We need meaningful engagement.

My sister often complains that Mom loves to sleep and that she sleeps too much. When we ask her to get up, she responds, “What is there to do?” She thinks she has nothing to do, and it doesn’t matter if she sleeps in.

My students and I visited a nursing home for nuns in Macau. It was 4 p.m. when our visit was almost done. We said goodbye to some of the nuns who were in bed and, before we left, asked one of them if she would like to get up. She said no; she had nothing to do. It was fine for her to lie quietly in bed.

My mother spends a lot of time in bed out of her own choice. I don’t know if it is the same for the nun we met. Although their daily lives are structured–they get up, groom, eat, rest, and go to bed—it it likely that they do so without engaging in activities that are meaningful to them. At least, that is the way I see it.

When kids explore their world by bumping around, we think they are normal; that they are healthy, active kids. When people grow old, we think it is OK for them to lie in bed not doing anything. Why is that OK?

Would my sister and I feel better if my mother got up, sat around and did nothing? Would it make visitors to the nursing home for nuns feel better if Sister got out of bed and sat in a wheelchair, but with nothing to do? By doing so, they would maintain the appearance of being “normal.” So I could happily attend to my own business?

As a gero nurse, I did not fully appreciate the importance of being engaged in life until I encountered these situations. People of all ages need to be engaged in meaningful activities. When they can no longer do this because of cognitive or physical impairment, it is up to us to create a structured world for them that is meaningful. They need to get up, engage in small tasks, talk to people, do things for themselves, or do little things for others. Only with meaningful engagement will our time in this world be worth living.

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

Wet markets: Not super, just better

I love wet markets. I guess many of us do. Wet markets are extremely colorful, full of scents and sounds. A wide variety of goods are on display for sale. Our eyes try to make sense of the myriad colors and textures. Our noses are suddenly awakened to a complex mix of aromas. Our feet move along with those of others in the crowd toward the spots with the greatest commotion. All of these are wonderful moments, making one feel very much alive.

The wet market is a social place, not just a market.

Nowadays, grocery shopping in supermarkets is the norm—clean, highly organized and efficient, but never as attractive. Older people love wet markets, where they can chat with the person selling the goods, some of whom may have become their friends. As “older” customers, they enjoy perks and special privileges. Day in and day out, they make trips to the wet market to buy fresh food to prepare meals for their families. The wet market is a social place, not just a market.

For the younger generation, supermarkets may be the preferred choice. I must confess that I sometimes prefer a supermarket to a wet market, too. I like the fact that, most of the time, I can trust the origins of the foods I buy, that the vegetables I purchase will not rot so easily, because they have not been excessively sprayed with water. Also, the scales work properly and won’t cheat me.

But when I am not in a hurry, when I am in a good mood, I, like our Hong Kong seniors, love to go to a nearby wet market to get the groceries I need. I enjoy seeing people making an honest living out of labor. The wet market is so much more human. You can talk to the person next to you without worrying about whether or not you are observing proper social etiquette. In fact, you are expected to chat with those around you.

The supermarket will never replace the wet market. Just as canned soup will never compare to a mother’s homemade soup.

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

Beauty in numbers

A sweet on the table; you think of kids, or your mouth waters.

A wildflower in a vase; your eyes light up. It delights you.

Plenty of sweets and many different kinds of them; a specific part of your brain suddenly becomes activated. You see a different kind of order.

Lots of flowers blooming at the top of a tree; a pleasurable sensation runs over you. In viewing such a pleasing sight, a pensive you becomes a happy you. There is magic in numbers, and increasing numbers are more magical, except, of course, when something unpleasant becomes alarmingly large, a swarm of locusts, for example.

Do we see beauty in a large number of seniors living together under one roof (in a nursing home)? I hope we do.

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

The long wait finally over?

Years ago—eight or more—some nursing homes in Hong Kong partnered with local hospital teams to provide medical consultations via a telecommunications set-up. It never has worked.

