Video Transcript: Pastoral Issues - Fraility

Hi there. In this particular session, we're going to be looking at some of the  biology of aging when we are ministering to those who are senior citizens it  helps to understand something of what's going on with, really everyone's body  as they age. So I thought I would just go through a little bit of stuff that I can that  can be found on Wikipedia. And, of course, if you go to Wikipedia, and you  follow some of the links they have, you'll be able to read lots more stuff about  what the biology of aging is. So I invite you on today to, to think about this, this  fact of aging and how it affects our bodies. First definition, aging is the process  of becoming older. I guess that's not such a staggering definition. And yet, it's  one that I think needs to be spoken out. Aging is the process of becoming older.  From the time we are conceived until the time we die, we're all in a process. And we're all moving from beginning to ending. And aging is what we call that  process of becoming older. Humans. Aging represents the accumulation of  changes in a human being over time and can encompass physical,  psychological and social changes. And we'll be looking at, at some of the social  things, and psychological ones a little later, I tell you about some of my friends.  But right now, just to realize that aging encompasses not just our bodies, but it  but our psychological sense of ourselves. And our social sense is the as we, as  we age, we become less comfortable with various people who are around us.  And it's all, it's all involved in this, this process of getting older and trying to  understand what's happening in our lives. And now aging is among the greatest  known risk factors. For most human diseases, I'm not sure that's even such a  shocking thing either. And yet, it is very, very real. Aging is among the greatest  known risk factors for most human diseases. The roughly 150,000 people who  die each day across the globe, about two thirds die from age related causes. So  about 100,000 people every day are dying around the world. And it's from age  related causes. And we do well to be aware of that because as people are  aging, they all become aware that there is a time when our days are going to  end. When when Wikipedia talks about mortality says that that can be used to  define biological aging. And it refers to the fact that you can die. It's used to talk  about biological aging, so that then you realize that and then an organism like a  human being that aging becomes something that leads to mortality. And so  biological aging refers to an organism's increased rate of death as it progresses  throughout its lifecycle, and increases its chronological age, as you get older,  there's going to be more and more people your age who die. Another possible  way to define aging is through functional definitions, which are two main types.  The first of those definitions describes how there are there are varying types  type or kinds of and here's a nice word deteriorative changes that accumulate in  the life of a post maturation organism and can leave it vulnerable leading to a  decrease the ability of the organism to survive. What I take that to mean is that  what happens is there are deteriorative changes that means there are things  that start to go wrong for example, in many, many older people their knees, give 

them real problems. It's a deteriorate deterioration of of what's going on between the bones and the pads that were created to keep those those bones separated  from each other. Arthritis is developed as a little tiny little spur type things on the  ends of the bones and then wears away at the padding between the ends of the  bones that come together and your knees. And pretty soon, it's just bone on  

bone. And that's extremely painful. And that is a deteriorative change. And it  makes the the person more vulnerable to dying because they start moving  around less and less and less and less. And that leads to a whole bunch of other kinds of things that can go wrong. Now, the second definition, functional  definition is a senescense-based definition. This describes age related changes  in an organism that increase its mortality rate over time by negatively affecting  its vitality, and functional performance. Now, when we get older, and our, our  body is aging, there are there age related or changes that happen. And one of  them, for example, is when we might have a stroke, and we lose our ability to  swallow by this time, then your mortality is going to increase because you need  to be able to swallow and to be able to eat in order to be nourished. And so  that's something to keep in mind also that aging involves a couple of different  kinds of things that have to do with our body. Now here, there's an illustration of  a normal aged brain on the left and a brain affected by Alzheimer's on the right.  And you can see that there are very definite differences, you can see that the  brain has, has disappeared, it has gone away, the the part in the middle right in  the center of the illustration has gotten much larger, there are other cavities, so  to speak, that have opened on the bottom, where there hadn't been before. And  with all of those things happening, the synapses are deteriorating, and they're  not working as well. And there's fewer of them and we lose our ability to think  well, and particularly to remember, and that is one of the most difficult things of  Alzheimer's is losing your history. Suddenly, you don't have a history anymore.  You can't remember who you were, you can't even remember who your wife  your husband is or you're one of your children in those things then lead to a loss of your person. Because our person is made up of our memories made up of  everything that has been in our past. And when we experience the aging that  Alzheimer's brings on, we lose that sense of ourselves. As we get older things  happen around age 50, the hair turns gray. And what happens is the what I've  been buying what I'm told anyway is that the hair follicles cease producing or  taking or making use of the color that is normally found in our skin and that gives the color to the hair that grows and so around age 50 the hair follicles as your  hair growing, stop injecting that, that color into it and gray is actually the natural  color of your hair. And pattern hair hair loss by the age of 50 affects about 30 to  50% of males so that by the age of 50 people are getting bald and they're losing  their their hair in one way or another. And actually hair loss occurs in 1/4 of all  females as well. Their hair gets thinner and thinner and and people notice this of themselves. They notice what's happening is that they look in the mirror and 

