From “Frustrated Daughter”

Dear Cliff and Len: My parents are in their mid sixties and seem intent on spending their retirement in front of the TV. They have few hobbies, rarely volunteer their time in the community, and shy aware from any occasions that will cause them to break with their stay-at-home routine. Neither have a regular exercise routine and my mother who suffered a bad fall down the stairs a couple of years ago, will not participate in any programs that have been shown to improve balance, strengthen bones, and help prevent accidental falls. All my efforts at reasoning with them have failed miserably. Should I give up and let them live their lives in the way they choose?

Signed, Frustrated Daughter

Dear “Frustrated”: Yes. Stop trying to reason with them. You’ve seen how well that works. But that doesn’t mean you should give up. Reasoning with them probably means giving them facts that they already knew……a sedentary life accelerates degeneration of the brain, heart, blood vessels, muscles, skeleton, metabolism and sleep. To say nothing of the waste of time that would be better spent doing something constructive. Your parents aren’t that old and can likely still be playing an active role in the lives of the family and community. Maybe they think they’ve already done more than their share. Maybe they don’t think they’re wasting time. They may actually do more than you think they do, but from your perspective, they waste too much time in passive activities like watching TV compared to how active and engaged they used to be. They may think they do enough and have earned the time relaxing at home. In any case, finding meaningful activities in retirement is a challenge for lots of people.

First, how much time is too much time watching TV? Do they really enjoy the time watching TV or are they doing it out of boredom, lack of interest in other activities? Are they too tired or in too much pain to be more active? From your letter, it sounds as if your parents are not just bored but have lost interest in leaving the house. This can be a hard habit to break.

Let’s think of different approaches. Fatigue and pain are common reasons for seniors to be withdrawn and sedentary. Have they seen their primary care provider recently? Many illnesses can cause fatigue and a loss of interest. They should have physical and mental status exams, along with blood work to rule out medical, neurological and psychological causes of fatigue. A sleep study may also be necessary, particularly if sleepiness accompanies the lack of energy.

Your mother had a bad fall in the recent past. Fear of falling and fear of incontinence are two other reasons seniors avoid leaving home. Perhaps your mother would be willing to do strength and balance exercises at home? There are some excellent programs available on line and on DVD. That’s a really good use of the TV! If she balks, maybe you or a grandchild can do it with her to get her started. If she saw physical therapists during her recovery from the fall, perhaps they could recommend the right level of program for your mom.

Almost always, one person in a couple is more sedentary and withdrawn than the other, but the more active person may not want to leave the other alone for various reasons. Sometimes one of two makes the other feel guilty if they leave for a few hours. If either situation applies to your parents’ case, try to get each alone to discuss this. Or try inviting each of them alone on an outing and see what happens. Even brief outings for a meal or shopping may help them break out of the rut.

Cliff

Dear “Frustrated”: My good colleague is right on the money in his advice…. for the most part. Yes, you should stop trying to reason with your parents. If they don’t want to change their lifestyle, they won’t. It is not going to happen especially if they seem to be satisfied and content with how they are choosing to spend their time. The fact is, being active, like being productive, as we grow older is ultimately defined in the eyes of the beholder – it is a personal decision to be made by each of us. Pressure from family and friends is not going to work in the long-term. And remember, you can be sure that there will be other older adults who are much more active than your parents and others who are even less active. There really are no rules of thumb that can be used as guides to the amount of activity required by each of us.

What I do suggest is that you may want to help your mom and dad determine if they are honestly satisfied with their rather sedentary lifestyle. Some people are “thinkers” and others are “doers”. What you and I may call living in a cave and being in a rut is what someone else may view as living in sanctuary where one can enjoy some peace and quiet and hear themselves think. The good news is that a thinker’s mind tends to be an “active” mind and that, in many respects, is just as important a consideration as an active body in terms of maintaining good physical and mental health. If your parents are keeping on top of current events, reading the newspaper, watching the news, reading books and magazines, and discussing the issues of the day with each other, this would be a sign that they are remaining intellectually active and are engaged in life. And, that is a good thing.

I know you want the best for your mom and dad and wish you well in insuring their well-being as they grow older. Remember to listen to what they have to say about their lifestyle choices, be open to different views of what active aging means, and most importantly, try to figure out whether they are living the life they want to live as they age.

Len

Cliff Singer

About Cliff Singer

Dr. Cliff Singer is a geriatrician and psychiatrist who is Chief of Geriatric Mental Health and Neuropsychiatry at Acadia Hospital and Eastern Maine Medical Center and an Adjunct Professor at the University of Maine in Orono.