‘I’ll tell you one thing,’ says Mum, distracting me as she scoops up the last of the chocolate brownie with vanilla ice cream.
‘I don’t know much about positive ageing, but I’m positive I am ageing.’
Firstly, never stand between my eighty-four-year-old mother and a shared dessert. Secondly, she’s right. Every single one of us is ageing: you, me, work colleagues, neighbours and loved ones all experience the challenges associated with growing older. How to deal with those challenges is up to each one of us.
Positive Ageing and Me
I began to think about the idea of positive ageing following a hip replacement in 2014 when I was only forty-two. My condition didn’t come out of the blue because I’d been in frog plaster for the first eighteen months of my life due to congenital hip dysplasia. Still, I was surprised when I began to experience difficulties in my early thirties. When I was a child, I’d been warned I’d suffer hip pain as I got older, but I always imagined that to be sometime after fifty – not thirty.
I first became aware I had a problem at a community dance in 2004. My ever-effervescent friend Robyn saw me standing alone to one side and dragged me on to the dance floor. I tried to follow despite a nagging ache in my left hip that had been bothering me all day. I thought it might be a sprained muscle from a session on the exercise bike, but after a minute of dancing sharp pain tore through what felt like every fibre of my being, and I had to excuse myself.
Obviously, this was a bit worrying, but I thought I’d give it a few days. Three weeks later, with the pain only intensifying, I dragged myself to the GP for further investigation and, as an afterthought, mentioned my early hip dysplasia. Sure enough, x-rays confirmed deterioration of the joint. To start with, as I was relatively young my surgeon advised me simply to start walking less in order to preserve my hip and prevent an operation. The longer I could keep going without replacing it, the better.
As a non-driver, I walked everywhere, which likely contributed to such severe degeneration at a younger age than I’d anticipated. Walking was my major form of exercise so it was a catch-22 situation – if I couldn’t walk regularly, how would I keep the weight off?
I began swimming at lunchtime and, ironically, although being submerged resulted in me feeling like a fish out of water, I soon learnt to embrace the activity. I felt better for it, both mentally and physically, despite the ever-present hip pain.
One of the worst aspects of the experience was dealing with the unwanted questions from well-meaning friends and strangers: ‘Have you hurt yourself?’ ‘Why are you limping?’ My approach was to accept my condition, do what I could to alleviate the constant aching, and busy my mind with other thoughts. But by focusing attention on my physical state, my friends reminded me of the ongoing deterioration. What was meant to be kind only made me depressed. Sometimes in conversation, people would advise against medication because of the possible long-term effects of the anti-inflammatories – but for me it was either that or incessant agony.
In August 2013, while I was waiting for a bus, a lightning bolt of pain raged through my entire left leg. I couldn’t move. Eventually, the torment passed, and the bus arrived, but the incident left me wondering what might have happened if I’d been crossing the road at the time, as there was no longer any rhyme or reason for this sudden flare-up of severe distress. It led me to conclude that, despite my age, it was time to insist on a hip replacement. Fortunately, my surgeon agreed.
Sadly, my vocabulary lacks the range to fully express the joyous feeling of liberation I experienced after the operation as I gradually realised I was pain-free. I could move without fear and I was able to sleep all night without a gnawing ache. However, when I ceased the pain-relief medication, I became aware of a new dull discomfort in my right hip which, presumably, had been masked for the most part by the anti-inflammatories.
Taking the advice of a mate, I paid a visit to a physiotherapist who prescribed a number of exercises to strengthen the muscles and reduce soreness. I was a bit sceptical, but to my great surprise, they worked a treat. My surgeon had suggested my right hip would also need replacing within a few years, but five years on, daily adherence to six muscle-strengthening exercises kept me out of pain. It takes all of about seven minutes each day to complete them, which allows me to have freedom and ease of movement. I’m pleased to say I don’t currently have any plan to replace my right hip.
