What Dr. Luke has to Say About the Very Old Person

China currently has about 7% of its population over 65 years of age.  The amount over 80 years of age is around 0.5-1% or 7-13 million people.  That number will double in the next ten years.  Though as a relative and absolute number it is not large considering China's massive overall population, these people have a unique importance to China and will consume far more resources per person than the rest of the country. They also can place a significant burden on families not only financially but also in terms of amount of time needed to care for them. Plus considering China's one child family policy which has been in place over 20 years, the challenges to society of those over 80 years of age will only grow over the next 10-20 years.

The people over 80 years of age are generally frail and in fact we call them the 'frail elderly.'  As a group they have unique needs which can only be met by paying particular attention to them.  What are these needs and how can they be met?  These people can best be understood by learning from a person named Li Jing.  Li Jing was 86 years old and lived with her daughter and her husband.  The were both 60 years old.  Li Jing's daughter's children were already grown and in fact Li Jing had some great grandchildren.  Li Jing's husband had died many years before of a heart attack.  Li Jing had retired from her job 35 years ago.  Li Jing's daughter spent a lot of her time caring for her grandchildren.  Thus she was very busy.

Last year Li Jing's daughter took her to the hospital in their city to see a doctor.  The reason was several things, which were causing problems at home, and the daughter wanted to see if there was any treatment for these problems of Li Jing's.  The doctor took a history, then examined Li Jing and then ordered some blood tests.  After doing all of these things he sat down with Li Jing and her daughter and discussed the results with them.

The doctor told them that first it was important to understand that most people over 80 years of age have some physical or mental health problems. The number of physical problems rises steadily over 60 years of age so that over 80 years of age most people have at least one physical health problem and many people have more than one.  These problems can be heart problems, high blood pressure, diabetes, cancer of some type, tuberculosis, eye problems, decreased hearing, constipation, arthritis, depression, lung disease and other less common problems.  Again he said, most people have at least one of these when they are over 80 years of age and many have more than one.

These problems cause people to have problems such as fatigue, medication side effects and the inability to do things that a person wants to do.  The doctor pointed out though that a number of problems do not present as clear-cut specific organ diagnoses.  For example, like a person having high blood pressure or diabetes.  The doctor said these most often occur in people over 80 years of age. These unclear problems in this age group though are common and cause a lot of problems.  He grouped them into five groups: 1. Intellectual Impairment; 2. Immobility; 3. Instability; 4. Incontinence; 5. Drug Reactions.  He told Li Jing that he wanted to explain each in detail with her and her daughter as she had some problems for each of the five categories. Li Jing and her daughter however had another appointment so they arranged another time to come back and see the doctor.

Li Jing and her daughter returned home and began to discuss the issues of very old people in China.  They both agreed it was a big problem.  40-50 years ago not that many people lived to be over 80 years of age.  However, now with the advances of medical science more and more people were living longer and longer.  What was the solution?  Better economics, social planning, health care system, home health companies or what?  They both knew this was a big issue.

During the middle of the discussion a friend of theirs came over to see them.  They asked their friend about the solution to the problem of having more and more old people in China and what to do.  The friend told Li Jing and her daughter what she thought, and then she told them that the solution to China's problems in this area would not give either of them personal contentment.  Only Jesus Christ could do that.  Li Jing and her daughter were surprised at this response.  How could Jesus Christ give them personal contentment? 

This friend told them about how Jesus Christ took away the sins and wrong doings which each of us has done before God.  She showed them this story in the Bible.  'Then they came to Jericho.  As Jesus and his disciples, together with a large crowd, were leaving the city, a blind man, Bartimaeus (that is, the Son of Timaeus), was sitting by the roadside begging.  When he heard that it was Jesus of Nazareth, he began to shout, 'Jesus, Son of David, have mercy on me!'  Many rebuked him and told him to be quiet, but he shouted all the more,  'Son of David, have mercy on me!'  Jesus stopped and said, 'Call him.'  So they called to the blind man, 'Cheer up!  On your feet!  He's calling you.'  Throwing his cloak aside, he jumped to his feet and came to Jesus. 'What do you want me to do for you?'  Jesus asked him.  The blind man said. 'Rabbi, I want to see.'  'Go,' said Jesus, 'your faith has healed you.'  Immediately he received his sight and followed Jesus along the road (Mark 10.46-52).'

This was truly an amazing story and Li Jing identified with a lot of things said in the story.  First, she had quite bad eyes and could not see a lot with her eyes.  Second, she really wanted better eyesight.  Third, she most identified when the people told the blind person to be quiet when the blind man called out to Jesus.  Many times she wanted to tell people how she felt and was doing but she knew most people were not interested because she was so old and that was just what was expected.   Fourth, she identified with Jesus' compassion and his ability to heal so quickly.

