Aging / With a whimper instead of a boom

Two thousand and eleven is a watershed year in the United States. This is the year the first baby boomers turn 65. They have become what is now called the "young old" (65-75 ), with some of them caring for their own parents, the "old old" (85 and older ) - the fastest-growing segment of the U.S. population. By 2030, some 20 percent of the country's population, or about 70 million Americans, will be older than 65.

Two books by respected New York writers illuminate society's current knowledge and thinking about old age. In "A Bittersweet Season," Jane Gross, a longtime reporter and blogger for The New York Times, writes a how-to book based on her own experiences caring for her aged mother. "Never Say Die" is an analysis by author and former Washington Post journalist Susan Jacoby of how American society handles old age and what we can do to make our last years better.

Gross' book is both heartwarming and heartrending, a story of the relationships within a family that is not particularly close, but that comes together at a time of crisis.

The author's mother, Estelle, was a fiercely independent widow living in Florida until 2000, when her health began to decline. She was 85, with no life-threatening illnesses, but was obese and suffered from arthritis, dizziness, diabetes, high blood pressure and depression. That was when Gross, then 52, and her younger brother Michael, also a journalist and writer, decided to move their mother back to New York. Thus began a tortuous three-year odyssey through the American health and welfare system.

Gross writes of the shock she and Michael felt "when our competence and resources proved all but useless in the face of America's incoherent and inadequate safety net for the frail elderly. We were flattened by the enormous demands on our time, energy and bank accounts; the disruption to our professional and personal lives; the fear that our time in this parallel universe would never end and the guilt for wishing that it would." And then, accepting the paradox of her new reality, she adds: "I can tell you now that it was worth every dreadful minute, a transformative experience."

"A Bittersweet Season" is an all-too-familiar account of what adult children experience with their elderly parents. The book resonated with me on both the personal and professional levels. In 2007, the year before I made aliyah from the U.S., my husband of 55 years died, following six years during which I cared for him as his physical and mental capabilities declined. In the years 1995 to 2003, I was also a caregiver at different times for my father, mother, sister and two aunts before their deaths.

Autonomy: It Can Make You Happier Than Hot Sex! | Psychology Today

- It's usually because you're feeling as if you're no longer in control of this area your life and bigtime lacking autonomy. Indeed, much of what creates sadness, anger , regret, disappointment - all these bad boy emotions - is having a feeling of being "autonomy-challenged"!

Researcher Angus Campbell emphatically endorses the perks of autonomy. "Having a strong sense of controlling one's life is a more dependable predictor of positive feelings of well-being than any of the objective conditions of life we have considered," says Campbell.

A University of Michigan nationwide survey also sings the praises of autonomy - reporting how the 15% of Americans who claimed they felt "in control of their lives" also raved about having "extraordinarily positive feelings of happiness."

All of this reminds me of that now famous study on on those mice who researchers either gave cheese or electric shocks - no matter what these mice did. Purposefully these researchers created no logic to when the mice would be rewarded with cheese or punished with electric shocks. After a while, these mice eventually learned that their actions had no effect on their environment, and they lapsed into a state of passive listlessness and depression . Even when the experiment changed over, and the mice were given autonomy to avoid the electric shocks or gain more cheese, the mice were so depressed, they just lay there, choosing not to do anything at all!

Luckily, unlike a mouse, you as a human have that terrific homo sapien perk called "consciousness." Meaning? You know better not to give up, even after your autonomy has been temporarily challenged. You know after a difficult time, you can take back the control you have over your life!

How to begin? Psychologists suggest if you want to resiliently bounce back after a sideswiping, that you slowly increase your "internal locus of control" - the power you have to make easy, small changes. Studies even show that all you have to do is take control of a few small actions - and you'll be on your way to feeling like the master of your destiny once again. Yale psychologist Judith Rodin encouraged depressed nursing-home patients to exert more control in their lives, by motivating them to make a few small but key changes in their environments. For example Rodin made sure patients were asked to decide for themselves if they wanted the air conditioning on or off, if they'd like to change the channels on the TV, or if they'd like to have different foods for dinner, or if they'd like to re-arrange the furniture in their rooms. Plus Rodin pushed patients to request changes in various nursing home policies - which they subsequently received. As a result, 93% of these patients became more alert, active, and happy. Similarly upbeat results where shown in prisoners who were allowed to move chairs and take control over lights and TV remotes. Is an out-of-control life challenge making you feel "out of control" over your entire life? If so, stop lying around doing nothing. Stop sleeping late. Stop watching too much TV. Start recognizing that this lack of a disciplined schedule will only increase your feelings of being out of control of your life.

Autonomy in nursing

Health care ethics, critical issues for the 21st century

Autonomy in nursing

Leadership and nursing care management

Autonomy in nursing practice