Over the past three weeks, we’ve discussed how anger at our aging bodies takes over at times, how we might be able to live with loss and live fully, and how we can live intentionally while experiencing medical realities following the ideas presented in the 4M’s Framework.

While the topics seem different on the surface, they share a common thread: ways to experience dignity and self-respect in our later years by

1. Listening to what our body is telling us - is the migraine headache stress-related or are stomach issues causing anxiety?

2. Finding ways to enjoy life after losing our loved ones, our purpose, or our sense of self.

3. Being an active participant in medical decisions - making them based on our values and wishes - not allowing ourselves to be the victim of someone else’s.

The question for today’s pop-up discussion is this:

• What is one thing we can begin doing today to support our overall sense of well-being, independence, and life satisfaction?

My answer would be to understand how deeply feelings are connected to my body and that they just might have a message for me if I’d listen.

Leave a comment

A few guidelines:

• Comments are friendly and supportive.

• I reserve the right to delete posts if necessary.

• I’m no longer a licensed counselor nor am I a medical professional, so I offer no advice, only thoughts based on my experience.

Let’s get started, and welcome! Ready?

If I must go to a doctor or the hospital, I want to be a partner in the decision-making process. So far, I’ve been able to keep myself out of that position, which doesn’t mean it won’t happen. My intention, though, is to maintain self-respect and advocate for myself during those circumstances.

This means shifting from being a passive recipient to an active collaborator. By being better prepared, and clearly understanding my concerns and needs, I can be more confident that my preferences and values are driving healthcare decisions.

I’m reading about The 4M’s Framework which focuses on the needs of older adults. It aligns care with personal goals and shifts from looking only at disease to viewing the whole person, and organizing care around their unique needs and strengths, which might lead to better outcomes and satisfaction.

I like the model because it’s not a prescription for how to age, but a reminder that there’s someone with values and feelings behind every diagnosis. This is the focus, briefly.

• What Matters refers to identifying goals, preferences, and values, making them central to our decisions and aligning treatment with what’s most important. In other words, what matters to us regarding health care decisions.

• Medication refers to reviewing prescriptions, OTC products, and supplements to ensure they aren’t causing harm, checking for side effects, interactions, and true necessity, because age can affect how certain drugs work. In other words, are the treatments we’re receiving honestly helping us live the life we want.

• Mentation refers to focusing on a positive state of emotional, psychological, and social health. In other words, medical problems don’t happen to our bodies in isolation - they happens to the whole of us.

• Mobility refers to promoting safe movement and physical function, helping us stay strong, active, and independent, preventing falls and maintaining an ability to do what matters. In other words, what do we want to be able to do during the rest of our lives?

Below, I use the 4M’s Framework to compare what I’m finding as an 87 year old and what experts generally say.

Experts say taking control of appointments require prioritizing our concerns by documenting the most important symptoms or questions in advance - noting dates, frequencies, and factors that make us feel better or worse.

What I’m Finding:

• This is where What Matters and Mentation from the 4M’s Framework comes in.

• Rarely have I been given the time for such discussions in a doctor’s office. I’m not sure the health system is prepared either with a typical in-office visit lasting about 15 -20 minutes.

• Which is why we need to be prepared to discuss our goals, preferences, values and emotional, psychological, and social health during the visit.

  ---

Experts say we should keep conversations clear and focused asking these three questions: What is my main problem? What do I need to do? Why is it important for me to do this?

What I’m Finding:

• The 4M’s Framework helped me understand that my preference is to work with medical professionals who view emotions as part of the body.

• The Medication component of the model provides a way for me to share my concerns about taking prescription drugs or having unnecessary surgery.

• Overall, I want a doctor who considers both conventional and alternative options which typically look at the whole person.

  ---

Experts say we should ask providers to explain their diagnosis and offer evidence supporting or ruling out specific conditions.

What I’m Finding:

• That seems wise if the provider agrees to such a relationship. It’s never been my experience, but I know others who have.

• With the 4M’s Framework, we consider whether or not the treatments we’re receiving are helping us live the life we want and provide ways to stay in control.

  ---

Experts say we should discuss our emotional and mental well-being, daily lifestyle, and family health history openly and honestly so the doctor can treat us holistically.

What I’m Finding:

• The doctors I’ve met never seemed interested in the emotional side of an illness, the need for treatment, or my daily lifestyle.

• That’s why it’s up to us to implement it.

We have a life to live—and that life is shaped not only by our health, but our values, emotions, lifestyle, and choices. So, perhaps the 4M’s Framework can help us do that.

A question to consider is this: Have you received medical care that resembles the 4M’s Framework?

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Please let your friends and family know about the newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, forward this email and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She’s been writing a newsletter on Substack for five years and recently published a book based on the articles entitled, “ The Insider’s Guide to Aging Well - Longevity Through the Eyes of an 87-year-old.”

The Insider’s Guide to Aging Well brings together many of the ideas and themes we’ve discussed. It’s not separate from the newsletter, which is my primary focus, but an extension of it—a way to collect the articles in one place for those of you who may find that format more useful.

This link takes you to the book on Amazon. All proceeds will be donated to the Alzheimer’s Association in my husband’s name.

You can buy the book here

At this age and after losing the love of my life six years ago, finding joy remains somewhat of a challenge. I’d like to say I have; yet, there are days when it couldn’t be less true.

My husband and I shared our lives since we were 12, we were a team, we grew up together. When he passed, the life we had was gone and for the most part I had no idea for what to do next - unlike when the children left home and my plan was to become a psychologist.

Many long held habits are proving difficult to release - they’re ingrained in me. Building a new routine is often easier said than done.

Life has irrevocably changed. I’ve changed, the world has changed, and he isn’t here to share those changes with me.

Below, I share what I’m finding and my experience at 87 years old compared to the general advice experts give.

Experts say we can stop being victims by taking responsibility, practicing self-care, saying no, and educating ourselves.

What I’m Finding:

• Practically speaking, I’m doing it - with my own apartment, writing the newsletter, and living my life - albeit a quieter one.

• The emotional wear and tear involved remain another story.

Experts say living with loss and living fully is about moving forward with grief rather than "moving on" or seeking closure. It’s a conscious choice to honor our pain while remaining open to joy, connection, and purpose.

What I’m Finding:

• Neither concept works for me nor does the idea of letting go of the past. Moving on can be seen as leaving someone or something behind. Moving forward can be viewed as putting the past behind us. Letting go can be thought of as loosening the love or connection.

• I don’t want to leave his memory behind or lose our connection.

Experts say living with loss while living fully means allowing grief and joy to coexist.

What I’m Finding:

• I can live with the losses, and experience moments of happiness, but, something is missing.

• I find myself being joyful and sad at the same time. Pure joy is playing with my great-granddaughters, and there is sadness that my husband isn’t here to share the experience and they will never know him.

This transition is something each of us will figure out for ourselves as our lives change - and they will.

So, a question to consider is “What can help me remain engaged with life, even though there are losses?”

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Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She has written articles for Substack for the past five years and recently published a book, The Insider’s Guide to Aging Well Through the Eyes of an 87-year-old.

Anger tends to pop up for three reasons basically:

• The frustration of aging and not being as independent as I want.

• Managing a household and what that involves on my own.

• The pressure I put on myself to manage the challenges well.

