Lesson 1: Introduction
Retirement is something that most of us spend half our lives looking forward to. The idea of finally being able to say goodbye to long work hours and hello to spending our time the way we want to is massively appealing.
But then comes reality, which for many people is not all it’s cracked up to be. Retirement can often be followed by a sense of loss – loss of energy, loss of purpose, loss of responsibility and loss of importance. This can be a painful transition in some cases and many people will even find that they end up having something of an existential crisis.
But even if you don’t feel that way psychologically, what it does to your body can sometimes be devastating. The problem is that you don’t just lose that focus and purpose – you lose the excuse to go out and socialize more often and thereby you lose the socialization entirely. Altogether, this can eventually lead you to stop both challenging your brain and pushing your body as regularly; which is when old age and physical deterioration can really start to sink in.
Think about the older people you’ve known in your own life: very often, the moment they enter retirement is the moment that they start to really deteriorate and physically age.
So the question becomes: how do you stop that from happening?
And that leads us to the core of this, our first lesson in setting up a Healthy Retirement.
Lesson 1: Core Material
Part 1: See your doctor, dentist, optometrist, etc.
As we get older it’s natural for our bodies to begin showing signs of wear and tear. But there are things we can do to prevent these changes from defining us or controlling our lives any more than necessary.
First and foremost is to not neglect our bodies, and the best way to do that is to increase the frequency of regular visits to our doctors, dentist and optometrist.
While important earlier in life, whether at our own or our employer’s request, these visits are even more important now in order to watch for patterns or trends that could portend future illness, injury or infirmity. Likewise, while watching our physical health throughout our lives is ideal, it’s never too late to start paying more attention to our health and thereby benefiting from a lifetime of experiences in taking good care of our bodies.
Key things to monitor with our doctors are:
- bone density;
- joint, heart and lung health;
- brain and nervous system function;
- digestive system function;
- acuity of our senses;
- dental hygiene; and
- condition of our skin.
Osteoporosis, a common condition experienced by seniors, is caused by decreased bone density, and increases the fragility of the skeleton. As we age, our bones become thinner and more brittle, especially in women, making us more susceptible to falls that can lead to broken bones. Accordingly, hip fractures are much more common in the elderly, and with complications of the surgery can lead to much more serious conditions, even death. But with regular checkups, our physician can help us prepare for, avoid or even mitigate such conditions.
Painful joints in our hands, arms, back, hips and legs are most often symptoms of osteoarthritis, another common age-related condition caused by the loss or wearing down of the cartilage in our joints. This condition can be brought on or aggravated by injury, smoking, heredity and obesity.
In addition to the more well-known and feared heart diseases, age-related changes in our hearts include overall enlargement of the organ, thickening walls and slower heart rate. Again, careful monitoring ourselves and by our physicians can help us mitigate or avoid the negative consequences of these changes, and even increase our life expectancy, with or without the aid of medicine.
Reduced respiratory function, such as asthma or chronic obstructive pulmonary disease, or COPD, is common among seniors, and makes us more vulnerable to pneumonia and other deadly infections. It isn’t hard to detect, however, through regular lung function tests.
It’s normal for our brain and nervous systems to change with age, often noticed as greater difficulty remembering things, but not always a sign of dementia or Alzheimer’s Disease. In some instances, plaques and tangles can form in brain and/or nerve cells, and these abnormalities could lead to dementia with time. Careful and frequent monitoring of our brain activity and reflexes can help our physicians ward off this deterioration in our brain and nervous systems.
As we get older, our digestive system often becomes more rigid, firmer and slower to contract. This can lead to constipation, diarrhea and stomach pain, but through close monitoring and discussions with our physicians these conditions can be avoided or at least mitigated through dietary adjustments.
Just as our brain and nervous system begin to show signs of reduced activity or function as we get older, we may also notice that our senses are beginning to weaken or become less acute. Foods may not taste as good as we remember, our vision may not be as sharp as it once was, and we may not be able to hear things as well as we once did.
