I’m Moving Forward and Facing the Uncertainty of Aging
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It takes a lot of courage to grow old.
I’ve come to appreciate this after conversations with hundreds of older adults over the past eight years for nearly 200 “Navigating Aging” columns.
Time and again, people have described what it’s like to let go of certainties they once lived with and adjust to new circumstances.
These older adults’ lives are filled with change. They don’t know what the future holds except that the end is nearer than it’s ever been.
And yet, they find ways to adapt. To move forward. To find meaning in their lives. And I find myself resolving to follow this path as I ready myself for retirement.
Patricia Estess, 85, of the Brooklyn borough of New York City spoke eloquently about the unpredictability of later life when I reached out to her as I reported a series of columns on older adults who live alone, sometimes known as “solo agers.”
Estess had taken a course on solo aging. “You realize that other people are in the same boat as you are,” she said when I asked what she had learned. “We’re all dealing with uncertainty.”
Consider the questions that older adults — whether living with others or by themselves — deal with year in and out: Will my bones break? Will my thinking skills and memory endure? Will I be able to make it up the stairs of my home, where I’m trying to age in place?
Will beloved friends and family members remain an ongoing source of support? If not, who will be around to provide help when it’s needed?
Will I have enough money to support a long and healthy life, if that’s in the cards? Will community and government resources be available, if needed?
It takes courage to face these uncertainties and advance into the unknown with a measure of equanimity.
“It’s a question of attitude,” Estess told me. “I have honed an attitude of: ‘I am getting older. Things will happen. I will do what I can to plan in advance. I will be more careful. But I will deal with things as they come up.’”
For many people, becoming old alters their sense of identity. They feel like strangers to themselves. Their bodies and minds aren’t working as they used to. They don’t feel the sense of control they once felt.
That requires a different type of courage — the courage to embrace and accept their older selves.
Marna Clarke, a photographer, spent more than a dozen years documenting her changing body and her life with her partner as they grew older. Along the way, she learned to view aging with new eyes.
“Now, I think there’s a beauty that comes out of people when they accept who they are,” she told me in 2022, when she was 70, just before her 93-year-old husband died.
Arthur Kleinman, a Harvard professor who’s now 83, gained a deeper sense of soulfulness after caring for his beloved wife, who had dementia and eventually died, leaving him grief-stricken.
“We endure, we learn how to endure, how to keep going. We’re marked, we’re injured, we’re wounded. We’re changed, in my case for the better,” he told me when I interviewed him in 2019. He was referring to a newfound sense of vulnerability and empathy he gained as a caregiver.
Herbert Brown, 68, who lives in one of Chicago’s poorest neighborhoods, was philosophical when I met him at his apartment building’s annual barbecue in June.
“I was a very wild person in my youth. I’m surprised I’ve lived this long,” he said. “I never planned on being a senior. I thought I’d die before that happened.”
Truthfully, no one is ever prepared to grow old, including me. (I’m turning 70 in February.)
Chalk it up to denial or the limits of imagination. As May Sarton, a writer who thought deeply about aging, put it so well: Old age is “a foreign country with an unknown language.” I, along with all my similarly aged friends, are surprised we’ve arrived at this destination.
For me, 2025 is a turning point. I’m retiring after four decades as a journalist. Most of that time, I’ve written about our nation’s enormously complex health care system. For the past eight years, I’ve focused on the unprecedented growth of the older population — the most significant demographic trend of our time — and its many implications.
In some ways, I’m ready for the challenges that lie ahead. In many ways, I’m not.
The biggest unknown is what will happen to my vision. I have moderate macular degeneration in both eyes. Last year, I lost central vision in my right eye. How long will my left eye pick up the slack? What will happen when that eye deteriorates?
Like many people, I’m hoping scientific advances outpace the progression of my condition. But I’m not counting on it. Realistically, I have to plan for a future in which I might become partially blind.
It’ll take courage to deal with that.
Then, there’s the matter of my four-story Denver house, where I’ve lived for 33 years. Climbing the stairs has helped keep me in shape. But that won’t be possible if my vision becomes worse.
So my husband and I are taking a leap into the unknown. We’re renovating the house, installing an elevator, and inviting our son, daughter-in-law, and grandson to move in with us. Going intergenerational. Giving up privacy. In exchange, we hope our home will be full of mutual assistance and love.
