Aging brings challenges – and the resilience to deal with them

03/10/2014 12:00 AM

03/10/2014 10:48 AM

Marge Gorman and Gordon Sims, a sociable and active retired Sacramento couple, had invited people over to their Arden Oaks home for a Super Bowl party. Then came the accident a few days before the game: Gorman, 69, fell in the bathroom late one January night. She fainted, hitting her head on the doorjamb and suffering a spinal injury.

“I couldn’t feel my arms or legs,” said Gorman, a retired state employee. “I wake up, and I’m blind. I can’t see anything. It felt like I was a pretzel when I woke up, but I couldn’t feel my arms and legs.”

Her sight returned during her weeklong hospital stay, but she regained only partial use of her limbs. What followed was several weeks of intense therapy at Sutter Rehabilitation Institute in Roseville, then a grueling but successful operation last week to fuse her neck vertebrae. Next up for Gorman, who is also a breast cancer survivor, is outpatient physical therapy that’s expected to last up to nine months, to help her regain the use and feeling in her hands and limbs.

Despite her ordeal, her attitude is positive.

“This has been a bump in the road,” Gorman said before her surgery. “A big bump. It’s slowed me down. I do have to be brave, but we do what we have to do.”

Aging experts call that positive attitude the paradox of aging: Although growing older increases the likelihood that people will deal with physical limitations, chronic illness and grieving the loss of loved ones – life events that could reasonably be expected to cause lingering sadness – research shows that aging generally also increases people’s likelihood of optimism.

And the resulting sense of emotional resilience plays a critical role in helping older adults weather the difficulties of age.

Interestingly, the hardships of aging are more easily quantified than the happiness. Although people are living longer than ever before, 80 percent of people 65 and older have at least one chronic illness, according to the U.S. Centers for Disease Control and Prevention, and 50 percent have two or more. And when disability results from those conditions, almost 15 percent of elderly Americans require assistance with the basic activities of daily life, such as bathing and preparing meals, according to the federal Agency for Healthcare Research and Quality.

Despite a diminished quality of life and gradual loss of independence, they’re coping: Only 10 percent of older adults are dealing with depression, according to the CDC. What’s more, a growing body of research shows that people’s sense of well-being tends to rise when the hectic midlife years come to a close, and it keeps rising as people grow older, even in the face of physical challenges.

American Psychological Association findings consistently show that mental health in general improves as people grow older, partly because many older adults have learned to avoid unnecessary stresses and dramas and instead concentrate on good times and happier memories.

The secret to their contentment is that simple: They don’t dwell on the bad.

“There are neural changes,” said Mario Garrett, a San Diego State University gerontology professor and a blogger on aging for Psychology Today. “Older adults’ brains rewire to look at positive things, so we remember more positive things, and we put value on those positive experiences.

“And the linchpin for all that is that older adults accept what is happening to them. Older adults flourish in the midst of diminished capacity through accepting those changes and realizing that those changes are what makes them who they are.”

That acceptance of the aging process is one element in helping build the emotional resilience that allows older adults to cope with aging, according to a 2012 report by Arizona State University researchers: Seniors who accept the physical and emotional wear and tear of their years are better able to bounce back from illness and crisis and cope with adversities. Other keys to emotional resilience include maintaining family ties and social connections, as well as feeling a sense of purpose.

“Not only does it take courage for older adults to confront those hard situations, it takes wisdom to focus on what’s important,” said AARP California spokesman Mark Beach. “It sounds like a cliche, but one of the things you gain as you age is wisdom. It means understanding what’s important and what you have the power to change and what you have to accept.”

But the challenges can be daunting. For example, while AARP research shows that 90 percent of older adults prefer to remain independent, living in their own homes, doing so becomes much harder after a catastrophe such as an accident, or a heart attack or stroke that leaves them weak, or a fall that causes spinal damage or a broken hip.

The average age of patients at Sutter Rehabilitation Institute is 67, and about one-third of them are recovering from stroke. Osteoporosis, falls, arthritis and joint replacement account for almost half of the center’s patients, said its medical director, Dr. Adora Matthews.

The best indicator of a patient’s chances for a successful rehabilitation – enduring weeks of physical and occupational therapy to relearn how to walk or raise a fork – involves the strength of the patient’s support system, she said.

“That’s one of the first things I notice,” Matthews said. “People with a strong support system tend to be more adaptable and less depressed. If they have people they can lean on, they tend to rally very well.

“I’ve been surprised at times by the adaptability of some of the young people we’ve had here. But for geriatric patients, their life experience helps a lot. They’ve seen a lot. They’ve had time to prepare for the fact that something difficult may happen in their lives.”

Marge Gorman was widowed in 2002. She met her partner, Gordon Sims, an 81-year-old retired federal worker, 11 years ago. They travel and spend time volunteering in the Sacramento community, partly through the Widowed Persons Association of California.

And Gorman paints. After retiring from the state in the mid-1990s, she devoted herself to artistic pursuits. She took lessons in doll-making and for years fashioned art dolls by hand, eventually teaching classes herself. And she began to create watercolors, again taking classes, then entering art shows.

“It’s just a joy,” she said. “You put your heart and soul into it. That’s how I feel about painting.”

Her recreational therapist, Alyssa Rose, worked with her during her three-week stay so she could hold a paintbrush steady in her right hand, using her left hand part of the time.

“I don’t want to see people limit what they do for leisure,” Rose said. “They’re retired. This is their time to enjoy themselves. They’re trying to remain young and active, and they’re trying to maintain social connections.

“We see seniors who’ve had active lifestyles, and now they’ve had this life-altering event. How do they return to the activities that have meaning and purpose for them? We focus on that quality of life.”

That’s what Gorman is focusing on now, too, as she recuperates from surgery.

“I’ve volunteered for everything in the past,” she said, “and I’m not going to do that anymore. I’m slowing down, because I need to. But I’ll still do my watercolor classes.”

She is using a walker now, and relying on Sims to cook and help her get up, get dressed, take her medications, and to drive her to medical appointments. They’re adjusting to their new reality together.

“You can’t let it whip you,” Sims said. “It’s an unfortunate situation, but we’ll get by.”

Gorman agreed.

“You go through hardships, and you pull up your bootstraps,” she said. “And you keep on going.”

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