I’ve been thinking about ways to handle the anger more successfully with ideas like:

• Avoiding harsh self-criticism.

• Maintaining a more positive attitude.

• Watching for signs of depression or stress.

• Paying attention to the present moment without judgment.

• Staying physically active and prioritizing consistent sleep.

While considering the options, I find myself agreeing with certain suggestions that experts offer, but not so much with others.

Experts say physical activity makes it easier for older adults to continue doing household chores, getting in and out of bed or a chair, easily and moving around the neighborhood. This ability may help them maintain independence.

What I’m Finding:

• I don’t disagree.

• Yet, my body seems to discover more and more ways to curtail those activities. It just doesn’t do what it once did and seems to provide valid reasons for slowing me down - some arthritis, stiff fingers, and eyes and ears that don’t see and hear as well as they did.

• I now worry about my heart when I want to walk up a hill, my knees when getting down and up from the floor, and my stomach - well, let’s just say it has ways of stopping me from going places, I’d like to go.

• My tendency is to stay home and do nothing, but that’s not a good solution.

Experts say that instead of harsh self-criticism over what we can no longer do, we should practice treating ourselves with the same grace and empathy we’d offer a good friend.

What I’m finding:

• I’ve never been an angry person - quite the opposite. But I’ve increasingly felt so the past year because of a body that doesn’t function as it did, the adjustments I have to make to keep going, and the simple things that are no longer easy to do. An angry person is not who I want to be.

• I’m kind-hearted with others - but not myself. There’s a double standard in play which needs rethinking.

• A starting point might be to appreciate what my body has achieved over the years and continues to do, because it has done and is doing a good job.

Experts say that in general, older adults report less negative and, more often, positive emotions than younger adults. They tend to use a wider variety of emotional regulation strategies.

What I’m Finding:

• My experience has been the opposite. A combination of losses, physical pain, and learning to manage on my own have triggered strong feelings.

• A part of it has to do with ageism. I resent people make assumptions about me based on what they think an 80-year-old can do - like thinking they need to help me walk across the street or go to the restroom. It’s also aggravating to hear people make jokes about my age, and decide I can’t do certain things without asking me.

• The combination of aches and pains, stomach issues and other ailments, having to redo things numerous times, and struggles with technology are wearing over time - frustration builds and explodes.

Experts say that in older adults, depression can show up as anger, irritability, and sudden outbursts. Research shows a strong connection, indicating that the more severe a senior’s depression symptoms are, the more anger they are likely to feel and express.

What I’m Finding:

• Depression is involved - not in a clinical way, but as a deep sadness regarding the forced changes I don’t really want to make.

• My body can no longer do activities that once gave me pleasure, and I haven’t identified enjoyable replacements - but I’m working on it.

• Technology is a major source of frustration, it seems to change daily, and there are many ways for tricksters and scammers to take my money or gain access to my information. I’m fairly computer savvy but still get tripped up.

• I wonder if my mind and body could find a way to work together as a team allowing the circumstances of aging to be more acceptable. Hmmm!!!

Experts say stress in older adults is often missed. It doesn’t always look like panic or worry, instead, but may show up as poor sleep, physical discomfort, forgetfulness, or a lack of interest in things that once mattered - signs that are easy to miss or explain away, if they are viewed as part of the aging process.

Yet, when stress is ignored, it can take a toll on mental and physical well-being. So, paying attention is important.

What I’m Finding:

• Stress connected to life changes cause physical symptoms, and physical symptoms cause stress.

• The undue stress and pressure I put on myself remains an issue as I navigate these later chapters of life.

• Frustration with my body probably adds to the stress.

Experts say older adults can manage stress effectively by focusing on the present moment without judgment, staying physically active with low-impact exercises, and prioritizing consistent sleep.

What I’m Finding:

• I’m physically active and have fairly consistent sleep patterns.

• Focusing my attention on the present moment without judgement remains a work in progress.

• I’m experimenting with the idea that a conversation between my mind and body may be essential for long-term health and emotional regulation.

• Acknowledging our body rather than ignoring it allows us to treat physical symptoms as information rather than an inconvenience.

• My most recent body symptom is a rash. I’ve changed the laundry soap, shampoo, and bath soap. It’s better, but not perfect. So, I’m looking into other possibilities.

• As an experiment, I asked the rash if it had a message for me - the thought that immediately came to mind was “ my body is irritated with me - for being irritated with it.”

• That’s possible! And it’s a concrete doable idea I can start working on today.

• Another option might be to look at my choices and self-talk to make sure they support both my body and mind.

So a question for you to consider: “Is there more I can do to honor my mind and body as I get older?

Please let your friends and family know about the Aging Well Newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

Share Aging Well Newsletter

So, forward this email and invite them to join us. They can subscribe here:

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She has written articles for Substack for the past five years and recently published a book, The Insider’s Guide to Aging Well Through the Eyes of an 87-year-old.

Over the past few weeks, we’ve discussed rebuilding confidence in our aging bodies, the role of choices as we age, and the importance of movement in later life.

While each of those topics approach aging from a different angle, all three point to a similar challenge: remaining engaged with life as our bodies and priorities change.

Physical limitations may lead us to doubt our independence, our identity, and our sense of competence. I’m finding that aging well depends less about trying to be who we were and more about learning how to work with who we are now.

The question for today’s pop-up discussion is this:

• In what ways are you learning to work with your body rather than against it?

My response would be paying attention to the information it’s telling me.

Your turn!

Leave a comment

A few guidelines:

• Comments are friendly and supportive.

• I reserve the right to delete posts if necessary.

• I’m no longer a licensed counselor nor am I a medical professional, so I offer no advice, only thoughts based on my experience.

Let’s get started, and welcome!

More often than not, I look for good reasons why I can’t possibly exercise later in the day. I’ve tried many ways to find something to like - running, joining a fitness club, using the exercise room at my apartment complex, hiring a personal trainer, playing pickleball, and taking exercise classes. Nothing excites me.

My best solution lately has been walking with a friend and practicing Qigong, which incorporates mindfulness, exercise, and breathing, but even that’s a struggle. Be that as it may, everything I read confirms the value of exercise for older adults - within their capabilities that is.

The words of Dr. Howard Luks, orthopedic surgeon and author, ring in my mind. “Every time we choose comfort over effort, we weaken the very system built to protect us, our body, and mind.” He says

• Movement is medicine.

• Discipline is armor.

• Don’t let laziness be the slow, silent injury that steals our strength.

• Get up, move, push forward.

Experts say that older adults need movement for maintaining independence, physical health, and mental well-being. It improves our strength and flexibility, and reduces the risk of chronic disease. Regular exercise may even help prevent falls, maintain independence, and support brain health.

What I Found:

• My body can’t do the same activities I did two or three years ago like hike five miles, or get up off the floor gracefully. Now when I exercise, worries pop up: Is my heart going to be okay? Will I hurt my knees? Is my stomach going to hold out? So, I’m having to adjust my expectations and my approach.

Experts say our exercise programs change with age due to decreased muscle mass, reduced nerve signaling, slower brain processing, and impaired coordination, which can lead to reduced speed, strength, and balance.

They also note that regular physical activity may help older adults reduce age-related decline, improve mobility, and maintain independence. As part of an active lifestyle, older adults should include various exercises. Even small amounts of activity throughout the day matter.

What I Found:

• I get bored doing the same exercises day after day.

