I like to run. I’m pretty sure that, when I am running, people around me think I am one of those workaholic types who can’t put the phone down for a second. “What is wrong with this woman,” they say. “She is running around talking into that phone – she can’t even take a break from her phone long enough to just run. Poor woman.”

I want to set the record straight, running voyeurs. You see, when I run, my brain runs. And I have to catch the elusive thoughts that are running through and out of my brain, because I will otherwise lose them. So, I run around with my phone, and I periodically talk into it to record my thoughts. So stop worrying about me, running voyeurs. I have work/life balance, trust me.

Now that I have explained myself, here is the result of one of my running musings. Time will tell if it is interesting, or just the result of a lack of oxygen.

I have a dream. I want to see a paradigm shift in the way we care for each other as we age. In particular, we need to change care systems (like nursing homes and assisted living but also other types of care systems) to communities where people can LIVE well, and the focus on their medical care is supportive (perhaps secondary?) to their LIVING rather than medical care being the goal in itself.

If a person who has grown older needs various supports, healthcare communities come up with a plan for that person, often called a service or care plan. They are primarily medical or healthcare services, like what type of medication a person needs and when, what type of help they might need with everyday personal tasks like bathing or dressing. It is all important.

However, this becomes the blueprint for a person’s existence. What I mean by this is that a person’s life might entirely be made up of, and driven by, these care tasks. This is what we intend to do for this person for their remaining time. These plans can be tinged by a sense of maintenance, of keeping people alive, but not people LIVING. This is why elders have told me they feel like death plans.

Can we try something different? How about we come up with LIVING plans, instead of death plans. What does this mean?

Think of yourself. If you had to create a plan for what you wanted your life to look like, for how you want to live, what would it say? What do you want to see happen for yourself? I am sure it would not say, “I would like to take showers, eat food, take my medication, and just keep doing that until the end.”

Maybe it is not effective to simply ask an elder, “What do you want to do with your life?”, although this is a valid question. Sadly, this might be perceived as silly by elders themselves, because it is not something we ask elders very often, and elders become unaccustomed to thinking this way. Perhaps we first need to create trust with, and build confidence in, elders that it is acceptable (actually, expected and encouraged) to want things from their lives, to look towards the future, to want something more than a life of maintenance.

I have seen elders become nihilistic and institutionalized, not necessarily because they are living in institutions, but because they have become confined in their thinking. Elders might not dare to hope or dream anymore. Why? Do they not think things are possible for them? Do they feel this is not their right “anymore”? How do “we” in the field of aging possibly discourage hoping and dreaming for the future? There is much emphasis on reminiscence and life review, but do we pay enough attention to who elders are now, who they want to be, and what they want from life?

Elders need people jumping up and down for them. They need to be encouraged to hope and dream. To seek and ask for those things that drive their lives.

These things might not be big things, although they could be.  It might be that an elder’s hopes and dreams are to be still, to appreciate the small things, to quietly think, and to watch. They are no less important than an elder’s wishes to take a hot air balloon ride, climb a mountain, meet Oprah, paint, write, travel, be with family, etc. Perhaps an elder wants their LIVING to be about sharing what they have learned, and supporting others in their LIVING. An elder’s hopes might even include planning for death, a death that is reflective of their wishes. These are important desires.

It is not the nature of these desires in a LIVING plan that is the point. It is that we need to be finding out what they are, starting from a place of what is important to people. THEN, we can determine what supports a person needs to carry out their LIVING plan. THEN, we can figure out what medications a person needs/wants and when they take them. THEN, we can figure out what type of help a person needs during their day to accomplish the things they want. THEN, these important medical and health services can enable the LIVING.

We can start by being curious about elders, finding out who people are and what is important to them, and building upon that. Let’s let them know that their LIVING is important and we want to hear their plans for it.

So, we just moved. From our home of over 10 years in Norfolk, which we loved dearly, to Arlington, which we have dated before, are dating again, and with whom we hope to build a relationship of mutual affection and respect. The range of emotions we have experienced over the last month has been staggering and overwhelming.

