“Could you stop singing, mom?” my kids would whine years ago as I carpooled them to their activities. “You’re ruining the song for me.” I reminded them that they never once lodged a complaint when I sang them to sleep when they were little, but I knew what they meant.  I have a lousy voice–I get it.  As the kids got older I sang only when I was alone:  in the shower, on a run, alone in the car with the windows up.

But in the past few years, I started singing as a mnemonic device.  Forget the string around the finger or the pad and paper, my voice became my most important memory tool.  I’d head down to the basement, singing an invented tune I dubbed, “Bringing Up The Paper Plates.”  I’d be in the shower and sing, “Pick up the script at CVS.”  One day about a year ago I was in the car and remembered that I had neglected to make an important work phone call that I needed to make from my home office where the papers were.

“Julie, Julie, Julie,” I sang out loud on the way home, “Call Julie, Julie!”  My “Call Julie” song morphed into “I’ve got to call Julie Mulie” to the tune of “Mellow Yellow.”  And it worked.  I walked into the house through the mudroom door singing the Julie song, and I reminded myself, “Got to call Julie now.”  And then I walked by the washing machine and saw the wet laundry silently screaming to be moved to the dryer.  “I’ll call Julie after I switch the laundry,” I thought, and I went about that task, humming to the tune of “Mellow Yellow.”  I never did call Julie.

So, for about a year now, I have been searching for a new memory tool.  I needed something that would always be by my side.  Something that I could use when I think my most important thoughts–when I am behind the wheel of a car.  Something that would be relentless until my task was completed.  And I knew from talking to my friends that I was not alone–millions of people just like me needed help remembering why they went down the basement.  In January, 2012, the “Today” show reported that mental capacity starts to diminish at the average age of 45.   I wrote that down as soon as I heard it, and I’m glad I did.

But now I am a new person.  I have a new lease on life.  I have an iPhone 5.  Imagine you, but with more memory.  The analogy, SAT style is as follows:

GPS: Directionally Impaired ::  iPhone5: Memory Impaired.

When I got my new iPhone,  my son showed me the basics of Siri.  “Mom, you’re going to love this,” he said, “it will help with everything.” And I do, and he was right. I haven’t forgotten anything in weeks.

I tested it out as I was driving:

“Siri, remind me when I get home to call Julie before doing anything else.”  After a brief exchange with Siri, my reminder was set.  Like magic, as I drove into my garage, Siri messaged:  “Call Julie before doing anything else.” And the best part?  Until I manually deleted it on my phone, that message stuck.

I tested it again. “Siri, at 2PM remind me to go down the basement to get paper plates.” Perfection. Over the next few days, I was a Siri addict, and she did not fail me–not once:  “Siri, tomorrow at 11AM remind me to visit Bubbie”; “Siri, remind me to do my stretching exercises at 10PM”; “Siri, remind me to send Debby a check for the tickets Monday at 9AM.”

“Siri, remind me not to sing in public.”

“OK, I’ll remind you to ‘Not to sing in public’. When would you like to be re-mind-ed?”

“Every day at 8AM.”

“Ok, here is your reminder starting tomorrow at 8AM.  Shall I create it?”

“Yes.”

“Ok, I’ll start reminding you.”

“I love you, Siri.”

“That’s nice, can we get back to work now?”

Isn’t that the best?  A memory device with a sense of humor!

As I was checking out at the grocery store today, I saw items going into my grocery bags that weren’t mine. I hadn’t put mushrooms and strawberries and ricotta cheese into my cart. I soon realized that not only had I switched carts with someone while shopping, but that I had just paid for someone else’s groceries. However, the lines were very long and a storm was on the way, so I just brought them home. And they’re not so bad. It’s not the kind of cereal we usually have, but overall, pretty close to what I would have gotten.

I share this story with you, my three sons, to make a point: I do these things now, when I’m 48, and believe they’re quirky and charming, although your teenage selves may strongly disagree. But, this is the kind of incident thirty or forty years from now that might encourage some of you to put me away in an old age home. This letter outlines the things I do now that do not qualify as reasons to put me out to pasture. You’ll just have to work harder and find other reasons.

Here we go:

1. I cannot remember numbers, any numbers, including my own telephone number, my Social Security number, or today’s date. I know my license plate begins with BGW, because I decided it stands for Big Woman, but beyond that I have no idea what the numbers are on my license plate. There’s no use trying, I have never and will never be able to put and keep numbers in my head, they just fall right out. But I am very good at remembering names. So if I can’t remember your birthday, don’t be alarmed, but if I can’t remember your name, there’s a problem.

2. I have absolutely no sense of direction. I get lost inside restaurants and shopping malls. I get lost driving to and from the drug store. I even get lost while using my GPS and phone — really. I was a subject in an international study for people who have no sense of direction. An interesting fact about that study is that one participant got lost inside his own house. I’ve never been that bad, and if I ever become that bad, it is time to worry.

3. I cannot find my car. I’m lucky if I get to the general area where I parked it. I spend an extraordinary amount of time wandering around parking lots and streets looking for the little black Prius with the BGW license plate. This time would be better spent reading a book or eating chocolate. It is time I will never get back, time I want God to give me back on my deathbed.

4. I don’t like driving, perhaps because I’m not very good at it. I often miss whatever is going on in that darn blind spot (well named!), I generally have no idea where I’m going (see #3) and I don’t like being in charge of a potential killing machine or at the mercy of killing machines being driven by not-so-bright other people. And I can’t figure out how to go backwards; am I supposed to turn the wheel the same way I want to go in reverse or is it the other way around?

5. I can’t see well. I’ve never had good vision, but then had a laser-eye surgery debacle that screwed the whole thing up and left me using a monocle because one eye can see close up and the other can’t. I have trouble seeing far away things, which doesn’t help my driving (see #4). Lights look like halos at night, which is why one of Dad’s jobs is to read subtitles to me, and it’s yet another reason I’m not a fan of foreign films. I’m perfectly comfortable just knowing that I’m missing some stuff out there, and you should be OK with that, too.

[Note: The solution to numbers 2, 3, 4 and 5 is for one of you to get a good job and pay for a driver for me.]

6. I am very happy eating the same thing day after day. I have my egg white omelet, toast and coffee every morning for breakfast. I could, also, easily have the same thing for lunch and dinner every day, but that would upset your father. Therefore, don’t be alarmed if you see me having a peanut butter and jelly sandwich for the forty-seventh day in a row. And one more thing: I will always consider a piece of steak and slab of chocolate cake a nutritious meal (you’ve got protein, milk, vitamins, all good stuff.) However, eating cat food would be new and shocking and bad.

7. I don’t believe in expiration dates for food or medicine. I think it’s a vast corporate conspiracy designed to make me throw things out and buy more stuff. Why would pain relievers “expire” after just a few years? And isn’t cheese moldy by definition — and vinegar, too? And if the meat’s bad it will smell bad, and if the spaghetti sauce is bad it will have fungus on the surface. (Which, by the way, you can just scrape off and use and no one knows the difference. Sorry to tell you that.) Of course, that yogurt I ate the other day that was six month’s old and in the refrigerator during the three-day power outage really didn’t taste good at all. But, I realized it halfway through and no harm was done!

[Note: The solution to numbers 6 and 7 is for one of you to get a good job and hire a chef for me.]

8. I eat dinner at 5 p.m.. I may eat dinner at 4:30 by the time all of you finally (finally!) leave the house. So, mock away if you want, but being early for the early bird special is not going to be a new development.

