Year: 2003
Type: article
Abstract: “I wanted to be able to age gracefully,” sighs my 84-year-old patient. Both her frustration and mine have grown over the past year as we have tried to limit the ravages of her increasing frailty. A former schoolteacher, Ms. C spent the first 15 years of her retirement hiking with the local mountain club, building the Colorado Trail, and volunteering with a local neighborhood organization. She still lives alone in her own home, working in her garden at 5 a.m. in the summer to avoid the heat, but using a cane now to walk the few blocks from her home to my office. Watching her snail's pace as she crosses the busy six-lane boulevard between her home and the clinic is a harrowing experience. Urinary incontinence limits her ability to take day trips to the mountains. Last spring, during a trip to a family wedding, Ms. C fell. Refusing medical attention until she returned home several days later, she came to see me, minimizing complaints of pleuritic chest pain. Her physical examination and chest x-ray revealed pneumonia. Although she recovered uneventfully, Ms. C became increasingly worried about her ability to manage on her own. Although she had taken great pains in the past to prevent her children from finding out about her falls, by midsummer, she began to talk about selling her home and moving into assisted living. The frequency of her clinic visits increased as I struggled to control her blood pressure, relieve her diastolic dysfunction, manage her incontinence, and help her cope with her ever-increasing frailty. Her struggle to maintain independence was intense, and there was little I could do to lighten her load. On September 20, 2001, I stepped into the examination room for a routine visit about her blood pressure and immediately sensed a change. “You look terrific,” I said, noting a healthy color in her cheeks and the return of the sparkle in her eyes that had been growing steadily dimmer over the past year. “Have you been getting the harvest in?” I asked, thinking that extra sun exposure accounted for the change I could see. “Well yes, but I also have a new attitude toward life,” she responded, “and my blood pressure is better because of it.”“Oh, and what would that be?” I asked, thinking to myself, “Right, and of course your blood pressure being better has nothing to do with the change I made last month in your medicine.”“I've decided to focus on what I can do, and stop worrying and complaining about what I can't do,” came the response. “How did that come about? I know you've really been struggling with this over the past several months.” I wondered out loud, hoping something I'd said or done had been of some use. Looking at me as though the answer should have been obvious, she replied, “September 11. I was watching television, and I realized I have a lot to live for. I got up from the television, called Travelers' Aid at the airport and told them I have three spare bedrooms that I don't use. I told them they could send people to stay with me, and they did. I had three houseguests for 5 days. The last one just left on Sunday. You could tell they were the sort of people who wouldn't have done very well sleeping on cots on the concourses.”
Author: Evelyn Hutt
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2123888337