments and items on to-do lists.
We’re simply not as clever as we were in our middle years, much of which may go unnoticed or acknowledged especially when we’re surrounded by others of like age equally, if not more, challenged.
Which brings up a major problem highlighted several years ago by the U.S. Surgeon General: loneliness. It’s not hard to see why.
If you’ve lost a partner, spouse or close friend and all the easy conversation and shared activities that implies, how do you fill the moments, days, months or years?
Sure, there are plenty of “things” and “events” to do, but they don’t fill the void of those linchpin people in our lives as we age, especially in the later decades because others of similar age increasingly suffer from similar losses and constraints.
Late life is the great winnowing — the slow, painful loss of someone with dementia, increasing physical fragility or out of the blue, a major stroke, heart attack or a fall with significant complications may strike.
I’m struck by loneliness in the long-term care facilities where my wife Janet lived for over six years and even before that, for several years at home.
From my observations, residents with dementia rarely form meaningful relationships with other residents, despite seeing and literally bumping into them daily, and sharing the same mealtime table for years.
The same residents rarely touch talk to, or even touch one another. Some staff are very helpful by talking to them or better holding them, but there’s only so much you can do when facilities are understaffed — a universal problem these days in underfunded, understaffed nursing homes.
Residents in long-term-care facilities are among the loneliest in our society and with that loneliness and social isolation, comes a withering of social skills and speech.
Isolation and loneliness are true also in the wider society, especially for those in apartments with little sense of community, and much worse in the middle of busy cities such as St. Catharines, Hamilton and Toronto.
The Surgeon General was right about loneliness, even in the midst of busyness.
Dr. William Brown is a professor of neurology at McMaster University and co-founder of the InfoHealth series at the Niagara-on-the-Lake Public Library.
