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Tom Perls and Longevity

“The older you get, the healthier you have been.” That is the mantra Tom Perls has devised, after almost ten years of studying people who have lived to age 100. Most of these centenarians, it turns out,  have not so much overcome life-threatening diseases as avoided them.

Dr. Perls, a geriatrician and  researcher now at the Boston University Medical Center, last week shared with a small but enthusiastic audience some of the insights he has gained from his dealings with people who have broken the century barrier.

Perls started his medical career believing, like most other doctors, that the older you get, the sicker you are. However, after getting to know two centenarians,  residents at Hebrew Rehabilitation Center in Roslindale,  he began to change his mind.

By now he feels enthusiastic about life in extreme old age. The 800 centenarians he has had contact with thus far have taught him so much that it has affected the way he lives his own life.

He attaches great importance to continuing to learn, especially acquiring  new skills. It’s a way of building cognitive reserve that can protect against decline in brain power. The links between two telephone poles are improved by adding new wires; if we learn a new instrument or a new language, we are, in a sense, adding new wires to our cognitive capabilities.

Dr. Perls also considers nutrition vitally important. And yet he is not a fanatic about food: rather, he believes in achieving and keeping a balance. If restricting your intake of calories is going to make you miserable, it’s not going to be good for you and you will not long keep doing it.

But Perls is dead set against being overweight. He confesses having been in that condition himself until he determined to stop eating two bagels a day along with several chocolate bars each week. He now takes special care to ration the carbohydrates in his diet.

He credits Walter Willet, a prominent researcher at the Harvard School of Public Health, with seeing that the famous food pyramid put out by the United States Department of Agriculture should be turned upside down.

Instead of carbohydrates being the largest item, at the base of the pyre, they should be on top. Fruits and vegetables should replace them as the nutrients of choice with carbos being carefully controlled. Fats are not always what they seem: they do not pose the same threat of obesity as do carbos. Carbos make the pancreas produce insulin that stores fat in the body.

Since some 70 percent of Americans are overweight, the importance of these nutrition issues is evident. Besides bad nutrition, another reason for this unhealthy situation is our lack of exercise. Only 15 percent of people over 65 exercise regularly, a factor that lessens chances for increased longevity.

Many of us who do exercise do not realize the importance of strength training, such as stretching arms and legs. Unlike aerobic exercise that boosts endurance, strength exercise aims to build muscles.  Amazingly enough, strength training of this sort can increase one’s brain power. To make sure his patients take it seriously, Dr. Perls writes prescriptions for strength training.

Certain common traits tend to characterize people who have reached 100. “Centenarians tend not to dwell on things,”  says Perls. “Also, they tend to be a gregarious, funny group.” What this means is that they manage stress very well.

A couple of other characteristics run through them as a group. “Religion seems to be quite prevalent among centenarians,” Perls says. Having some form of faith has led them to discover a reason behind things. Prayer seems to reduce stress, especially forms of repetitive prayer like the rosary.

Another trait is having social networks and enjoying other people. “I have come across only two or three curmudgeonly centenarians,”  says this researcher into their ways. Most of them are gregarious and they have the good sense and the ability to bring young people into their lives, people to receive help from them.

Despite his enthusiasm for the centenarians he has known, Tom Perls does not see getting to 100 as some kind of life goal. Rather, he is interested in the quality of life, in extending one’s life to its full span while enjoying good mental and physical health. He supports the “compression of morbidity” ideal, whereby the time when we are seriously ill at the end of life is reduced to the shortest time possible.

As for the so-called anti-aging purveyors who see aging as a sickness and doing away with the limits to life as a goal, he judges them dangerous. “There are  hucksters out there that are doing no different than what the snake oil salesmen of the 1800s were doing.  When they are selling human growth hormone, it’s the same as ground-up goat testicles. Injecting yourself with this stuff is buying yourself an aggressive form of cancer 20 years down the road.”