9. The reason for #8 is that eating dinner any later begins to interfere with my bedtime, which is now 10 p.m. and may soon be 9 p.m.. And I often take a nap, too. The only change I can imagine in this category is the addition of another nap or two — and what could possibly be bad about that?

10. I’m not a very good housekeeper. Dirty dishes are often in the sink (and I blame you all for that, but truthfully, it’s me, too.) I am slow to wash dirty laundry and slower to put away clean laundry. Vacuuming, dusting, doing windows and mopping simply never occur to me as things one needs to or should do. (Blame Nana, in fact, blame Nana for most of this list.)

[Note: The solution to #10 is for one of you to get a good job and hire a housekeeper for me.]

Looking at this list now in its totality, I am struck by the fact that it is far less about my peculiarities and far more about the need for one of you (please, note, I am only asking for one) to study hard and get a good job and hire a driver, chef and housekeeper for me. I will still love you other ones, although maybe not quite as much as the one with the good job.

All adolescents “try on mental illness.” This is why all diagnoses are provisional in adolescence. In other words all adolescents have their crazy behavior, language and thinking process.  Think back to what was important to you when you were a teenager?  I bet it has changed! Many of the hundreds of patients and families I have seen over the last 35 years want definitive answers, but the behavior has to exist for many years before you can truly know if it is bipolar disorder or a really difficult adolescent. I have treated hundreds of families who have a loved one with “bipolar disorder” and the issues change over the years.  Wait until they are 22 to 25.

IF it is a real bipolar disorder, this is the trend that I have observed:  The parenting issues come in stages. There is the “what is wrong with my child?” phase. When you are having struggles and don’t know what to do.  You think it’s you or think its them or the marriage or the community.  Some people suffer in silence and others go for help.  For many people who go for help they are both relieved and saddened by the diagnosis.  The label says there is something wrong and it isn’t my imagination (which can be validating) but it is also painfully sad.  Parents (and siblings) experience a mourning process.  A loss of a dream of who you hoped your child/sibling would be.  The mourning process hits people in different ways but as a family therapist I watch it destroy marriages and families.  My first advice for couples and families is stop blaming.  This isn’t about blame, its about coping minute to minute or day to day.  Work together as a team and be on the same page.  It isn’t in anyone’s best interest for the child’s illness to have that kind of control over the family.  You need to actively educate yourself, seek help, look hard for everyone’s strengths, take care of yourself and don’t forget humor.

The next phase is putting a great support system in place both professionally and personally.  Find a psychiatrist and a therapist for you and for your child.  The concept of high maintenance parenting means that you need to spend more time and energy on yourself to see choices. For example, your child asks you to stop at Dunkin’ Donuts on the way to the therapy appointment and you don’t have time–so you say no–and they have a full-fledged tantrum in the car or at the house.  You don’t have time to think about the best approach, you just react, the decisions have to be made in a second. The tantrums or manipulative behaviors can hijack you at any moment.  And we all know you cannot negotiate with terrorists so you have to learn to see choices in the moment. That takes work. You can take her home and take the appointment yourself, you can drive there and leave her in the car, you can stop and get the coffee and then talk about it later… but the problem is that you have to accept that you are not going to resolve this in a logical,calm manner.  If you keep yourself healthy, you will be a good role model and you will handle their outbursts or mood swings in a healthier way.

Support systems also mean friends and family.  If your friend likes to brag about her child who just won the Nobel Prize and is judgmental of you, then its time to minimize your contact with her and find a new friend.  Don’t get rid of her but minimize your exposure. There are support groups on line and in your local area, go check one out!  If your mother blames you or the medicine for your child’s behavior then make that topic off limits–change the subject.  Answer the phone from a position of strength.  If you are having a bad day, use your caller ID and let it go to voicemail and go for a walk, take a shower, phone a friend  or make an extra appointment with your therapist.  Having a support system doesn’t cure anything but it makes life more manageable.

My father used to say, “There is more than one way to live a life.” He gave me that wonderful gift of perspective. I love that, because accepting each other for who we are is truly the key to peace of mind.  Accepting the diagnosis does not mean giving up or ignoring them.  It means you need to look at them and figure out who they really are and adjust your expectations and behaviors accordingly.  SEE THAT YOU HAVE CHOICES! You have choices about what YOU do with your time, energy and money. When children are little they can’t do anything themselves, we need to do it all and can’t even go to the bathroom without an ear to what they are doing.  When they are older our job has changed without our consent. We need to detach with love to let them live “their way to do life.”  Use a good support system to define who your child is, pick your battles (the laundry isn’t a battle I would pick, taking your medicine is one but even that is complicated),  play to their strengths and your own! Take it one decision at a time.

Most of my clients who went through the mourning process when their children were diagnosed have learned to have a healthier perspective to make their lives and their children’s lives more manageable. Those in the the midst of adolescence need to batten down the hatches through the storm.  Adult children need a very different approach.  More manageable does not mean that they are living the way YOU dreamed  they would, it means that they are being who they are.  There are a lot of talented and successful people who have had this disorder.  Challenge yourself to see that you have choices and accept your child.  It is the key to peace of mind!

Trying to keep young and hip?  It’s always harder than you think.  Did you spill a little stardust from the bottle of meteorite cream?  Miss the free shipping offer on the Garcinia Cambogia Extract?  Maybe you could not find a hairdresser to do your balayage just right.  Maybe your gym does not offer Piloxing classes, or maybe you weren’t able to splurge on the bee venom facial.  But even if you feel and look fantastic–even if it hurts to smile, you are still running marathons and you haven’t eaten gluten in a year, it doesn’t matter.

Here’s what matters:  How on top of social media are you?  And sorry, the fact that you have a Facebook page and use it to stalk your kids, wish the people you can’t stand in real time a “happy birthday,” and brag about your fabulous vacation just doesn’t cut it any more.  My mother and aunt both use Facebook…need I say more?

Can you tweet?  Do you stumble upon?  Have you reddit?

I know, I know. It was so much easier for our parents back in the day, right?   #Itsuckstogetold.

But at least I am trying.  See, I have used a hashtag!

I actually started tweeting a few months ago.  To be fair, I only started because I had to.  I’m promoting #betterafter50.com, and it’s just one of those things you do these days if you have a business–especially an online business.

But I kept asking myself why a normal, everyday 50-something–one who is not promoting either herself or a business–would want to tweet.  When asked by friends, I parroted the answers of social media gurus, but their arguments seemed utterly unconvincing.  Here’s what the experts say about why anyone should tweet:

You can follow “thought” leaders, get real time news, interact with your favorite brands, stay abreast of the latest trends in your field, follow your favorite sports teams, keep up to date on your interests and hobbies, follow hashtags during events to follow “backchannel” chatter.

B-O-R-I-N-G, right?   Who really cares about that stuff?

What if I told you that you could complain all day long about the little stupid things that bother you (what my daughter calls “first world problems”), in real time, conveying a sarcastic tone, showing how clever you are–and not get into any trouble–you’d jump right on that bandwagon, wouldn’t you?

Are you almost convinced?  Consider this bonus:  Although unconfirmed by any scientific research, I am sure that tweeting is good for your brain.   Tweeting requires you to be clever while you are complaining in 140 characters or less.  Believe me, that is not only a challenge, but it is more satisfying than Words With Friends–and you can’t lose to the friend you thought was kind of an idiot.

And so, my friends, tweeting makes for a fun and creative pastime that you don’t want to miss out on.  Are you with me yet?

There really aren’t any rules to tweeting (other than the 140 character limit), but you’ve got to know about hashtags (you’ve probably seen these # symbols lately in all sorts of places you were sure they didn’t belong.)