• What works better is exercising in segments: do some stretches, feed the cats, then practice a couple of Qigong routines. Also, exercising with a partner helps.

• Household chores are part of my exercise routine - getting down and up from a low chair or the floor takes effort. It’s awkward, and laughable, but it’s exercise.

• I firmly believe in the adage “if we don’t use it, we lose it.” Even missing exercise for a couple of days tends to make a difference.

Experts say there are benefits to exercising for those with chronic conditions. However, existing health issues can affect our ability to engage in regular physical activity. The goal is to be as active as our bodies and circumstances safely allow us to be. They further admit that facilities and equipment can be costly, and concerns about the risk of injury, or the possibility of falling are valid.

What I Found:

• There are numerous free television and YouTube programs to support our exercise routine.

• Many websites have programs to help older adults maintain a healthy lifestyle.

• Items around the house could become exercise equipment - cans of soup make good weights, and a tennis ball against the wall works well for massaging the back.

• The challenge is getting myself to use them.

Movement can be seen as reflecting a willingness to continue meeting life as we are, rather than mourning who we once were. Even small amounts may help us restore a sense of steadiness and participation in our lives.

My question for you this week: How well is your exercise plan working for you?

Leave a comment

I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, please forward this email to a friend and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She has written articles for Substack for the past five years and recently published a book, The Insider’s Guide to Aging Well Through the Eyes of an 87-year-old.

Two realizations have come as quite a shock lately. The first is that many of my so-called problems were caused by earlier choices of mine and the second is that responsibility for my actions also requires me to consider their impact beforehand, like when I chose not to fix the broken chair leg properly, and had to buy a new one, or when I mistakenly deleted my password list and had to reconstruct a new one.

The connection between choices and problems seems to be a matter of shifting our focus from a belief that says life happens to us to one that says our choices and actions play a role.

Moreover, being accountable or responsible for the consequences of our actions allows us to learn from mistakes, make better decisions for the future, and build emotional resilience, even when the immediate choices are challenging.

This shift in thinking may allow us to transform from helpless recipients of circumstances to active agents contributing to our future in various ways. It may even allow us to stop waiting for others to act, turn difficulties into opportunities, and make more thoughtful choices.

Experts Suggest that aging well and maintaining our quality of life in the later years isn’t about controlling what happens, but about how we participate, given the inevitable losses and constraints that arise. Not everything is under our control, but we do have influence. Our choices might be fewer or different, but they’re meaningful.

What I’m Finding:

• I always saw myself as making sensible, ethical, and trustworthy decisions regarding my actions, but didn’t always consider the outcomes. One that comes to mind: My husband made it clear that he would not want a funeral service when he died. His death occurred during COVID, so, we had a small family lunch to celebrate his life. I didn’t consider that out of town relatives would be disappointed they were not included. We could have easily arranged that through FaceTime or Zoom, which may have been a more thoughtful decision.

• I’m able to manage the physical demands of loss and aging fairly well, but less successful when dealing with the emotions involved. A better plan might be to honestly acknowledge my feelings, learn more about the emotional effects of loss and aging, be more compassionate with myself, or maybe join a support group.

Experts Say that even though life deals us challenges, we still have choices in terms of how we respond emotionally, how we interpret those events, the words we say to ourselves, what we focus on, and how we use our energy.

What I’m Finding:

• I was unprepared for the outcomes my choices produced such as my self-talk becoming more negative, my general mood changing, and my life seemingly less meaningful.

• Not every aspect of aging is within our control, but we can choose to approach ourselves with frustration or kindness - for me, that continues to be a work in progress.

Experts Say that we can stop being victims by taking responsibility and practicing self-care, saying no, and educating ourselves.

What I’m Finding:

• A need to please others and a loss of self-confidence caused me to distrust myself and tended to keep me from being as responsible as I wanted.

• There was little time for self-care and compassion. I was too busy coping with the realities of the moment. Be that as it may, both are important priorities.

• Similarly, dealing with daily issues left little time and energy for educating myself, which doesn’t mean it wouldn’t be a useful undertaking.

When we recognize that loss and aging are physical and emotional, we can begin making sensible choices regarding both our bodies and feelings.

While it’s sometimes painful to admit that we have a role in situations, it does give us control over what comes next.

My question for you is this: How are your choices treating you?

Leave a comment

Please let your friends and family know about the newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, forward this email and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She has written articles for Substack for the past five years and recently published a book, The Insider’s Guide to Aging Well Through the Eyes of an 87-year-old.

One loss I’ve been experiencing more the past year has been confidence in my body. It’s time to face facts: the body I live in really doesn’t do what it used to. Activities that were easy and automatic require more thought, effort, and adjustment today, a fact which tends to impact me emotionally as well.

Experts say rebuilding confidence in an aging body involves shifting our focus from limitations to capabilities through consistent, gentle physical activity like walking, tai chi, and strength training, cultivating a positive mindset, and embracing self-care.

They also discuss our need for emotional resilience - adapting to physical decline by maintaining social connections, staying active, and fostering a positive, purposeful mindset.

What I’m finding:

• Shifting focus is all well and good. However, doing so doesn’t relieve the frustration and discouragement that arises when I get tired more quickly, make mistakes I never use to make, and no longer confidently walk as far I did - new worries come to mind: can my knees manage, will I see the curbs clearly, or is my stomach going to be okay.

• Practicing self-compassion is also a good idea, but not always easy. Intellectually, I understand the reason and need to do so, but resentment and impatience tend to show up as well.

• Adapting routines to prioritize what's best for functioning and joy makes sense, but I enjoyed the life I had, and really didn’t want it to change.

Experts note that key strategies include cultivating gratitude, engaging in cognitive stimulation, managing stress through mindfulness, seeking support to maintain a high quality of life despite the challenges, and setting small, achievable goals.

What I’m finding:

• I’m grateful and know how really fortunate I am. I read and write daily, have plenty of support, and manage to achieve small and large goals. That works - to a degree.

• At the same time, I’m exploring additional ways to provide quality of life at this age - particularly in terms of managing stress.

• A major contributor to my loss of confidence has to do with technology - my fingers have a tough time typing on my iPhone, and after having eye surgery for a detached retina my eyes play games in terms of double vision and not seeing quite as clearly.
  I’ve adjusted and do what I can, but both facts add to self-doubt. There is also a lack of knowledge about devices and technology in general, which suggests making a greater effort to learn how to use them effectively.

Experts recommend that, to regain confidence, we must remind ourselves of our capabilities, address the obstacles that keep us from feeling confident, and work around them.

What I’m finding:

• I want to focus more on ways to appreciate what I’m doing rather than being so angry at what I can’t do. I may not be able to walk as far or climb hills, but I’m a much better writer and I’m learning more about technology every day.

• Dressing nicely every morning even when I’m not going anywhere allows me to feel better about myself.

• I want to be at peace with who I am today, which may include changing my expectations of what is now honestly manageable.

• It’s possible that my tight shoulders and upset stomach are signs of stress that wewren’t fully processed mentally or emotionally.

• It’s easy to focus on the physical signs of aging - joint stiffness and easily bruised skin are hard to overlook, conversely it may be just as easy to ignore that a loss of mobility or changes in physical appearance affect how we feel.

Research says that most older adults enjoy high levels of affective well-being and emotional stability into their 70s and 80s.

