The difference between 'people anxious about old age' and 'people who are not' that I saw at a special nursing home. What an occupational therapist who has cared for nearly 100 people wants to convey

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My father retired from Panasonic at the age of 65.

For two years until he was 67, he did nothing. He was just at home, and since my mother was working full-time, their interaction became extremely limited.

One day, my wife said.

"Lately, your father's hearing has gotten worse, and I wonder if his cognitive functions are declining?"

My wife is a full-time homemaker and has more opportunities to interact with my father than I do. As a physical therapist, her observational skills are sharp.

I asked my father, "Are you looking for work?" He just replied, "Oh, slowly but surely," and didn't seem to be looking very actively. He might have been being picky.

Rather than letting him develop dementia like this, I introduced my father to a job at a special nursing home. It involved tasks like driving, washing company vehicles, and inspecting and repairing equipment.

My father's expression changed. He began working from morning until evening, looking as lively as he used to.

A year has passed since then. Now, he is a fine day-service driver, transporting users without any falls or accidents. Although most of the staff are younger than him, he has become someone they can rely on.

I am nothing but happy about this.

This experience became one of the triggers for me to think about anxiety in old age.

The person who refused admission to a special nursing home from the hospital

I once spent two hours persuading someone who refused admission to a special nursing home from the hospital.

Their dementia had progressed, and they couldn't understand "Where am I?" or "Why am I being brought here?" Their family was there too. I couldn't just carry them in by force. So, I spent two hours listening to them, explaining things little by little, and waiting until they were convinced.

That person was clearly anxious.

I have worked at a special nursing home for over seven years and have cared for nearly 100 people. I have noticed something during that time.

There is a clear difference between people who are anxious about old age and those who are not.

Common characteristics of anxious people

When observing their state at the time of admission, there is a common pattern among people with strong anxiety.

It is common in men. They cling to their own ideas. Showa-era men who have high pride and a mentality that it is natural to have things done for them tend to have particularly strong anxiety.

Men who lose their wives first are prone to dementia. Of course, this is not true for everyone. My grandfather is 95 and lives alone, but he is still doing well. However, statistically speaking, many men experience a rapid decline in cognitive function after losing their wives.

And above all, those who have lost their roles. Like my father, people who stopped doing anything after retirement see their cognitive function decline in the blink of an eye.

Upon admission, they are so preoccupied with their belongings and anxiety about 'what will happen from now on' that their expressions are stiff. They have no room to look at the surrounding staff or environment.

Conversely, people with less anxiety have the room to observe the outside world regarding a new environment, wondering, 'What kind of place is this?' It might be easy to understand if you think of it as the feeling of tinkering with the initial settings of a device. They first look around and try to understand.

Commonalities of people who are not anxious (calm people)

People who have a sense of contribution to others and can naturally say 'thank you' to the staff are extremely calm.

This is close to what Adlerian psychology calls 'community feeling.' The feeling that you are useful to someone and that someone is grateful to you stabilizes the mind.

My father was like that, too. By safely delivering users in his transport job, he was able to feel that he was useful to someone. By being relied upon by younger staff, he could feel a sense of belonging. That protected my father's cognitive function.

Conversely, people with an attitude of 'it is natural to have things done for me' are always harboring dissatisfaction. Even when receiving the same care, the expressions of those who are grateful and those who are not are completely different.

An episode of a 'person who has prepared'

I remember a user who lived alone and had hemiplegia.

They were someone who was admitted because life at home became difficult. They could do things to a certain extent, but there were situations where assistance was needed. When the care staff helped, they would show a smile and say, 'Thank you. That helps.'

I felt that from the time they were healthy, they had accumulated the habit of contributing to others and expressing gratitude.

In fact, that person had many people—family, acquaintances, and friends—come to visit. I thought they must be a very loved person.

I think this is the essence of 'preparation for old age.'

Money, health, human relationships: which is the most important?

As an occupational therapist, I can say this from the experience of having attended to nearly 100 people.