they can see that hair isn't where it used to be. Or it's not the color that it used to be, it's not as thick as it used to be, you can use take a comb and kind of tug it  through your hair. Now it just simply glides through because there's just not  much of it there. Atherosclerosis is classified as an aging disease. And what it is, it's a thickening that goes on in the wall of your blood vessels. And the  illustration there on the right shows a typical artery that's that got the blood  plates, platelets flowing just nice, and there's a couple of them can come  through together and so on. But the one that has the deposits there, you can  see, the blood does not flow through it very well, it doesn't the platelets cannot  come through. In a normal way, they have to start going sideways. And what  happens after sometime is that they can get blocked. And that's what leads to a  heart attack. Cardiovascular disease, for example, stroke and heart attack,  which globally is the most common cause of death. Vessel aging causes  vascular remodeling and a loss of arterial elasticity your your arteries need to  when you feel your pulse, you feel the boom, boom, boom, boom, and that's  your your arteries, pushing up going down, pushing up going down, pushing up  going down, and it's like a balloon as it stretches out when the heart puts  pressure on and then it goes back when the heart is at rest. And so you have  this constant pressure, not pressure, not pressure not. And once you lose that  elasticity, the blood just doesn't flow as well. And the stiffness of the the arteries  then becomes reason for blood not getting where you need it. You get winded  when you're walking because you can't get the blood to where it needs to be  and so on. Depend dementia becomes more common with age about 3% of  people between the ages of 65 and 74. About 19% of those between 75 and 84.  And nearly half of those over 85 years of age have dementia. And as the  illustration shows, dementia is really an umbrella term for a variety of different  things. It's it's something that that covered that one term covers several different  possible diseases that one might have. There's vascular dementia and  Alzheimer's, this fronto temporal dementia dementia with Lewy Body,  Parkinson's disease, dementia caused a basal degeneration progressive  Supranuclear palsy, of course, I don't know what those all mean. But  nevertheless, dementia is, is what is used to describe in a in a simple way that  this is going on in a person. Aging is among the greatest known risk factors for  most human disease. As we noted before, the roughly 150,000 people who die  each day across the globe, two thirds 100,000 per day die from age related  causes. And in industrialized nation, that proportion is higher reach as much as  90%. And that's why I want to include this again, the proportion in industrialized  nation in the first world, we might say in the second world, the proportion of age  related causes that people die from it reaches all the way up in 90% and goes  past the 65% and goes all the way up to 90 so that you can tell that it's the age  related causes that that are really the most likely cause of death as we go along  in our lives. You know and there's so much more that's been published on the 

subject of the biology of aging and And I just wanted to give you just a little bit of that it's, there is so much to be seen. And this is just to give you a senior  ministers insight into a phenomenon that my friends and I have often remarked  upon. When one gets to be in the upper 60s and older, the topic of conversation  often turns through recounting of one's ailment as the illustration has, there's,  there's these five guys sitting there, and surely, you can't go about 15 minutes,  unless one of them starts talking about one of their ailments. That's just the way  it is with older people. And if we're going to be ministering to senior citizens, we  have to realize that that's going to be a topic of conversation. And we have to be able to understand a little bit about what that's like. Because for older folks,  dealing with our ailments is something that affects us every single day. When  you can't get up and walk because your hip hurts so bad, when you when you  can't feed yourself, because your Parkinson has gotten to the point where your  hand shakes so badly that you can't lift your spoon or your fork to your mouth.  These are issues that need to be talked about. These are very real things in the  life of one of the elderly people. And it's, it's so in my life, it's so in my wife's life  and all my friends that are getting to say, there's so many things that we can talk about, that have to do with our ailments. And what we're doing to take care of  them how we're taking care of them, who which, which doctor do we think  handles this thing faster, that it's a, it's a remarkable phenomenon that we need  to be aware of. I want to tell you about some of my friends, for the last, oh,  about, let's see, eight, nine years now. Except for the year COVID. Now 2020,  we've stopped and we've only been able to see each other a few times  throughout the whole the whole year. And it's something I miss terribly. But I  want to tell you about some of the people that I get together with I've given them different names, and, and these are not their pictures, but I'm using this in order  to to help you be able to visualize a person. So Pete is 81 years of age. He's  been widowed. For the past seven years, his wife died. Very difficult death of  cancer. He had cared for her for about four or five years. She very very slowly  died of cancer. Now he himself had colon cancer about 40 years ago when he  was just like 41 years old. And he's had a colostomy bag ever since and this  colostomy bag is not just not easy to deal with. If if you and I had to deal with  that, we might realize that, you know, this is something he needs to talk about  once in a while. It's not a pleasant subject. It's a it's kind of a an icky one, one  might say, but it's very significant in his life. He's had a colostomy bag for 40  years. And that requires attention several times every day. His life is deeply  affected by that colon cancer 40 years ago, and what they needed to do and  they removed his bowels. And Pete often mentions that he's very depressed,  and he just wants to die. Recently, during this time of COVID, that was a chance we had to, to get together as a group. And he mentioned again, that it was very  difficult for him to be a part of life these days because he's holed up in his  apartment, and you can't really go anywhere, you can't talk people and so on. 