There are no guarantees this will work. But we’re giving it a shot.
Without all the conversations I’ve had over all these years, I might not have been up for it. But I’ve come to see that “no guarantees” isn’t a reason to dig in my heels and resist change.
Thank you to everyone who has taken time to share your experiences and insights about aging. Thank you for your openness, honesty, and courage. These conversations will become even more important in the years ahead, as baby boomers like me make their way through their 70s, 80s, and beyond. May the conversations continue.
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Take Care Of Your “Unwanted” Parts Too!
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Meet The Family…
If you’ve heard talk of “healing your inner child” or similar ideas, then today’s featured type of therapy takes that to several extra levels, in a way that helps many people.
It’s called Internal Family Systems therapy, often “IFS” for short.
Here’s a quick overview:
Psychology Today | Internal Family Systems Therapy
Note: if you are delusional, paranoid, schizophrenic, or have some other related disorder*, then IFS would probably be a bad idea for you as it could worsen your symptoms, and/or play into them badly.
*but bipolar disorder, in its various forms, is not usually a problem for IFS. Do check with your own relevant healthcare provider(s), of course, to be sure.
What is IFS?
The main premise of IFS is that your “self” can be modelled as a system, and its constituent parts can be examined, questioned, given what they need, and integrated into a healthy whole.
For example…
- Exile is the name given to parts that could be, for example, the “inner child” referenced in a lot of pop-psychology, but it could also be some other ignored and pushed-down part of oneself, often from some kind of trauma. The defining characteristic of an exile is that it’s a part of ourself that we don’t consciously allow ourselves to see as a current part of ourself.
- Protector is the name given to a part of us that looks to keep us safe, and can do this in an adaptive (healthy) or maladaptive (unhealthy) way, for example:
- Firefighter is the name given to a part of us that will do whatever is necessary in the moment to deal with an exile that is otherwise coming to the surface—sometimes with drastic actions/reactions that may not be great for us.
- Manager is the name given to a part of us that has a more nurturing protective role, keeping us from harm in what’s often a more prophylactic manner.
To give a simple illustration…
A person was criticized a lot as a child, told she was useless, and treated as a disappointment. Consequently, as an adult she now has an exile “the useless child”, something she strives to leave well behind in her past, because it was a painful experience for her. However, sometimes when someone questions and/or advises her, she will get defensive as her firefighter “the hero” will vigorously speak up for her competence, like nobody did when she was a child. This vigor, however, manifests as rude abrasiveness and overcompensation. Finally, she has a manager, “the advocate”, who will do the same job, but in a more quietly confident fashion.
This person’s therapy will look at transferring the protector job from the firefighter to the manager, which will involve examining, questioning, and addressing all three parts.
The above example is fictional and created for simplicity and clarity; here’s a real-world case study if you’d like a more in-depth overview of how it can work:
How it all fits together in practice
IFS looks to make sure all the parts’ needs are met, even the “bad” ones, because they all have their functions.
Good IFS therapy, however, can make sure a part is heard, and then reassure that part in a way that effectively allows that part to “retire”, safe and secure in the knowledge that it has done what it needed to, and/or the job is being done by another part now.
That can involve, for example, thanking the firefighter for looking after our exile for all these years, but that our exile is safe and in good hands now, so it can put that fire-axe away.
See also: On Being Reactive vs Being Responsive
Questions you might ask yourself
While IFS therapy is best given by a skilled practitioner, we can take some of the ideas of it for self-therapy too. For example…
- What is a secret about yourself that you will take to the grave? And now, why did that part of you (now an exile) come to exist?
- What does that exile need, that it didn’t get? What parts of us try to give it that nowadays?
- What could we do, with all that information in mind, to assign the “protection” job to the part of us best-suited to healthy integration?
Want to know more?
We’ve only had the space of a small article to give a brief introduction to Family Systems therapy, so check out the “resources” tab at:
IFS Institute | What Is Internal Family Systems Therapy?
Take care!
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Why Telomeres Shorten, & What Can Be Done About It
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Telomeres are protective caps at the ends of our DNA, similar to the plastic tips on shoelaces (there’s a repeated “junk DNA” string, TTAGGG in humans, kept safe in a sheathe, which made of shelterin, a protein complex).
