Ageism, Old People and the Right to Folly with Dr. Bill Thomas

“If you want to actually enjoy all that life has to offer, you have to be who you are”

     Dr. Bill Thomas     

Dr. Veronica Anderson, Host, Functional Medicine Specialist and Medical Intuitive interviews Dr. Bill Thomas about
Ageism, Old People and the Right to Folly.

Are you scared of growing old? Musician, teacher, and physician Dr. Bill Thomas, known for his health care system innovations, works to improve the care provided to older people.

In this episode, Dr. Thomas talks about ways of transitioning into older age and accepting care gracefully. Listen to the end to learn how to give others the care they need without imposing on their autonomy.

Listen to episode 34 on iTunes here or subscribe on your favorite podcast app.

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34: Show Notes


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Book:

What are Old People for? – Dr. Thomas

 

Show Notes:

03:00 – Dr. Veronica’s father’s health challenges

08:00 – Ageism

09:40 – Giving and receiving care

12:30 – Transitioning through the years

18:00 – The right to folly

 

Full Transcript:

34 Ageism Old People and the Right to Folly with Dr. Bill Thomas

 

Female VO: Welcome to the Wellness Revolution Podcast, the radio show all about wellness in your mind, body, spirit, personal growth, sex and relationships. Stay tuned for weekly interviews featuring guests that have achieved physical, mental and spiritual health in their lives.

If you’d like to have access to our entire back catalog visit www.drveronica.com for instant access. Here’s your host, Dr. Veronica.

Dr. Veronica: I am Dr. Veronica and I have also with me my co-host Russell Cook and the topic that we are going to discuss next is about ageing.  And, this is something that people hate to talk about especially in the American culture and society.  It seems that when you pass 25, 26, maybe 29, it’s all over according to everybody.  You don’t do anything well anymore, it’s just the end of it.  And, so, and then we have those of us we are “sandwich generation” where we are dealing with our kids who are going into maturity and our parents who are going into maturity and driving us all bananas.  And, as you might know and if you have heard on another segment, Russell recently lost his father and so it’s a perfect time to talk about aging.  Russell just said to me, right before we got on, about how he felt privileged one, to have his father so long but also to be with him during the dying process. And I am a physician and nobody here likes to talk about death and dying.  I think we understand so little about death and dying but also so little about ageing and the beauty of ageing and we have to have this conversations all along.

One thing about the way we have set up in America, we have put in place social service programs that have made it such that even into ageing, it used to be that families lived together more as a necessity for financial reasons and everything like that.  Whereas now in our culture and society we put it together, so the people are pretty independent financially a lot of the times, sometimes not but a lot of the times even as they age.  And so families are not together the same way that they used to be.  And so I have seen, you know, when I was in the traditional practice the multiple generations of family and it seemed to me that the older people ……0:02:48.2 to issues were much more difficult than even the issues dealing with teenagers and young adults.  There was this, I don’t know, rugged individualism and lack of cooperation, I will call it, of the older generation in refusing to, let’s call it go with the program.  So both Russell and I have experienced this to an extent.  I think I have experienced it the most recently, and my father ended up going in a hospital, he was acting a little bit strange and we found out what was going on, the thyroid was underactive but it was because he wasn’t taking his medication.  He was living by himself, not functioning fully and taking his medicine and eating and doing everything the way should because he was forgetting.  And so why did he end up staying in the hospital for so long because when I went in and I said listen, my father who was a very brilliant man and still he is a brilliant man, who was very high functioning snowed everybody and nobody picked up that he had any memory loss or any difficulty with his function.  But, when they picked it up it was quite a challenge to figure out how do we handle this because the support systems are not great in our society to help people maintain their independence.  Now, my father in his wisdom at this point in life, he is 79, former electrical engineer, he used to be the president of IEEE, has some early memory loss which you when you talk to him you will not necessarily pick up but I knew it was there from how he was functioning and I was watching some things happening.  When he was presented with at the hospital, okay, here is, the hospital didn’t want to discharge him because they felt, I am sure medical legally are problematic in this situation because we discharge him and something happens to him, everybody knows he is not functioning well until therefore legal liability.  And this is why I was just like listen, my father is not doing well, you have got to figure it out.  So when they decided he needed nursing care, he takes insulin several times a day, he has a lot of medicine, he needs to have somebody come in and help him with this. Well, under our current system, under Medicare, I think you can get a nurse maybe a few times a week to come in.  the rest of it has to be paid for out of pocket.  Well, guess what, who is going to pay for it?  Now, my father has a pretty good pension and some money, he has no car payment, now house payment and so there are some moneys there.  He is not wealthy but there are some moneys there.  Dad doesn’t think that that’s where his money should go. He doesn’t think it’s worth it, he can do it on himself.  And so there was this standoff that lasted about five weeks and he was in the hospital under the acute care setting because of it.