It is becoming more important to monitor all of these changes with age, not just because early diagnosis increases our chances for finding mitigating procedures or devices, but more importantly because these conditions could become dangerous to our health.
Poor vision can result in us tripping or falling, or walking into the path of a moving vehicle or falling down stairs. Poor hearing could prevent us from receiving a warning in time to avoid a serious accident. Diminished taste and smell could prevent us from detecting spoiled food or a dangerous chemical, like a gas leak or even smoke from a fire. And decreased sense of touch can prevent us from feeling pain, a warning of serious injury, including bath or dish water that is dangerously hot.
Just when we think everything else is under control, we may find that our tooth enamel is getting thin, making our teeth seem more sensitive to extremes of temperature (cold/hot), but also making them more susceptible to cavities and decay. Even our gums could become more susceptible to disease, and we are likely to find that our saliva production has also decreased.
This is all made less tolerable by the fact that, for many seniors, our health insurance, if we have any, no longer covers routine dental care (like MediCare). Further exacerbating this is the fact that many of us grew up before the days of fluoridated water or toothpaste, or in less developed areas where these were viewed as unnecessary or luxuries. It is a sad trend for too many of us to no longer have many of our natural teeth by the time we retire or reach retirement age.
And not only are our bones getting thinner and possibly more brittle, but our skin is getting thinner and more brittle (and fragile) with age as well. This makes us more likely to be cut where we used to just bruise, and bleed more profusely than we once did.
The bad news is that all this depends mostly on how well we protected our precious skin when we were younger. The good news is that we CAN still help it by increasing those protective activities as we get older.
At the very least, adding a dermatologist to our regular visits is well advised in order to identify skin disorders and potential cancers early enough to increase our odds of successfully preventing or treating them.
Part 2: Measure your Body Mass Index (BMI), weight and waist.
What is Body Mass Index, or BMI? Technically, it is a ratio of our weight and height; specifically, our weight in kilograms (kg) divided by the square of our height in meters. For those of us who haven’t fully begun thinking metrically, it is our weight in pounds (lb) divided by the square of our height in inches, multiplied by a conversion factor of 703.
Although it isn’t a direct method of measuring body fat, like the skin pinch method, it does appear to correlate very closely with metabolic and disease conditions when compared with other more direct methods of measuring body fat. The prime benefit is the ease with which we can obtain these two numbers and making the calculation ourselves, without the necessity for specialized (and expensive) equipment or technical expertise.
BMI is a screening tool that can help us determine in which standard weight category we fall; underweight, normal or healthy, overweight or obese. Once we have placed ourselves in the appropriate category, if we find ourselves outside of the normal or healthy category we can then seek the counsel and advice of our medical experts to draw up a course of action for moving closer to our ideal body weight.
Children and teens are evaluated differently from adults, and since we are concentrating on Baby Boomers we will also confine our discussion to how BMI corresponds to weight categories for adults over 20 years.
Following are the four categories and the range of BMI for each:
- Underweight - below 18.5;
- Normal or Healthy - 18.5 to 24.9;
- Overweight - 25.0 to 29.9;
- Obese - 30.0 and above.
Again, although there is a strong connection between BMI and body fatness, it isn’t a direct measurement, and so there is to be expected some variability in body fatness between people with the same BMI. For example, athletes tend to have less body fat than non-athletic persons with the same BMI, principally due to the higher ration of muscle to fat in athletes. Thus their weight is due more to muscle mass than fat.
There are other generalizations that can be attributed to BMI, but the only other one that we will mention is that older people tend to have more fat than younger folks, on average, with the same BMI.
Part 3: Account for your regular activity.
Physical activity is one of the most universally accepted ways to maintain good health into our senior years. But as with most resolutions or goals, if we don’t make them measurable we won’t be as likely to continue them. We need to make them habitual.