They prevent our genetic material from becoming damaged or tangled. However, each time a cell divides, telomeres get a little shorter because the copying process isn’t perfect (DNA polymerase can’t replicate everything inside the sheathe, because it is too well-protected).
So, how do we deal with this?
Lacing up for long life
An enzyme called telomerase (discovered as recently as 2009 by Nobel Prize-winning scientists Dr. Elizabeth Blackburn et al.) can rebuild telomeres. It has two main parts: one part1 that makes new DNA and another part2 that acts as a guide. Most cells don’t produce enough telomerase, so telomeres still tend to shrink over time.
1 TERT (Telomerase Reverse Transcriptase), which synthesizes telomeric DNA
2 TERC (Telomerase RNA Component), which serves as a templateWhen telomeres become too short, cells stop dividing. Some cells may enter a damaged state (e.g. senescent “zombie” cells) or die. In some cases, cells bypass this limit by reactivating telomerase, which can lead to cancer.
Studies on mice show that when telomerase is missing, they age more quickly and struggle to repair tissues. When telomerase is restored, aging effects are reversed. Human research also links short telomeres to age-related diseases like immune system decline and organ damage.
Researchers have already found some ways to slow aging by:
- Activating telomerase (e.g. with small molecules like TA-65).
- Gene therapy to transiently express telomerase.
- Stabilizing TERC RNA component to prevent degradation.
However, increasing telomerase too much could raise the risk of cancer. So, it’s a bit of a juggling act yet.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Fisetin: The Anti-Aging Assassin ← kills senescent cells, meaning newer cells are copied rather than older ones, resulting in copied cells with less DNA damage
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What is PNF stretching, and will it improve my flexibility?
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Whether improving your flexibility was one of your new year’s resolutions, or you’ve been inspired watching certain tennis stars warming up at the Australian Open, maybe 2025 has you keen to focus on regular stretching.
However, a quick Google search might leave you overwhelmed by all the different stretching techniques. There’s static stretching and dynamic stretching, which can be regarded as the main types of stretching.
But there are also some other potentially lesser known types of stretching, such as PNF stretching. So if you’ve come across PNF stretching and it piques your interest, what do you need to know?
Undrey/Shutterstock What is PNF stretching?
PNF stretching stands for proprioceptive neuromuscular facilitation. It was developed in the 1940s in the United States by neurologist Herman Kabat and physical therapists Margaret Knott and Dorothy Voss.
PNF stretching was initially designed to help patients with neurological conditions that affect the movement of muscles, such as polio and multiple sclerosis.
By the 1970s, its popularity had seen PNF stretching expand beyond the clinic and into the sporting arena where it was used by athletes and fitness enthusiasts during their warm-up and to improve their flexibility.
Although the specifics have evolved over time, PNF essentially combines static stretching (where a muscle is held in a lengthened position for a short period of time) with isometric muscle contractions (where the muscle produces force without changing length).
PNF stretching is typically performed with the help of a partner.
There are 2 main types
The two most common types of PNF stretching are the “contract-relax” and “contract-relax-agonist-contract” methods.
The contract-relax method involves putting a muscle into a stretched position, followed immediately by an isometric contraction of the same muscle. When the person stops contracting, the muscle is then moved into a deeper stretch before the process is repeated.
For example, to improve your hamstring flexibility, you could lie down and get a partner to lift your leg up just to the point where you begin to feel a stretch in the back of your thigh.
Once this sensation eases, attempt to push your leg back towards the ground as your partner resists the movement. After this, your partner should now be able to lift your leg up slightly higher than before until you feel the same stretching sensation.
This technique was based on the premise that the contracted muscle would fall “electrically silent” following the isometric contraction and therefore not offer its usual level of resistance to further stretching (called “autogenic inhibition”). The contract-relax method attempts to exploit this brief window to create a deeper stretch than would otherwise be possible without the prior muscle contraction.
The contract-relax-agonist-contract method is similar. But after the isometric contraction of the stretched muscle, you perform an additional contraction of the muscle group opposing the muscle being stretched (referred to as the “agonist” muscle), before the muscle is moved into a static stretch once more.
