Traveling with Elephants

The worries of aging

A few days ago, I had an experience that would thrill anyone of grandparent age. One of my granddaughters texted me that a friend was preparing a presentation for her Social Work degree program, which required talking with someone aged 65 or older. I have met that criterion for about seventeen years now, and I felt qualified, so I agreed to be interviewed. I will refer to her as Mary (since I haven’t asked for permission to use her name here). Mary is an extraordinarily gracious person and a very effective listener. I was able to share my story with a young person who was eager to listen. In my world, it doesn’t get any better than that.

It was a marathon FaceTime session, and Mary hung in there like a trooper. She wanted to hear about my life—what I had experienced, my parents and family, my career—everything. She sought my perspective on life as someone over 65. I shared it in a way that I believed could be beneficial for a social worker working with older adults. At the end of the session, she mentioned that I should reach out to her if I thought of anything else that might help her with the project.

Our conversation sparked a lot of thoughts about the concerns older adults have, concerns that resonate with me. I couldn’t stop the resulting stream of reflections. I realized there were several major worries that, to varying degrees, linger in the minds of us older folks, particularly my own. The first concern came to me as the elephant in the room—always present, enormous, and beyond my control. Then, another area with the same features emerged, followed by a third and a fourth. I recognized that I am traveling with a herd of elephants that accompany me in my Airbnbs, hostels, guest rooms, and the occasional hotel. They ride along in buses, trains, planes, Ubers, and taxis. They are by my side when I walk, hike, sit on a bench or a rock, or stand while admiring a beautiful scene, or when I’m sitting at a restaurant or coffee shop.

The Elephants

Health:

The most significant elephant in every elderly person’s room is health. An accident, a fall, an illness, or a diagnosis of a chronic disease can occur unexpectedly. Such events can alter the course of life in seconds. I am always conscious of the risk of falling. While traveling, I have encountered bathtubs with high sides and no support to stabilize myself while getting in. With my shorter stature and reduced flexibility compared to my younger years, it has been challenging to navigate in and out of these tubs. Often, the only thing to grasp was a few inches of cold pipe leading to the spout. The hot side of the faucet has frequently been dangerously scalding, as the hot water in the places I have stayed can be extremely hot. Sometimes, there was no shower curtain around the tub, allowing water from the handheld shower sprayer to spray onto the floor. No amount of careful maneuvering and precise spraying could entirely prevent water from spilling onto the floor, making the exit perilous when stepping onto a slippery surface. At times, working out the logistics of my morning shower has proven difficult. One fall could sabotage my current lifestyle. About a year ago, I missed a step descending into a subway and landed on my knees. Fortunately, the damage healed within a week or two without any medical intervention other than Ibuprofen. In the older buildings throughout Europe, there is no standard configuration for stairs. Building codes from previous centuries were not always uniform. Especially when descending stairs, one may encounter unexpected distances to the next step, baffling the brain's autopilot. While touring castles in the rain, I have encountered slippery stone pathways. Given that I spend a significant amount of time walking, often on unpaved woods paths, hiking up and down hills, the risk of falling is a harsh reality.

I am on Medicare, but it only covers me in the US. I travel outside the country for nine to ten months each year. I choose not to have travel insurance because it's extremely expensive. However, I do have an AAA product (Emergency Assistance Plus) that applies when traveling anywhere in the world. It provides help and, if necessary, transportation back to the US in the event of a serious medical issue. There is good quality health care in the countries I visit, and it's much less expensive than in the US. Therefore, for less serious matters, I am self-insured and pay for the care I need. People my age have to contend with the constant risks associated with aging bodies and slowed mental acuity.

I am currently in good health and have only two prescriptions: one for low thyroid and a low-dose statin to keep my cholesterol in check. Because I am traveling outside the country and moving around frequently, I must stay on top of my prescriptions so that I don’t run out while on the road. It takes at least three weeks for a package to arrive, so mailing them isn’t practical. I visit my doctor in the US twice a year and undergo blood work during those visits to monitor any changes that might arise. I also see the dentist twice a year and the dermatologist once a year to check for anything suspicious. I have two brothers who use CPAP machines for sleep apnea, which could complicate my travel if it became an issue for me. My doctor has always supported my lifestyle and has encouraged me to stay active without restrictions.

There is no escaping risks. Living is always about risk management.

The number one cause of death is being born.

Being alive is terminal, and it includes certain death. Doing nothing and sitting all day is not safe; a sedentary lifestyle can lead to an early death. Allowing the fear of taking risks to prevent me from being active is self-destructive behavior. Whatever limitations come with aging will arise whether I am in Louisville, Vienna, Austria, Tivat, Montenegro, Tobermory, Scotland, on a plane to Australia, a train to Helmsedt, Germany, or in a car driving on the Interstate between Kansas City and Louisville. The health elephant in the room travels with me wherever I go and while I'm getting there.

Money:

I have Social Security and a pension. It’s less common these days for people to pay into and receive a fixed pension (annuity), but my employer group still provides one. It doesn’t adjust for inflation but will stay at the level set when I retired, meaning the buying power of that amount decreases each year as the cost of living rises. My monthly pension is about the same as my Social Security (which is also essentially an annuity). That one does adjust for changes in the cost of living. The reason I can afford to travel is that by selling or giving away all my belongings, including my car, and no longer renting an apartment, I have significantly cut my living expenses. I’ve replaced those costs with the expenses associated with planes, trains, buses, and rental cars, as well as the fees for Airbnbs, hostels, and the occasional budget hotel.

