My 88th birthday approaches. A humongous number no matter which way you look at it. Fellow travelers in advanced old age may chuckle if I write I am an Old(s) 88. My musician son just told me I have lived a year for every key on the piano keyboard! Brava, Mom!

How am I doing? I used to answer that I was still vertical, but I hereby coin a new word. When people ask me how I am, my answer will be I am β€œfrailing.” It means I am not yet frail but I can see fragility on the horizon … with my good glasses of course.

Frail is a word I would not use to describe myself until recently. Chunky, maybe. Robust. Energetic. Hardworking. But I am slowing down.

I walk slower and very carefully. My creaky knee troubles me. Balance is something I have to think about β€” a far cry from that little girl on a bike or the woman on a tough hiking trail that I once was. Plumbing problems plague me, so a restroom is the first thing I look for wherever I go. There are several prescription drugs to keep track of. I forget more easily and recall less speedily.

On the positive side, I am doing pretty good when I compare myself to others my age. I am still alive while for every 100,000 white females born the year I was born, only 37,745 are still alive. Life expectancy at 88 is 5.6 years. Males do not fare quite as well: For every 100,000 white males born in 1930, only 25,139 are living and life expectancy is 4.4 years.

These are statistical analyses, not guarantees. When we are young we know our life will end but don’t pay much attention to the passing of time. Maybe because life is so fulfilling and interesting the future seems endless. But now even those of us who weren’t good at math can count the possible number of days we may have left.

The epitaph of the book β€œNumber our Days” by Barbara Myerhoff about elderly Jews is a prayer adapted from two psalms that ends β€œSo teach us to number our days, that we may get us a heart of wisdom.” We oldies know our days are numbered. Let us hope we also get us a heart of wisdom so that we can accept ourselves as we are today. And that our wisdom helps us do our damnedest to enjoy each day.

We all need to pay attention to two things that can affect both the quality and length of our lives. Our wise parents had us immunized against deadly childhood diseases. Now we have to β€œimmunize” ourselves against loneliness and falls, two important risk factors for both mortality (dying) and morbidity (disability).

This is a process of accepting who we are now and what our capabilities are. And accepting the fact that, like time, the trajectory of our β€œfrailing” goes in only one direction. There is no Fountain of Youth.

β€œLoneliness as a Public Health Issue” published in the American Journal of Public Health is a study of people 60 and over. Those who reported chronic loneliness visited a physician significantly more times than those who were not lonely. Loneliness is a health risk associated with hypertension, risky behaviors like inactivity and smoking, and dementia.

The β€œGrey Gender Gap” described by Paula Span in the New York Times found more elderly men are likely to be married than women. Women live longer and generally marry men who are older. Thus women are more likely to be widowed. Forty-six percent of women over 75 live alone compared to 23 percent of men and a higher percentage of elderly women live in poverty. However, elderly men living alone do not fare as well as women who are more connected with friends and relatives. Widowers no longer have a wife to supervise their social life and health care.

Is there a cure for loneliness? Yes, friends and activity. The positive effects of people in the lives of the elderly are well-known. I am happy doing what I am doing right how, writing a column, but I can do that anywhere I have a desk and computer, so I am planning to sign up for an independent living facility in Tucson.

It is true I will give up a beautiful home and possessions when I downsize. But the gerontologists advise us to make such a move earlier rather than later. Why? We still have energy for the physical move and the spirit to adjust and make new friends. Plus, who wants to get so frail that their children have to make the decision for them? I look forward to new friends and convenient activities.

It is vital to prevent and avoid falls. In old age we have slower reflexes, less coordination and muscle strength, loss of proprioception (the ability to know where our body is in space) or visual problems.

Look around your home with a critical eye and eliminate β€œfall traps” like scatter rugs or room rugs that are curling up at the edges. Do away with or safely store boxes of β€œStuff I am going to go through any day now.” Make sure lighting is adequate for your aging eyes. Install grab bars in the shower and tub. Ditto rails on steps. Use rails in public buildings and walk slower than usual in new places or in the dark.

Don’t walk barefoot or in socks. Use only sensible footwear that have corrugated rubber-soles. High heels are for models not oldies. Take walks, the best exercise for the elderly. Use a cane if necessary.

Sadly, not all falls can be prevented, which means we must do all we can to eliminate the preventable ones. Ironically, while researching and writing this column I had a fall. I wore proper shoes, it was broad daylight but down I went. Nothing broken, a bit of facial blood, a few bruises (my kneecaps are still purple) but I am fully ambulatory. I dodged a fall-bullet.

But I have developed PFSD, post fall stress disorder. I am scared of another fall, so I will redouble my efforts to prevent one. Because of travel, family illness and the death of our dog, I have not been walking and exercising. Back to our morning walk and working with a trainer to strengthen my leg muscles and improve my balance.

Finally, I am redoubling my efforts to stay positive in my thinking. And I am working on another kind of balance in my life. I resolve to keep busy but pay attention to when I need a break. And enjoy the quietude of doing nothing, a new skill for this old lady.


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Dr. Heins is a pediatrician, parent, grandparent, great-step grandparent and the founder and CEO of ParentKidsRight.com. She welcomes your questions about parenting throughout the life cycle, from birth to great-grandparenthood! Email info@ParentKidsRight.com