Richard Griffin

Seeking Nourishment

As to beauty, the basement of our parish church leaves much to be desired. With its hard stone floors and rather dim lighting, this space possesses precious little grace or style. It looks like a place for storage rather than for people to come together for food and company.

And yet, on this site take place some of the most important activities sponsored by the parish. This is where people arrive each Saturday morning to receive food to take away with them uncooked or, on Wednesdays during Advent and Lent, to eat a meal served to them by volunteers.

At noontime on a recent Wednesday, I came there to help serve the meal. With the other volunteers I stood behind the tables, waiting on the men and women who filed by. My job was to preside over the desserts; that meant ladling out the rice pudding and making sure that everyone got what they wanted of the fruit, cookies, and other dessert offerings.

Before the guests came by, we all stood and grasped hands to sing a blessing over the food. This music was not a solemn hymn but rather a jaunty tune with words I did not recognize. This blessing seemed to lift the hearts of people in the group before we sat down to eat.

Not all of those who lined up to receive food were guests from outside. Some were insiders, members of the parish who had come to share fellowship with the visitors. Among those parishioners already known to me I noticed Frances, a college sophomore, who sat and ate with some of the older people from outside the parish.

This mingling of visitors and parish regulars seemed to me important because it made being there easier for the homeless and other people lacking money who had come because they needed a nutritious meal.

My reason for describing this parish lunch in some detail is because I see it as an important manifestation of community. To me, it expresses who we are spiritually, a community of believers who try to extend to others the love we have received ourselves.

Serving food to others in this setting is not mere “do-goodism” but rather an action grounded in spirituality. As people blessed by the Lord, we think it vital to share the inner wealth given us by God. And since Christians believe that Jesus gave himself in the form of bread, what better way is there for us to share his love?

This sharing of bread with the hungry strikes me as an answer to a problem recently raised by a group of lay leaders in the parish. They feel concern that we are not a community for enough of our members. Too many feel isolated, cut off from personal contact with others.

For instance, a woman who has been coming to our parish church for two years regrets that she has never spoken to anyone during that time and no one has spoken to her. Probably she has shared a word or two with the people around her when exchanging the kiss of peace during the liturgy of the Eucharist, but nothing otherwise.

In response to this situation the lay leaders have issued a call to action designed to change isolation into community. They have taken this initiative because they see community as located at the heart of Christianity.

Christians also believe themselves joined together with Christ and one another with bonds that go beyond what can be seen. These mystical connections are what give the church its basic character –  –  though, admittedly, the church often does not live up to this character.

Christians also feel their church’s call to social justice aiming at human rights for all people, especially those now impoverished and needy. Without community, precious little progress toward peace and justice can ever be achieved.

Left to ourselves, we Americans are notoriously individualistic in the way we live and in what we value. So to push for more community, as the parish lay leaders wish, will require going against some of the values of our culture.

I feel thankful for the opportunity to have shared a meal as one of a community of people needing nourishment, both physical and spiritual.

Richard Griffin

Neville Manor and Reform

It was my first visit ever to a nursing home where residents are free to go to bed at night at whatever hour they wish and to get up when they feel like doing so.

“We are trying to emphasize a different model, where the residents have control,” says Paul Hollings, director of Neville Manor, an institution in my home town where I stopped to see how that new model works.

Located at Youville Hospital until its new facility near Fresh Pond opens next spring, Neville Manor makes no small claim for historical roots. It traces its remote origins back to 1779 (starting with the city’s poorhouse and allowing for many changes of site and institutional culture.)  

According to Hollings, until recently the mindset for nursing homes went, “I will take care of you; you are dependent on me.” This was not all bad but it led to institutions that were focused much more on the bodies of the people who lived in them than on their overall wellbeing, psychological and spiritual as well as physical.

Neville Manor is by no means the only nursing home that recognizes the right of residents to determine their own bedtimes and to make other decisions about themselves. It is one of a significant minority of institutions across America that have begun to change the culture of nursing homes.

