 to my program, don't just age, engage. Now, whom do you deem as the most responsible person for your happiness in your elderhood? If you attribute it to anybody else other than yourself, you're placing a painful burden on family or friends. I'm Larry Grimm. Welcome to don't just age, but engage. Exploring the dynamic of aging and creating an extraordinary elderhood. I am dedicated to assisting people in doing that myself because I am a life coach, personal life coach and personal life, I offer personal coaching for life and faith, especially for those who have gone through elderhood and are going through elderhood. I am a skilled experienced pastor of Presbyterian congregations and chaplain in long-term care. And most recently here on the island of hospice care for three years. I have worked with elders all my life and I very much believe in the possibilities and believe and want to work in favor of the good things that are coming up for people in their elderhood. When we move into elderhood, we actually move through a transition because this is a stage of life that's unlike any other stage. I say we have a childhood, you have a young adulthood, you have an adulthood and now you have an elderhood. And as with the other stages, there are important tasks that we have to do and if we don't pay attention to them and really make them happen and accomplish them and meet them as they ask our attention, then we don't benefit from the stage of life as well as we can. And I have identified five spiritual tasks of elderhood. The road ahead, if you're just entering your elderhood, will be marked by grieving, sorting, forgiving, preparing and letting go. Grieving is a very strong emotion and the older we age, the more we lose, losing friends and family, losing abilities, losing our identity. It really provides for a lot of grief that's new for us and if we try to suppress it or ignore it, it becomes dominant. So part of my coaching is around enabling people to grieve the losses that they experience in this stage of life. Sorting through their stories is one of the interesting things for me. I really look at myself as a professional story listener and I know I often hear people talk about how much stuff they have in their elder years. They have got a hold of so much stuff. They said, how did I ever get so much stuff and why do I keep holding on to it? Well, one of the reasons we hold on to our stuff is because our stuff represents our stories and what's most important to us is our stories. So part of coaching is also sorting through those stories that enable you to know who you are, to help you celebrate who you are now, bring the past into the present, sorting out your stories. The third thing is forgiving and I don't mean that there's an imperative to forgive, but what I mean is that we have a need to kind of clean this late, clear the conscience, to extend forgiveness. Now that may not result in reconciliation with someone, but there's been a broken relationship. Reconciliation requires at least two people want to come back together and rebuild, but we can forgive unilaterally. We can forgive others and we can forgive ourselves and set ourselves free and so them free from any obligation towards us. For giving, then preparing, so much to do to prepare and I'd like to touch on that today. Preparations for our external life, preparations for our expectations internally, what do we expect on the other side of our dye, what do we expect we will encounter, which oftentimes has to do with our religious background, and then finally letting go. There's nothing quite as prominent to our lives as letting go and the olderhood and we learn how to let go all through our lives, but it's finally the let go at the last of our dying process that oftentimes becomes most challenging, most difficult. We can prepare for those. So each of these five spiritual tasks asks for our attention and if we are responsible adults, we'll take care of that and we'll look into those. I called it stewardship of my life. Now stewardship is an interesting word we use it a lot, stewardship of our resources, stewardship of our finances, put placing finances where we hope they will do the best for the common good of humanity. We think of stewardship in terms of the earth, now we use the resources of the earth. And being a proper steward means that we are paying attention to how we dispose of things, how we engage things in our world, how we help to lower the cost on our environment in the things that we do. Stewardship comes from the time when pigs were of value in Europe and a wealthy person had pigs, hogs, I guess you'd say today, a wealthy person had hogs in their hog farm and in the stye the owner would place a very trusted person who he became the stye warden, the warden or the ward of the stye. And what made his or her love, it was a hell of course, so important was that he would carry out the will of the owner even when the owner was not available. It wasn't a matter of the running back and forth between owner and the needs of the hogs. The stye warden, the stye ward knew what to do and that's why the steward of the pig stye was held in such high esteem. So we become stye wardens of our own life. We become stewards of our own life and that is very important to hold on to as we come into our elderhood. You are responsible for the stewardship of your elderhood years, but fortunately you're not alone. I have a website that I would like to share with you. It's part of the work that I do as a community-based chaplain, you could say. I'm building a global community for your extraordinary elderhood and this website, which is personal coaching at life and personalcoachingforlifeandfaith.com, will give you an opportunity to look at the kinds of things that are involved in eldering and becoming an elder. Elderhood has become a very popular term since the 1990s. I know some people when they hear the word elder think of growing decrepit of losing so much and don't want to be seen as that. In fact, I think most of our people, most of our friends and family wait until the physical part of aging drags us into elderhood and we have to sort of give