People Over Age 65

We all get older! Most don’t want to think about it, but we hope to be a resource on how to grow older gracefully! As we age, we may be concerned that we will become a burden on our families, and we don’t have to be. In our culture, many people believe that getting sick is just a normal part of aging. While we can’t prevent everything, we can frequently have more vibrant health and be able to do much more as we age. However, it is crucial that we understand what contributes to health challenges in the elderly. Here, you’ll find ideas and plans regarding proper nutrition, exercise and more as you get older.

People Over Age 65: An Introduction
Written by: Dr. Frannie Koe, MD

I never thought I would provide health care for so many older patients. When I was in residency, I worked with a lot of parents and their children. My largest population in my residency clinic was pediatrics. I imagined myself continuing to focus on kids when I began my medical practice. I was nervous when I opened my clinic, wondering if I knew enough to care for older adults with serious illnesses and complicated health conditions properly.

Of course, my education served me well, and I can care for everyone who comes to see me! Now, I see predominately older patients rather than very young children. I am fortunate to have a varied patient population, which is the reason I went into family medicine. The most important thing I want to convey with this post is that there are many issues I did not understand about dealing with an older parent until I helped care for my father when he was in his late 80s and early 90s. I want to help people know more and understand more about specific issues that older people often face. Also, I want to provide support and education for the family members who oversee an older person’s care, as it can be both difficult (medically speaking) and emotionally and financially taxing. This category will contain a series of posts about the challenges of caring for an aging parent or other family member, as well as how to overcome those obstacles, and education related to the prevention and the care of health conditions related to aging.

Challenges in Elder Care: Distance
Written by: Dr. Frannie Koe, MD

My dad was living independently until he fell about four years ago. Perhaps this story sounds familiar to you. So many families are interacting with their older parents differently now than they have in the past. Our parents handle their own lives differently than in previous generations. Our society has changed so much over the course of just a few decades.

My great-grandmothers died at home. One lived until she was 104. Both my grandmothers lived independently until they died. One passed away at home and one had a very brief hospital stay for 12 hours.

My grandmothers also lived independently until their deaths. Both could drive. They paid their own bills and bought their own groceries. They were both approaching 90 when they passed. There was no need to provide long term in-home care for my grandmothers. However, if they had needed extended care, they both would have gotten it. Neither my mother nor her sisters worked outside the home, so they all would have been able to care for their parents without the pressure of other responsibilities.

Now, many family members work away from home, so it is much more difficult to care for aging parents. In previous generations, families lived in a much closer geographic area than they do today, often under the same roof. Multigenerational families living together are not as commonplace today, which makes it much more difficult to share the responsibilities of providing care for older relatives among family members.

My brother lives in Florida and my sister lives in California. I live here in Alabama. My dad was in Texas when he fell. He had remarried and was living near his second wife’s family. She passed away the year before his fall, and it was not their responsibility to see to my father’s care. My siblings and I could not be there with him immediately. As his health improved, we had to help him decide where to move to be near us. He lived in Fort Payne, Alabama, and I frequently provided care and support for my father until his passing in the spring of 2024.

I did not realize how much an aging parent would fight to remain independent. Often, they cannot realize that they are struggling. They rarely see that their brain is changing. They may feel normal, or the change may be so gradual, it is not something they can process. Sometimes, they have moments when they know something is not right. But most often they don’t see it. Some parents can become paranoid that you are trying to take over their lives. They will hide as much as they can from their kids to keep their independence. I am writing about this because I want folks to know that they are not alone in struggling to care for an older relative or loved one. Juggling distance and work-life balance while still trying to maintain a quality of life of an older parent is a constant challenge.

Challenges in Elder Care: Financial Issues
Written by: Dr. Frannie Koe, MD

When you take on the role of caretaker, it isn’t just the person’s physical well-being that you need to address. Before I began to care for my father, I did not realize how much time it takes to handle the business affairs of a person who can no longer do so for themselves. I was not aware that as the brain ages, some older people will make very poor financial decisions and even sometimes try to give money or belongings away. Also, after having been a practitioner at my clinic for 15 years, I have seen that, unfortunately, there are some people who try to exploit the cognitive challenges that some older people develop. Family members may try to take control and slip money away from the older adult’s accounts. If a stepparent is involved, the family drama can kick up a notch, especially regarding financial matters. Thankfully, there are steps you can take to avoid these issues. We will try to help people understand how to protect their loved ones in all ways as they age.

Challenges in Elder Care- Exercise, Chronic Disease and Nutrition:
Written by: Dr. Frannie Koe, MD

The diets of our parents are far less nutritious now than in the past. The lack of proper nutrition is causing chronic disease to manifest more frequently in the older population today than in previous generations. Our parents are a lot sicker and there is more cognitive decline in the older adult population than previously.

My grandmothers ate real food. They did not drink any sodas, nor did they eat chips and fries. Processed foods were not an option for them. They prepared most meals fresh at their homes. They ate meats and veggies, much of which they grew and raised themselves. My grandmothers cooked with flour and made some desserts, but rarely. They also both walked a lot. One even rode a bike into her early 80s. Very few people in my grandmother’s generation were overweight.

Our parents are becoming much more sedentary than in the past. As someone slows down physically, they are much more at risk of falling. People lose their balance easily when they are sedentary. Our lifestyles now are so much more conducive to being sedentary. It is usually a gradual process over the years, which frequently begins with sedentary jobs, and it is often hard to turn it around the older we get. Once someone sits more and more, falls can happen so easily. I tell people it is like being an astronaut going into outer space. When a person is weightless in space, even for a few days, they quickly lose their ability to balance and stand properly. It is similar when we sit for much of the time for days, weeks, and months on end. Our cerebellum, an important part of our brain that controls balance, will not work as well. I have seen many people have to hold on to the walls to get down the clinic hall. It is so important to keep moving!

Challenges in Elder Care: Mental Health and Family Connection:
Written by: Dr. Frannie Koe, MD

I did not realize how lonely some people get as they age. There is often a lot less interaction with family members who must work and are tired after spending long hours at their job all week. These folks have their own responsibilities to take care of, such as kids in after-school activities, grandkids, their homes, and bills, and often struggle to care for an aging parent. Some parents have had to move to be closer to children, so they may lose their long-time social networks and can lose their closest relationships. I have seen this over and over. They become dependent on their children and their families for social support that may not be there.

If families have strained relationships with each other, there are even more issues of painful interactions, misunderstandings, guilty feelings, resentment, and other emotions that come out during these tough times while attempting to be a caregiver. Siblings may have very different relationships with their parents. Some may be more cooperative and willing to help, while others are not. Conflicts can occur. Some children of older parents may be very unstable themselves and cannot properly help.

The good news is that if you are struggling with some of these issues, not only are you not alone, but there are solutions as well. We can reverse many of our failing health problems if we work at it. Some of these problems can even be prevented with some knowledge and planning. Proper nutrition, exercise, support, and resources for mental and physical well-being can go a long way to ensuring a graceful passage into our later years. We can help ourselves and our parents age gracefully. In our clinic and at our classes, we are working to help people learn all that they can about this thing called graceful aging. We will add to our posts here and continue to teach how to overcome long term aging problems and age backwards!