What I’m Finding:

• This has not been true for me. The last ten years have been filled with stress and worry with four years of caregiving, another four years of building a new life after my husband died, and now the added stress of an aging body and changing times.

• The toll on my emotional well-being is something I work with daily. However, memories, feelings, and doubts pop up regularly, which in turn can affect my physical health.

Question for the comments:

What small shift would help you have more confidence in your body right now?

My answer and goal would be to acknowledge the normal changes in my body as I get older and adjust accordingly, while treating myself with the same kindness, care, and understanding I’d show a good friend who was experiencing them.

Leave a comment

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She has written articles for Substack for the past five years and recently published a book, The Insider’s Guide to Aging Well Through the Eyes of an 87-year-old.

Subscribe now

The Insider’s Guide to Aging Well brings together many of the ideas and themes we’ve discussed. It’s not separate from the Aging Well Newsletter, which is my primary focus, but an extension of it—a way to collect the articles in one place for those of you who may find that format more useful.

This link takes you to the book on Amazon. All proceeds will be donated to the Alzheimer’s Association in my husband’s name.

You can buy the book here

Over the past three weeks, we’ve talked about the stress we create for ourselves without realizing it, the fear of becoming dependent and irrelevant, and the dread we often feel when navigating the healthcare system.

While those topics seem to be quite different on the surface, they share a common underlying thread: the way we relate to ourselves matters.

As we grow older, we encounter situations that tend to challenge our self-view. Physical changes, loss, uncertainty, and increased dependence may affect our sense of identity and swamp us. What often makes these experiences more difficult is not the changes, but how they influence us.

We may not be able to control all the aspects of aging or the healthcare system, but we can control how we speak to ourselves, prepare ourselves, steady ourselves, and remain engaged with our lives, which then plays an important role in shaping the quality of our experience.

Our Pop-up discussion question for today’s is this:

• How is my relationship with myself shaping the way I respond to this stage of life?

Leave a comment

A few guidelines:

• Comments remain friendly and supportive.

• I reserve the right to delete posts if necessary.

• I’m no longer a licensed counselor nor am I a medical professional, so I offer no advice, only thoughts based on my experience.

Let’s get started, and welcome! Ready?

How do we want to be when involved with the healthcare system, whether it be a doctor's visit, a hospital stay, surgery, or figuring out insurance claims?

It’s easy to focus on the external factors—the doctors, the diagnoses, and the decisions being made. But over time, we might notice that something else plays an important role: how we relate to ourselves in general, and how it applies in those situations.

Moments of uncertainty, dependency, or feeling overlooked can quietly intensify stress and erode our sense of control. Yet it’s often our relationship with ourselves—how we prepare, respond, and remain grounded—that determines whether we move through them with confusion and fear or with clarity and dignity.

My plan has been to find other ways - and that’s worked well so far, but what if my best attempts aren’t enough and I must use those services? Maybe, it would be wise to prepare for such an eventuality.

Experts warn to watch for red flags such as feeling ignored, interrupted, or rushed, having our concerns dismissed, sensing a lack of empathy; and encountering unprofessionalism or refusals to explain treatment options.

What I’m Finding:

• In some cases, those worries are valid, particularly when a lack of empathy and dismissing of concerns are involved.

• However, I always thought “they” knew best and didn’t question their decisions. I plan to be much better prepared now.

Experts suggest that we prepare for a doctor's appointment or hospital stay by bringing a list of medications, medical records, insurance cards, and a prioritized list of questions.

What I’m Finding:

• I’m realizing how much self-induced stress I’ve created regarding such circumstances. I haven’t taken the time and energy to create the lists, document and research concerns, or establish a relationship with a primary care physician.

• When in fact, completing those activities just might reduce the stress, support me in being as independent as possible for as long as possible, and help me preserve my dignity in settings where it could get lost.

Experts explain that the healthcare system will always have complexities, and there will be moments when we feel uncertain, dependent, or out of our depth. These experiences are real and can’t be entirely avoided. But they don’t have to define us either.

What I’m Finding:

• If I’m well-prepared and have a working relationship with a doctor, I might be more comfortable as a patient.

• However, I still question whether or not the professional would have time for such a relationship or if I can trust them completely.

• Listening to my body and intuition typically could add important information.

• Using positive self-talk and encouraging rather than scaring myself would also be helpful.

The way we relate to ourselves—how we prepare, how we respond, and how we remain grounded—can help us move through such situations with greater clarity and a steadier sense of who we are. In that sense, navigating healthcare is not only about managing the system, but about maintaining our dignity and exercising our agency within it.

Please let your friends and family know about the newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, forward this email and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She’s been writing a newsletter on Substack for over five years and recently published the book, The Insider’s Guide to Aging Well - Longevity Through the Eyes of an 87-Year Old.

Before my husband died, being a burden to others or no longer being needed never occurred to me. We were a team - solved problems, played, and made decisions together. Once I was on my own, those concerns quickly rose to the surface.

Fear of dependency and irrelevance is a deeply rooted anxiety stemming from a threat to a person’s sense of self-worth, purpose, and autonomy. It’s often tied to major life transitions, such as aging, career changes, shifts in family dynamics, and the death of a spouse or partner. Furthermore, childhood experiences and societal pressures typically play a role.

Fear of dependency - Also known as “counter-dependency,” this fear includes resisting the need to rely on others, even when it makes sense to do so. The fear is that we’ll become a burden.

It’s said that when a person grows up with overbearing parents or in an environment where their needs are not met, they may come to believe it’s not safe to trust.

What I’m Finding:

• My parents were micromanagers; my physical needs were well met, my emotional ones not as much. Trust has been a nagging issue for a long time, but especially since being on my own.

Professionals say that societies emphasizing self-reliance may view seeking help as a sign of weakness. Older adults may perceive their lives as being less valuable, putting them at risk for depression and social isolation.

What I’m Finding:

• I didn’t want my children to go through what we did as my husband struggled with dementia and COVID. I was a psychologist, and thought I could handle it by myself. Wrong!

• I was not sufficiently prepared, and in hindsight, I’d handle things differently - be more assertive, ask more questions, and take better care of myself.

• That experience became the basis for the newsletter - a place for me to share what I’d learned with others.

They further claim those fears can lead to low self-esteem, anxiety, and depression, distorting a person’s sense of value.

What I’m Finding:

• Before my husband’s death, I had confidence - but the confidence was in us as a team, and the knowledge he had my back. I still haven’t developed that level of confidence in myself - yet.

Fear of irrelevance - often involves feeling undervalued and insignificant, and concerns that our presence or skills no longer matter, particularly as older adults. One remedy may be doing more of what we enjoy and do best.

Experts identify three possible reasons.

• Aging: As people age, declining health and societal ageism may contribute, particularly in Western cultures that tend to revere youth.

• The workplace: The rapid pace of technological change, especially with the rise of automation and artificial intelligence, is a significant source of anxiety for workers who fear their skills will become obsolete.

• Changes in life roles: Major life transitions, such as retirement or children leaving home, often trigger this fear because our sense of identity can be deeply tied to one’s former role.

What I’m Finding:

• My fears seem to be driven by aging and changing life roles.

• We were fortunate to live next door to our grandsons for nine years. We saw them daily and were involved in their lives. Our older grandson lived with us while he was in college. They’re now grown men with families and careers; who no longer live next door or visit as often. I’m surprised at how much I miss them and those special times.

