Kathy Kastner

‘You’re Just Getting Old’ and Other Words That Just Miss the Boat

In her role as founder, curator and blogger for the website Ability4Life, Kathy Kastner dedicates herself to investigating both the essential lessons of aging and its myths in need of puncturing. She seeks better ways to see our own or our loved-ones’ journey through life, ways which empower dignity, life quality, and happiness.

So beware the notorious idea with which we dismiss so much about aging: You’re just getting old.

“On that ‘You’re just getting old’ business, which is an excuse too many professionals and family members use, I’m attending as many informational sessions as I can all over the place – at Toronto’s Baycrest geriatric facility they have a lot of sessions; Toronto Rehab has lots of sessions on fall prevention, stroke rehab, those sorts of things; I’m on the board of The College of Occupational Therapists, and there’s a day to celebrate OT Research. Now what I’m learning is the possibilities, the fixes for the various abilities that come with aging.

“Some of the things that come up again and again are loneliness, inactivity, and feeling worthless. I think of someone I know who’s 91. He’s hard of hearing but has all his capacities, to the extent that he says to me ‘Kath, I need a woman. And I don’t need Viagra’ – which is a bit too much information, but he was feeling so isolated and frustrated! Then he moved into an assisted living facility with other people, and he went from drooping on this own, to being vibrant and alive and enjoying the company there!

“Among my goals with Ability4Life is to reposition common issues. One of the things that brought me to CAPCH was that [CAPCH president] Vaughan Glover and I have a mutual passion for language and its barriers.

“There are tools coming from Technologies for Aging Gracefully (TAGlab) at the University  of Toronto, developed to help solve communication issues. It’s positively liberating. But with these technologies coming down the pipe, we need followup with people, with users, to check the actual language in use.

“There’s a problem of communication in healthcare appointments. Even single-syllable words used in a medical context can cause you to stop listening. If someone doesn’t know ‘poop’ as ‘stool’, they’re gone from the conversation as soon as ‘stool’ is used, because they’re trying to contextualize seeing the word as something they know with four metal legs! Other words like ‘static’, ‘mass’, ‘gait’ – they have two meanings depending on the context, but one is more common than the other depending on whether you’re a patient or a doctor. I’m collecting single-syllable words that I’ve learned can just throw communication. That’s what got me connected to Vaughan at an Ontario Hospital Association conference: someone asked a question that allowed me to stand up and say ‘I think a glossary is needed not just for the jargon we all know about, but the words we use in everyday language that acquire a different meaning in health.’

“But I think healthcare professionals are hobbled by their schooling. I actually see that as where a change needs to happen.

“I also think it depends on the person. Most healthcare professionals are well-meaning, so in my work with the family doctors and even the occupational therapists, my role as a public member is to recognize when they’re not being people-centred and call them on it. On the language front, an OT recently said to me, ‘I’m going in for Wound Care training,’ andI thought knifing, bullets, return from the war. No – she’s talking about bedsores! We understand, but put together it sounds like she’s treating people coming back from a Middle East conflict! I said to her, ‘You wouldn’t use those words with a client, would you?’ She was mystified. Then the group I was talking to all kind of went into their hearts for a minute and went ‘Oh, yah….’

“Same with the family, because I’ll hear them saying of their elders: ‘Well, if they’re not going to do what I tell them to do…’ and I just go ZING! That’s talking down, assuming a power position. Or, ‘They’re not taking their meds the way they’re supposed to.’ When I ask the person why it is they’re not taking their meds, you find a goldmine: ‘I find it demeaning – demoralizing – It makes me feel like I’m a failure – It’s hard to swallow…’  If you just maybe found out WHY, you’d have one of the keys to the problem. You’re taking 15 pills? Of course it’s hard to swallow all those! People or doctors don’t know the questions to ask.

“If I’m told to take this three times per day, is that every eight hours? And if I’m a shift worker, when does that start? If I have breakfast at nine and lunch at twelve, how does that work in? It’s so interpretable. That’s one of my intentions – a mutual collaboration to fill those gaps, to let people know they’re not stupid. If you come away with your prescription filled, now what does that mean?

“Take the whole thing of how to communicate with Alzheimer’s patients who’ve lost the ability to communicate. When someone’s already upset and overworked and emotionally fraught, it’s not fair to ask them to be optimal. They’re not. Plus they’re taking meds for everything, which adds confusion and brain fog. AND they’re being asked to be proactive and on top of this-and-that?!

“I’ve gotten involved with the Society for Participatory Medicine. They were talking about various abbreviations, a list that would be handy for us patients to know. I have established a Wiki with the intention of collecting words and stories by a group from the Society of Teachers of Family Medicine  - one of the most people-centred groups I know – in which doctors are sharing their experiences with language.

“One doctor was treating people in the Appalachians and he realized that when he asked where their diabetes was at, he just got blank stares. But when he asked ‘How are your sugars?’ they knew exactly what he meant. It was the same with ‘diuretics’ versus ‘water pills’. That’s what I want to do with this Wiki, too. For instance there’s a whole bunch of colloquialisms for stool. I intend to collect and include all of them.”

Kathy Kastner fearlessly researches where more squeamish or less insightful folks don’t think to go. And online or in person, people are benefiting from the lessons gleaned.

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