STORY BYDoing research on the health of the aged transforms any investigator into a feminist.
Older women, even those who vow to wear purple dresses and red hats — as the poem goes — generally have longer, sicker lives than men. On average they die poorer and lonelier. So birthdays count when treating women of a certain age.
In addition, dealing with women's health issues means that doctors, nurses, social workers and other attendants have to pay attention to the disabilities that come with the passage of time.
Half of all women surveyed by the American Association of Retired Persons (AARP) and Lou Harris 2003 reported the onset of at least one disability between the ages of 40 and 60. Sixty-eight percent of the maladies affect physical mobility, 19 percent hearing or vision, and 18 percent cognition or emotionality. Nearly a third of these afflictions were reported as very severe, more than a third “somewhat severe.”
Roughly 40 percent of all women over 65 report at least one functional limitation. No wonder aging with a physical disability is a critical women's health issue.
Women with disabilities are twice as likely as those without chronic conditions to suffer from high blood pressure and heart disease with advancing years. (In contrast, the incidence of asthma and migraines, while higher among people with disabilities, declines with age.)
Women with disabilities typically suffer complications resulting from the original injury. Mobility is taxed by underuse, misuse and overcompensation of the neuromuscular system. Poor coping techniques affect lifestyle behaviors.
When I am an old woman
I shall wear purple
With a red hat that doesn't go
and doesn't suit me.
And I shall spend my pension
on brandy and summer gloves
And satin sandals
and say we've no money for butter.
I shall sit down on the pavement
when I'm tired
And gobble up samples in shops
and press alarm bells
And run my stick along the public railings
And make up for the sobriety of my youth.
I shall go out in my slippers in the rain
And pick flowers in other people's gardens
And learn to spit
You can wear terrible shirts
and grow more fat
And eat three pounds of sausages at a go
Or only eat bread and pickle for a week
And hoard pens and pencils
and beermats and things in boxes.
But now we must have clothes
that keep us dry
And pay our rent
and not swear in the street
And set a good example for the children.
We must have friends to dinner
and read the papers
But maybe I ought to practice a little now?
So people who know me
are not too shocked and surprised
When suddenly I am old
and start to wear purple.
Jenny Joseph has written several poetry
volumes, including Rose in the Afternoon
Secondary conditions vary widely. They range from arthritis, carpal tunnel syndrome, depression, chronic pain, diabetes, obesity, urinary tract infections, sleep disturbance, sores, to especially excessive fatigue. What these conditions have in common is their negative effect on disabled elders' quality of life as well as their ability to interact with others.
Older women with three or more limitations usually do not have private health insurance, which limits their access to screening for cancer and other health care services. They are more likely to live alone, to be poor, and to be unemployed.
“The problem, unstated till now,” writes poet Adrienne Rich, “is how to live in a damaged body in a world where pain is meant to be gagged, uncured, un-grieved-over.”
Current theories of the process of aging, obsessed with disengaging the impact of age and disability, rarely address the conditions and needs of persons growing older with chronic physical limitations. And because of the gerontologist's focus on late-life health issues, the importance of dealing with those afflicted with early-onset physical disabilities is often overlooked. Health promotion programs for older women with long-term maladies are in their formative stage. We're just not there, yet.
Yet some researchers are making a difference. Dr. Sharon Ostwald, the Isla Carroll Turner Chair in Gerontological Nursing at the University of Texas School of Nursing, Center on Aging, gained an international reputation studying the physical and emotional burdens that caregivers (mainly women) faced in helping their spouses or parents, often while still raising children.
“Caregivers possess such courage and resiliency — this is particularly true of women. All of their lives they have worked, raised children, parented parents, many times cared for husbands, simultaneously. These women have a real sense of dignity, commitment,” she says, and can advocate for anyone but themselves.
She believes this is changing.
Ostwald sees the “growing-older” woman at the tail end of a learning curve—that of learning to put herself if not first, at least somewhere near the top.
“The next few decades for us women baby boomers will be about taking care of ourselves—our bodies, our mental health. We know that we live longer than men and we know that we may likely lose the men in our lives as we go along. We will live a substantial portion of our years alone, and not necessarily in good health.”
Ostwald has now turned her acumen and energy to studying strokes, the third cause of death and leading cause of long-term disability among older women. With funding from the National Institutes of Health, she is measuring the impact of education, skills training, counseling, support, and community resources to survivors and their spouses' recovery. Using audio and video equipment, Ostwald tries to facilitate recovery by inviting people to talk about anger, intimacy, spirituality, and coping.
She also hopes that the younger aged — those who look forward to 50 — will pave the way for their daughters, by letting them in on the secret to living life in the fourth quarter of the game. “Women know the secret to putting one foot in front of the other and going forth, fitting in their own rounds of chemo between caring for sick spouses, parents and young children: women have other women.”
UPDATED: 5-24-2005
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Dr. Andrew Achenbaum is a noted gerontologist and visiting fellow at The University of Texas McGovern Center of Health, Humanities and the Human Spirit.
See Dr. Achenbaum also at:
Make an appointment
with your stress—
and keep it!
Set aside a specified time of day, say 3:00 to 3:20 P.M. Keep this appointment with yourself—make it as important as a client or a child’s reading time.
Now, let the stress pour out of you, all the worry, guilt, what-ifs, if-onlys. Hold nothing back. Imagine every possible scenario that intrudes on you, day and night. Funnel it into that 20-minute period.
When the bell goes off, you are done, finished, until your next appointment with yourself.
When you’re tempted to let stressful thoughts crawl across your mind, remind yourself that you have 20 minutes to address them—tomorrow.