Those in the know suggest that older adults stay engaged and flexible in their lives by learning new skills and embracing change.

What I’m Finding:

• Being flexible and embracing change is much easier said than done. Many long-held habits and beliefs are firmly entrenched.

Professionals suggest focusing on contributions beyond traditional work after retirement. Volunteering, hobbies, or mentoring can provide a continued sense of meaning.

What I’m Finding:

• A key seems to be having a sense of meaning - a reason to get up in the morning. Volunteering and hobbies don’t do that for me as much as mentoring does.

Furthermore, they suggest cultivating healthy relationships and engaging in community activities to combat isolation and foster a sense of belonging. Learning to ask trusted friends and family for help can reduce the fear of being a burden.

What I’m finding:

• I get together regularly with family and friends, face-to-face and online, but also cherish my alone time.

• Permitting myself to ask for help remains a challenge. I’ve always been the giver - it’s difficult to ask for help.

Finally experts encourage older adults to treat themselves with kindness and understanding - recognizing that everyone experiences struggles may help shift our negative self-talk.

What I’m Finding:

• Treating myself as if I were my best friend remains a work in progress.

Something to think about! Where in our lives do we still feel useful, connected, or valued?

I would love it if you could share the Aging Well newsletter with others. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, please forward this email to a friend and invite them to join us. They can subscribe here:

Dr. Janice Walton is a psychologist, a widow, a mother, a grandmother, a great-grandmother, and a writer. She’s been writing a newsletter on SubStack for five years and recently published the book, An Insider’s Guide to Aging - Longevity Through the Eyes of an 87-Year-old.

After my husband died, the need to do things perfectly increased dramatically, and my expectations of what I planned to manage were overwhelming - basically, my goal was to continue what we were doing by myself - a goal that was unrealistic and led to a great deal of negative self-talk. My body was also naturally aging, and the changes were noticeable, which added to the pressure I put on myself.

Experts say that self-induced stress occurs when internal factors like perfectionism, worry, and unrealistic expectations, lead to mental and physical strain - that’s in addition to the external stressors that regularly occur.

Self-imposed stress is often caused by how we interpret situations, and frequently results in anxiety, fatigue, and chronic health issues like high blood pressure. Conversely, chronic health issues and high blood pressure can cause mental and emotional stress.

Such pressure can be exacerbated by inadequate sleep, poor diet, and procrastination, which tend to increase our emotional reactivity.

What I’m finding:

• Today, my exercise routine is modified. I used to run 5K races and climb hills. Now I walk daily on flat ground - 3.5 miles last weekend, though, with ease - and climb stairs.

• My goal is to eat healthy meals and drink plenty of water, but we know how our best-laid plans can go astray.

• Night sweats disrupt a good night’s sleep, as do trips to the bathroom, worry, and a cat who wants to snuggle incredibly close - all night.

• I don’t procrastinate as much because I’ve found that getting bothersome tasks out of the way relieves anxiety.

Experts say that proactive habits for managing self-induced stress include mindfulness meditation, journaling, and setting healthy boundaries, such as limiting screen time and saying "no" to nonessential tasks. Other effective habits include prioritizing tasks to avoid feeling overwhelmed, fostering social connections, and practicing gratitude daily to shift focus away from stressors.

What I’m finding:

• I journal, practice Qigong (which includes mindfulness, exercise, and breathing), and walk.

• I listen to the news less and participate minimally on social media; instead, I watch YouTube landscape and music videos - oh and baseball games in season.

• I’m eternally grateful for what I have and for everyone who supports me.

• At times, I’m overwhelmed by the demands of managing life by myself.

Experts say that reducing self-induced stress involves managing expectations, reframing negative thoughts, and setting healthy boundaries. Key strategies include practicing self-compassion, learning to say "no" to avoid overload, prioritizing tasks, and limiting social media.

What I’m finding:

• Increased stomach distress and headaches seem to indicate that my health is being affected - and I’m not doing enough to manage it.

• There are improvements - some self-compassion, saying no a bit more, and focusing on being my coach rather than my critic - yet, there is room for continued improvement.

My stress seems to boil down to three factors: an unrealistic need to do things perfectly, worry about everything, and negative self-talk. If I want to experience overall well-being and happiness at my age, I’d be smart to keep on finding more powerful management tools.

My next steps include:

• Increased self-compassion - reminding myself of what I’ve accomplished during the last ten years.

• I’d say stop the negative self-talk, but that’s unrealistic; maybe a better option is using positive self-talk more often. Not trying to change the old habit, but creating a strong new one.

• I’ve read about energy being the new currency, so I’m choosing to spend mine wisely.

• Honoring the worries, doing what I can about them, and letting them go as the Serenity Prayer suggests.

My question for you is this: How much do you stress yourself?

I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible. Above all, I want to continue expanding our community of readers.

So, feel free to forward this email to a friend or family member and invite them to join us. They can subscribe here:

Subscribe now

Thank you for being part of the Aging Well community.

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She has written articles for Substack for the past five years and recently published a book, The Insider’s Guide to Aging Well Through the Eyes of an 87-year-old.

Over time, readers asked whether these reflections might someday be gathered into a book. I’m writing today to let everyone know they can and are.

You inspired me to write The Insider’s Guide to Aging Well: Longevity Through the Eyes of an 87-Year-Old. I’m deeply appreciative of your readership, reflections, and willingness to engage thoughtfully with the topics.

The Insider’s Guide to Aging Well brings together many of the ideas and themes we’ve discussed. It’s not separate from the newsletter, which is my primary focus, but an extension of it—a way to collect the articles in one place for those of you who may find that format more useful.

This link takes you to the book on Amazon. All proceeds will be donated to the Alzheimer’s Association in my husband’s name.

Learn more about the book

In the last two articles, we’ve touched on topics that seem incredibly important - particularly if we want to enjoy overall well-being and happiness in our older years. I’m referring to the relationship we have with ourselves and letting go of the person we were to make room for the person we can and want to be now.

As a child, I was taught that others knew best about everything, from what clothes I should wear to what decisions I should make. That belief influenced me for years in many ways. So I’d ask their opinion, accede to their wishes, and ignore my intuition more often than not.

However, I’m finding that they - professionals, advertisers, and well-meaning family and friends - may not know what’s best for me after all. They don’t know my body, my values, and my intentions as I do.

I’ve also been surprised by the sadness I’m feeling about activities, long-held habits, and special relationships that are no longer there. So, I’m experimenting with new ways of being based on what is true for me now.

One question we might want to ask ourselves to begin with is: How has my relationship with myself changed as I’ve grown older?

Leave a comment

A few guidelines

• Comments are friendly and supportive.

• I reserve the right to delete posts if necessary.

• I’m no longer a licensed counselor nor am I a medical professional, so I offer no advice, only thoughts based on my experience.

Let’s get started, and welcome!

After my husband died, I wrote about letting go of life as a married woman. Practically, I’ve been successful; emotionally, not so much, given our shared 70-year history and intertwined lives.

It appears there is a similar - maybe larger - challenge to deal with - one I hadn’t considered, but one that is causing anguish lately. As the aging process marches on - despite my best efforts to slow it down - I’m having to let go of who I was and what I could do, to embrace what I can do, rather than continuing to force myself to do things that are now stressful.

