So what do we do after retirement?

I used to tell my sister to keep working and not retire too soon. If we live until 90 or 100 years of age, which doesn’t seem so unbelievable, then retiring at 60 or so means spending a third of our lives not engaged in full-time employment. And that is a long time. Work has many advantages, as we all know. It keeps us in touch with the world, helps maintain social contacts, brings in income and daily gives us a sense of purpose and usefulness. If the job is also interesting and meaningful to us, so much the better.

In Hong Kong, the retirement age is 55 for civil servants and 60 for employees of most companies and agencies. There has been talk of deferring the retirement age to 65 for certain jobs, such as that of academics.

I think that women (or men) who stay home to raise their kids are wonderful. Their children are so blessed. It is an extremely important job but often not recognized. I think that women who try to be working moms are superwomen. It is not easy dealing with competing roles.

If I say that females are the tougher sex, will I be called a sexist?

Inventory on display.

Open and ready for business.

Waiting for another passenger.

May I help you?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Form over substance

Appearance (or should I say packaging?) is overrated, but it is all we are focusing on these days—the presentation, the form, the look. As a teacher, I am sometimes frustrated by the demand or expectation that every lecture I give must be entertaining and that it should use the latest technology, or whatever is in vogue.

I wonder whether people in the audience (be they be the public or students) realize the amount of time that is needed to produce some interactive elements or to build some simulation exercises into a lecture. The use of multimedia in teaching is quickly becoming the norm, but it takes a tremendous amount of time to get the prep work done.

Some would argue that it is only the initial setup that is time consuming, that after that’s done it becomes easier. Not always. Imagine that you have produced a video clip and made a certain point (fact or argument, it doesn’t really matter). Later on, you want to revise your statement based on the latest research findings. What do you do then? Redo the entire video shooting or just make a corrective statement at the end of your clip?

I once watched a TV program about how a researcher in one of the local universities was trying to use virtual simulation, using computers to help children who were autistic. I cannot convince myself that this is a good idea at all. Imagine all the resources and effort required to produce a virtual simulation environment. But a child does not need a game. The child needs a person who loves, cares about and understands him or her and his or her condition, someone who is able to teach things and be patient when the child fails to cope with the demands of the situation and becomes withdrawn. Also, there is no guarantee that the skills one has learnt in a simulation environment can be transferred into real life.

Yes, I am aware that we must move on, that it is only with repeated use of technology that we become proficient. But the essence is not in the novelty of a communication technology. The essence is about the human connection. Nothing can replace it, not Facebook, not Twitter.

Nobody these days seems to be able to sit through lectures and concentrate on the knowledge—the substance—shared by the speaker. Yes, I am aware that, to learn, students need to be interested. Anything that is multimedia is, of course, interesting, more interesting than the words or syllables that make up the sound of words.

But, as a teacher, I do not believe it is my business to put on a show in every class I teach. Is that really necessary? What is the role of students in learning? Is it to learn only if the subject matter or the presenter is interesting? Unfortunately, what is interesting is different for different individuals.

I believe I need to motivate students to learn. I believe that, sometimes, my time is better spent on efforts to make the content of my talk cutting-edge knowledge. When time is short, my choice is always the substance, not the form.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Integration: The final developmental challenge of older adults

According to Erik Erikson, a person’s last developmental task in life is to overcome the psychosocial task of “integration and despair.” Either you integrate your life experiences and rise above them or become desperate for failing to meet the challenge.

I have read Erikson’s writings about the psychosocial task of old age. I have even discussed his perspectives in an assignment for a master’s course I took. But do I really know what integration means?

Does it mean making meaning out of one’s entire life experience? Does integration require us to determine what achievements we have made in our long life? Or to accept the fact that we really are small beings and have led ordinary lives? Does it involve finding out which relationships still bother us and settling all grudges with those we dislike? If that is not possible, does it mean we accept that we will never be able to make peace with those people we can no longer reach, to let it go and not let it bother us again? Or is it about forgiving ourselves for being silly, cruel, vain and stupid at various times in our lives?

What is integration, really? Is it possible? How do you forgive yourself for the tempers you have thrown and the cruel things you have said or done to people? How do you integrate odd and unsettling experiences that, over the years, you purposely have tried to forget? How can things be put into perspective when you cannot make sense out of these weird experiences?

Can integration occur if, after long introspection, you don’t like who you are or have far too many regrets? Can it happen only when you can see yourself in a positive light?

How, in old age, do we integrate all the things that have happened to us over a lifetime? As a gerontologist and a person, I am intrigued. I realize that I don’t really know.

Older people have a lot of work to do in meeting this developmental challenge. And only they can provide firsthand knowledge.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

“All older people are vulnerable.”

The above statement is from the lecture notes of an established global nurse leader at a conference on institutional care of older people, which I attended recently. The statement caught me by surprise. No offense intended, but I could not disagree more.

First, it’s patronizing. I don’t think all older people hold similar beliefs about themselves. I think health professionals should be caring and empathic, but certainly not patronizing. We do not always know what is best for others. We would like to think we do, but we don’t, at least not always.

Second, the message seems to imply that people can be categorized purely on the basis of age, according to whether they are fully capable of looking after their own affairs or not. In our society, we generally agree that children and disabled people are vulnerable and require protection, but if we follow the conference speaker’s logic, it would mean that only those in the well adult population are fully capable beings. So where does that leave us? Should we allow only well adults to lead the world?

