There is one guarantee in life: you will age, no matter how hard you try not to. Some age with more grace than others, and some age so quickly it’s astonishing. Aging can come quickly or slowly, it is not necessarily determined by your age but the whole dynamics of the life you have lived and perhaps your relatives’ lives before you.
Aging isn’t just the change from dark hair to grey or perhaps wrinkled skin that used to be smooth and moist. It is a biological, physiological, environmental, behavioral, and social process. A decline in function, the senses and activities of daily life, and increased risk of disease or disability are more accurate definitions of aging.
Aging is the major risk factor for many chronic diseases. Would this mean we want to live shorter lives to avoid these diseases? I believe most would say, “No!” There is always the chance that maybe you won’t get one of these chronic illnesses, but you will still age.
No single factor can explain aging, and the process can’t be slowed. This suggests that if we target aging early on that, we can perhaps stop the rate of aging. This would also mean the appearance of aging and possibly the reduction of the diseases related to aging. This would increase what is called “Healthspan.” The portion of life spent in good health.
New interventions for the prevention, early detection, diagnosis, and treatment of age-related diseases, disorders, and disabilities must be investigated and researched so we can understand the causes and factors that place people at an increased risk for the aging process. We can’t stop aging, but we can slow it down with some general guidelines from all levels of science. Some people are more susceptible to early aging and age-related diseases. But why? Is it genetic, environmental, lifestyle, behavioral or social factors that initiate the forward march of aging?
It’s very clear from the current emphasis on food that diet has a lot to do with the way we live and, therefore, age. Whether we are overweight, exercise or not, eat fats instead of vegetables, smoke, or drink alcohol can determine our early entry into the aging process. Unfortunately, it is too late for some, and the damage may have already been done. But aging can be slowed down no matter how late you make these changes.
Bill spoke to a palliative care doctor about two years after being diagnosed with idiopathic pulmonary fibrosis. The thought was that the doctor would help us make it easier for Bill to get around, eat, sleep, and remain productive in his remaining life. These are usually the doctors you talk to before hospice is initiated.
Palliative care is an approach that improves the quality of life of patients and their families who are facing problems associated with a life-threatening illness. I had every hope that this would bring some relief to the day-to-day struggle that Bill seemed to be dealing with. I wasn’t sure what I expected, but I thought this doctor might have some “magic” to make things easier here at home.
We had a teleconference call with the doctor and a social worker. Both were very pleasant and well-informed about their jobs. The doctor asked, “Bill, how are you feeling, what symptoms are you having, and what do you think might help you?” Bill answered, “I feel so weak, like I’m slipping away and don’t have anything to hang on to.” “I cough a lot and choke when I eat sometimes, and I sleep all the time.”
Bill’s walk had deteriorated quite a bit over the last few years, and I wasn’t surprised to hear him say he was weaker. The doctor looked at his medications and suggested he stop two of them because they can both cause weakness. One was the pill to stop acid reflux, which Bill’s pulmonologist thought might have caused his pulmonary fibrosis; he could have aspirated food during one of his choking spells.
The other drug to stop strokes and heart attacks was started when he had a stroke. I quickly butt in. “He was started on that drug when he had the TIA, isn’t that dangerous?” The doctor answered, “Yes, he has a ten percent higher risk of having a stroke if he stops taking it.” I wanted to yell, “That makes no sense, why would he want to do that?” I ended up saying nothing, knowing I could talk to Bill about it later.
The social worker got on the call then and asked, “Have you two ever considered moving to assisted living?” Again, I’m aghast and answer. “We have considered it, but I have promised Bill we will stay home as long as I can get help to care for him. I have been to several of the places, and the two-bedroom apartments are all upstairs, and that won’t work for us!”
Her comment, “Well, as long as you can afford to stay home.” I wanted to ask her, “Do you know the price of assisted living and what many places are like?” That was all she had to offer. I was not thrilled with this conversation, as this was not helping us. I backed away so I was not on the screen anymore.
I let the doctor continue to talk, and he told Bill, “You are not in need of hospice right now, you have a bit longer to live, so that is basically all I can suggest for you, except you should change your diet.” Now, I’m wondering what is going on. He told Bill, “Go on a plant-based diet, and you won’t need the pill to stop the strokes and the heart attacks.” My ever-kind and sweet Bill says he doesn’t know what that means. I’m pretty sure he does. The doctor explained further that he should not eat meats or fats but only vegetable-based foods.
I walked away, this was good advice if Bill was younger and had a chance of it helping him. He eats peanut butter and mayonnaise sandwiches and loves a good hot dog or a hamburger, not to mention a steak for dinner. Bill kindly said, “I’ll try to eat less meat, thank you, doctor.” The call ended.
I stopped the two drugs the doctor suggested we discontinue, and immediately Bill had heartburn. I emailed his regular doctor, who told me to restart the heartburn preventative medication. I did, and he has been fine since. I would try to stop worrying about the drug that prevents strokes, but it is Bill’s choice to stay off it, so I will follow his wishes.
We were newly initiated to plant-based diets when we hired Bill’s caregiver, who was vegan and ate a plant-based diet and has for most of her life. She was 60 years old and looked 35. This was good evidence to me that the diet worked. She also has some auto-immune diseases, and this diet has kept her off medication. I admire this more than I can say, but I’m not sure we can make these changes completely, when I thought plant-based diets take a lot of work and a lot of planning, yet she seemed to eat only frozen dinners with an avocado every day.
I bought a simple recipe book and tried some of the recipes. I also bought some plant-based “meat” balls to add to spaghetti sauce. I didn’t tell Bill what they were, and he said they were pretty good. I don’t think our diet will change completely, but I agree that some changes won’t hurt us. I’m afraid Bill will continue to eat bacon, no matter what.
In this case, Bill changing his diet was not going to stop his aging process, it was probably too late. I’ve watched him age more in the last five years than I have the whole time we’ve been married. Yes, changing his diet may have helped several years ago, but he deserves to be comfortable now too. Idiopathic, as in idiopathic pulmonary fibrosis, means no known cause, so the diet change would not change his diagnosis, and frankly, his living longer with this debilitating disease may not be the most compassionate thing to do for him.
The bottom line really was, will any of these changes save Bill? Probably not, and I refuse to let him suffer even if it means giving him a vegetable instead of bacon. He deserves to be comfortable in his remaining days, and one must pick and choose what works for themselves, the doctor’s advice was just that, advice. Bill will always tell me what he needs or wants to eat.
A palliative care doctor is trained to make patients comfortable in their remaining years, but I am the one taking care of Bill and need to also take care of myself. Doctors can tell you what’s best in their opinion, but they aren’t the ones living with the illness. Most patients find the right path and live their lives out as gently as possible to the end.
Nancie Wiseman Attwater is the author of A Caregiver’s Love Story.