So these are some of the issues that I am sure our next guess can talk about.  Russell is here with some issues with going back and forth with his father.  I don’t know how we do this but one of the other issue is that there is ageism, so I am talking about my father who is, you know, 79 years old and Russell was talking about his father who was 94 years old.  But on the other side of ageism, I jokingly said when you are past 26 its over but I have also seen a lot of people who are very productive individuals mid midlife, get downsized and also have a lot of problems getting into a new place, a new life, a new job, a new everything.  So ageism starts way before your senior years.  But yet the wisdom that I have gained from my mother, from father, I mean, I am talking about the frustrations but, I mean, my mother and father were wonderful parents, still are able to give, you know, advice if I ask them and guide and that nobody could give because they have the perspective of years and wisdom that other people don’t have.

So, let’s talk a little bit with Dr. Bill Thomas. Dr. Bill Thomas let me just tell you www.changingaging.org is the website that you go to, www.changingaging.org.  Dr. Bill Thomas, welcome to Wellness for the Real World.

Bill: Well thanks for having me on.

Dr. Veronica: I always like to set up my personal stories because that makes some triggers in the guest that come in because you like say okay, I agree with that but I don’t agree with that, I agree with that, oh, you can do this, you can do that.  And so first I know you were sitting there, your brain going, because this how us physicians work, and you work in geriatric medicine and elder care. There needs to be more geriatricians out there so please doctors going to medical school think about geriatrics.  In the beginning what I was saying, what is the first thing you thought about when I was talking about my father and his issues?

Bill: Well, I thought, you hit a number of points that were really key and I disagreed about a couple of things.  So it should be interesting.  I think that you made the point that ageism isn’t just for older people, there are ageism really starting at astonishingly young age in American society and that ageism colors a lot of what we believe about our own selves and our own potential and our own worth and value.  We live in a world that is just tone apart by sexism and racism.  Ageism is there too, in some way it’s more insidious but it also has an impact on the way we live and the what we expect and how we expect the world to be.  So I think it was great that you called that out as a ………… 0:08:26.8 of the lived experience from a very early age.  Also you talked a lot about that idea of independence being the only marker of successful older people.  So if you want to be thought of or seen as a successful older person then you have to not just not be helped, you have to deny or you have to deflect attempts of people to help you and that’s really not very healthy.  The other thing though and I thought it was most interesting to me in part of the conversation was negotiating with your dad.

Dr. Veronica: Oh, my god

Bill: About priorities and what matters and where the money ought to go.  Well as a geriatrician I was like yeah, hello, I am home. That’s the tough stuff right there, that’s the really hard stuff.

Dr. Veronica: The negotiations and I am sure people are listening to this and saying oh, my god, it was so and, you know, I share with my clients this and practically all my clients have at least one parent that they have had this.  I have a client who her father is 98 years old.  So she is up there herself but her father needs care like this and although he is in a facility, he needed things like undershirts and things like that.  And she would go out and get him some undershirts and he would say to her, now this is a man who had had a business and has been doing quite well. He said, no don’t spend money on that, don’t spend money on that.  It’s there and so we also have this idea that we are supposed to accumulate wealth in our life but we are supposed to now use it on ourselves, we are supposed to pass it on to everybody else.  So what’s going on with that?

Bill: Let me tell you a quick story about that.  That has to do with some research that was done in Scotland, now the problem was done about twenty years ago but it’s a brilliant study.  At that time energy prices were high and there were a number of older people in Scotland who were being found in their homes having died of hypothermia.  And the reason is they had turned the heat down to save money and of course the body temperature dropped and they died of hypothermia.  So a researcher got the idea of buying a bunch of parakeets and going to see the older people in this neighborhood and saying look I have got this parakeet, it’s kind of homeless, it needs a place to stay, here is the food, here is the cage would you take care of it?  And people would say okay, yeah I will take care of the parakeet and then the kicker, but the house has to stay at least 68 degrees or it’s bad for the parakeet.  What do you think happened?

Dr. Veronica: People were dying of hyperthermia

Bill: So people turned up the thermostat not for themselves but for the parakeets who they were parakeets sitting for.  And I tell that story because it has a lot to do with that undershirt idea.  People have strong feelings about this and people, especially older people are often very graceful in the way they give care to others or the way they show concern to others and they are often very clumsy about how they receive care.

So, in my practice I would often say to older people listen, I know you are really good at giving care, look at what you have done, three generations you have raised up, however, I want you to practice being graceful receiving care and that is a whole new kettle of fish and you can work on it and you can get better at it.  So notice that I said receive care gracefully, I did not say be dependent, I did not say be a burden, I said, you know, back to the t-shirt example, receive those shirts with a spirit of joy and understanding and gratitude and not to receive them with a feeling of fear or anger because that’s not receiving gracefully.