Vulnerability should be perceived as a multi-dimensional concept when applied to humanity and should be not used as a descriptive label. A disabled person can be physically handicapped and, therefore, vulnerable to environmental barriers they come across in their daily life. A physically frail person can be vulnerable, in that he or she easily falls ill. A terminally ill person may be vulnerable to “assaults” on his or her humanity when the need for analgesics is ignored. A cognitively impaired older person may be vulnerablebecause his or her power of discretion is compromised.

But not all older people are vulnerable. They should not be. An elder with no loss of mental faculties, even though physically frail, can adequately manage his or her own affairs. Whenever we refer to the vulnerability of older adults, qualifying statements are required so that we are not disempowering our older clients.

The first baby boomers reached 65 in 2006. Let us not forget that future cohorts of older people are better educated and economically more secure than their predecessors. They certainly are in a much better position to manage their own affairs, and we should respect that.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. 

Engagement in life

I came across a new term, “the potentialist,” in an inflight magazine aboard Air Canada on my annual visit to Toronto to see my mother. A potentialist is someone who lives life to the fullest. I love the idea. The magazine was describing a couple who, in late adulthood, have found new meaning in life and want to spend every minute of it doing meaningful things, such as tapping into their physical potential, combining vacation with charitable activities, and so on. This is admirable. I have a lot of respect for such an attitude toward life. But wouldn’t it be extremely tiring as well?

There is a Chinese saying about the careful use of time that we all learnt when we were small. I don’t think elementary schools teach these things nowadays, because I have never heard kids talk about it. “An inch of time is like an inch of gold. Yet, an inch of gold cannot buy an inch of time.” What an apt description, if you truly love time.

As children, we were indoctrinated into believing the idea that we shouldn’t waste time. I would feel terribly guilty if I wasted any significant blocks of time. I love to account for things I do. Checking off tasks on a list gives me a sense of control and, more importantly, a sense of accomplishmentand the confidence that I have not wasted my life away.

Yet, I am aware that I am not that self-disciplined. I have wasted and still do waste my time every now and then, largely by doing nothing, doing silly things, or doing things that are unimportant while many more-important tasks lie there awaiting my attention. I can’t help it. I am only human.

I bet nurses are all more or less alike. We multitask a great deal, we hate to waste time and we like to check items off lists. Although, when I think about it, I don’t know if it is because we are nurses, or the fact that most nurses are female, that we exhibit such behavioral characteristics. Quite honestly, I can’t tell.

Coming back to where I started, I would love to be a potentialist sometimes, maybe more often than not. Still, not all the time. Not for me.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Are we set in our ways?

Are we set in our ways when we grow old? Do we become more stubborn in our old age? People ask questions about the possibility of changes in personality in older age.

Stage theorists maintain that personality changes over time, as a person progresses from one stage to another. Trait theorists argue that personality is stable, and cite personality-inventory studies indicating that a person’s traits remain stable during adulthood.

Life-span theorists of human development pose that human beings have considerable potential for becoming what they want to become and accomplish in a lifetime. However, other theorists suggest it is people’s habits that change—habits related to health, vigor, responsibilities and life circumstances—and not their basic personalities. In short, the foregoing can be interpreted to mean that many so-called personality differences are generational.

Is it not reassuring, then, to know that the theory that “as one grows older, one becomes more stubborn” has been debunked? If we are flexible and adaptable when we are young, we will still be flexible and adaptable when we grow old. If we are rigid in our ways at a young age, we will likely remain so as we accumulate years in life.

It is unfair to associate old age with stubbornness. The other message to take home is that, to better prepare for old age, we should nurture open-mindedness and adaptive coping responses.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Fast-changing images

My eldest sister used to live in Wanchai, on the island of Hong Kong. She died of stomach cancer in March 2010. Because she lived there for so many years after getting married—not in the same apartment but in the same district—I knew the area pretty well, too, because I visited her often, ever since I was a child.

I knew the streets, the buildings and the shops. I still go to my sister’s place, because that is where my cousins live. Because I visit the area quite often, I can usually follow the changes that are occurring in the landscape.

I wasn’t quite prepared for what I saw one day, though. Traveling on the tram from Central to Wanchai, I tried to look outside the tram window, through a packed carriage full of passengers, to see if I had reached my stop. I knew I would be close. I was somewhat taken aback by the view of an unfamiliar landscape. The shops and neon lights that met my eyes were unfamiliar to me. Where were the places I once knew?

As in all fast-growing economies, Hong Kong is one of the places in the world that undergoes frequent and rapid changes to her city landscape.

If I become sentimental about lost images in a city, what is it like for our senior citizens? Whenever I teach introductory concepts of age and aging, I ask my students to try to imagine what seniors in their 80s or 90s must have gone through. A senior who is 90 years of age would have gone through the First World War, the Second World War, the war against Japanese occupation (1937-45), the Chinese Civil War (1945-49) and the Cultural Revolution of China (1966-76).

I try to help my students understand why seniors like to save and not waste anything, and why they go a long way to save a few pennies. I hope that, through such reflections, young people will come to appreciate that such “odd” behaviors represent strengths, not weaknesses. However, I have never asked my students to imagine the landscape changes seniors have seen in their lifetimes.

If we consider for a moment what seniors have gone through, it must be a most amazing experience. They have been to places we have not and seen things we have not. We should know, therefore, that all seniors likely have something to teach us, regardless of their background or educational level.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.