These innovating institutions have drawn inspiration from a group of far-sighted people from around the country. A leader among them is Bill Thomas, a Harvard Medical School-trained physician who has developed the Eden Alternative, an innovative plan for a new approach to nursing homes. I recently heard this charismatic reformer speak in Chicago, where he called for a new view of aging to propel a new kind of facility.

At Neville Manor, an important vehicle for change is the residents’ council. Paul Hollings wants it empowered not so much to address gripes as to solve problems. “We’ve been working actively with the residents to get them to come up with solutions,” says Hollings.

I talked to the three officers of this council and was impressed with their upbeat approach to life at their facility. Knowing that their opinions on important issues count for something, they would seem to experience a higher level of morale than residents of old-style homes.

In a mission statement the cultural change committee at Neville says of applicants: “Their admission to our institution should not require them to sacrifice what made their lives meaningful in order to receive (our) treatment and care.”

Just as members of the staff in their own private lives enjoy the right to make choices such as “what we will eat, what we will do to entertain ourselves, when we will get up and how often and when we will bathe,” so residents should have the same right, so far as possible.

Another principle vital to nursing home change concerns the treatment of staff members. The reformers believe that how management deals with staff determines in large measure how staff deals with residents. When staff members have their own rights and dignity respected, then they are much more likely to treat residents with respect.

At Neville, every staff member expects to answer resident requests for help. If a particular staffer cannot take care of it, he or she will find someone else who can. Regardless of their job title, they are all involved in the common enterprise of meeting the needs of residents.

Normally, however, nursing assistants are assigned to the same small group of residents, thus enabling these staff members to get to know better the people they serve.

I talked with several staff members about the changes in ways of doing things and in atmosphere. A nursing assistant, Mahnaz Akhtar, told me about the improvement in communication among staff members. “When we have a problem, we can talk to each other,” she said.

With her was Rohi Khan who explained how they resolved a problem that resulted from managers at first not talking to the staff members directly involved in a difficult situation. “It worked out really good,” she said of the solution.

Wendy Lustbader, a Seattle-based geriatric social worker and author, calls for creating a homelike environment and promoting a sense of community.

“Dogs, cats, birds, plants, children, and gardens accessible to everyone,” Lustbader writes, “can transform a sterile monoculture into a human habitat worthy of a home.”

A conversation I had with Jenni Caldwell, Ombudsman Program Director at Somerville-Cambridge Elder Services supports what I have written here.

Of Neville Manor and Paul Hollings, she observes: “What is unique is that they welcome finding out about problems so they can change things.”

And speaking at large of nursing homes committed to the new ways, Caldwell says: “Culture change is the most exciting thing that has happened in a long, long time – an idea whose time has come.”  

Richard Griffin

End of Life Care

Dame Cicely Saunders is one of the great spiritual benefactors of the modern era. At least that is how I rate the white-haired, kindly looking British physician who, in 1967, began the hospice approach to helping people at the time of their dying.

This quietly dynamic Londoner, now 85, thought it important to move the place where people prepared for death away from hospitals to a home-like setting. She also placed emphasis upon making people comfortable rather than trying to cure them when that was no longer possible.

Thus she brought to the care of the dying not only physicians and nurses but also chaplains and others who could provide for their spiritual needs. She recognized that the soul needed support as much as did the body.

Dr. Saunders has taught people to express five sentiments as they approach death:

  1. I forgive you
  2. Please forgive me
  3. Thank you
  4. I love you
  5. Good-bye

She herself is a person of great spiritual stature. She once told an interviewer that, rather than dying suddenly, she would prefer to die of cancer. Dying a slow death would give her time to make the statements noted above.

Dr. Saunders draws inspiration from writers both ancient and modern. She finds hope expressed by Julian (or Juliana) of Norwich, a 14th century English mystic who, living at the time of the black plague that ravaged Europe, nevertheless wrote the famous words “all shall be well.”

She also takes inspiration from J. R. R. Tolkien, author of “Lord of the Rings” with its promise of overcoming evil, and from J.K. Rowling who has written the wildly successful Harry Potter series.