A commonly accepted axiom is that it takes 30 days to create a habit. That applies to both good and bad habits. So it’s very important for us to identify the bad habits that we want to replace with good ones, ones that will help us leave longer and fuller lives.
One of those bad habits is a sedentary lifestyle. This is particularly true, and even dangerous, among our seniors. We harbor long-held ideas that when we get old we are going to be tired all the time and just sit around in a rocking chair watching our grandchildren (and the world) run right by us. NONSENSE!! That prophesy is strictly the self-fulfilling kind.
FIRST of all, we need to document ALL of the physical activities that we undertake daily and weekly NOW; that's our status quo. That may take some time to account for, so we might need to start an activity diary, sort of like a Nielsen TV Rating diary, only for OUR OWN benefit, not for the networks.
THEN, we need to discuss with our physicians what kind of activity we are currently doing, and what others we can do that are both suitable AND beneficial for us now and in the future.
And FINALLY, once we arrive at an activity that interests us, we should set some step-wise, measurable and achievable goals. We should also find some way to track our activities, whether written in a journal, recorded on our phone or computer, or monitored and recorded in a smart-watch-like wearable fitness tracking device.
Whatever activity and tracking methods we select need to be something that we are not only able to do, but even more importantly WILLING to do and keep on doing. Even better is something that is scalable, so that we can increase the level of activity in some measurable way.
An example is walking, something we can measure in steps, distance and/or time; and it can be increased as we reach our first goals in order to keep its benefits from diminishing over time.
So, back to tracking our activities. We need to create a system of reminders, whether they are marks on a wall calendar, alarms on our phones or even sticky notes on the fridge, TV or computer. And the two characteristics we need in our activities are PERsistency and CONsistency.
In other words, we need to keep doing it regularly AND over the long haul, not just a dash, but a long distance run for our lives.
Part 4: Account for your diet -- list what you eat in a diary.
Just like we need to account for our current activities in order to build a plan for increasing them over time, we also need to account for everything we eat or drink NOW so we can discuss with a physician or dietitian whether or not we need to change something. Often our propensity for being overweight or obese isn’t about eating LESS, but more about eating RIGHT.
WHAT we eat is nearly always more important than how MUCH we eat. And this is never more true than if we never seem to feel full even when we are finished eating. This is almost always due to a lack of protein and fiber in our diet, or an overabundance of processed sugars. That’s why starting with an eating journal is SO important in making our diet MUCH more healthy.
But before embarking on some newly minted fad diet, it’s always better to check it out with your doctor to ensure you aren’t going to do something counter to any medications you might already be taking. It’s also important to record as much nutritional information about the food we are eating at the time we are preparing it, or right after eating.
Fortunately the packaging of most are now required to provide a minimal amount of nutritional information for us, but for those things that don’t, like fresh produce and meats, we need to ask where we shop for the information, and most of them have some kind of data sheet or website where we can find out what we need to know.
Part 5: Measure your mood and evaluate your energy level.
It’s a fairly easy thing to measure our physical state of health or fitness. But what about our mood or our energy level? How do we measure that? Why should we? Well, it’s often thought that we all slow down as we get older, exhibiting lower levels of energy, both of which can contribute to feeling “down” or moody. While generally lower energy or moods can be considered normal, a sudden drop in energy or drastic mood change can be symptomatic of more serious conditions.
Additionally, noticing changes in our physical health may be difficult at first as they tend to start slowly, more subtly, and at times are imperceivable. The more noticeable changes may first come in our overall level of energy or mood. So it’s just as important to find a way to measure and track these changes as it is the physical ones. But how?
Well, we can adopt a simple scale by which to measure them, similar to the way doctors ask us to assess our level of pain: "on a scale of one to ten, what level is your pain right now?"