The most important thing is human relationships (community feeling).

Even if they have money, lonely residents look sad. Even if they are healthy, if they have no one to talk to, their cognitive function will decline.

As Adler says, 'all problems are interpersonal relationship problems,' but conversely, 'all happiness is also found in interpersonal relationships.'

If you have relationships where you can say 'help me,' you can cover for a lack of money or health to some extent.

It was the same for my father. Even with money and health, his cognitive function declined just by staying at home. But the moment he found a place to belong at work and his interactions with people returned, my father came back to life.

Things you can do now to reduce anxiety about old age

As an OT, I have an answer I can say from real experience.

It is to 'have multiple roles.'

I want you to cultivate an identity outside of work. Note, games, local communities, anything is fine.

Muscles and savings are also important. But in the end, the subjective feeling that 'I am useful to someone' (community feeling) creates an unbreakable heart.

A Pokémon GO community, mahjong friends, or a tennis circle are all fine. Diversifying where you belong is the ultimate risk hedge.

If work is your only identity, it will collapse all at once after retirement. But if you have multiple places to belong, even if one is lost, the others will support you.

My father needed a place to belong called work. When that was gone, his cognitive function began to decline. But the moment he gained a new role, he began to shine again.

Old age is not a 'process of losing'

It is often thought that old age is a 'process of losing.'

Physical strength declines. Memories become vague. The things you cannot do increase.

But from an OT's perspective, old age is a 'process of reconstructing a new self.'

My father retired from a large company at 65. He lost his identity up to that point once. But at 67, he gained a new role and reconstructed a new self.

Even if the things you cannot do increase, you can create new relationships in a new environment. You can be someone who can say 'thank you' to others.

I want you to shift your focus from 'what you have' to 'how you live' starting now.

Just by doing that, the scenery of the future should become a little brighter.

Occupational therapist, 16th year. Working at a special nursing home. Former dementia care instructor and manager. HSP/ISFJ. I work at the same workplace as my father.

Recommended reading and listening

Thank you for reading this article to the end. 'Anxiety about old age' cannot be wiped away by money or health alone. Ultimately, I have learned from many people in the field that what protects us in the end is warm human relationships where we can say 'thank you' to each other.

If you are currently thinking about your own or your family's 'future way of life,' these articles should also be helpful to you.

🌿 Thinking about 'old age' and the 'essence of living'

In the process of experiencing the end-of-life care of nearly 100 people, I have written about the commonalities of 'people who live true to themselves until the end' and tips for having no regrets.

• 'Commonalities of people who are energetic until the end, as seen by an occupational therapist who attended to nearly 100 people in a special nursing home'

• 'The difference between 'people who regret at the end' and 'those who do not,' as seen in a special nursing home'

• 'If the last 1% is happy, that person's life is happy: What an occupational therapist who attended to 100 people in a special nursing home wants to convey'

💡 To let go of anxiety and build good relationships

These are tips for fostering the 'sense of community' I talked about in the article. I have written about the practice of Adlerian psychology and how I have let go of my own anxiety about human relationships.

• 'The Courage to be Disliked felt cold to me as an HSP/ISFJ at first. But even 13 years later, it remains the axis of my life'

📖 For those who want to 'check their answers' on how to work and live (Kindle)

The human relationships and physical/mental health that enrich old age are an extension of your current 'way of working.' I have compiled the ways of thinking I found over 16 years to survive while remaining kind into one book.

• Book: 'A Way of Working That Stays Kind and Doesn't Wear You Out'

🎧 Relax while listening (YouTube)

'I don't even have the energy to read text right now...' On nights like that, please try taking it in through your ears like listening to the radio. I deliver stories about the mind and body in a YouTube podcast format.

• Kiri no Ha Official YouTube 'Occupational Therapist's Podcast'

The stretch pole I love and use every day

A stretch pole is essential for physical care in old age.

As an occupational therapist, and because I have been using it myself every day for over 10 years, I can recommend it with confidence.