For example, I can’t and don’t care to be an online adjunct psychology professor anymore, but I can write a newsletter about aging well, which I love. The same expertise and skills are required; they’re just applied differently.

I suppose that challenge begins with defining what’s true for me today, and acknowledging four important facts.

1. I'd best take excellent care of the body I live in - even more so now.

2. My husband was my rock - he always had my back. Initially, my goal was to be my own rock, but that doesn’t seem possible. I can’t replicate what he provided in terms of safety, love, and support. However, maybe I can advocate for myself to the best of my ability, build a support team, and let them help when needed.

3. I’ve spent a lot of time, too much, truthfully, being angry and frustrated at what my body can no longer do and pushing myself to do things I don’t want to do.

4. The past can provide wonderful memories and lessons that support me now and the woman I’m becoming. The losses remain; there’s no way around it, but maybe the key is to use them as a catalyst for something new.

Experts say the solution is not to rage against the changes, but to relax into them. Acknowledge that we’ve entered a new phase of life, one that’s going to be different from the way we lived before, and look at it as an opportunity for a new adventure.

What I’m finding:

• Raging certainly hasn’t worked, nor has forcing myself to do things I don’t want to do - they only create more stress.

• I have values, beliefs, and experiences that help me formulate something new, but I also have long-held beliefs and habits that hold me back.

• Maybe the key is in adjusting - if it’s something I really want to do - doing it in a way that meets my body’s and my heart’s needs. Case in point: I’d been doing the acrylic landscape paintings for several years, but my hands aren’t as steady, and painting was no longer fun. However, I can use colored pencils much more easily and apply my art skills in a new, challenging, and interesting way.

Experts say that, as an older adult, using the past to build a new future involves a proactive process of repurposing—shifting from a career-focused identity to one based on legacy, passion, and mentorship. This transition may enhance mental health, foster a sense of meaning, and allow us to filter our most valuable life lessons for future generations.

What I’m finding:

• This information rings true for me, and it’s what the newsletter is all about.

• I discovered the term "sage-ing," a way of living in the second half of our lives that can be fulfilling and beneficial.

  • It suggests living our later years creatively and with purpose, harvesting the accumulated wisdom of earlier years, and sharing it with others.

  • Enriching our lives as we expand our own. Sage-ing can empower us to add years to our lives and life to our years.

  • I’m also finding that hobbies, per se, don’t entirely meet that need for me. However, if I switch from acrylic painting to colored-pencil art and send them to friends or include them in the newsletter articles, it does.

Experts say that learning how to see our successes and apply them going forward is priceless. Seeing what you might not have done so well, and what you can do differently in the future, is also priceless. Living in the past doesn’t create an adaptable life. Using the past to help create the future does.

What I’m finding:

• Maybe if I apply my qualities and the lessons I’ve learned in the past to my future, I can create a fulfilling quality of life no matter my age.

A question we might want to ask ourselves is this: What aspects of who we were are we still holding on to—and do they or can they still fit who we are now?

I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible. Above all, I want to continue expanding our community of readers.

So, feel free to forward this email to a friend or family member and invite them to join us. They can subscribe here:

Subscribe now

Thank you for being part of the Aging Well community.

Dr. Janice Walton is a psychologist, widow, mother, grandmother, great-grandmother, and writer. She has written articles for Substack for the past five years and has just published a book, The Insider’s Guide to Aging Well Through the Eyes of an 87-Year-Old, which is available on Amazon.

It’s becoming increasingly clear that a relationship I’ve neglected over the years is the one with myself. I know why: wanting to be liked, making friends, and succeeding in the world were more important.

Putting others first worked for a very long time. However, it seems like my ‘giving bucket’ has run dry, and I’m tired. My body and my heart are now asking, “What about me?”

Experts say the relationship we have with ourselves is the foundation of mental well-being, influencing how we interact with others and handle life. It requires understanding our emotions and using positive self-talk to build resilience and self-worth.

They also say that building this relationship involves practicing self-care, setting boundaries, acknowledging emotions, and spending time alone. Important habits include journaling, daily exercise, pursuing personal hobbies, and speaking kindly to ourselves to foster self-trust. These habits should be part of a non-negotiable, proactive relationship and a lifelong journey, rather than a one-time task; a continuous process of self-discovery, compassion, and acceptance.

What I’m finding:

• While journaling, daily exercise, and personal hobbies are helpful, what matters most now seems to be time alone, being kinder to myself, and fostering self-trust.

• The fact that our bodies’ needs and desires change as we age was something I hadn’t considered.

Experts claim that building a relationship with ourselves in older adulthood, especially if we’ve not done so already, is a journey toward planned action, self-compassion, and curiosity that could transform solitude into a fulfilling, independent life.

What I’m finding:

• This task seems formidable. However, there are steps I can take.

• I enjoy the solitude, which surprises me.

• One important aspect for me is permitting myself to let go of the person I was and to focus on the person I am now. More about that next week.

Experts explain that building a relationship with ourselves as older adults involves moving from seeking others’ approval to listening to our own needs, emotions, and values.

What I’m finding:

• I’m in a huge self-discovery phase right now - figuring out who I am and can be at this age.

• However, self-compassion has been pretty much ignored in the process.

• I continue to listen to what others say, but I’m also listening more closely to my body, my values, and my emotions. Listening to them entails a real effort to trust myself more.

They note that after a lifetime of taking care of others—a pattern often referred to as chronic people-pleasing—we should take intentional steps to reconnect with our own needs and identity—both of which may have changed over time. This is not about being selfish, but about moving from "selfless" to "self-full."

What I’m finding:

• I’ve spent most of my life helping others, and it’s somewhat painful to let that go and reconnect with my needs and identity now.

• However, my plan is to gently incorporate the following practices.

  • Without judging, notice when I ignore myself to please others, say “yes” when I want to say “no,” or hide my honest feelings to keep the peace.

  • Decide what I’m willing to do and what I'm not. The word “no” can be a complete sentence requiring no apology or lengthy explanation.

  • Set aside specific times for activities that rejuvenate: reading, playing the piano, or doing art.

  • Reflect on what truly matters to me—not what others expect. This helps me set a long-term vision and prevents my days from feeling meaningless.

  • Begin asserting myself by saying no to small requests and expressing my opinion more freely.

A shift in our relationship with ourselves may lead to a better quality of life as we age, and it seems to be another piece of the aging well puzzle. As we change, the quality of our lives changes—and sometimes that requires us to let go of earlier versions.

A question we might want to ask ourselves is: How am I relating to myself at this stage of my life?

Please let your friends and family know about the newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, forward this email and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, a widow, a mother, a grandmother, a great-grandmother, and a writer. She’s been writing a newsletter on Substack for five years and is currently publishing a book based on the articles.

I’m not denying the reality of illness or the need for medical care, but I do want to be an advocate for myself, my beliefs, and my values in the process.

My most recent medical experiences were outpatient eye surgeries about six years ago; they were successful and went smoothly. My last hospitalization was in the 1960s, when my children were born, and I’ve visited the emergency room three times since then: for a rabies shot, a broken wrist, and a deep cut requiring stitches. I currently take no prescription drugs.

I go to the doctor when necessary - probably not often enough, some would argue. My intention is never to be a patient. Several loved ones were, and I saw how that went.

