Ideas
Old Like Me
The hottest subject in sensitivity training? The elderly.


My feet hurt. My knees are so stiff that walking has become a chore. When I climb stairs, I’m out of breath by the time I reach the top. It takes a special effort just to tie my shoes. My vision is so poor that I require a caregiver to accompany me on my morning stroll. I can barely hear when she asks what I’d like for a snack. But it doesn’t matter anyway. Food just doesn’t taste the same as it once did.

After I’m told I’ve been eating an oatmeal cookie, I face an even worse indignity: shuffling and feeling my way, alone, into the men’s room — or at least I hope it is the men’s room. After fumbling with my zipper, I can barely make out the urinal. It is my sincere hope that my aim is true. As I exit, I’m nearly knocked backward by a couple of young guys barreling through the door. “Damn kids!” is what I want to shout.

This, apparently, is what they call aging. I’m told that my tribulations are common, and I’ll likely be labeled a complainer around the senior center. Aging is not for sissies, I’m told. But here’s the big difference. Twenty-five minutes ago I was a relatively fit 37-year-old. Not a triathlete, but certainly someone who didn’t need help opening a pill bottle. Now I am suddenly old and feeble. Allow me to be perfectly candid: It really sucks.

I’m undergoing an aging simulation administered by Monika Deppen Wood, a sociology professor at Rutgers University in Camden, New Jersey. Wood teaches an undergraduate course called the Sociology of Aging, in which she requires all of her students to undergo the same simulation. “Reading about aging is not the same as experiencing it,” Wood says.

So my aging is all a fake. My feet hurt because I have dried corn kernels in my shoes. My stiff knees are due to tight, restrictive bandages. My hearing loss is due to earplugs. I am forced to breathe through a straw, simulating diminished lung capacity. I’m wearing oversized latex gloves, with restrictive tape wrapped around my joints, to suggest the loss of touch and dexterity. I have a cotton ball stuffed in one nostril that takes away my sense of taste.

The most profound impairment is, of course, my loss of sight, created by special glasses that simulate the fuzzy blur of cataracts. “What type of vision impairment would you like?” Wood asked as she handed me glasses that were altered to simulate the following: cataract, macular degeneration, and glaucoma. I chose cataracts, since those glasses seemed to be the most cheat-proof.

As Wood guides me around the Rutgers campus, I am unable to read most of the signs we pass. At some points, I can sense someone approaching us on the path, but only see them flicker into my sight when they are nearly face-to-face with me. The effect is disorienting and more than a little scary.

In about an hour, we return to Wood’s office and I — unlike a real old person — get to remove all of my impairments. I’m (relatively) young again!

But there is still another exercise left, one that she calls an “unfair hearing test.” I listen to a tape in which I hear a list of ten words, filtered and spoken softly, as if I have a slight high frequency hearing loss. I must write down the words I hear. “We have rigged the test to prove a point,” says the voice on tape.

This is what I hear: the word “catch” sounds like “kept”; the word “thumb” sounds like “friend”; “wedge” sounds like “red”; “choose” inexplicably sounds like “sold.”

“We said it was an unfair hearing test,” says the voice.

Point proven. I fail the hearing test miserably, guessing only two out of ten.

Several years ago, Wood published a paper on her walk-a-mile-in-my-shoes methodology in the journal Gerontology & Geriatrics Education. The students in Wood’s sociology course are mostly liberal arts majors from across many disciplines—they’re generally not studying to be gerontologists, or even to go into a healthcare profession.

By forcing the young, healthy student to experience functional losses, she writes, “it brings home the meaning of functional impairments to healthy, young undergraduate liberal arts students in a much more effective way than the best written chapter in a text or the most brilliant lecture could hope to achieve.”

Aging simulation exercises like the ones I underwent at Rutgers and several other locations around the country lie at the heart of so-called “aging sensitivity training” that’s been practiced now for at least two decades. Originally, these exercises were designed for nurses, physicians, therapists, social workers, and others who work with elderly patients.

For instance, at Valparaiso University’s College of Nursing — highly regarded nationwide for its emphasis on gerontology — every student must take a junior-level course called The Aging Process, regardless of what field of nursing they intend to enter. One of the first assignments in that course is an aging simulation.

“Even some of the nursing students, when they first get here, will tell you, ‘I hate old people. I’d never want to work with old people.’ They want to work with babies, or in the ICU,” says Kristen Mauk, a nursing professor at Valparaiso and one of the nation’s leading experts in gerontological nursing.

“We have to prepare our students, because there are going to be so many more older people in years to come,” Mauk says. “We’re preparing our students to be nurses in the future.” Of course, Mauk’s students also go on to spend a great deal of time in retirement villages and nursing homes with real live old people. “In the end,” she says, “an aging simulation is not enough.”

Yet outside the health professions, aging sensitivity courses are catching on among a wider swath of the population. Many businesses and organizations that cater to older customers are also now requiring their employees and volunteers to attend aging sensitivity training.