Sadness, anxiety, loss. For leaving our 120-year old house, with its beauty and fond quirks. Our neighborhood, which held an incredible sense of community for us, one that we had not yet experienced in our adult lives. And perhaps, most difficult, saying “see you later” to our friends and family.  Knowing that we would not sit on our porch again with them, having drinks, laughing, getting to know each other deeper and deeper. Accepting that we would no longer be hosting holiday get-togethers, or dinner parties, or my infamous Ladies Wine Club in that house.

Yet.

At the same time, there is a feeling of excitement at my husband’s new job. My own anticipation and happiness at meeting up with old and new colleagues and friends in D.C. Seeing the opportunities this new area will hold for my work. Having curiosity for a new neighborhood, with its beautiful trees, unique houses, and walk-ability to the train that will take us all over the nation’s capital. New restaurants, shops, museums, opportunities to meet new people. Hopeful planning on how I will infiltrate and get to know the group of older women who always meet at our local coffee shop, and seem to be engaged in the most interesting conversations. Deep appreciation and gratitude for dear Norfolk friends and family who helped us so much over the last month and will always be there for us.

How is it possible that I can hold all these emotions in me at the same time? Surely, we all can. But do we acknowledge this? In particular, do we recognize this in the experience of growing older? This cohabitation of different feelings, perspectives, and perceptions in one person – equally forceful, sometimes at the same time.  “We” in Gerontology are so fond of placing people and experiences in categories. An older person is “frail” OR “well”. They are aging successfully (or not, I guess, although I am not sure what that means?). Think of the stories we hear about growing older. There is the story of pure loss. Or all-encompassing illness. Or, there is the story of pure contentment. Overwhelming wisdom. “The best time of your life – the golden years.” We describe elders as having positive outlooks, or they are just pessimistic.

Could it be possible that this is ALL true? That for each person one could be both experiencing loss and feeling joy. Finding pleasure in small moments, and anger that one moves slower or with pain. Could it be that a person is both scared of growing older, and also looking forward to it? Could it be that a person with dementia is both sad and happy? Frightened and hopeful?

I think we neglect this so often in the experience of growing older. We neglect this idea that it is possible, even likely, that each person experiences a wide range of emotions related to their growing older, sometimes at the same time. And it is so complicatedly different for each person.

I am thinking of a man with whom I worked, who had dementia. He was a world-renowned artist, and when he moved into the assisted living community, he was devastated. He was so angry that he destroyed his own artwork. We were so focused on making sure that he was making a positive transition. But did we also allow him to mourn his losses? To just be and experience the sadness, as well as the lovely possibilities of living a different life with new people. Did we even acknowledge how hard it was for him to move into this new place, leaving not just his house but his identity? We were so focused on him adjusting, with good intent, but we didn’t honor what he was leaving behind. He was experiencing a wide array of emotions. What could we have done so he could have held them all in the same space?

Do we assume that people, as they grow older, are uni-dimensional? Do we emotionally anesthetize them to the point that we forget that they are complex just like any human being?

I would argue that there is evidence of this. And I think it is so detrimental. Because this is a condition of being human – to be all these things at once. It is important to recognize this for each individual as we grow older, but it is also important to how we think about aging overall. Growing older is not one experience, one emotion, one category. Growing older, i.e. living life, is an array of experiences, emotions, and sensations. All at the same time. I think this is true because, not only do I see this in my own living, I have heard this from others. From the person living with dementia who tells me about their pain and sadness, as well as gratitude for how this has brought them closer to family and taught them to appreciate the little things. I have heard the person who left her home, her community, and her friends to live in a new community, and found love and companionship.

I think there is significant impact to this possibility – that we see people as they grow older as uni-dimensional and perhaps over-simplified. I haven’t totally gotten my head wrapped around it yet, but I think it is there, and we need to be aware of it.

How are we not honoring the full spectrum of the individual experience of aging, for the individual, and for our society? How does this impact how we serve elders? What can we do about this?

This is what happens when I am stuck in too many moving boxes. I am bursting. Thanks for listening.

Note: All of the artwork in this post was created by John Hain. Of his work he says, “I offer messages that promote practices of self-awareness, mindfulness, and non-judgmental withness in the quest for human wholeness, wellbeing, and communion.” See more of his work at http://www.Built4Love.com.