The experts will tell you that you use hashtags to make your tweets searchable.  But that is ridiculous–no one is searching what you are tweeting about.  Hashtags are simply a method to help you be creative or sarcastic.

It is best to explain by example.

Are you pissed at yourself for eating the entire box Girl Scout Cookies?

Tweet:  Bought Caramel Delites from niece.  Crumbs and plastic only evidence.  #EatTilYouHateYourself.  #hopeIgetastomachbug

Get it?

Did you recently get an insulting package from AARP?

Tweet:  Today I got a package from AARP with a tacky looking red nylon bag for carrying diapers/meds. Conveniently hooks on a walker. #WTFisAARPthinking?

Are you at a new restaurant and the waitress is a little too slow bringing you the menus?  You are so on top of it.

Tweet:   @awfulsteakhouse.  Might die here before waitress brings over menus.  #WorstserviceEVER.

Do you have a pain in your hip flexor, shoulder or lower back (of course you do!)?

Tweet: every day I wake up with a new pain. #middleagesucks #IWishItWereTheBDSM.

I think you get it (but you may want to follow me for more exciting tweets like these.)  And I am sure you will love it too.  Complaining in 140 characters or less is very liberating and fun.

It’s time to show the world that we BA50s are so very #youngandtrendy.

Are you ready to set up your Twitter Account?  It’s easy!  Click here for step by step instructions on setting up a Twitter Account.

“Seriously, Mom? What is wrong with people over 50?” my son asked me the other day.  “Everyone over 50 feels the need to explain how to get somewhere. It’s annoying.”

What is wrong with us?  Why do we insist on giving directions when just about all of us now have a device that pleasantly talks us to our destination, and politely corrects us when we make a wrong turn?

“I try to cut them off by telling them I have a GPS and all I need is the address, but they keep on going like I never said anything,” my son explained, “they don’t really get it… so I just tune them out.”  It is probably safe to say that if you are on the phone with someone under 50 and you are insisting on giving them directions, they are probably checking their emails or texting. I say, “Don’t waste your breath.”

I know, I know, we just gave up Red Meat, Salt and Ice Cream.  Do we have to give up Directions too?

I hate to admit it, but I don’t want to hear Directions either, unless you are warning me of a special hazard or that there is a possibility I will input the wrong address into my device.  I don’t mind:  “that turn comes up really fast after the exit,” or “there are three Highland Streets in the city–make sure you input Highland Ave.”  With my iPhone in my pocket and my GPS in the car (duo systems for checks and balances), I have begun to think that people who insist on giving Directions are annoying and dare I say it…. “Out of touch”?

But oh, I remember Directions well….

When I was little, in the rare event that my dad drove me anywhere alone, my mom would always give my dad Detailed Directions.  My dad would listen attentively.  Then we would get in the car and drive to the end of our street and he would stop.  “Did she say ‘Left’ or ‘Right’?,”  he would ask with a smile– and we would both crack up.   My dad had a great natural sense of direction–he seemed to just “feel” his way to where we were going.

When I got my license, it was as if I had been asleep in the passenger seat for 16 years.  I had no idea how to get anywhere. When I would inevitably get lost, I would pull into the nearest gas station and ask the attendant.  Without a pen and paper to write down the directions, I would repeat the Detailed Directions from the attendant in an attempt to emblazon them in my memory.   By the time I got to the end of the gas station driveway, I’d think, “did he say ‘Left’ or ‘Right’?”  And then I’d get lost again.  But I assume that is how I eventually learned how to get around Boston, and maybe, just maybe, it exercised my memory a tad, which perhaps comes in handy now that I am post-50.

For a quarter of a century, I was astounded by my husband’s inability to Ask Directions.  No matter how lost we were (we are never lost anymore–we have a GPS), Mike simply refused to stop and ask. “Men don’t ask for directions,” he joked.  But it wasn’t really a joke, it was life.

Lately, GPS has brought me across my home town, across oceans, and directed me around the highways of foreign countries.  I have wanted to kiss it when it has shown me back roads that lead me from one town to another that I didn’t know existed.  I have wanted to murder it when it did not recognize an address I knew to be correct, I couldn’t get the holder to stick to the windshield, or the battery died on route and I didn’t have the charger cord.

But I do wonder if GPS has stifled any sense of the Big Picture in young people who have grown up with this technology fully integrated into their lives.  When the kids are following Directions blindly, do they ever develop the sixth sense of direction that we all need sometimes- especially when technology goes haywire?

I reminded my son of the time he plugged “Dudley Street” into the GPS instead of “Dudley Road,” and he drove around Roxbury for hours.  I reminded him of the time he wound up in New Hampshire after a track event in high school.  Neither of these reminders fazed him.  He swears technology never fails him, but I know that can’t be true.

My son moved into a new apartment the other day. “Is it closer to Washington Square or Coolidge Corner?” I asked him.  “When I go down Beacon Street, where do I take a right?”

“Mom, can I just text you the address?” he asked.   I wondered if he really knew where he lived- in the big sense.

I guess I will just have to rely on Siri to tell me whether I turn “Left” or “Right” to visit my son.  I am sure she won’t let me down, but if she does, maybe my son will remember where we live.

My heart hurts—I just got off the phone with my sweet, darling mom. I have the same experience every week—I call her because I want to hear her voice, and though her voice starts out strong, by the end of our (very short) call, it is a scared, sad, tearful voice.

I wonder what is happening inside her head and heart. I have some idea…

I think that although mom knows she is talking to me, her older daughter—she loses her grounding almost as soon as we start our conversation. She seems to struggle to make sense of why she is talking to me on the phone, why she hasn’t seen me in soooo long (when it may have been the day before), why she can’t seem to place where she is, or why she’s there.

Mom will turn 83 this November. And for the past five years she has been losing her cognitive abilities. Mom has Alzheimer’s Disease, the most common form of dementia, as did her mother and older sister.

And while I still have mom…I am also losing her—day-by-day, minute-by-minute, second-by-second. It’s heartbreaking for both of us.

I love this woman with all of my heart and soul. For more than fifty years she has been there for me every single step of the way. This is my beautiful, smart mom with a Master’s Degree, who was a New York City schoolteacher for thirty years. The woman who was liberated way before her time, and didn’t hang out much in the kitchen because she had more “interesting” ways she wanted to spend her time.

This is the woman who taught me to be strong and independent by example—and to always stand up for what I believe to be right and true.

This is the woman who has been an amazing wife to my dad for fifty-seven years, mother to my sister and me, and grandma to her five grandkids.

But now she has lost her footing. When we speak, although she knows the love we have for each other is fierce, she’s not always sure exactly why or how we are connected. When she comes to my house, she sometimes asks if she has ever been there before (hundreds of times)!

And so here I sit trying to make sense of the loss of my mom—for though she may be sitting in front of me, or on the other end of the phone line, she is lost, I am lost, and the world we once knew, is lost.

And though it’s not a physical death, it is a death of the world that was—the world that I have known for more than fifty years.

As I write, my dad breathes steadily. He sleeps endlessly, about 22 hours each day. I sit by his side and tell him I love him and massage lotion into his hands because I can’t think of what else to do. He wakes up a little and looks at me with the blank eyes of Alzheimer’s. Does he know who I am? Somewhere in his head, I know his feelings about me float. They bubble to the surface and I get a smile. They sink to the depths and he looks at me with no recollection.