Empathy is what nearly all of the courses purport to teach.

“There’s a real demand for this type of training,” says Vicki Rosebrook, executive director of the Macklin Intergenerational Institute in Findlay, Ohio. “In generations past, we didn’t need sensitivity training. But now we’re all segregated by age in this society.”

For that reason, the Macklin Institute has developed its “Xtreme Aging Training,” a one- to three-hour program for groups, which costs about $30 to $60 per person. According to the brochure: “Renewed tolerance, kindness, patience, and compassion will be gained through the experience of aging instantly to 85 years old.”

Rosebrook gives a recent example of a training session she did for building inspectors in the state of Ohio. Building inspectors make money based on the number of homes they efficiently inspect. Conversely, elderly people comprised the majority of those selling and buying homes. “The older people moved a little slower, and it caused the inspections to take a little more time,” Rosebrook said. This dynamic caused a great deal of tension between inspectors and elderly homeowners. Complaints mounted, and the state felt it was time for some sensitivity training with the Macklin Institute.

“As the inspectors did the Xtreme Aging, I saw light bulbs going off,” Rosebrook says.

I visit the Macklin Institute to experience “Xtreme Aging” firsthand. But before I start, Rosebrook gives me a tour around Birchaven, a unique assisted living and nursing home where the Macklin Institute is based. Birchaven, built in 2003, is an “intergenerational” facility, meaning the seniors share their space with a full children’s daycare center. Children from six weeks to pre-school-age mingle on a daily basis with the seniors who live at Birchaven. The children make visits to the seniors, who read and play and even sometimes eat lunch with the kids.

“This is real interaction,” says Peg Gordon, Rosebrook’s assistant. “We strive very hard not to be entertainment. We don’t ever want to say, ‘Well, it’s 3 o'clock, let’s go sing a song,’ and then go back to class.”

“We want the children to understand aging and not be afraid of it,” Rosebrook says. “When they finally go to school, they’re going to wonder where all the grandmoms and grandpas are.” These children, Rosebrook hopes, will not require aging sensitivity training in the future.

Later, I’m sitting in the basement of the College First Church of God in Findlay, Ohio. Pastor William Reist has gathered about 20 of his flock for today’s Xtreme Aging training.

Some are adult volunteers who help care for elderly parishioners, but others are pre-teens and teens who are accompanied by their youth pastor, Dave Sprouse. I sit at his table next to three girls with ponytails — Natalie, 13, Emily, 12, and Tia, 14 — and a 12-year-old boy with a mohawk named Aaron.

Seated behind us is a table of middle-aged men and women. And on the other side of the room is a table of people who look like they’ve already aged, naturally, into the senior citizen category.

“We’re all aging,” Rosebrook says, and points to the kids at my table. “Even you guys.”

Aided by a PowerPoint presentation, Rosebrook dispels ten “myths” of aging with a ten-question true/false quiz. (True or False: The majority of older people are socially isolated and lonely. False: “Seniors are more mobile, active, health conscious, and vibrant than any aging population ever before.”)

“What do you think of when I say old or aging?” She asks us to call out words we associate with aging. Here is what our group shouts at Rosebrook: Gray hair; wrinkles; pain; joint replacement; cataracts; dementia; false teeth; loneliness; car accidents; family separation; memory loss. Ours is clearly a group in need of some sensitivity. After listing 15 words, someone says, “Wisdom.” There is applause. “Finally, a positive word!” Rosebrook says.

“Do we ever see elders on TV or in commercials?” she asks, somewhat rhetorically.

“Help! I’ve fallen and I can’t get up!” yells one of the middle-aged women in the back, and everyone at her table laughs hysterically.

“What should the aging population be called?” Rosebrook asks. “Senior citizens? Senior adults? We talk about wisdom. What about Saged adults?”

“That sounds like a cooking class!” says someone at the increasingly rowdy middle-aged table behind us. “What about basil-ed adults!” More guffaws.

Now it is time for the simulation. For our first exercise, Rosebrook asks us to write our name, address, and profession on a 3x5 card. With our left hand. With our leg crossed. While rotating our foot counter clockwise.

It is difficult enough to write legibly this way, but as we write, Rosebrook and Gordon wander behind us shouting “Hurry up!” It is completely unnerving and my notecard is full of illegible chicken scratch. Rosebrook tells us “time’s up” before I finish writing all the information.

“This simulates performing as if you were a recovering stroke victim,” Rosebrook says.

Next, we are given 11 small sticky notes and asked to write five possessions, the names of three loved ones, and three privileges we enjoy. One by one we are asked to whittle down our sticky notes. Until everyone is left with three notes. I, for instance, am left with a son, a laptop, and the ability to speak freely. “That’s all you’ll get to bring with you when you’re sent to a nursing home.”

“That’s it?” shouts a guy at the middle-aged table. “Well, will the nurses at least be hot?”

