Sensuous seniors

Use it or lose it. That’s the essence of “sensual reconditioning,” which I began discussing in my column last Wednesday.

Sensory impairment among the elderly is not just a matter of the deteriorating “apparatus.” Ultimately, it’s the brain that sees, hears, smells, tastes and touches, and even when the senses seem impaired, we can train the brain to delay the deterioration, and to reorient the way it processes the stimuli, turning them positive and helping the elderly overcome negative feelings like frustration, despair, even anger.

I’ve touched on what we can do about impaired vision, more of outsmarting the brain when it “camouflages” objects to make them invisible (for example, dark-framed glasses on a dark-colored desk).

The brain tricks us not just with perceptions but also with the judgments that come out of those perceptions. This is best shown by a common geriatric problem of “sundowning”—mood changes toward sunset. One explanation for this phenomenon is that the decrease in light affects the level of a chemical in the brain called melatonin. I’d propose a sociocultural component: Sundowning is probably more serious if we have been socialized into associating darkness with hopelessness, even evil. We can counteract this by training ourselves—in our younger years and, hopefully, with the elderly—that we can also find comfort in sunsets. Many Filipinos are still fortunate to live in places where they can catch the splendor of sunsets, but even in Metro Manila there are such places, UP Diliman being one.

Hearing voices

On to the auditory sense, or hearing. The neurologist and writer Oliver Sacks wrote a wonderful book, “Musicophilia,” which is all about hearing and how the brain and culture shape what we hear. If the elderly are left alone, or are not talked to, their brain takes over, continuing to fire off sounds from the past. This is why the elderly will claim to hear deceased relatives, or assorted beings in the house: laughing children, marching soldiers, all kinds of music. It’s like a tape recorder left running.
So do engage the elderly and let them hear your voices, rather than those of ghosts. Talk about what interests them, show photographs. But know when to stop babbling. Play music (religious music for those who enjoy it). Ask what they want:
religious music, Ruben Tagalog, Madonna? One of my fellow senior citizens sent me a wonderful link to icons from our generation (Meryl Streep, Bette Midler, Cher, Olivia Newton John and Goldie Hawn) singing “What a Wonderful World” (m.youtube.com/watch?v=rHRGYLutYAY).

Be aware that auditory overload is not just a matter of quantity. An elderly professor told me many years back how she had stopped listening to the news because it so upsets her. How I pity patients who have had a stroke and are unable to move or talk in their beds while their relatives listen to the news full-blast—corruption, killings, disasters. Check on what your caregivers watch on TV while caring for your relatives; one of my mother’s caregivers, it turned out, loves watching wrestling, which my mother hates.

Next, the olfactory sense, or smell. Note how we Filipinos tend to smell everything, but there are many paradoxes in our smelling environment. Unlike other Asians we use few spices, so our kitchens are dull when it comes to odors. On the other hand, homes are oversprayed with air fresheners… and then there’s the pollution from vehicles, and the stench from garbage and polluted rivers.

Find ways to make our elderly’s environment more pleasant. Tune up the brain by bringing in familiar scents from the past: My father loves Maja soaps and powder from Spain, together with Tiger Balm and nutmeg oil for massage.

Depending on the elderly’s preferences, you can plant a scented garden near their room: ylang-ylang (the sosyal spelling), sampaguita, even citrus fruits that fill the air with strong (even overwhelming) scents when they flower. But be careful; some people, like myself, have allergies (hay fever) when some trees flower (kapok is the worst for me, but it’s not scented so you won’t have it in a scented garden).

Tied to the smells are the flavors of life. Sometimes when the elderly complain they can’t taste their food, it might actually be related to problems with smelling. Be a bit bold with the spices and other stuff to liven up their meals, smell-wise and taste-wise.

My parents’ doctors long ago told me not to restrict their food unless absolutely necessary. Let them enjoy the foods—and food aroma—that they love. I’m looking forward to the next season of lychees, coming up soon, because when my mother had a massive stroke years back, she said it might be her last year of lychees. That was in 2010.

And now the tactile. Culture dictates social distances: how close and touchy (meant in the positive sense) you can get. Unfortunately, we’re one of those cultures that discourage male-to-male touching (some rural areas continue to be liberal, though). Holding Lolo’s hand can go a long way, as does a light brushing across their skin. Train the grandchildren to help; even just offering assistance for walking allows touching… while touching the hearts of both grandparent and grandchild.

Sunbathing

Now here’s an important tactile stimulation that people overlook: sunlight. Last Wednesday I referred to how the elderly are often sequestered in their rooms. Depriving them of sunlight can lead to vitamin D deficiency, which is now being linked to cognitive impairment in the elderly. There’s the irony: You keep the elderly in their rooms thinking they’re becoming senile and need to be protected, but depriving them of sunlight by keeping them indoors worsens the senility.

But don’t overdo the sunbathing. Use sun block if Lolo or Lola is fair-skinned. A few minutes a day can be sufficient to get the required daily dose, even as they exercise the brain’s tactile areas, appreciating the warmth on their skin.

Our senses, directed by the brain, work as a team. My ex-partner’s grandmother was totally blind but we became good friends, carrying on the longest conversations. She could hear whispers, and more. She’d call out my name when I visited, even before I’d tell her who I was. She claimed she could tell just by my footsteps and my smell. And I’d say, “The machang (glutinous rice and various ingredients wrapped in lotus leaves) gave me away again.” That was her favorite, together with kiamoy (dried salted fruits).

Other times I’d watch her telling other visitors to speak up, and I’d tease her afterwards about playing deaf. No longer their brain but the senior citizens themselves will be mischievous, too, pretending to be hard of hearing or to having failing eyesight when actually they know what’s going on. Let them have their fun: A sense of humor is always a good sign that they’re still sensuous and armed with a zest for life.
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