It has occurred to me that my father is no longer alive, but that is a painful thought. He’s still here, but the man he is now is not who he is…was. He loved chocolate chips in milk and B movies late at night. He is the man my mind still tells me to call when I have a financial question or a new business idea. This is the father who offered wonderful words of wisdom to me in moments of stress, the words I now share with my kids and still tell myself when I’m looking for a little comfort.

When I was a kid he sometimes recited a joke or two at the dinner table. I recall one was a long and meandering story about two polar bears. He called it a “Shaggy Dog” story. The story goes on and on in a long and nonsensical way and then finally the bears find themselves sitting on two ice floes that have separated. As they drift apart from one another, one bear calls out to the other: “Polar Bear!” I remember thinking, why is that funny? That is sad that the two bears are drifting apart and can no longer be together. I didn’t like Shaggy Dog stories.

So now here we are grappling with Alzheimer’s and like most families, the extent of how unfair it is is palpable. Do bad guys get Alzheimer’s or is it only the smart, loving and intelligent ones who fade away before our eyes. Even in the confused state he now drifts in and out of, my father has continued to be sweet and thoughtful of my mom’s feelings, even though she is mostly a stranger to him.

Many friends who have already been down this road are sending me beautiful words of advice and tales of last words suddenly spoken. The advice I receive is the same each time: spend every day with your dad like it is the last, tell him that you love him and that it is ok to let go.

So I sit here and watch him breathe. We are close to the end now. I dread in equal measure the phone call that will tell me he has died, or the one that tells me that nothing has changed and he still lives, suspended in sleeping but not in living. I feel dread that even at my age of 50, my childhood ends when I am no longer someone’s child. We are arriving at the punch line. And I don’t get it. Alzheimer’s has caused my dad to drift away from me and I’m left with the icy awareness that he is gone. I miss him.

Polar Bear.
Daddy.
Polar Bear.

Read more: http://www.thesucculentwife.com/about-my-dad-or-polar-bear/#ixzz2En1XeR6n

In the last months before my father died from complications of Parkinson’s Syndrome, he was out of it much of the time.  When I would visit him at the nursing home, he would give me a smile of recognition. I knew he was happy to see me, but there was no give and take, no ping pong of conversation.  When the weather permitted, he would sit outside on the patio to each lunch, where he would break our hearts by trying to put his napkin in his mouth.

“Daddy, that’s not food,” I would say, taking it from him.  He would try to spear imaginary food on his plate with a fork.  “Daddy, let me help you,” I would say.  He would sit, strapped in the wheelchair, face tilted slightly to soak up the sun, a Patriots or Bruins cap askew on his balding head, a bib tied around his neck, bits of food sprinkling his salt and pepper beard.

We knew what to expect when we came in for a visit.  Dad would be in the bed, slanting awkwardly to the right.  Years before, I used to tell him he was “listing to starboard” reminding him of his boating days, but that was when he could laugh at the reference and could straighten himself out.

In those last weeks, I had the urge to fix him like I fixed my babies when they fell asleep awkwardly in their car seats, but he was too heavy, and so we relied on the aides to come with extra pillows to prop him up. If no one was around, he stayed slanted, yet amazingly, like a baby, he slept peacefully.

In those last weeks, sometimes he would wake up when we came in for a visit, sometimes he wouldn’t.  Sometimes he would be comfortable and at ease, sometimes he would be distressed and tell us, “You gotta get me out of here.”  Sometimes we would be graced with a smile or a chuckle at something funny we said.  It seems his most prominent personality trait, his sense of humor, was one of the last things to go, and when he no longer laughed, there seemed no point to his living.

But it’s not over until it’s over.  One Friday night in the last couple of weeks of his life, Mike and I visited my dad late, around 8:00 PM, just after attending Shabbat services at our temple. We struggled with whether to just go home after services, because we were tired, and it was late for a visit to the nursing home.   In the end we decided to go. And there he was, in his room, sitting up in the wheelchair, and he greeted us, smiling. “Where’ve you been?” he called to us, clearly asking why we were visiting so late.

“Daddy, you’re up!”

“Where’d you expect I’d be?” he answered back.  And so it went.  We had a conversation.  Maybe it was about the sports game on the TV in the background, maybe it was about his surprise that we were coming from services.  I’m not exactly sure what it was about, but it was an actual conversation.    There was life in his eyes.  He had energy.  His essence beamed.  We joked.  He got the jokes and laughed.  We were sarcastic.  He got the sarcasm.  We asked him what he was watching on TV.  He knew.

“Daddy, you’ve had us worried,” I said to him.

“Why?”

“Because you’ve been pretty out of it lately.”

“Really?”

“Yeah, really.”

And when we said goodbye and I love you that night, I knew he understood what we said.  And when he told us he loved us, we knew it wasn’t just a rote repetition of words that had no meaning for him. As we left the nursing home that night, it felt surreal, like we had been dreaming his condition the last few months.

The next day, all traces of the man in the wheelchair the evening before had vanished.  Dad was in the bed, out of it, body again slanted awkwardly, his right side propped up by pillows. The television was on, but no one was watching.  He did not wake up when I got there, did not smile, and we never really had another real conversation, not one that made any sense.

On Father’s Day I remember my dad’s last gift to me.   Out of the blue, he gave us an hour of clarity and energy that I will cherish.  Today, that gift helps me remember the real dad, the guy with the great smile that made everyone laugh, the guy who could show us how much he loved us.

We have no idea who wrote this, but it was going around the internet and we love some great humor! Here are 18 reasons it is great to be a BA50- enjoy!     

1. Kidnappers are not very interested in you.

2. In a hostage situation, you are likely to be released first. 

3. No one expects you to run – Anywhere.

4. People call at 9 PM (or 9 AM) and ask, ”Did I wake you?”

5. People no longer view you as a hypochondriac.

6. There is nothing left to learn the hard way.

7. Things you buy now probably will never wear out.

8. You can eat supper at 4 PM.

9. You can live without sex, but not your glasses.

10. You get into heated arguments– about pension plans.

11. You no longer think of speed limits as a challenge.

12. You quit trying to hold your stomach in no matter who walks into the room. 

13. You sing along with elevator music.

14. Your eyes won’t get much worse.

15. Your investment in health insurance is finally beginning to pay off. 

16. Your joints are more accurate meteorologists than the national weather service.

17. Your secrets are safe with your friends because they can’t remember them either.

18. Your supply of brain cells is finally down to a manageable size. 

I have a wonderful friend who’s been like a mother to me. She calls me her “other” daughter, and my kids think of her as a bonus grandmother. Her name is Ruth.

Ruth celebrated her 100^th birthday in December. She still lives completely independently, and enjoys going out with family members who love the opportunity to share her company. She’s sharp as a tack, and loves to discuss current affairs, politics, and our baseball Cardinals.

Unfortunately, Ruth was hospitalized last month with a brief illness. I visited her daily to check on her and make sure she was getting what she needed.

After a week she was released to rehab to help her regain strength. Once there, my daily visits were prompted by the desire to keep Ruth company, and not allow her to feel abandoned or forgotten in the institutional setting, lovely as this one was. I spent mornings with her, and her son came in the afternoons, so we knew what was going on, and she had distractions from her sometimes wailing roommate.

In the first days of her stay, I would stroll down the hall and look for her in the therapy center. If she was indeed getting her daily physical therapy, I would be waved in by the staff, and would sit with her while she practiced leg lifts or played balloon catch with the therapist. We’d chat. The therapists were charmed by this delightful woman, always amazed to learn her age. They’d consistently peg her as 80-ish. That’s our Ruth.