It’s true that having a primary care physician can provide essential, personalized healthcare by focusing on prevention, early disease detection, and the management of chronic conditions.

Similarly, a hospital can provide immediate, specialized, and life-saving care for severe injuries, critical illnesses, and emergencies. It ensures access to advanced diagnostics, 24/7 care, and the support needed for acute conditions.

It’s also true that, despite my best efforts, I may need a doctor or hospital someday. If or when that time comes, I want to advocate for myself as much as possible.

Experts say patients want to be heard, validated, and treated with dignity. They want warmth, compassion, effective communication, and social connection to help cope with fear, pain, and uncertainty during treatment.

What I’m Finding:

• While some readers have wonderful relationships with their doctors and positive experiences with the system, that has not been my experience for the most part.

• However, I haven’t put much effort into finding the right care provider either.

Experts say that to make sound choices, we should pause, gather information from trusted sources, and involve a support system.

What I’m Finding:

• In several cases, particularly as a caregiver, pauses were not offered. A decision was required in the moment, or they made the decision.

Experts suggest that if we find ourselves feeling pressured, we should take time to think and reflect before making a final decision.

What I’m Finding:

• I was rarely given time to make a decision, but I also didn’t know I could ask for it.

Experts advise us to talk with friends, family, or a professional about our fears to prevent them from increasing stress.

What I’m finding:

• I don’t want to burden family members with what I consider to be my problem. Maybe that thinking needs reassessing.

We can also consider these guidelines:

Before and During Appointments

• Write down our top concerns, detailed symptoms, and questions.

• Bring a trusted person along to help remember the information, or record the appointment for later review.

• Document daily symptoms, medications, and diet, which makes it easier for a doctor to understand our issues clearly.

• Keep a medication list that includes prescriptions, over-the-counter drugs, and supplements to prevent dangerous interactions.

Communication Strategies

• Use “I” statements to express our concerns, such as: “I’m worried that this medication is causing new side effects.”

• If we feel unheard, we can say, “I’m uncomfortable with this plan.”

• If we don’t understand a term or plan, we can ask, “Would you explain what that means?”

• Repeat what the doctor says to ensure we’ve heard correctly.

In the Hospital

• Hospitals have staff who can help us navigate care and resolve issues. Know who they are and what resources they offer.

• As patients, we have the right to informed consent, to refuse treatment, and to expect privacy.

• We can confirm the name and purpose of a medication, procedure, or test beforehand, and ensure we understand follow-up instructions, including medication dosing.

Feeling Unheard or Dismissed

• If we’re uncomfortable with a diagnosis or treatment plan, or consistently feel rushed or dismissed, we can seek other medical opinions, though that might involve out-of-pocket costs.

• If a doctor refuses to run a test or provide requested treatment, we can ask them to document their reasoning in our medical record.

Key Phrases for Self-Advocacy

• I know my body, and this is not normal for me.

• I want to explore other options.

• Would you help me understand why this test is necessary?

Many of us, as older adults, will need to visit a doctor or go to the hospital at some point, or we may have loved ones who do. There are steps we can take to support and advocate for ourselves and them.

A wise question to be considering is: “How can I be my advocate in medical settings?”

I want to share the lessons I’ve learned over my years of life and caregiving with as many people as possible. More than anything, I want to continue to expand our community of readers.

So please forward this email to a friend and invite them to join us. They can subscribe here:

Subscribe now

Thank you for being part of the Aging Well community.

If you want to contribute to my work, consider donating to the Alzheimer’s Association. This link takes you to their website. The choice is yours.

Dr. Janice Walton is a psychologist, a widow, a mother, a grandmother, a great-grandmother, and a writer. She’s been writing a newsletter on Substack for over five years and is in the process of having a book published based on the articles.

I have no reason to go to the doctor or to the hospital right now, and I’m doing my best to keep it that way. My concerns are that they won’t know me well enough to make the correct diagnosis in a short appointment, or that I’ll get trapped in the medical system, referred from doctor to doctor, and required to take unnecessary tests. All of which has occurred in the past, so even the possibility causes anxiety.

However, there might be a time when I need medical care, and I’m finding that taking care of my emotions is a must if or when it happens.

People rarely think about their feelings when they give up control to a system, wait weeks for appointments, are defined by a chart or diagnosis, and subtly shift from being a person to being a patient. So maybe now’s a good time to begin.

Key emotional drivers and impacts include:

• Fear and anxiety tend to play a role in serious medical issues. Those emotions can lead us to choose options that provide immediate emotional relief or cause us to refuse necessary tests.

• Feelings of helplessness can create a desire to regain control and impact treatment decisions.

• Negative emotions often lead to a focus on negative outcomes and may make it harder to understand medical information, potentially leading to poorer decisions.

• Healthcare providers have emotions, too—biases, sympathy, or negative reactions to patients —that may influence their clinical judgment and decision-making.

• Second opinions can be important for reducing emotional strain and helping people move from anxiety to feeling informed and confident in their choices.

Recognizing emotional factors is crucial for effective care; decisions without reference to them can be seen as “mechanistic and inferior.” Furthermore, when we need medical assistance, we’re better served by acknowledging and accepting our feelings rather than suppressing them.

So, the question becomes, how can we support ourselves emotionally if we find ourselves in that situation?

Experts say that the emotional toll of being a patient can be traumatic, characterized by a mix of anxiety, depression, fear, frustration, and isolation. They often endure significant, long-term stress, which may lead to post-traumatic stress or feelings of helplessness.

What I’m Finding:

• Just the idea of going to the doctor causes concern. I look for every home and over-the-counter remedy first. However, if need be, I would.

Experts claim that managing emotions while in the hospital or under a doctor’s care involves deep breathing and mindfulness, maintaining routines, journaling, and engaging in light, distracting activities.

What I’m Finding:

• I’m not good at deep breathing, but I practice Qigong, which includes exercise, breathing, and mindfulness. I also maintain routines, journal daily, and have hobbies.

• Honoring my feelings is one of my strategies, but it’s often easier said than done.

Experts note that emotions are typically involved with medical care and that fear, sadness, and anxiety can affect patient decision-making and outcomes. Empathetic communication and “emotional fit” between providers and patients improve treatment adherence, while failure to address emotions often leads to patient distrust and higher stress.

What I’m Finding:

• I’ve rarely found an emotional fit in a doctor’s office or in a hospital setting. Appointments were short, the doctor knew best, and my emotions were never considered either as a patient or a caregiver.

• Past experience has led me to distrust the medical system in general.

Experts advise that we should accept it’s normal to feel overwhelmed, sad, or scared, and avoid judging our reactions.

What I’m Finding:

• I don’t judge my reactions or feelings, but I certainly know they exist, and they definitely play a role in my decisions.

Experts warn that we should be mindful of our feelings and how they might affect our decision-making. The goal is to balance rational information with emotional needs.

What I’m finding:

• Medical personnel have emotions that affect their decisions. That’s why I’d want to know their beliefs regarding certain key issues. Do they agree with the mind-body connection? Are they willing to listen to my thoughts and ideas?

Experts suggest we focus on what we can control, such as learning about the condition and engaging in the decision-making process.

What I’m Finding:

• Today, I’d do much more of that as needed.

Experts note that we can manage our emotions as patients by practicing deep breathing, mindfulness, and grounding techniques to stay present. They suggest we stay connected with loved ones for support, maintain a sense of control by asking questions, and use distractions like reading or music.