Dr. Saunders has brought about a revolution in end-of-life care. Many Americans have found in hospice care crucial support in their time of passage. However 50 percent of those who die each year do so in hospitals despite the desire of the overwhelming majority to be in their own homes when they die.

If all American hospitals offered hospice or palliative care services, then the situation would not be so bad. But, despite the advances in such care, fewer than 60 percent of our hospitals do offer such.

Emily Chandler, a Boston-area resident who is both a nurse and an ordained minister, explains the benefits of the hospice approach as follows: “Experience with hospice has taught us that rather than being a fearful, dreadful experience, dying can be healing, peaceful, even spiritually fulfilling for patients and their loved ones.”

As to what caregivers can do, she writes: “Attuned to the possibilities of sensory spirituality, we can enhance a peaceful, even joyful participation in the encounter with mystery that dying entails. In the process, we can learn something of our own spiritual journeys ourselves.”

The reference to “sensory spirituality” refers to Emily Chandler’s confidence in experiences that engage more than one sense at the same time. As an example, she says that combining sights and sounds or sounds and aromas can be effective in supporting healing memories.

Rev. Chandler also thinks that the great need of people when they come to die is to remember hope. It is a time for them to look back on their lives, if possible, and recall the images they have had of the transcendent, of what goes beyond the seen.

It can help them spiritually to think back to the familiar symbols that put them in touch with God, the beyond, the mystery of life. This is also the time when well-loved stories can be retold with the help of family members, friends, or others in attendance. These tales can stir the heart as they bring back the people and the events that figured large in the person’s life.

In this way, hope remembered can provide comfort and perhaps inspiration at this time of such crucial importance. Dying can thus become an event that summarizes life’s value, making it a supreme human experience.

The approaches to end-of-life care indicated here give expression to a strong movement toward favoring care over cure when the latter is no longer feasible. More and more people in later life want their time of dying to be one in which their bodies are made as comfortable as possible and their souls receive the attention they need.

Richard Griffin

Child Growing; Elder Growing

A small personal encounter in my 75th year has brought into sharp relief the fact that we all, young and old, are silently changing, growing older physically and being transformed internally. Even in an anxious time when the world is preparing for war, and people feel unsettled by catastrophe, incidents like this one call for attention and reflection.

On a recent evening I arrived at the home of dear friends and was greeted at the door by their 11-year-old daughter, whom I will here call Alison. She is a delightful young girl, sprightly in body and lively in mind, whom I have known from almost the beginning of her life.

Arriving at her house for dinner, I was warmly greeted at the door by my young friend. On this occasion, Alison made conversation with me more easily than usual, among other things telling me about her dog Euterpe who was running around the area near the front door, excited by the approach of us visitors.

I did not notice anything else unusual in my contact with Alison on this occasion. While we conversed, she maintained eye contact and was attentive as I took off my coat. Assuming the role of hostess while her parents were busy in the kitchen, she made me feel comfortable in her home.

Later in the evening, however, when Alison was out of earshot, her mother, whom I will here call Wendy, told me of questions Alison had asked her about me. “What has happened to Richard’s arm? Did he injure it?” Alison wanted to know.

Wendy was astonished to hear her daughter’s questions and replied: “Why nothing has happened to Richard. His arm was always like that, since it was damaged during his birth.”

Like Wendy, I also was surprised at Alison asking about my arm since, throughout her life, she had seen me dozens of times previously and had had many opportunities to notice the signs of this injury. Never before had she given any indication of recognizing my impairment.

In reflecting later on the girl’s discovery, I attributed it to Alison’s arrival at a new stage of development. Previously, I surmised, she was not able to notice my disability, despite numerous opportunities to do so. She had not matured enough to take note of this kind of defect in an adult. It required more internal growth for her to see me as I really am.

Some adults, it is true, have occasionally failed to notice that my left arm is shorter and smaller than my right. Looking at me from certain angles, they could have missed this fact. But they would not have taken years to discover the bodily defect caused by birth injury.