“You’re going to get a timeout,” says Rosebrook, smiling but clearly irritated.

Finally, it’s time to get old. We drop dried corn kernels in our shoes, we put cotton in our ears, we wear glasses covered with yellow tape that replicate cataracts, and we pull on too-big latex gloves and tape our knuckles.

“Is this supposed to be wrinkles or arthritis?” asks Aaron as he pulls on his gloves.

“I think this is what your skin feels like with wrinkles,” Emily says.

We’re asked to perform a series of tasks with our impairments. First, I must button and fold a men’s shirt. This takes about 10 times longer than it normally would. Next, I must shuffle and sort a deck of playing cards. This, again, takes longer, but is manageable.

Then, however, I move to some tasks that are nearly impossible. I’m given a wallet. I’m asked how much money is in the wallet, and then I’m told to pretend I’m at the grocery store and need $11.12 to pay for an item. I fumble through the bills and change, dropping some it onto the ground. Then, with my cataracts, I find that it’s hard to differentiate between bills. On my first try, I actually overpay the grocery store with a $100 bill.

My immediate thought is: Thank God for debit cards. But Rosebrook reminds us to think about this the next time we get huffy with that little old lady fumbling for her change in line at the supermarket.

For the next task, I must find the best route from Findlay, Ohio, to Wakeman, Ohio, on a map. Since this is the first time I’ve been to Findlay — and more importantly, since my cataracts have rendered the tiny type on the map almost unreadable — I decide to cheat. I overhear Emily, Tia, and Natalie telling each other the best route, and so I write what they have: Route 224 East to Route 60 North.

In the final task, I’m asked to look up the number of “B. Feltro” in the telephone book. This task is perhaps the most disturbing for me. Though the map was difficult, it’s nearly impossible to search through the tiny names in the book. It’s also hard to turn the thin pages with my gloved hands. After a great deal of effort, I locate Feltro and write down the number. Later, when I remove my cataracts, I see that I have written down the wrong Feltro. This makes me think, sadly, about the poor woman who always calls my house looking for her granddaughter. When I inform her she’s called the wrong number, she always gets indignant and says — in a tiny, shaky voice — that she has indeed dialed the right Wilson. Next time, maybe I shouldn’t just hang up on her.

Soon we’re finished, and we all remove our impairments. After a few final thoughts, Rosebrook implores us to remember what these tasks felt like the next time we have contact with an old person.

When it’s all over, I turn to Emily and ask if she’d learned anything today.

“Yeah, I don’t want to get old.” The other teens nod their heads in agreement.

“I don’t want to be an old person either,” Aaron says.

“You mean a senior adult.” Tia says.

“Yeah,” says Aaron, “I don’t want to be a senior adult.”

I press them a little further. Haven’t they come to some deeper understanding of the aging process today?

“Well,” Emily says, “I think I have a better understanding of old people after today. I have a great-grandmother, and sometimes I get mad at her because she can’t control her farts. Now I think I’ll be a little more understanding.”

How old is your great-grandmother?

“I think she’s like 75.”

“Nah,” says Tia. “I think she’s probably more like 90.”

As the program winds down, Vicki seems mildly irritated by the group of middle-aged people who were cracking jokes and laughing during the exercise. But she says it’s not uncommon for middle-aged people to react that way to the exercises. “They’re getting closer to being old,” she says. “I think these exercises made them uncomfortable.”

Before we leave, a fit-looking older man with white hair stands up. “I’m 88 years old,” he announces. “You know, I felt pretty good about getting older. At least I did until today!”

Earlier, when I finished my Rutgers simulation with Wood, I asked how healthy, young undergraduates generally react to their sudden aging. Wood makes her students write a two- to three-page paper in which they reflect on their experiences, and she tells me that the reactions have clearly changed over the years.

“In the past,” Wood says, “I’d get responses such as, ‘Now I understand why Grandpa is so grumpy.’ But over the past two or three years, the responses I’ve been getting in class have been very different. Now they say, ‘I don’t want to be like this when I grow old. I’m going to start taking better care of myself. I’m going to quit smoking. I’m going to go to the gym. I’m going to eat better.’”

Wood sees this as a definitive generational difference in young people raised by Baby Boomer parents. “I don’t know if it’s a belief that they have control over their destiny, or the attitude that if they really want something bad enough it will happen,” she says. “There’s a downside to that. It leads to thinking that if people are handicapped, or overweight, or old…well, then it’s just their own fault.”

I ask her if she thinks that empathy can truly be taught by sensitivity training and simulation exercises such as these.

She pauses a moment. “Do I think empathy can be taught? No, I don’t think it can be taught. But I think people may remember this experience. If an old person tells them, ‘My feet are hurting,’ maybe they’ll remember the corn in their shoes.” • 28 September 2007


   


Jason Wilson is editor of The Smart Set. He also edits The Best American Travel Writing series (Houghton Mifflin).




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Go for it, Granny
This is not a simulation.
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