The equipment was set up as planned. Nursing home residents who are too frail to travel and wait long hours in an outpatient department sit in front of a computer in the nursing home. But hospital doctors’ schedules are rather unpredictable, so residents and nurses still have to wait.

After a long wait, residents need to go to the bathroom, or are too tired or in too much pain to remain seated, so they ask to go back to bed. Or the nurse has to answer an urgent phone inquiry, or it’s time to give out meals or medications, and so on and so forth. In the end, the resident or the nurse is not there when the doctor finally shows up at the other end of the telecommunications set-up.

Now, it’s the doctor’s turn to wait and, of course, his or her schedule is too filled to wait for long, and residents are usually not fast enough to connect with a doctor who is always on the go. That’s why this mode of telemedicine doesn’t work.

With smartphones, all these nightmares will disappear. Apps allow residents and others to connect immediately with doctors, and vice versa. Problems associated with lack of portability of telecommunications equipment is no longer a deterrent to the timely consultation needed by seniors, no matter where they are.

Although I am not personally a fan of smartphones, I applaud the advance of technology and all those who put so much effort into popularizing their use.

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

Does iPhone mean it’s all about me?

Social norms are more dynamic than I imagined. It has become acceptable, when a couple goes out for dinner, for each to be absorbed in their own smartphone. Then, I ask, why go out to dinner together? Just to eat at the same table? Is a smartphone more fun in the presence of a person who is not engaged in what you are doing? This puzzles me.

I have also seen younger persons sitting at a table together, all playing with their phones, not looking at each other. This is different from the sight of a child comfortably playing with his or her toys, secure in the knowledge that his mother is around. It seems the person I like to hang out with—go to dinner with—is no longer as interesting as the game I am playing on my iPhone. I am still pondering the deeper meaning of these relatively recent phenomena, which say a lot about how we relate to each other as humans. How will these new norms affect intergenerational communication? Where should we draw the line between acceptable and unacceptable social behavior? These are questions with no easy answers.

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

Dim sum and family: Prescription for blessing

Chinese seniors are easy to please. Traditional older-Chinese folks’ idea of a blessing is simple—having dim sum with the family. Better still, doing so on a regular basis. Going for dim sum in a Chinese teahouse or restaurant is such a deeply rooted cultural behavior that, even to date, it has not gone out of fashion. Young and old alike, we all go for dim sum every now and then—sometimes for morning tea, sometimes for brunch, lunch or even afternoon tea, probably because we Chinese from the southern part of Canton, China, love food.

To a Chinese senior, having dim sum with one’s children and grandchildren is the symbol of a complete family, of being blessed in old age. It is something to boast about if a family can have five generations, all dining together. It is also a source of great delight to the elders.

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

Fashion statement

If one lives long enough, one will see fashions coming full circle. I see clothing styles from my youth becoming fashionable again. Sometimes, when my sisters and I window-shop, we make fun of each other about the dresses displayed. We say that we regret not saving those clothes. If we had been more patient, we would have stayed trendy without having to spend much. But who knows whether out-of-style clothes will make a comeback.

Although some clichéd styles have made a comeback, fashion in a general sense has made some progress. I use the term “progress” because I think the subtlety in trends reflects improvement. While I lament lack of imagination in today’s fashion, I admire its boldness. Nowadays, fashions are more diverse and eccentric. It is as though young people are making loud statements about who they are and what they do. In a certain sense, it is liberating. 

There are no more rules in fashion. While, in the past, everything was symmetrical in design—the collar, the neckline or hemline, the sleeves and the seams—symmetry is no longer in style. Asymmetry rules.

Asymmetry rules!

If, in the past, society subscribed to a common notion of beauty, this is certainly not the case today. There are no more rules for beauty. Character has a higher value. What a person wears is how the person expresses him or herself, and now we have freedom of expression. So there is less group-think and more individualized ways of living. Fashion is no exception.

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