What I’m finding:

We can also do the following:

• Work on healing our bodies through visualizations and other practical interventions as we prepare for doctor visits, surgery, or hospital stays.

• Know and understand the reasons for being a patient so we can ask relevant questions and not take what they say at face value.

• Join a support group and listen for fresh ideas.

• Focus on what we can do to support our health.

Being a patient can subtly reshape how we see ourselves. Appointments, diagnoses, and treatments begin to define our days and, at times, our identity. Yet beneath the medical chart, the self remains — the thinking, feeling person who is still making choices about how to live.

You can read Part 2 of this series, “How To Advocate for Yourself as You Age Well,” next week.

Please let your friends and family know about the newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, forward this email and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, a widow, a mother, a grandmother, a great-grandmother, and a writer. She’s been writing a newsletter on Substack for five years and is currently publishing a book based on the articles.

I was determined to be independent. I did not want our family to go through what we’d been through as my husband struggled with dementia and died of COVID ever again.

I’ve given it my best effort. Yet, I’m finding that in truth, no man - or woman in my case - is an island as John Donne, the poet, suggests.

For some reason, it’s okay to pay for outside services like a house cleaner and a financial planner, but it’s not okay to ask family members for help, which I’m having to do more often - even though they repeatedly say and show they’re willing to do so.

Maybe we shouldn’t be asking the question “How can I do this?” but rather asking, “What kind of support preserves my self-respect and allows me to feel good about myself during this stage in my life?”

Experts say that as older adults, we face significant challenges to maintaining independence, primarily because of declining physical mobility, chronic health conditions, and cognitive impairment.

• What I’m finding:

  • My physical mobility is pretty good. I walked five miles with ease last week at the Getty Museum in Los Angeles, which included several flights of stairs.

  • There are no chronic health conditions, and I take no prescription medications.

  • My cognitive functioning is solid. I’m a lifelong learner, and writing weekly articles for this newsletter helps keep me sharp.

Experts say key issues as we age include managing daily tasks, navigating unsafe home environments, financial constraints, social isolation, and loss of transportation.

• What I’m finding:

  • I fix three meals every day - some better than others - keep the house clean with the help of a once-a-month house cleaner, have no financial concerns, and get together regularly with friends and family.

  • I no longer drive, but can still walk to most services -or there is always DoorDash and Amazon. My daughter offered to be my taxi, and I can take an Uber if needed.

Even so, I’m not as independent or as self-sufficient as I’d like, and that may worsen in the coming years.

Self-sufficiency is the notion that we can or should meet all our needs independently, without relying on others. It’s probably a false premise because human survival depends on community, shared resources, and specialization, which make complete independence impossible and can cause burnout.

A better word might be autonomy, which is defined as the internal capacity to make choices aligned with our values and desires, which, in turn, allows us to maintain dignity and receive support.

Perhaps, an even better term is interdependence - a deliberate decision to embrace mutual reliance, balancing individual autonomy with collaboration to create greater value than working alone. It involves recognizing the impact of our actions on others, fostering trust, and moving beyond isolated self-reliance to creating shared, sustainable success.

So, maybe our independence isn’t really lost as life changes—maybe it just evolves. The question isn’t whether we remain as independent as we were, but whether we can redefine it in a way that preserves our inherent sense of worth.

This way of thinking involves allowing others to help, making adjustments, and carefully choosing where to invest our energy. It doesn’t diminish who we are, but it does reflect a different form of independence.

Please let your friends and family know about the newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, forward this email and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, a widow, a mother, a grandmother, a great-grandmother, and a writer. She’s been writing a newsletter on Substack for five years and is currently publishing a book based on the articles.

I’m an older woman - some would say really old - I just renewed the lease on my lovely apartment, I have two wonderful cats, no financial concerns, and minor health issues. My career is writing. I have numerous hobbies, and family and friends support me. Life is good. At the same time, I struggle with anger, anxiety, doubt, frustration, and deep sadness, for seemingly no apparent reason.

In recent articles, I discussed how aging is often emotionally harder than we expect. Readers confirmed that point: many of us anticipate and accept the physical changes we experience as we grow older, but we’re less aware of their emotional impact.

As it turns out, aging well is not simply a matter of staying positive or managing medical care. It also requires deliberately adjusting to losses, renegotiating identity, and choosing how to respond to change.

Losses in aging tend to accumulate, often occurring one after another before previous ones are completely processed. I’m also finding that rather than a single loss, they come in clusters.

I was somewhat prepared for my husband’s death on a practical level. However, I wasn’t prepared for the secondary losses of identity, confidence, friendships, and everyday life without him, or for the feelings that came with them.

Experts suggest that we tackle loneliness by spending time with family and friends, or joining community-based organizations such as churches, senior centers, or adult education classes.

What I’m finding:

• I get together with family and friends, but I cherish my alone time and feel most safe at home.

• I’ve gone to the Senior Center and attended Adult Education Classes, but not anymore. Playing cards, making puzzles, or line dancing aren’t for me. I’ve taken more classes than I can count over the years, but now I can learn anything I want at home, thanks to the Internet and YouTube.

Experts say that walking or doing yoga to reduce anxiety and improve sleep helps regulate emotions and makes us feel good.

What I’m finding:

• I exercise daily, but less vigorously than before because my knees complain, which causes anxiety when they hurt and frustration because I can’t do more.

• My sleep is interrupted most nights with trips to the bathroom, hot flashes, and a cat who insists on sleeping as close as possible. A couple of weeks ago, it was interrupted by an earthquake - that’s California for you.

Experts explain that practicing deep-breathing exercises, meditation, or journaling can help us manage stress and reduce excessive worrying.

What I’m finding:

• I haven’t been successful with deep breathing or meditation, but I practice Qigong, which combines exercise, breathing, and mindfulness. I also journal daily - worries still tend to sneak in.

Experts tell us to structure the day with consistent habits, such as hobbies, volunteering, or caregiving, something that provides a sense of purpose.

What I’m finding:

• I have several hobbies, and writing the newsletter provides a sense of purpose, but the deep sadness of a special someone’s absence remains.

Experts advise us to focus on proactive problem-solving, like setting daily intentions or viewing emotional situations objectively.

• What I’m finding:

  • I do set daily intentions and focus on solutions, but anger, fear, and sorrow linger.

  • As for viewing emotional situations objectively, I find that’s easier said than done. Unexpected but valid feelings arise at inopportune times, and they deserve to be honored.

Aging well is not accidental. It requires attention, emotional honesty, and a willingness to work with the life we still have. The losses are real. So is our capacity to respond thoughtfully. The goal isn’t to eliminate our emotions — but to remain steady, engaged, and respectful of them.

My question is this: What emotional changes in aging have surprised you the most? For me, it’s been the increased worry coupled with a loss of self-confidence.

Please let your friends and family know about the newsletter. I want to share the lessons I’ve learned over the years of life and caregiving with as many people as possible, and, more than anything, I want to continue expanding our community of readers.

So, forward this email and invite them to join us. They can subscribe here:

Subscribe now

Dr. Janice Walton is a psychologist, a widow, a mother, a grandmother, a great-grandmother, and a writer. She’s been writing a newsletter on Substack for five years and is currently publishing a book based on the articles.