up wanting to be prosperous and thriving on top of our physical well-being and other aspects of our lives. But I'm saying that really by planning ahead, by considering the things that are needful and the resources that are available, we can plan for an elderhood that takes into account so many different possibilities and that's what I'd like to share again with you here today. One of the fascinating things about stewardship is that you can, in fact, plan for outcomes, a variety of outcomes. And when you do, your family, your friends, and you have a lowered anxiety level. So let's look at this because, you know, there may be things that I can bring up for you even here in this short time of this presentation which will raise some questions in your mind that you have not yet thought about. So I have a website, another website that's a very important website. It's called, it is called Caregivers Connections in Hawaii and it caregiver connection up Hawaii.org and it has great information about elder care. So I'd like to share with you some of these resources that are available and in doing so perhaps raise some questions within your own mind of how you can best take responsibility and prepare for your elderhood. One of the first ones, it's not listed at the top, but probably the most critical and most important decision to make is where do you want to live. Now it's very easy to say, oh, I want to stay in my home. I'd like to live in my home because I grew up here and I have my family here and it's so meaningful and yes it is. And planning for that is possible, but it does take some intentional planning in terms of the facility, the easiness with which you are going to be able to move through your own and who is going to be there in attendance for certain needs that could be arise, could arise. So remember, I don't want you to be a victim of your elderhood. I don't want you to be a victim of your aging process. Louise, Dr. Louise Aronson, one of my favorite gerontologists who wrote a book, Elderhood, has said in that book, people don't die from growing old. People don't die from aging. People die from disease. People die from catastrophes, things that may be more vulnerable towards as we age. I often tell people, you know, where most men in our culture die, most men in our culture die in restaurant bathrooms and at the foot of a ladder. Restaurant bathrooms because they'll get something caught in their throat. And being embarrassed, they get up and run to the bathroom, but don't really know how to get anything dislodged from their throat. And so they can easily die. And that's a common depth for many, many of us. The other place that we die is at the bottom of a ladder. And I have a friend who told me today that last week, his father-in-law in the midst of all the storms that we had here in Hawaii, got up on the ladder, got up on the roof, was clearing out the gutters, slipped, fell right off the roof. Fortunately, he was not hurt. But it's very often because of our stubbornness at letting go, stubbornness at realizing that we have lost some capacities due to our aging process, that we put ourselves in precarious and vulnerable positions physically. So it is true that we can plan for our life and our aging in our home with the help of others who will be there with us. You may want to consider who would be your caregiver. Would it be a spouse? Would it be a hired in-home care person? Would it be a professional all kinds of professional caregiver? These are things that are very important to consider. And how are you going to change the facility of your home? Take out steps, move walls, put up handles so that you can navigate through the house without any problems. So where am I going to live is a big, big, big question, first question. And if you're not going to live in your home but want to go into some kind of facility care, there are then several Larry levels of care that we find in various facilities. One level, foster home. Foster homes usually are two or three patients, a low number of patients in someone's home, and they take care of those patients. And you can find foster homes all over Honolulu with dedicated, wonderful people who want to care for aging parents or aging family or aging friends. Next is an established care home, which is licensed by the state, overseen by the state, which will have more people, more patients, five or six patients, but not a huge amount. And they usually have established criteria that they have to have fulfilled by each patient. So they don't do the full range of care, but they do a certain kind of care that they can handle within their own home facility. Beyond that, we move into true facilities, like assisted living care. Again, parameters have to be met, all capabilities, life skills, certain set of life skills have to be met, and then the assisted living will help with those that can't be met. For instance, will the patient be able to toilet themselves? Will they be able to feed themselves? Will they be able to take medication? Or are these the things that assisted living assistance is limited, assistance is needed in the caregiver? So you can explore this. Now, when you don't have any pressures, any worries, it's an opportunity now to look at what's available to get to know these facilities. After beyond assisted living moves to nursing care, specialized nursing care, and then often beyond that, to memory care. I was chaplain in Arvada, Colorado for Lutheran home in Arvada, Colorado. And we had an independent living segment section. We had an assisted living section. We had a skilled nursing care section, and then a memory care section to deal with the specialties of dementia. So person could actually move through their whole life. And many of my patients there did through their whole life, end of life span of elderhood. And it was very convenient for the family. We built very strong relationships with family members and with our patients. So consider where you're going to live, one of the most important decisions that you will have to make because it's very costly. Advanced healthcare directives are so very important as well. Advanced healthcare