Of course, this is unique to each of us, but here’s a suggestion to try: take daily stock of your energy level, self-esteem, stress level, and quality of sleep. You can adapt this to yourself, but here are some of my thoughts on it:
- On a scale of 1 to 5, with 5 being the highest, how is your energy level today? Are you full of boundless energy ready to take on any and all challenges (5), or did you have to drag yourself out of bed and been dragging along ever since (1)? Or are you somewhere in the middle?
- On a scale of 1 to 5, with 5 being the highest, how would you rate your stress level today? Do you feel like you are about to explode, or bite someone’s head off (5), or is nothing bothering you at all, just rolling off of you like water off a duck’s back (1), or somewhere in between?
- On a scale of 1 to 5, (5 being the highest) how do you feel about yourself today? How's your self-esteem? Do you feel like king of the hill, a rock star, full of confidence (5), or like nobody likes you, everybody hates you, you’re gonna go out and eat some worms(1)? Or are you really somewhere between these two?
- On a scale of 1 to 5, (5 being the highest) how would you rate the quality of your sleep last night? Did you sleep soundly, like a rock, awaking fresh as a daisy and excited about the day (5), or did you toss and turn all night, waking constantly, only catching brief naps all through the night (1)? Or something in the middle?
Taking daily stock of our wellness levels in these four areas can help us and our doctors identify and track trends and patterns that could allow us to notice smaller more subtle changes in our health that aren’t manifested physically yet. Assessing these areas and recording them daily will allow us to tweak our activities for better results over the long haul.
They also interact synergistically; that is, one area can have an effect on one or more of the others. Our energy level can be influenced by the quality of sleep we are getting, the level of stress we are under, the kind of foods we are eating and the amount of exercise we are (or aren’t) getting. But persistently low energy levels can also be symptomatic of abnormal mental (depression) or physical (anemia) conditions that need attention from a professional.
Stress doesn’t just impact our quality of life, but the physical conditions as well. It can cause us to eat more, and less healthy, foods, and can even contribute to high blood pressure, headaches, and digestive problems.
And both the quality and amount of sleep we regularly receive has been linked to weight gain, respiratory distress, diabetes, high blood pressure and numerous other physical ailments and conditions beyond just feeling tired all the time.
So, it’s just as important to assess our general mood and energy levels daily as it is our physical condition.
Part 6: Count your connections -- family and friends, social, spiritual, etc.
For most of us the holidays mean family gatherings, renewing friendships, and enjoying time spent with others in special community, workplace and religious activities. We often remember exchanging stories, ideas and smiles, while also providing support in times of illness or hardship.
Not only do these relationships bring us joy and strength emotionally and mentally, but numerous studies have shown the benefits extend just as much to our physical well-being and long-term health. They are reporting that people with rich social lives among family, friends and community are happier, have fewer health problems and live longer.
Conversely, those lacking these strong bonds are more likely to experience depression, anxiety and a more rapid and pronounced decline in mental acuity later in life. One study, of over 300,000 people, reported that a lack of strong relationships increased their risk of premature death from all causes by 50%.
This effect on risk of death is roughly comparable to smoking up to 15 cigarettes a day, and is much greater than that from obesity and physical inactivity. So don’t easily discount the impact which isolation can have on not only the quality but even the length of our life.
So what is it about these social connections that results in such an impact on our health? There are several factors that have been documented. Social interactions can help reduce our stress levels, thereby also impacting the condition and function of our coronary and digestive systems. Additionally, there are some studies that indicate social activities also result in release of beneficial hormones that aid in stress reduction.
Furthermore, research has demonstrated that the benefits flow in both directions, improving the lives of both giver and receiver. And the best news is that caring for others, even just offering advice or support, is easy to do, requires no special equipment or expertise, and is most often inexpensive or even free.
This is one case where quantity doesn’t make up for quality, however. It is the quality of these relationships that is of primary importance. Numerous studies have drawn correlations between healthy relationships and cardiac health, and between negative or disappointing relationships and the poorer health of the participants.