Incidentally, I do not claim this disability counts as major, comparable to what many other people face. But, like all bodily differences, it has loomed large in my psyche, especially when I was young, and has had an important role in my own personal development.

Thus, aside from the growth in consciousness that I assume this discovery on Alison’s part may reveal, I paid attention to my own response to Wendy’s telling me about the incident. Though she related it to me in the presence of several other friends, I did not recoil in shame and embarrassment as I would have done earlier in my life. Instead, I listened to her anecdote with intense interest, but with most of my attention focused on what was going on in Alison’s adolescent psyche.

I confess, however, to some lurking feelings of defensiveness, but they were lodged in the far background of my psyche rather than in the front of my mind. Not yet am I entirely free of emotional response to remarks about my body image.

Reflecting further on this event, I take this apparently minor incident as an important sign of change in myself. It serves as evidence of my progress in self- acceptance, to my mind the most fundamental of later life’s tasks.

I had come far from the time when I used to stand before three-way mirrors in department stores, trying on new sports coats, and cringing at my own image. Now, after the passage of decades, I can at last accept myself with some equanimity as I actually am rather than as I wish myself to have been.

However, God has not finished with me yet, my life is still not at an end and I still have a distance to travel before that self-acceptance becomes more definitive.

This apparently trivial incident has signaled for me the way younger and older are all in the daily activity of growing interiorly as well as visibly. What we are able to see and how we come to feel about ourselves and our body image form part of the human adventure.

Richard Griffin

Benedictine Spirituality

Does a man who was born somewhere around the year 480 have anything to say to modern-day Americans? If that man is Saint Benedict, the answer is yes.

The spirituality taught by this patron saint of Europe speaks to many people nowadays and not all of them are monks. One such person is Lynn Huber, a resident of Colorado, who draws daily nourishment from Benedictine teaching., After growing up in a different religious tradition, this middle-aged woman discovered Christianity and, in recent years, has become an Episcopal priest.

In a talk given a week ago in Chicago, Ms. Huber laid out the major elements of this spirituality, showing how they can enrich the lives of people living in the world.

The small book of rules that Benedict left for his followers provides a framework for a vibrant spiritual life. Chief among his requirements are vows of obedience, stability, and conversion of life, three ways of finding God.

For Lynn Huber and others like her who choose to become affiliated with a monastery without actually becoming a  monk or nun, the spirit behind the vows has meaning. Obedience implies an effort to see yourself as you really are in the sight of God. It means listening to God in the effort to discover a simplicity of life.

For monks, stability means living one’s whole life in the same monastery. Recognizing both the challenges and the blessings of living with the same people for years, Benedict described this setting as “the place of our wounding and the place of our healing.”  

For those living with a spouse or with other people in the world, this changes the basic question from “Am I going to stay” to “How are we going to make it together?”  In other words, one expects to stay with life partners and one concentrates on making it work.

By contrast with those who commit themselves to stability, we Americans tend to be restless and, on average, move every five years. There is not necessarily anything wrong with frequent moves, but it may make personal relationships more difficult.

St. Benedict called the third vow “conversio morum” or a radical change of behavior. In practice this involves the determination to “seek and serve the Lord in all things.”  For lay people outside the monastery that would mean, among other things, the habit of seeing Christ in every person.

The Benedictine way of life is marked by equal attention to work, prayer, study, and leisure. In the current era when so many people seem to have no time for anything but work, this ideal can serve to remind us of the importance of balance in our life. Sometimes, if we want to give God a greater place in our days, we must learn to slow down.

An effective way of approaching this rhythm of life is to take up the practice of another Benedictine spiritual device called “lectio divina”  or sacred reading. Currently many seekers, among them Lynn Huber,  hold this practice in high regard and use it every day.

You do it by taking four steps:

  1. Lectio, by which you read out loud and slowly a passage from the Bible or other appropriate text
  2. Meditatio, or thinking about it, whereby you let your mind play with whatever strikes you in the reading and pay attention to your feelings about it.
  3. Oratio, or praying about it. You talk with God, sharing with God your thoughts, feelings, desires, hopes, and what ever else moves you.
  4. Contemplation, or sitting with it. This involves listening to God and waiting on God with your eyes closed, your body still, your mind and heart open.