The overall costs of each of these lifestyles are comparable.

My income has solely come from my salary as a Pastor in a mainline church. In my tradition, the congregation being served sets the salary, often following the church body's guidelines. In my case, it was consistently adequate, reflecting the average middle-class salaries in the congregations region. Raised by parents who experienced the Great Depression, I learned to live frugally, saving and investing wisely, which has resulted in IRAs and mutual funds large enough to ease the anxiety of potentially running out of money. Concerns about the high cost of medical care in the U.S. linger, and even with Medicare, the risk of catastrophic expenses depleting savings remains. There's always worry about the steep costs of assisted living or nursing home care. One sister spent a short time in a residential care setting late in her life due to her long-standing struggle with rheumatoid arthritis. Aside from her unique situation, no family members—grandparents, parents, aunts, or uncles—spent more than two weeks in such a setting. I have older siblings who are 90, 93, and 96, all of whom are still fully functional, living independently (one with his wife of over sixty years). This has helped ease my concerns. I have discussed end-of-life issues with my daughter and have a living will with advance directives in place. I’ve explained to her the type of setting I would prefer should I need residential care. The current political climate and the recent steep decline in the stock market have significantly reduced my nest egg, offering a harsh lesson in vulnerability. This elephant is always in the room.

Reason for living, purpose in life:

This elephant is in every room, every plane, train, bus, morning, noon, and night. After retiring from my very public career of forty years—counseling people, marrying them to one another, baptizing their babies, visiting them in the hospital, and supporting them after the death of a loved one—my purpose, the purpose that came with that role, ended. I needed to disconnect from the people I had served so the next pastor could find his place in their lives; that positive feedback loop ceased, and external validation was lost. It comes with retirement. Mary Ann required full-time care, twenty-four hours a day, for two years until she passed away on June 14, 2010. After forty-five years of marriage, twenty-four of those years spent managing Parkinson’s disease, including the last ten years of advanced symptoms, she needed constant care from either me or one of the volunteers from the congregation. That part of my life, that purpose, came to an end with her passing. Responding to her needs had defined my central purpose, especially during those final ten years. The external validation of my purpose in life disappeared.

No matter how hard I tried, I could not think of anything I could do that could even begin to match the value of what I had already done.

I did not need to work for survival. I was exhausted from the demanding full-time work of the last few years and from caring for Mary Ann both during the day and much of the night. Many retirees from satisfying and challenging careers struggle to find validation once external validation fades. I am one of them. Traveling to what felt like exotic places helped for a time, but even experiencing beauty and visiting magnificent places cannot satisfy the need for purpose.

Practicing mindfulness as an approach to life and participating in a weekly Spiritual Formation group has helped me find validation from within, lessening my reliance on external validation. Still, I find myself needing external validation, so both at home and while traveling, I tune into those willing to share, using the listening skills I developed throughout my career and marriage to cultivate connections quickly. Those connections allow me to nurture and affirm others with unconditional acceptance and to seek to validate them. This activity also nourishes me. The challenge has been in accepting that this is enough, even though it doesn’t quite measure up to what I achieved in my career and marriage.

Exposure to pain or sadness:

In later years, exposure (insurance jargon) to loss and concern for the well-being of loved ones increases as the number of loved ones grows. This growth depends on how many children, grandchildren, and great-grandchildren a person has. It also hinges on the number of siblings one has, how many of them have married, and how many of them have children. Ultimately, it depends on how many people have entered your circle and remained.

I recall my mother in her late 80s and 90s lamenting how many of her friends had “fallen by the wayside.” Mary Ann and I were part of a group of four couples, each with a girl as their oldest child and a boy as their second. The boys were all born the same year, shortly after we met. We raised our children together, vacationed together, and celebrated birthdays together from the time we met. We were eight adults, and now only three of us are still alive. Three have passed away in the last two years. One of my siblings died a few years ago. (Still miss you, Tish.) The other three are in good health, with no life-threatening diseases at the ages of 90, 93, and 96. I keep my phone on all night, every night at home, and when I travel, in case something happens to one of them. My son has faced a serious bout with thyroid cancer, followed two years later by a diagnosis of leukemia. Initially diagnosed as acute leukemia, it was later determined to be chronic leukemia. His life was at risk, but he is stabilized now, and the treatment is working. A member of my Spiritual Formation group, which has met weekly for 22 years, died a short time ago. Learning to cope with losses and potential losses is a necessary part of later years.

Tapes of bad experiences from years gone by continue to play. They accompany me no matter where in the world I am living. There is no escaping past failures or difficult relationships. They transcend geographic borders and must still be addressed. They don’t vanish simply because years have passed or locations have changed. The good news is that the fact I am still alive, still surviving despite it all, is reassuring. Recognizing that opens up the possibility of enjoying the wonder that comes with each new day.

Finally:

The fears remain, whether I travel or not. Staying home to feed them makes no sense, because they will grow bigger and faster without facing them and at least staying active despite them. They simply have to be faced and managed no matter where a person is or how old they might be. These elephants stay in the room with me; they sometimes grow bigger and more threatening, or smaller and less intimidating at other times. They are not easy to train. I do the best I can, but they are not living in captivity; they remain wild. I need to keep an eye on them and treat them with respect.

The Destination is Now,

Peter