After nearly ten years of dealing with pain every single day – from the moment I woke up to when I finally slipped into an uncomfortable slumber at night – my new hip offered me a second chance. I’m grateful to be living in a time when medical science makes this possible. Up until the age of thirty I had taken my mobility for granted, but through my thirties and into my forties I gradually acknowledged I’d have to do everything in my power to keep my joints healthy and my weight in check if I was to avoid a second hip replacement. In other words, I came to understand I’d have to age positively.
In 2011, my mum was diagnosed with dementia. As I struggled to accept and understand her illness, I also struggled to understand the attitude of people who wanted to blame her somehow for her condition. Raising awareness of the realities of preventing and living with dementia became a cause dear to my heart.
When I became the presenter of ‘Medical Matters’ with ABC Radio Hobart in 2015 – the year after my hip operation – I found whenever I raised the topic, I received an enthusiastic response from an audience eager to learn practical ways to their brain as healthy and active as their body. ‘Medical Matters’ also allowed me to explore my interest more deeply through the exciting and important research being undertaken at the Wicking Dementia Research and Education Centre. Through my discussions with researchers, doctors and psychologists, I discovered there are many basic measures you can adopt in your daily life to prevent many age-related health problems, including serious conditions like dementia – that topic of urgent interest to many people over fifty. These measures allow you to tackle the challenges of growing older and can best be described as ‘positive ageing’.
Positive Ageing and You
This is what I mean by positive ageing:
- Recognising there is no time like the present when it comes to your health
- Taking responsibility for your own wellbeing
- Learning what you need to do to look after yourself – and doing it
- Staying engaged and keeping yourself occupied
I’ve written this book as a guide to remaining vital through mid-life and beyond. In the chapters that follow, I reveal practical measures you can take to keep your body in good shape and your brain sharp and alert. I also describe how to take care of your mental health and stay engaged with life. Think of it as a handbook for the habits of positive ageing.
I start with a look at the body, describing major diseases of ageing – dementia and diabetes – and how to prevent them. I also go through many other body parts you need to take care of to remain active and well. Then I go on to taking care of the brain and how to maintain your cognitive functioning. After that I look at emotional wellbeing, dealing with depression and finding purpose, meaning and enjoyment. And because my aim is to be practical, I provide heaps of activities and suggestions to inspire you.
Along the way, you meet the experts I have consulted, including Dr James Vickers (Director, Wicking Dementia and Research Centre), Pip Inge (Sports and Exercise Medicine Physician), Deb Lewis (Operations Manager, Tasmanian Council of the Ageing), Caroline Wells (CEO, Diabetes Tasmania) and Sabina Lane (Clinical Psychologist). A few of my mates have pitched in as well. Sally Wise and Phil Shanny share some delicious and health-boosting recipes, and Phil and Peter Cundall reveal the secrets of nurturing your garden.
While I talk about the body and the brain in separate parts of the book, in your physical being they are deeply interconnected, of course. Your body and your brain influence and modify each other. Dr Mark Nelson, Professional Research Fellow at the Menzies Institute for Medical Research, points out that when it comes to positive ageing, our physical and mental health are ‘one and the same’. Believe it or not, preventing a disease as serious as dementia is as much about pursuing interests and having a flourishing social life as it is about standard health prescriptions. Simply put, good nutrition, regular exercise, relaxation, social interaction and healthy activities are paramount for your body and your brain and your emotional outlook as you get older.
Use It or Lose It
Dr Nelson also says that ‘most medical conditions have age as a risk factor’. In other words, the older we are lucky to become, the more problems we are likely to encounter. This process is unavoidable. But many of the functional problems people suffer from as they get older are the result of inactivity or poor lifestyle choices, rather than ageing itself. These can be delayed or, to a degree, reversed. This is where the principle of Use It or Lose It comes in.
- If you don’t use your muscles – they’ll weaken and atrophy
- If you don’t use your little grey cells – you’ll have greater problems with memory, planning, organising and other mental processes
- If you don’t maintain friendships and interests – you’ll have more low moods and become more withdrawn
If anything describes positive ageing in a nutshell, it’s Use It or Lose It. It’s the driver of positive ageing and I’ll show you multiple ways to put it into action.