Dr. Veronica: Do you notice in our culture and society that people as they get older have trouble transitioning through the faces of life more in this than in other cultures.  Because, what I see is, you know, everybody is trying to be, I don’t know, whatever stage you are, you are like say okay, thirty years to new twenty, forty years to new thirty, fifty years to new forty.  I mean, it’s that we are redefining but we don’t transition to the next phase and so then we even get closer to the phase where it’s time to transition to another state of being, we don’t transition well.  But I also want to put in a comment there because of our a lot of time religious beliefs we are really fearful of what’s going to happen when we die.  And so, is it that fear or what’s going on that you have found working with older people that makes the transition just so challenging?

Bill: I think you are really right about this calling up the problem of sixty is the new thirty, eighty is the new forty, there is always something I can’t keep up but the problem with that is that’s not true.  You know, sixty is the new sixty and if you want to actually enjoy all that life has to offer you have to be who you are. And I will give you an example, so I am a fifty six year old man, next year I will be fifty seven if I am lucky enough. If I am lucky enough twenty years from now I will be seventy six.  And what I aim to do is to be my age all the way.  So when people come to me and tell me that they, well, I don’t feel fifty or I don’t feel seventy, I will ask them, what does it mean to feel fifty, what does that mean, what do you mean feel fifty?  And they will often give you back a ……….. 0:14:33.8 of just stereotypes and it’s a case of the people internalizing age of stereotypes and using those stereotypes to demean their own self and the only way to escape is to say that I am not really fifty, I am not really seventy, I am really some other age.   And it’s not true.  There is an old saying that goes like this pleasure may rely upon elusion but happiness requires the truth.  So the truth is you are sixty, no problem, that’s good be sixty

Dr. Veronica: I am laughing because I always say the truth shall set you free.  So the truth really does set you free and when people are free they are happy and so, but there is not much help in bracing that.  Now Russell what do you think about all this given you just helped your father transition, he was ninety four, what are you thinking here?

Russell: Oh boy, so many things.  Certainly in my father’s case, he was quite a tough old bird, he was living, up until a month before his death, he was living alone in his house.  And, I think back when my mother was alive he was often floating the idea of selling the house and buying into one of these retirement communities, you know, so that they don’t have to worry about nursing care, it will be there when and if they needed.  ……… 0:16:09.6 for the last ten years my brother and I have been trying to get him out of this house.  So he certainly had bad scenes of attitude.  By the end of the line he had people helping him, he had people stopping him twice a day to check on him and make sure he was okay but I think people at that age they are so attached to their routine and their home and that routine is what gets them through in my experience.

Dr. Veronica: Did you get to the point where you stopped trying to get your father to do something different or you just accepted okay, he is going to be here and this is it?

Russell: Yes I did, yes I did. A few years back after lots of false starts with him trying to get him moved out I said to him very frankly, dad, you know what happened to this friend of mine’s father?  He stayed home forever, he was out of his mind and not able to take care of himself and one day he had a nasty accident and was sent to the hospital and they would not let him return to the home situation, you know, is that what you want to have happened to you that you could, you know, go to the hospital one day and never see your house again and never have control over the things that you love and, you know, deal with them in the way you want to?  And he looked at me right in the eye and he said yes, that’s what I want, I want to be in my home.  And so at that point we said okay.

Dr. Veronica: And so Dr. Thomas is that the right approach because I earlier probably than Russell has, I came to that approach now, it’s too stressful, even though there is a better answer and everybody including everybody in the hospital agree that the right answer wasn’t what he was choosing and maybe he is not mentally okay for our stress levels to all be lower. He has gotten to that point in life, I have lots of years before I get there so if I let him stress me out I am going to be sick and you know what I am going to live enjoy my life and I will just wait for the phone call from wherever I get the phone call from.  What do you say about that Dr. Thomas?

Bill: Actually these is a really interesting concept that is well known that applies here that I think you guys and your listeners would be interested in, it’s called the right to folly or the right to do the thing that is not the smartest thing.  And if I were to take my guests, the hosts on the show, you and Russell, if I were to take back to your early twenties, I might witness some folly on your part, I bet I could find some folly.

Dr. Veronica:  Absolutely

Bill: And you know what, believe in agreement, people in their early twenties they get to do things that, you know, your mum is looking at you and going that boy is trouble, you know, that’s a wrong guy for you but you have a right to go with the wrong person and to stay out late and to do all kinds of things that are probably not the best for you.  Well, the right to folly stays with you your whole life.  So, you know that apartment that you sold in Brooklyn that, you know, now would have been worth a million dollars, yeah, the right to folly.  You get to make your own decisions.  The right to folly follows you into old age.  So just like the twenty year old, the seventy nine year old gets to make decisions that other people go that’s a bad decision.  As long as he doesn’t and this is the same for twenty year olds, as long you are not hurting other people or you are not literally endangering yourself, you know, then in that case your right to folly is very large and it’s great or families to recognize that dad, you are dating this woman, I don’t like here but he has got a right to go out with a wrong person, you know.  So that’s why I thought Russell’s story was really kin on catching that hey. we have all got a right to folly and it’s fair and it stays with us for life and that means we do stuff that other people don’t think that is the right thing.