directive and pulse forms are available online in several different manners. So important because we can go through a catastrophic event in your elderhood and not be able to make decisions on your own, or not be able to be consulted about decisions that need to be made about your healthcare at that point. And so if you map it out, so to speak, with the help of advanced directives, your family can always turn to those and say to the physician, this is what my father, this is what my mother wanted. And follow your will and your wish. There's a document called Five Wishes, which I personally like a lot. There are also documents here available in Hawaii and carry on the conversation or make the conversation happen. It's one of those available resources that will help your family to go through the conversation about what you want in your elder care. And again, the conversation, the talking it over with family members really is important. I find my children sometimes say, not that we got it covered, don't worry about that. Let's not talk about it. And we set ourselves up possibly to be victims of our aging or catastrophe rather than planning ahead. So going back to this, there's adult daycare centers, case management agencies, both of those come to mind today because I came across a young man who was today on online, was talking about how he was a primary caregiver for a relative, had been for three years. And the relative has progressively gotten aggressive and fights with him and with anybody who comes into hell. And this young man was wondering, what do I do? How do I manage this? Being in touch with case managers, with the system of adult care that's available in our city and in our nation, very important for the caregiver to be able to fulfill his desire to make sure that his relative has the best elder care possible. Let's bring that back up. Again, the list provides some questions that we really don't think about. You probably don't think of yourself as going to an adult daycare center. But maybe that would be a good thing for you sometimes. Go visit one of them, see the kind of experience they have, the kind of community that they build and strengthen with each other. Developmental disabilities are cares available, home care. I'm a very strong proponent of hospice care. Hospice care begins when a can begin when a physician says you have approximately six months of living left. And I encourage people to get involved in hospice care right when they get that word. Because the hospice care can make so much difference in how the whole family moves through that six months and makes the end of life experience a rich and rewarding experience for everyone. So hospice care provides not just care for the patient, but for the family as well. There are four types of pain in hospice care that are addressed. Physical pain is emotional pain and spiritual pain. There's a financial pain and resources pain. I mean, I'm sorry, relationship pain. So all four of those are part of the hospice care plan. And you get a whole team of people who are able to do that. Nurses and physicians, social workers, spiritual care counselors. Home care may become a necessity. Meal services, medical equipment that need to be brought into the house and into your home or into your facility room. And palliative care is a new and important service. Palliative care deals with pain. How palliative means that we're working to cover the pain to minimize the pain. And how often do we hear people say when they talk about they're dying, what do you want when you die? What do you want to have that? Because they'd like not to be alone and they'd like not to be in pain. And so palliative care can be an important dimension to that in which medical assistance is brought to bear in covering the pain. In Hawaii, you have the opportunity to enlist medical aid in dying if we desire. Medical aid in dying, MAID, or the actual law that was passed was entitled Our Care, Our Choice. And it gives an option for ending my life or ending my life with medical assistance. The requirements that are set out by the legislature are pretty strict and very important to follow have to do with physician acknowledgement and psychological acknowledgement of well-being. Senior setters provide opportunities again. There's a Kapuna Power program that I've seen on TV and you have probably as well. Support groups for caregivers, all kinds of support groups, Alzheimer's support groups, Parkinson's support groups, caregivers desperately I think need to have the support of and the wisdom of families who have gone through some of the same things that they too must fall are going through. Veteran services here in on the island are abundant and you can get help with what are the Medicare, Medicaid, and Supplemental Income SSI, Supplemental Income that's available from the federal agency. That pretty well covers the list. Again, it's a list that you can see on this wonderful website. You can also get in touch with social workers who can help walk you through it. I will be glad to help walk anyone through it who would like to ask me to. Again, it will provide you with some questions that you probably have not asked about your care. I guess I would close also with a personal story of friends and family that I have who have news that they are news that even though they're well healthy and well look well now, they're having to deal with prostate cancer and the care that needs to be given to prostate cancer. It's important, it's important. I as a friend and relative can say I want so much for them to dig into these issues and to empower themselves to take responsibility as stewards of their own care so that they know that things will be done as they want them done to the best of the ability of those who are around them. Again, my ministry now and my work is with elders in elderhood with family members who have elders in their family and relatives and want to navigate the system that's available. PersonalCoachingForLifeAndFaith.com is a good place to be in and I will look forward to having the opportunity to be a partner with you in stewardship of your elderhood. Aloha, peace be with you.