It sounds obvious but the notion of knowing yourself is key to your responses to the advice and suggestions that follow and how you choose to act. As you read this book, you must be realistic about what appeals to you. There’s no point in adopting a lifestyle prescription if you know you just won’t be able to do it. Swimming? Social dancing? Gardening? Board games? If a suggestion makes you roll your eyes, it’s probably not for you. What you have to do is establish positive ageing strategies that make sense to you and fit into your existing lifestyle. While you might want to make changes in order to improve your quality of life, you have to be honest with yourself about which ones you’re likely to maintain over the long term.
Before trying something new – a new approach or activity, for example – ask yourself if you’re being swayed by advertising or the media or what someone else is doing. If you take something on against your better nature, you might find you can’t meet your self-imposed goals and then guilt sets in, followed by avoidance. You’re less likely to succeed and then you won’t have the satisfaction of achievement that builds motivation. By knowing who you are, your limitations and your passions, you can build a positive ageing framework that works for you.
Don’t worry about what other people are doing. It doesn’t matter if Jeremy next door is walking the length and breadth of the Blue Mountains in his summer break, or if Helen from the office rides her bike to work every morning. Jeremy and Helen have their own lives to lead, and a positive approach to ageing begins with no comparisons.
See Your GP
Taking responsibility for your health and learning how to care for yourself are major components of positive ageing and, in practical terms, that starts by talking with your GP.
If you’re over the age of forty and haven’t visited your doctor in the last twelve months, make an appointment now. It may seem like an inconvenience if you feel well, but I know you’re familiar with the term ‘better safe than sorry’.
There’s every likelihood you’ll be given a clean bill of health, but some problems are asymptomatic and you could be at risk of developing a chronic condition without realising it. For example, your blood pressure might be too high, in which case you could be referred for twenty-four-hour monitoring before it leads to a major problem such as a heart attack or stroke. Another example is high cholesterol, which is a risk factor for heart disease. Taking a test and talking with your GP will reveal if you should adjust your lifestyle, take medication or carry on as usual – but you won’t know unless you begin the conversation, and you can’t begin a conversation unless you organise regular check-ups to ensure everything under the hood is ticking away.
Once you’ve established your health risk profile, you should set up a regular annual check-up. Even if your eyesight, hearing and blood pressure are all perfect, that all-important appointment is a small price to pay for peace of mind and an expert opinion on your overall wellbeing. Naturally, you’ll have to arrange more frequent check-ups if you have any pre-existing conditions which need monitoring monthly, bi-monthly or quarterly.
Dr Nelson also recommends anyone over the age of forty obtain an annual flu shot. Not only does this reduce the risk of contracting influenza, it also minimises the chances of complications associated with a secondary infection such as pneumonia. ‘There is also some evidence that regular vaccinations can help prevent other diseases such as cancer by stimulating the immune system,’ he says.
Throughout this book, I recommend you consult your GP as a first port of call. He or she is perfectly placed to point you in the right direction if you experience any health difficulties or wish to try something new. It’s the first practical measure that all other health experts recommend.
A good place to begin setting up your positive ageing plan with your GP is by considering the following aspects of your lifestyle:
- What is the quality of your diet – are you eating enough fruit and vegetables?
- Do you need to modify your intake of sugar, fast food and alcohol?
- Do you exercise for both strength and cardio?
- How could you incorporate more exercise into your daily routine?
- How well do you sleep?
- Are you socially connected, regularly catching up with friends?
- When was the last time you went out?
- Do you feel you have a purpose in life?
- If not, what are the things you care about?
- Have you thought about volunteering or joining a society or club that reflects your values?
- When you experience a health problem, do you always visit your GP for evidence-based preventative and therapeutic treatments?
Now is the time to take a good hard look at yourself, warts and all.
What you see is for your eyes only, but it’s essential to reflect on how you could integrate positive physical, mental and social practices into a positive ageing lifestyle. What do you do well? Which areas of your mental and physical health need work? What are your passions?
As you ponder these questions, keep in mind that all medical experts agree it’s never too late to start doing something and something is always better than nothing.
So, let’s begin!