As the days went on, however, I’d find myself tightening my jaw as I walked the halls. I noticed that my fists were clenched as I approached the nurses’ station. I began to have flashbacks to the 1983-1990 years that were my late mother’s nursing home odyssey.

Things that hadn’t entered my mind for many years came back to me like a flood of biblical proportions. Memories long suppressed of how Alzheimer ’s  took her at an early age swept over me every time I walked through those corridors. The empty-eyed, hunched-over elderly, lining the halls evoked images of my mother in her various stages of decline.

She endured three nursing homes in all. The first was a residential care home. She was there a short time when she lost the ability to speak or recognize us.

When my father passed away in 1987 I became her legal guardian.  I moved her to a nearer and newer, skilled nursing facility. In this location, though, she endured an ongoing series of urinary tract infections, which, in her fragile state led to repeated hospitalizations. Eventually, reality hit me: (“Hello? Neglect? Is that you?”) I moved her to the Shangri-la of nursing homes. At last she received excellent care. This facility was part of the same chain as the one Ruth was in, and although it’s now 23 years later, and the décor is fresh and new, the similarities (not to mention the names) picked away at the scabs on my psyche.

Now, although I was there visiting an alert centenarian, I could almost feel my mother’s presence. Despite the engaging conversations Ruth and I were having, I couldn’t shake the sense of despair and loss that I had buried long ago. Each time I had to check with a nurse about Ruth’s medication, my stomach tied in a knot. When I would touch base with the social worker about a care plan for Ruth’s release, my head hurt.

It became increasingly difficult for me to set foot in the place. I’d pull into a parking space there and sit for ten minutes, trying to convince myself to go in. I had to practice yoga breathing to function, and put on a happy face when I greeted Ruth. Once I was in her presence, I was fine. But after I’d help her get seated in her dining chair for lunch, I’d kiss her goodbye, and it would all start up again. Pounding heart, shallow breaths, tight jaw, clenched fists.

I also noticed how much trouble I was having focusing on my own life. I’d forget to plan something for dinner, and would have to make extra trips to the supermarket. Then I’d have a chicken in the oven and nothing to go with it. I was completely unable to make phone calls to friends. I started taking naps in the afternoon.

By the end of her 21 rehab days, I realized that this wasn’t just about my mother. I had begun to see myself as the next in line. At 63, I’m not that far away from being the one in the bed or the chair, with empty eyes and unanswered pleas for help, from being incompetent to live on my own, or just another patient to a series of anonymous caregivers.

The day Ruth went home, I was giving my daughter a long-distance update on her “Gramma Ruth.” She told me I sounded tired. Unexpectedly, I unleashed my feelings about being in the nursing home, and how it had affected me.

She said, “Mom! Of course this was horrific– you have PTSD when it comes to nursing homes. The whole Grandma thing was a nightmare.”

Click.  How did I raise such a smart and insightful kid?

She really nailed it—my mother’s journey was my journey, too, and it was traumatic for me in a million ways.

When my mother died in 1990 I was 40 years old with adolescent kids. Now I’m a multiple grandma with an empty nest, a wrinkled neck, and age spots on my hands. I know I’m privileged to get this far; we all know people who were not so fortunate. But sometimes the future is scary.

I’m glad my daughter was able to define this. With this added perspective, I’ll try to stay out of the combat zones, at least emotionally. If the PTSD should recur, I will ask for help, now that I know its name.

Thanks to improved public sanitation, medical advances and smart lifestyle choices, people are living longer.  The US Census reports that the fastest growing demographic is people 90 plus.  They used to constitute 2.8% of all older adults (those 65 plus). Now those 90 plus make up 4.7%. “By 2050, this share is likely to reach 10 percent.”

Many older adults are using this time to pursue second careers, practice hands-on grandparenting, adopt new hobbies and enjoy new or long-standing friendships.  But living longer doesn’t allow a complete escape from changes to the mind and body.

As people move into late adulthood, many must manage a number of chronic diseases: arthritis, heart disease, diabetes, COPD, etc.  Also the risk of dementia increases as people age.  The Centers for Disease Control and Prevention estimates that between 25% and 50% of those 85 plus show signs of dementia. Alzheimer’s disease is the most prevalent form.

As people acquire more and more age-related diseases, they require help with a number of day-to-day activities. Many older adults receive help with activities of daily living from family members—spouses and adult children primarily. Family Caregiver Alliance shares these statistics: “43.5 million of adult family caregivers care for someone 50+ years of age and 14.9 million care for someone who has Alzheimer’s disease or other dementia.”

Family caregivers often make great sacrifices to provide care.  They often suffer setbacks financially, emotionally and physically while serving as caregivers.   They are often too overwhelmed to explore support services such as home health care, respite care and caregiver support groups.  Contacting a local Area Agency on Aging is a good place to start seeking support.

Sometimes, however, the caregiving needs become too much for family members—even with support. The older adult then moves into nursing home care.   But how many people end up living in a skilled nursing facility?

I often see people quote this statistic: Only 4.5% of people 65 plus live in skilled nursing facilities.  True.  But this is a snapshot statistic. It’s similar to saying that in the US only 3% of women 15 to 45 are pregnant – at any one moment.  However, roughly 80% of women in the US have a least one child over time.

By looking at older adults over time, people 65 plus have a 40% chance of living in a skilled nursing facility as reported by Medicare.  The rate increases with age. It increases for every chronic disease a person accrues. It’s also higher for women, who tend to outlive their spouses by several years.

Unfortunately, Medicare does not pay for long-term care. Yes, they will pay partially for skilled nursing for a short time (around 3 months). For example, those undergoing rehabilitation following knee replacement or hip replacement can receive help from Medicare for part of the cost of recuperating in a skilled nursing facility.  With supplemental insurance, the costs for such care are quite manageable. (See your local State Health Insurance Assistance Program (SHIP) for free Medicare counseling.)

The average cost of a year in a skilled nursing facility is about $80,000 a year with the average stay at approximately 2.5 years. This bears repeating: Medicare will not pay for your parent or spouse to live permanently in a skilled nursing facility.  Until I started volunteering as a Medicare counselor a few years ago, I was quite naïve about the costs of Medicare care and long-term care for older adults.  I also assumed that Medicare would pay for more or pay a larger percentage than it does.

The cost of long-term care are paid for by private pay, long-term care insurance, or by Medicaid. The last requires a person to demonstrate low income and low assets prior to receiving benefits.  People must all-but impoverish themselves to qualify for Medicaid.

Yes, there is much to celebrate as we age.  I am enjoying a second career and good physical health.  I can analyze and synthesize material with greater richness than I did as a twentysomething.  My age allows me to take the long view on day-to-day challenges.  I see many others in midlife growing, achieving and developing in amazing ways. Hopefully, we can also apply the strengths of midlife to meet the age-related challenges that our parents and we ourselves will face in the coming decades.

Read more from Karen Austin at The Generation Above Me. Follow her @TheGenAboveMe

My doctor will be interested in this story about the borrowed book–the book I do not remember returning. Doctors are starting to pay more attention to people’s own sense about whether they are losing it. According to a recent article in the New York Times, studies show that people who sense they are losing it–even when others close to them can’t–are more likely to later develop dementia.

I’m writing it down now, because most likely I will forget this story by the time of my doctor’s appointment; I will only remember that I had a story to tell.

“Doctor,” I will say, “I need to tell you the story about The F**king Book.”  The edgy title will help me remember the details.