Her friend told her that though Jesus had compassion on many and helped and healed a lot of people, his primary goal was not to heal, though that was important, but to give people eternal life.  Li Jing and her friend, with her daughter, read in the Bible this verse, 'for God so loved the world that he gave his only begotten Son that whoever believed in him would not perish but have everlasting life (John 3.16).'  God's purpose was to have us live with him forever.  Li Jing knew that she would not live long but she had wondered what would happen after she died.  Plus one of the things she struggled with was constant discouragement as her health problems continued to grow.  If it was not one thing then it was another. She was glad when they returned to see the doctor and he reviewed the rest of her problems in more detail. That is the five things, which people her age, tend to get.

First, the doctor mentioned intellectual impairment or dementia.  The doctor told Li Jing and her daughter that this was where people have impairment of two or more of the following: language, memory, personality changes and judgment or calculation problems.  Clinically significant changes in these abilities affect an estimated 5-10% of people over 65 and 20% over 80 years of age.  Some experts say as many as 47% of people over 85 are affected.  Thus this is significant.  Li Jing and her daughter knew that Li Jing had a component of this.  The doctor told her that this would only slowly advance and there were new medicines for this but very expensive.  A lot of research around the world was going into this area of medicine.  In the mean time it was important for her to talk with other people and friends as much as possible.

The second area the doctor mentioned was immobility or being chair or bed bound.  Though not completely chair bound, Li Jing needed a cane to walk a few feet without assistance.  She needed full assistance to go up and down stairs and that was very slow.  The doctor told her that the more people are stationary or do not move much the more deconditioned they get and then they have less ability to walk.  Also people who sit or lye down a lot develop pressure sores on they hips and bottom which are hard to heal and are painful and can get infected.  The best treatment for this is to try and walk as much as possible.

The third area the doctor mentioned was instability or having increased falls or an unstable gait.  This was a concern because people in this age group fell a lot more and when they fall they are much more likely to have serious and even life threatening injuries from broken bones and head injuries.  The doctor to them that the best thing they could do in their home was to have all furniture and rugs in the house in place so if Li Jing walked on or fell into these things they could hold her weight.  If she fell into a piece of furniture or just held onto it and it could not hold her weight when she grabbed on to it then she could fall.  The same with rugs.  Li Jing knew she was instable and knew she needed to pick up some of the rugs in the house as she was sometime slipping on them.  This was also the main reason she did not visit other people's homes.  She was afraid she would fall.

The fourth area the doctor mentioned was urinary incontinence.  This is where urine leaked out when you did not want it to.  Li Jing had some problems with this and this was also a reason she did not go out in public very much.  This could cause her to smell bad at times.  The doctor told her there were many causes of this and they would need to do some more testing to understand why Li Jing had this problem.  However, the doctor gave Li Jing and her daughter re-assurance they could probably help this problem Li Jing had.

The fifth and final problem the doctor mentioned was side effects from medicines.  The doctor told them that almost all people over 80 years of age took at least one medicine.  Many patients over 80 took many medicines. They took both Chinese Traditional and Western Medicines at the same time.  People over 80 years of age have more problems with their liver and kidneys not working as well as they did when they were younger, thus they had more side effects from medicines.   Some of these medicine reactions can be so severe that they can cause patients over 80 years of age to be hospitalized for the reaction.  The doctor told Li Jing and her daughter it was important to take as few Chinese Traditional and Western medicines as possible.

Li Jing and her daughter returned from the doctor much more assured of things they could do to make life easier for them at home.  They also wanted to know about how to have eternal life through Jesus Christ.  For though they could help Li Jing now they could not make her live forever.  However, eternal life with Jesus Christ very much interested them.  They got back together with their friend to discuss this some more.

Their friend showed them a place in the Bible, which showed them how to know Jesus Christ as their personal Savior.  This place stated, 'if you confess with your mouth that Jesus is Lord and believe in our heart that God has raised him from the dead you will be saved. For it is with the heart that you believe and are justified and it is with the mouth that you confess and are saved (Romans 10.9,10).'  Li Jing's friend explained that if we confess that Jesus created the world and all that is in it and that he died on the Cross-for our sins, we will be saved.  Jesus died on the Cross-for our sins because he loved us and because we were not capable of saving ourselves.  She explained that 'the wages of sin is death but the gift of God is eternal life through Jesus Christ our Lord (Romans 6.23).'  The result of our sin is to separate us from God.  Jesus died on the Cross so we would not have to bear our sins or its results, which is eternal death.  Jesus gave us eternal life.  Thus if we believe Jesus is Lord because he died for us on the Cross and then believe that after he died he rose from the dead to new life to show his victory over sin and death, we will be saved for eternity with Jesus Christ.

Li Jing and her daughter wanted this life and prayed with their friend the following prayer to receive this new life in Jesus Christ.  'Dear Jesus, I know that I have sinned and thus am separated from you.  I believe that you died on the Cross-for my sins so I would not have to bear them. I believe that after you died on the Cross you rose to life and now live.  I ask you to come into my life.'  Li Jing and her daughter prayed this prayer to have new life in Jesus Christ.  You to can pray this prayer and have eternal life.