Again, if you’re trying to improve hamstring flexibility, immediately after trying to push your leg towards the ground you would attempt to lift it back towards the ceiling (this bit without partner resistance). You would do this by contracting the muscles on the front of the thigh (the quadriceps, the agonist muscle in this case).
Likewise, after this, your partner should be able to lift your leg up slightly higher than before.
The contract-relax-agonist-contract method is said to take advantage of a phenomenon known as “reciprocal inhibition.” This is where contracting the muscle group opposite that of the muscle being stretched leads to a short period of reduced activation of the stretched muscle, allowing the muscle to stretch further than normal.
What does the evidence say?
Research has shown PNF stretching is associated with improved flexibility.
While it has been suggested that both PNF methods improve flexibility via changes in nervous system function, research suggests they may simply improve our ability to tolerate stretching.
It’s worth noting most of the research on PNF stretching and flexibility has focused on healthy populations. This makes it difficult to provide evidence-based recommendations for people with clinical conditions.
And it may not be the most effective method if you’re looking to improve your flexibility in the long term. A 2018 review found static stretching was better for improving flexibility compared to PNF stretching. But other research has found it could offer greater immediate benefits for flexibility than static stretching.
At present, similar to other types of stretching, research linking PNF stretching to injury prevention and improved athletic performance is relatively inconclusive.
PNF stretching may actually lead to small temporary deficits in performance of strength, power, and speed-based activities if performed immediately beforehand. So it’s probably best done after exercise or as a part of a standalone flexibility session.
Static stretching may be a more effective way to improve flexibility over the long-term. GaudiLab/Shutterstock How much should you do?
It appears that a single contract-relax or contract-relax-agonist-contract repetition per muscle, performed twice per week, is enough to improve flexibility.
The contraction itself doesn’t need to be hard and forceful – only about 20% of your maximal effort should suffice. The contraction should be held for at least three seconds, while the static stretching component should be maintained until the stretching sensation eases.
So PNF stretching is potentially a more time-efficient way to improve flexibility, compared to, for example, static stretching. In a recent study we found four minutes of static stretching per muscle during a single session is optimal for an immediate improvement in flexibility.
Is PNF stretching the right choice for me?
Providing you have a partner who can help you, PNF stretching could be a good option. It might also provide a faster way to become more flexible for those who are time poor.
However, if you’re about to perform any activities that require strength, power, or speed, it may be wise to limit PNF stretching to afterwards to avoid any potential deficits in performance.
Lewis Ingram, Lecturer in Physiotherapy, University of South Australia and Hunter Bennett, Lecturer in Exercise Science, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
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Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
First things first… How much fiber should we be eating?
- The World Health Organization recommends we each get at least 25g of fiber per day:
- A more recent meta-review of studies, involving thousands of people and decades of time, suggests 25–29g is ideal:
- The British Nutritional Foundation gives 30g as the figure:
- The US National Academy of Sciences’ Institute of Medicine recommends 21g–38g per day, depending on age and sex:
- A large study last year gave 30–40g as the figure:
*This one is also a great read to understand more about the “why” of fiber
Meanwhile, the average American gets 16g of fiber per day.
So, how to get more fiber, without piling on too many carbs?
Foods that contain fiber generally contain carbs (there’s a limit to how much celery most people want to eat), so there are two key ideas here:
- Getting a good carb:fiber ratio
- Making substitutions that boost fiber without overdoing (or in some case, even changing) carbs
Meat → Lentils
Well-seasoned lentils can be used to replaced ground beef or similar. A cup of boiled lentils contains 18g of fiber, so you’re already outdoing the average American’s daily total.
Meat → Beans
Black beans are a top-tier option here (15g per cup, cooked weight), but many kinds of beans are great.
Chicken/Fish → Chickpeas
Yes, chicken/fish is already meat, but we’re making a case for chickpeas here. Cooked and seasoned appropriately, they do the job, and pack in 12g of fiber per cup. Also… Hummus!
Bonus: Hummus, eaten with celery sticks.
White pasta/bread → Wholewheat pasta/bread
This is one where “moderation is key”, but if you’re going to eat pasta/bread, then wholewheat is the way to go. Fiber amounts vary, so read labels, but it will always have far more than white.