I borrowed the book from Bea, an outstanding, larger than life 70-something mother of a friend of mine, at her insistence. Bea is a big fan of betterafter50.com and raved about Oh, To Be 50 Again, a self-helper by Eda Leshan. Bea had lovingly highlighted and plastered the book with yellow sticky things. “Ignore the notes, and don’t touch the yellow sticky things,” she warned me when she handed it over to me, reminding me that the book had changed her life.  “By the way, this book is out of print. Take care.”  Pressure.

I knew I read the book, taking care with the stickies.  I knew I kept it for longer than I should have.  I remember distinctly that a little ocean water got on it when I read it on a boating trip.  But I didn’t recall any details about returning the book.  I didn’t remember handing it over with a smile and a thank you.   I thought I had returned it, and maybe I had.  But maybe I hadn’t.  I had a sense of writing a thank you note and stuffing it in the front cover, but it was just a vague sense–much like how I am able to recall the first letter of someone’s name even when experiencing a full brain freeze.

And then I ran into Bea.

“When am I going to get my book back?” she asked.   She explained that she was anxious to give it to her daughter-in-law to read. I just stared at her and plastered a smile on my face.  Hadn’t I given it back?  ”Soon,” I answered. “Very soon.”

That was when the borrowed book became “That F**king Book.”

I frantically searched my basement, my bedroom, the den, the piles in the kitchen.  Where was That F**cking Book?   I tore apart closets, searched boxes in the attic. No book.  I woke up at night with anxiety about That F**king Book.  I imagined Bea stopping by my house for the book (she said she might) and me having to pretend I wasn’t home.

I started to avoid Bea. In the days before Bea’s granddaughter’s wedding, I imagined she would ask me about the book as we were dancing the Hora, and I would blurt out the truth and ruin the wedding for her.  The guilt was getting to me and the truth became obvious:  I had lost Bea’s treasured book, stickies and all.

I thought about “Plan Bea”. I needed to get her another copy.  The book was indeed out of print, but I found a used one on Amazon for $.99.  When it finally arrived, it was a paperback.  The borrowed book was hardcover. I found a used, hardbound copy for the bargain price of $30.00, and when that came in, I knew it was time to fess up and offer Bea the poor substitute.

I approached her daughter-in-law, my good friend, as to how to break the news. I explained the borrowing, the highlights, the stickies, how the book had changed Bea’s life and how Bea was anxious to share the book with her.  “That F**king book,” I told her,  “I have no idea what I did with it.“

“The one with the all the stickies?” my friend asked.

“Exactly.”

“That book is sitting on my night table. Bea’s been asking me to read it for months.”  Of course.  Bea and I are apparently both need to have a little talk with our doctors.

Truth be told, I can’t remember what the book was about either.

But I do have a hardcover and a paperback if anyone wants a copy.  And I know just where they are.

I am not a religious person.  I’m not even sure I believe in a higher power, let alone one true God.  Even so, for the past several years I often find myself praying.

When I do pray, it is always about my mother who has Alzheimer’s disease.

My prayers are never about reversing or even improving my mother’s condition because it is simply too late.  She is entering the latter stages of dementia and has already lost so much cognitive ability.  Even with all the research and focus on Alzheimer’s, there is no cure and not even effective treatment or drugs that will slow the progression of this elusive disease.

Alzheimer’s is a dark, bottomless pit.

Instead of a magical cure, I pray for an end to my mother’s life.  I ask God to ease her into death, and do it soon.

Ironically, Mummy, as her family often calls her, is in remarkable physical health.  At age 92, she takes few medications and is ambulatory.  In fact, with the aid of a walker, Mummy strides up and down the halls in her care center, sometimes for hours.

When she is walking the halls, Mummy often appears to have a purpose and a destination in mind.

But looks can be deceiving.

Up close, it is immediately apparent Mummy is locked into a prison from which there is no parole.  While Mummy may not have major physical ailments, there is no doubt that she is suffering terrible mental anguish.  Alzheimer’s has wiped away most of her brain, including her memories, personality and ability to communicate.  Every day she seems to withdraw a little more, and I’m no longer sure she even knows I am her daughter.

Mummy’s dignity is also ebbing away.  She now needs help with everything — even the most basic human functions.

At this point, I believe she is simply existing in her body.

Mummy’s situation is especially ironic.

If anyone knows how tragic Alzheimer’s can be, it is my mother.  She lovingly cared for my dad — who also had the disease — at home for many years.  Before my dad showed signs of memory loss, Mummy had been the primary caregiver for her own mother who had some form of dementia.  Then, she managed the care of her brother, a lifelong bachelor, who had probable Alzheimer’s.

Mummy experienced the devastation of Alzheimer’s disease firsthand.  Time and again she told my sisters and me that she did not want to continue living if she had advanced memory loss.

How can I help fulfill her wish?

Although I’ve seriously pondered it, there is no legal way for me to help my mother die.

Even if we lived in a state where choosing death is an option, Mummy would have to possess the mental capacity to make this crucial decision and then personally carry it out.  Sadly, she is far beyond the point of making any decisions, especially the choice to end her own life.

However, I believe individuals will eventually have more control over how and when they die, including decisions of how long to be kept alive with severe dementia.  It is long overdue.

Until then, I keep praying — just in case there is a higher power.

God, it’s me, Nancy.  My mom is ready.  Please help her die.

I don’t consider myself retired, but my work as a writer allows me to take advantage of “retiree hours.”  That means that I no longer have to go to the gym at the crack of dawn on my way to work. Now I can choose the times I work, play and exercise, and I find myself at the gym taking classes at civilized hours. My favorite class is yoga, though I benefit from the stretch and strength classes offered there as well.

People of all sizes, shapes and ages attend these classes. Yoga attracts 30-somethings as well as those in their 70s or 80s. The strength and stretch classes seem popular to those between 40 and 60…almost all are women.

I never thought about the “mix” until standing next to an older man in my strength and stretch class today and realized how few men participate in these classes. After seeing him struggle, I thought, “What a pity.”  It’s a pity because the few men who do venture into these classes are usually over 60 and almost always struggle with balancing their very stiff bodies.

Although he looked strong, the man in today’s class had difficulty even lifting one leg. He couldn’t consider standing on the bosu, the fitness training device used in the class, let alone bounce on the crazy round half-balls that beautifully fit instructors challenge us to risk our lives on. I felt for him. He spent more time trying to catch his breath than moving.

My intent isn’t to pick on this man––he made the effort after all. Nor do I want to bash men––I really like men. I just wonder why they seem more interested in lifting weights or running on the treadmill like gazelles. There’s nothing wrong with treadmills or weights, they just don’t contribute much toward flexibility and balance. And those are crucial factors in maintaining a beautiful life.

Yes, life is better after 50. Let’s keep it like that into our 70s and 80s––for ourselves and the men in our lives. Even at 50 your guy could start to get stiff. You could encourage him to do yoga. After all, the room is dark, and no one can see if he can’t do the lotus position. If he’s spooked by the quiet in the room, strength and stretch classes are great for flexibility and balance too. Help him avoid the pain of the man in my class whose bones are frozen in an upright position.

Consider this a gift to you and your guy. It will help both of you do the things you want when you  eventually retire.

New York Times columnist, David Brooks, asked persons over the age of 70 to send him a brief report “…on your life so far, an evaluation of what you did well, of what you did not do so well and what you learned along the way.”  I sent it to my friends as an assignment for our Wise Women’s Weekend.  Eighteen women reflected on the experiences we have lived and explored future life issues, even though not all of us are, as I am, of une age certaine.

This is our executive summary.  Listen up.

Number One:  Grow to like yourself.