Dr. Veronica:  So let’s interject, because you are a physician and you see all kinds of people with all kinds of health issues.  My father diabetic, one insulin, who has hypoglycemic episodes and who lives by himself and doesn’t seem to be able to administer that on his own reliably.  And has been diagnosed with some cognitive impairment, does he still have the right to folly?  How do we know when?

Bill: There are two answers to that.  There is a legal answer and then a moral answer.  The legal answer, he has as much a right to do what he wants as you do, in America your dad is citizen, I don’t know, he is a citizen maybe, right?

Dr. Veronica:  Yeah he is absolutely. We were born in Philadelphia

Bill: Okay, your dad is a citizen, he is equally as much a citizen as you, he gets to do what he wants. And there is no law that says you have to take your insulin exactly the way the doctor prescribed, in fact I can point to lots of young people who don’t handle their insulin very well.

Dr. Veronica:  Yes

Bill: As we know.  So legally he has a perfect absolute right.  Now, it gets a little severe on morally.  What moral obligations does he have and you know, the kinds of things you are talking about certainly it’s creating risk, I mean, heaven forbid have a hypoglycemic episode and not get help in time.  Things like that could happen but it’s a two way street.  He has a right to call his own shots and you have a right to tell him, I think that’s dumb.  So you have a right to say, if one of your friends was doing this you would say it was stupid and you know that and you can talk about that.  Now, we are talking about medicine and stuff and there are times when people come to a point where they are not actually not able to realize that what you are doing is dangerous and that can happen and then that sets up a different dynamic but your dad is not living that way by the sounds of it.

Dr. Veronica:  Not yet. So Russell has allowed his father the right to folly until pretty much right before he moved on to the next phase, he follied.  I have decided I am going to let my father folly.  Let me just tell you where it gets a little bit stickier, because he doesn’t handle his finances well he believes that my sister and I should give him money even though he has enough so that he can folly with his money and we are supposed to pay the tax bill and all these other things.  You are over there laughing because he feels, see this is where it gets sticky.  Well, I am like saying I am not going to support your irresponsibility.  So what has become incredibly challenging at this point is every time my father calls me with his, and he just doesn’t call me, he now doesn’t call me because he knows I am the no lady, he calls my husband, he calls my husband and you know, ‘we are both engineers, you can understand this’ and his logic is very off and my husband sees his logic is off.  So I don’t talk to him very much which is sadder than me because I love to be going into a phase where we are becoming closer whereas I don’t because he always says something or wants me to agree to something that from a responsibility stand point for a moral ethical stand point is just wrong.  I mean, when I wrote the letter to Motor Vehicle, yes I did that, write that letter to the Motor Vehicle to say he needs a medical review.  I wrote the letter because I was concerned about, not just his own safety, but I didn’t want to see that I knew something was wrong and he killed somebody else’s kid.  That is just blithely unfair.  Oh, he is downright mad about that but I felt a moral obligation to the whole of society and so therefore if you want to keep driving you submit to a medical review and let the Motor Vehicle objective people say that you can still drive.  Now, you know what happened?  It was fabulous, he decided that he just wasn’t going to do anything with it and so therefore his license was suspended and he is off the road and we are all safer for that.  So I want to thank Dr. Bill Thomas for being on Wellness for the Real World. www.changingaging.org we really have to have more geriatricians out there so that we can have these discussions to hear things like the right to folly, you know, I have never heard of that before but it’s absolutely the right thing.  So Dr. Bill Thomas keep doing what you are doing, www.changingaging.org.  you are listening to Wellness for the Real World, I am Dr. Veronica with my co-host Russell, www.drveronica.com is where you can reach me.  I really appreciate you listening, much love to you guys out the audience, I hope that you are able to allow your parents to folly.

 

Female VO: Thank you for listening to the Wellness Revolution Podcast. If you want to hear more on how to bring wellness into your life visit www.drveronica.com. See you all next week. Take care.

 

 

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Dr. Veronica Anderson is an MD, Functional Medicine practitioner, Homeopath. and Medical Intuitive. As a national speaker and designer of the Functional Fix and Rejuvenation Journey programs, she helps people who feel like their doctors have failed them. She advocates science-based natural, holistic, and complementary treatments to address the root cause of disease. Dr. Veronica is a highly-sought guest on national television and syndicated radio and hosts her own radio show, Wellness for the REAL World, on FOX Sports 920 AM “the Jersey” on Mondays at 7:00 pm ET.

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