At her talk last week, Lynn Huber led those present in a lectio divina, using Psalm 23, “The Lord Is My Shepherd.”

Many people who have adopted Lectio Divina do it for 20 minutes, twice a day. But this form of prayer is flexible, ready to be adapted to whatever time you have.

These few features of practices handed down by Saint Benedict may suggest the value of his tradition. The beauty of Benedictine spirituality is its simplicity, its way of making the approach to God attractive and adaptable to use by many different kinds of people.

No wonder that Saint Benedict has long been recognized as one of the great masters of the spiritual life.

Richard Griffin

Mr. Rogers

Mr. Rogers was easy to make fun of. Even a person like me, without a talent for mimicry, could have parodied his words and actions. “Won’t you be my neighbor?” could be made to sound mawkish. And his ritual taking off his jacket and outdoor shoes, then putting on a sweater and sneakers, might have been held up to ridicule.

In fact, comedians on television did sometimes parody Mr. Rogers. However, he was obviously too genuine a person for them to do so with  any ill feeling.

After his recent death, the best thing said of him was that he was just as fine a person off screen as he appeared to be on his program. Apparently, his private personality was identical with the TV persona that reached milllions.

In these times, when public image seems far more powerful than private character, the authenticity of Fred Rogers comes as a morale booster. Unless the nation has been terribly taken in, this man was the real thing.

His spirituality goes far to explain why he was able to maintain his personal qualities throughout a television career that lasted almost 50 years. His custom was to rise before five in the morning and then devote two hours to prayer and spiritual reading. In an interview with Kim Shippey, a Christian Science writer, in 2000, he offered more detail: “I read a chapter from the Old Testament and one from the New Testament, and inspirational works by many other writers.”

But Fred Rogers did not conclude his devotions after his morning session. “All day long I offer prayers of gratitude to God for God’s goodness,” he told Ms. Shippey. “I’ll be driving along and I’ll see something and I’ll just say, ‘Thank you, thank you, thank you.’”

Of course this Presbyterian minister was well schooled in the Bible. In his seminary courses he had received training about the sacred scriptures of the Jewish and Christian faiths. But not everybody who studies scripture makes it an integral part of his or her lifestyle. Fred Rogers internalized it so that the Bible fed his soul each day.  

What always impressed me about Mr. Rogers was the love he manifested toward each child who appeared on his program and each child in his television audience. Making the kid feel good about who he or she was went far beyond mere self-esteem therapy. For Mr. Rogers it was a recognition of the human being as God’s handiwork.

Subtly Fred Rogers was doing his own form of ministry. In the television age he had discovered a new way to extend the Lord’s good news to the children of America. No wonder that the day after he died, the student newspaper at our local  university reported that students were mourning his loss.  

When they were growing up, most of them at least, this television personality had been one of their most familiar teachers and they now missed him. It’s true that most children would outgrow him. At a certain point in their development some would become embarrassed if caught still watching him. But later on they might  recognize the unique contribution he had made to their lives.

That contribution rests on the skillful way he taught them the most important things about life. He was an educator in the classic sense of someone who was committed to inculcating values, rather than just facts. What a contrast he made with the Saturday morning cartoons that were typical television fare for so many children!

One of the values most prominent in his programs was human diversity. By treating everyone with respect, no matter their color or origins, this man taught children and other viewers, whatever their age, that each human being deserves to be treated with respect and love.

Yes, many older people watched “Mr. Roger’s Neighborhood.” Of them, he told his interviewer: “There are those who have said to me, ‘I watched your program on such-and-such a day, and you said exactly what I needed to hear.” And I look back at the videotapes and find that wasn’t what I said at all. I think people hear what they are spiritually ready to hear.”

Others may wish to quarrel with me but I believe Fred Rogers to have been a saint for our times.

Richard Griffin