Do whatever it takes.  If you want to be thin, get thin.  If you want to be a mother, get pregnant.  If you want to be a boatwoman on the Amazon, learn to row.  Appreciate your uniqueness.  The corollary is to tolerate everyone else’s uniqueness even if you don’t like it.  Comparing yourself to anyone else is a waste of the time you have.  Acknowledge your ridiculous and annoying tics and work on changing them. (Like my tendency to always know some arcane trivia about everything and say it.)  More importantly, value your virtues – name them to yourself (not others) and build on them.  As Margaret Thatcher said in the movie, The Iron Lady,“Your virtues become your character and your character becomes your destiny.”

Number Two:  Take care of your body.

Start with the relatively non-replaceable parts – teeth and bones. Flossing is not just about a pretty smile. Weight-bearing exercises and calcium with vitamin D have long-lasting effects throughout your life.  Avoid systemic diseases – the usual killers of heart disease, cancer and diabetes. Obesity and lack of exercise is a risk factor for cancer as well as almost everything else that can go wrong with you. Your body is going to change no matter what you do, but good habits can make a big difference in the quality of your life from age 50 and beyond.

Be slightly vain but don’t count on beauty.  I have seen, in both women and men, that relying on your cuteness can result in a lack of being appreciated for your more permanent qualities.  Above all – nourish your brain.  It is not only the biggest sex organ you have, what you feed it will bring you riches all the days of your life.

Number Three:  Listen to your inner self.

Even if you don’t understand what it is saying. Listen. When your gut or heart or bones send you a signal that something isn’t right, pay attention.  The big mistakes I have made in my life have been because I let my head distort what my body was telling me.  Conversely, 40 years ago, after a four-month long siege of sciatica had me in pain, immobilized and on drugs, I figured out that it was due to hugely unexpressed anger.  I controlled incipient lower back pain for over 40 years by determining why I was mad.  Not surprising that the sciatica started again the week I began cancer chemotherapy and ended the week of my last radiation treatment.  That doesn’t take Dr. Freud to analyze.

Number Four:  Choose to be happy.

Happiness or unhappiness exists only in the brain, in your brain.  It does not exist because you are eating at The French Laundry, watching an exciting football game, having great sex or seeing the Taj Mahal.  You can be happy or unhappy in any of those circumstances.  You make the choice.  You can be happy when you have cancer.  Believe me, I know.

Number Five:  Be realistic – awful things happen.

Accidents happen, illness happens, recessions happen, if not to you then to someone you love.  Deal with it realistically.  Don’t waste time wishing someone else will behave differently.  The daily Ann Landers columns are filled with people wanting someone else to change to fit their needs.

Terrible boss?  Try to work it out with her, learn meditation techniques or quit and take the consequences. During my working life I had several unhappy situations. Overall they stemmed from the fact that I did not listen to my inner self. I like to direct things, make things happen.  I should never have worked in a department where I could not possibly be head honcho.  I compensated by finding other areas in which I could be Queen (my family nickname). I started a new area of research that put me in touch with scientists from all over the world.  This ended up with my having decision making positions on executive boards of several organizations. Very satisfying.

Do not forget that each of us is going to die.  Accept it.  What is possible is to live each day and moment with mindfulness and care.  Find something every day to admire, be grateful for or learn.  It is one more tool for growing to like who you are.

Margaret S. Burns burns.margaret99@gmail.com 530-795-3524

This piece is the second in a series.  To read the first, click here.  The last in the series will be published on Wednesday, Sept. 4.  This piece was originally published in The Davis Enterprise.

******************

When I was offered a free gene test kit from a company called 23andMe, I signed up as a lark. I was curious to learn about my ancestors, and I didn’t pay attention to the fact that I’d be receiving health data, too. When it arrived via a web site, the little padlock around my Alzheimer’s risk brought me up short.

Should I look?

Instead of clicking, I headed for the library where I found a book titled “Here is a Human Being,” published in 2010 with the subtitle, “At the Dawn of Personal Genomics.”

The author, Misha Angrist, was one of the first to have his entire genome sequenced. Although he describes himself as a pretty anxious guy, he has a strong background in genetics and was comfortable making his genome public.

However, most of his book is about other people: scientists and entrepreneurs who have been trying to decode DNA and market the decoding. In addition, Angrist tells stories of first-time users like himself.

It turns out that I’m far from alone in being nervous about my Alzheimer’s status. The APOE4 gene correlates with higher-than-average odds of getting Alzheimer’s, especially if you receive copies from both parents. No lesser person than James Watson, co-discoverer of the structure of DNA and one of the first to have his genome sequenced, chose not to know whether he carries APOE4.

Unfortunately, another scientist was able to deduce Watson’s APOE4 status from studying genes around what Watson had put in the public domain. Angrist doesn’t reveal Watson’s results, but he observes that nowadays steps you take toward privacy don’t necessarily succeed.

***

The company I used, 23andMe, does not decode your entire genome. Rather, it studies something less expensive: about one million individual points on the genome called single-nucleotide polymorphisms (SNPs), biological markers that offer clues to your DNA.

When 23andMe utilizes a marker for disease, how much is known about that marker? How does it compare to other markers they don’t test for? For each disease, does it take one marker or many to know your risk?

These are important questions.

23andMe cites numerous research studies from all over, but it is difficult for a non-scientist like me to weigh the importance of one study over another.

In addition, scientists agree that environment plays a huge role in whether or not you develop a disease. If, for example, I have a susceptibility marker for diabetes but I lead an extremely healthy lifestyle and eat a good diet, what are my chances of getting the disease? If my uncle had diabetes, am I more likely to get it?

Some day aggregated data from millions of people will provide answers. 23andMe asks customers to fill out questionnaires that will contribute to that kind of research, but how much should I trust what I receive right now? How well do I understand it?

Angrist writes, “I knew enough about statistics to know that having a risk ratio go from 1 to 1.6 or even 2 meant my absolute risk had only risen from, say, 1 in 10,000 to 2 in 10,000.”

I didn’t know that. Most of the risk numbers I received from 23andMe compare my risk to average risk. This is confusing. Do I have to investigate each marker further to understand my absolute risk?

***

People react unpredictably to news about their genes. Some of us are great at denial or letting go of worries, while others are inclined to make mountains out of mole hills. When it comes to health, I’m in the latter group.

Angrist cites one scientist, Harvard neurologist Robert Green, who discovered that people who learn that they are at higher-than-average risk for serious disease become distressed at first but then return to normal, with no regrets about having obtained the information.

Really? I’d like to know more about this.

Even if people remain calm in the face of bad health news, will they overload the medical system as they investigate possible future problems? Should we anticipate a new flood of medical spending?

DNA-related companies are proliferating and information about genes is coming at us like a tidal wave. For example, the director of the National Institutes of Health, Dr. Francis Collins, has predicted that complete sequencing of newborns “is not far away.”

How will this affect a child’s future? The brave new world of genetics could change our society as much as cell phones or the internet.

But interpretation of results is in its infancy. And we don’t know enough about human response to receiving this data, which my own psyche says could be painful.

In his last pages, Angrist reminds us that the devil is in the details. He gives the example of a gene for type 2 diabetes which, if you receive it from your father, puts you in danger of the disease, but if you receive it from your mother, protects. It will take huge population studies to tease out the truth of such things; those of us who get genetic information now don’t receive much that is comprehensive and verified.

I still haven’t looked at my Alzheimer’s results.

The other day I was checking out at the hair salon next to a woman with beautiful gray hair.  “I recognize you,” she said, giving me a warm, generous smile.