He says I just want to die. And we tried to give him some encouragement,  because we don't want him to, to think that we wouldn't care if he died. But  nevertheless, he just wants to die. When we minister to seniors, that's going to  be a phenomenon that we're going I do be given opportunity to deal with quite  often. That is Ben Ben is about 75. He was a truck driver for his whole adult life.  And he is really quite burdened with family issues. His son is an alcoholic. He's  been dry now for a couple of years, but he has some, some addiction issues  that he's striving to get on top of. And Ben is always trying to help him in trying to find a way to assist him in life without giving him everything. He doesn't want to  just hand him stuff. Ben has cancer. He's had cancer in a few different parts of  his body. He's undergone treatment for them. And he has his cancer pretty much under control at this point. And I was talking to him a month or so ago and just  call it I called him up to see what value was doing. And he says, Well, you know  like because I said I was your cancer doing. Well, that's not too bad. But well, I  suppose you know, that I did once a while to do some things that really aren't  too smart. And he had suffered third degree burns in a fire in his yard he had, he was burning something out in the backyard and started this fire and went in the  house. It got away from him, he came back out and all he could think of doing  the stomping on it already had to go out. Well, then his pants started fire in his  pants burned and gave him third degree burns. And he's had to have skin  grafting and so on. Well, obviously, this becomes a topic of conversation when  we see each other when we when I call him up and ask him how he's doing. I  want to know, how is your skin grafts doing? Are they taking? Are they giving  you problems? Are they infected? Are they doing good. And Ben needs to be  able to talk about that. But again, it's a biological thing about his body. And it's  something that happened. And he's not proud of it. He says, I do some stupid  thing. But that's that's who part of who he is, is my friend. And I will accept him  that way. And when we ministered to senior, we're going to find lots of quirky,  fun, people whose lives still have all these issues that that has to be dealt with.  Tom has a guy just turned 80 He's had cataracts removed out of his eyes. And  he needs multiple medications here in and they're very expensive. And so he  finds himself often trying to find ways to cut down on the expense of his  medications. He drove a delivery truck for 40 years loves a good story. And he's  and he loves to tell them himself. But he's part of our group too. And you know,  when we're talking about well, how are things going well, then he will he'll come  around sooner or later to the medications. And how he's trying to figure out how  to have a less costly ones because he's got a lot of out of pocket expense there. But you know, he loves a good story. But same time once in a while, you'll  become quite vulnerable and he'll start talking about some of his grandchildren  that he's so concerned about, because as he puts it there, they're just headed in the wrong direction. And that's heavy on him. Just very heavy. And even though  he may laugh, and he may have lots of good stories still down underneath down 

at any time is still hurting down and then there's Jerry Jerry reached age 88. And I say reach because he's now deceased. He was a businessman since dropping out of high school. He he was early on one of the computer businessmen in his  city. And now he's chairs empty after he died of lung cancer, and we all miss  him. And that's just part of life as well for us. So as we age we face the looming  reality of our own mortality. Biological ill aging and ailments that brings reminds  us every day of the passing of time and the approach of our own passing away.  And to think about that is not something that people enjoy doing. In fact many  times, they simply don't. And they try not to have it be a part of their life. So  doing some reading of the biology of aging will help you to minister those who  are seniors and those who care for them. Having some insights of the aging  process will help you avoid those embarrassing mistakes, which I have made  myself and I'm just letting you know that they are something that happens. And  they can occur when dealing with an older person biological issues, and you  really don't want to call attention to that in order to make them embarrassed.  Well, that's all for this time. We'll catch you next time.