Processed salty snacks → Almonds and other nuts
Nuts in general are great, but almonds are top-tier for fiber, amongst other things. A 40g handful of almonds contains about 10g of fiber.
Starchy vegetables → Non-starchy vegetables
Potatoes, parsnips, and their friends have their place. But they cannot compete with broccoli, peas, cabbage, and other non-starchy vegetables for fiber content.
Bonus: if you’re going to have starchy vegetables though, leave the skins on!
Fruit juice → Fruit
Fruit juice has had most, if not all, of its fiber removed. Eat an actual juicy fruit, instead. Apples and bananas are great options; berries such as blackberries and raspberries are even better (at around 8g per cup, compared to the 5g or so depending on the size of an apple/banana)
Processed cereals → Oats
5g fiber per cup. Enough said.
Summary
Far from being a Herculean task, getting >30g of fiber per day can be easily accomplished by a lentil ragù with wholewheat pasta.
If your breakfast is overnight oats with fruit and some chopped almonds, you can make it to >20g already by the time you’ve finished your first meal of the day.
Enjoy!
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Fluoride Toothpaste vs Non-Fluoride Toothpaste – Which is Healthier?
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Our Verdict
When comparing fluoride toothpaste to non-fluoride toothpaste, we picked the fluoride.
Why?
Fluoride is indeed toxic; that’s why it’s in toothpaste (to kill things; namely, bacteria whose waste products would harm our teeth). However, we are much bigger than those bacteria.
Given the amount of fluoride in toothpaste (usually under 1mg per strip of toothpaste to cover a toothbrush head), the amount that people swallow unintentionally (about 1/20th of that, so about 0.1mg daily if brushing teeth twice daily), and the toxicity level of fluoride (32–64mg/kg), then even if we take the most dangerous ends of all those numbers (and an average body size), to suffer ill effects from fluoride due to brushing your teeth, would require that you brush your teeth more than 23,000 times per day.
Alternatively, if you were to ravenously eat the toothpaste instead of spitting it out, you’d only need to brush your teeth a little over 1,000 times per day.
All the same, please don’t eat toothpaste; that’s not the message here.
However! In head-to-head tests, fluoride toothpaste has almost always beaten non-fluoride toothpaste.
Almost? Yes, almost: hydroxyapatite performed equally in one study, but that’s not usually an option on as many supermarket shelves.
We found some on Amazon, though, which is the one we used for today’s head-to-head. Here it is:
However, before you rush to buy it, do be aware that the toxicity of hydroxyapatite appears to be about twice that of fluoride:
Scientific Committee on Consumer Safety Opinion On Hydroxyapatite (Nano)
…which is still very safe (you’d need to brush your teeth, and eat all the toothpaste, about 500 times per day, to get to toxic levels, if we run with the same numbers we discussed before. Again, please do not do that, though).
But, since the science so far suggests it’s about twice as toxic as fluoride, then regardless of that still being very safe, the fluoride is obviously (by the same metric) twice as safe, hence picking the fluoride.
Want more options?
Check out our previous main feature:
Less Common Oral Hygiene Options
(the above article also links back to our discussion of different toothpastes and mouthwashes, by the way)
Take care!
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The Immune System Recovery Plan – by Dr. Susan Blum
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The subtitle of the book is “A Doctor’s 4-Step Program to Treat Autoimmune Disease”, so we’ll not keep the four steps a secret; they are:
- Using food as medicine
- Understanding the stress connection
- Healing your gut and digestive system
- Optimizing liver function
Each of these sections gives a primer in the relevant science, worksheets for personalizing your own plan to your own situation, condition, and goals, and of course lots of practical advice.
This is important and perhaps the book’s greatest strength, since there are dozens of possible autoimmune conditions, and getting a professional diagnosis is often a long, arduous process. So while this book can’t necessarily speed that up, what it can do is give you a good head-start on managing your symptoms based on things that are most likely to help, and certainly, there will be no harm trying.
While it’s not primarily a recipe book, there are also recipes targeting each part of the whole, as well as an extensive herb and supplement guide, before getting into lots of additional resources.
Bottom line: if you are, or suspect you are, suffering from an autoimmune condition, the information in this book can make your life a lot easier.
Click here to check out The Immune System Recovery Plan, and help yours to help you!
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