I smiled back—it was one of those awkward moments, causing me to force the smile that I use for the outside world, when on the inside I am thinking, “oh shit, here we go again.”

“….Of course,” I said, lying through my teeth, keeping the smile plastered on my face, “how are you?”

“…We met last year…” she went on, clearly trying to help me out.  She reminded me of her name— which did indeed sound familiar.

“Of course,” I lied.  But my eyes betrayed my smile; I had the deer in the headlights look.

She saw right through me.  “…You and your husband made us dinner at your home…”

Busted.

Luckily, for me, this lovely woman was kind enough to spare me the embarrassment of stating the obvious: “you have no frigging idea who I am, do you?”  But I have no doubt that the woman left the salon thinking, “What a bitch.”

Because it’s one thing to not remember someone you have met briefly once before, but when you have sat at the dinner table and broken bread with someone at your home, when you have engaged in meaningful conversation, it brings it to a whole new level of rude.   The fact is, when you don’t remember someone you have met before, you are sending a message:  I don’t give a shit about you.

But the truth is, I do give a shit.  People are important to me, and I’m not a bitch.  I just don’t recognize faces very well.

I’ve known I’ve had a problem for a while.  When the kids were little, I would ask who the brunette was singing on the  TV. “Mom, are you kidding me?  That’s Britney Spears! Don’t you recognize her?”

“But Britney has blond hair!”  I would respond.  When a star changed the color of her hair, gained or lost weight, or tried on a whole new look, I was clueless.  Lady Gaga, who sometimes came out as a donut and sometimes a green leafy vegetable, was a lost cause.

I always assumed I had a mild case of “prosopagnosia,” a neurological disorder characterized by the inability to recognize faces (the term prosopagnosia comes from the Greek words for “face” and “lack of knowledge.”) I didn’t think I had a bad case:  I always recognized my mother, the kids (even when they were dressed for Halloween), the cousins, my friends, most acquaintances, the dog, my hat. I just had difficulty recognizing faces that I have only met once or twice…or maybe thrice.   But like so many things that get more pronounced as I get older–my facial lines, my neuroses, my stunning sense of humor (ha!)– the facial blindness thing is really starting to cramp my style.

Again this past weekend, I found myself in my own personal hell:  behind the registration desk at a lady’s luncheon, wearing my name tag, helping women I am supposed to know at the check-in desk find their name tags.  I should have known better. It was not pretty. “Ronna, how are you, and how are your kids?” a woman greeted me, smiling.  I smiled back, a bit angry at the unfair advantage she had, but the panic was taking hold as I looked down at the name tags, realizing that one that was not going to jump out and claim her.  There was a moment of awkwardness.

“uh…..how do you spell your last name?”  I asked quietly, and I could just about see her thinking:  ”is she an idiot?” But here is what she said out loud:

“C-O-H-E-N.”

Beam me up, Scotty.

Exhausted from the tension of registration, I collapsed at my table, and confessed to my friend about the misery of the registration desk.  I was happy to see that my table was filled with friends.  All except for one person I didn’t recognize at all.

“Who is sitting next to you?” I asked my friend, indicating the lovely blond next to her.  “She’s the only one I don’t know. Can you introduce me?”

And so she made the introductions.

“We’ve met a few times before,” the woman informed me flatly.  “I sat next to you at Lisa’s daughter’s Bat Mitzvah.  Our kids entered NYU the same year.  We had a long conversation about it.”

“Of course we did!”

My friend cracked up;  I couldn’t wait to go home.

That afternoon, I was incentivized to do a little bit of research on facial blindness.  Just how bad was my case, anyway?  It turns out the Prosopagnosia Research Centers at Dartmouth College, Harvard University and University College London (jointly called Faceblind.org) are doing research into the causes and treatment of prosopagnosia.

My husband and I both took the facial recognition test they have on their website.  The average person without facial recognition problems scores an 85%.  My husband scored a 93%.  So apparently, when he doesn’t recognize you, he is just being rude and anti-social.  But I have an excuse.  I didn’t recognize Robert De Niro, Oprah, Tom Hanks, or Mr. Bean, among others (they don’t have hair in the test pictures.) I scored a 46%.  I guess that is pretty bad, but not as bad as some people, who aren’t able to recognize their own image when they look in the mirror.

I will continue to learn coping mechanisms (the first is not to volunteer at any more check in tables) and excuse myself when I re-introduce myself to the same people over and over again. Perhaps it’s good for a laugh now and again.  And I’m in pretty good company.  It turns out that about one person in every 50 may have facial blindness. Apparently, Brad Pitt is one of them.

So Brad and I have something in common; that is, other than our staggering good looks.  And if we should happen to run into each other, I won’t expect him to remember who I am— and hopefully, he won’t mind when I have no idea who he is either.

I had the good fortune to spend the past week on a boat in the Caribbean.  The opportunity arose a few weeks prior when a conversation about holiday plans yielded the inevitable “alternate years” discussion that is pervasive amongst the divorced set. Presented with the choice of staying at home alone with the dogs while my children were with their father and the Out-Laws, or hopping a plane and heading south, well, I chose the latter.  While it was hardly a Thanksgiving in the traditional turkey-gravy-football-family sense, it was, nonetheless, a week of giving thanks, during which I learned a great deal about myself, and that which is truly important to me.

Depending on your perspective, boats can be the ultimate dichotomy.  They are at once liberating and confining; organic yet technical; assiduous yet indolent.  Being on a boat can bring out the best and the worst in a person, depending on the company and the external (and I suppose internal as well) conditions.  I wasn’t quite sure what to expect on this adventure, but I packed my bag, boarded my flight and set off to warmer climes.

For the past decade my life has been on overdrive. Every day was stuffed with something or someone that needed attention and handling. My phone was never off; my inbox never empty; my brain never fully at rest. The more I did, the more I needed to do. I began to believe that the only state that was familiar and comfortable was one of chaos and disarray, and that feeling permeated my relationships as well. I was never calm, never still, never truly at peace.  Always on alert, I made sure that I was always prepared, dressed and ready to spring into action – any action – at a moment’s notice.  And I was always exhausted.

Someone once accused me of constantly being in motion because I feared what I would find if I stopped and took a good long look at myself. Perhaps there was some truth to that, or maybe they were just being mean, but as I turned off my computer, shutting out a barrage of messages, and powered down my phone, I had a moment of angst that in disconnecting from the cyber world I would lose a part of myself that connected me to humanity.

What I wasn’t expecting was to find the part of me that was actually missing.

With no cell phone and no Internet, no distracting messages or clamors for my attention, I was able to relax into a deeper and more meaningful connection.  I thought complete thoughts; had comprehensive conversations; filled my lungs fully with fresh air; slept when I was tired; ate when I was hungry.  I was rested and energized, ready to tend to tasks that were real, in some cases matters of survival, not just busy work.  I lived deliberately and organically, thriving in a limited space and finding focus and clarity in the vastness of the wind and the waves.

It was the best week of my life.

Back at home, unpacking my gear and slogging though an accumulation of messages and chores, it dawned on me that in crossing the ocean this week I had also crossed a passage to a new way of living.  I felt a new clarity of thought and deed, a sense of purpose, and an ability to think through situations before reacting to them.  My Thanksgiving, in its lack of familiarity, allowed me to really see the people and things that I choose to include or exclude from my life.  It gave me the time to understand why I am making the decisions that I am, and to transition from habits and reflexes of the past into a fuller, saner and happier present tense.

And that may lead to the best time of my life.