Growing Old (Gracefully?) in Amsterdam

I usually don't dwell much on getting older, but this birthday seemed different somehow. Maybe it's because my sister - who is only a splash older than I am- recently turned 60. That milestone is soon going to be knocking on my door. Maybe it's because I recently became a great-aunt. The picture I have in my head when I hear the word "great-aunt" is of my Aunt Rose, the matriarch of our family. In our house, she was like Queen Elizabeth to the English people: what she said we instantly respected. In her book, no meal was complete without jello. And because of that wisdom, we suffered through many a meal with various brightly-colored jellos with mysterious sorts of canned fruits suspended in them whenever Aunt Rose was a guest. Maybe my preoccupation with aging comes, well, just because I am getting old. I recently heard someone explain the way her elderly mother's doctor discusses aging. Rather than say, "As we grow older...", he prefaces his elder-care advice with the much more graceful, "As we celebrate more birthdays...". So, in that spirit, I write this month about celebrating more birthdays Netherlands-style. In other words, let's take a look at how the Dutch deal with their residents who have celebrated a lot of birthdays. How a country deals with its elderly population should tell us a lot about that country and its values. 

Before we look at the Dutch, let's take a peek at the aging expat. In some ways, moving abroad has frozen us in time, or even sent us coursing back to our college days. That's because, just like when we were in college, expats live in close proximity to lots of people a lot like them both in terms of age and also in terms of interests. We have free time to explore, go out to dinner, and try out the wines from the countries so close we can practically touch them. So sometimes, you have the illusion you are much younger than your birth certificate - or the mirror - tells you. One big difference is that unlike in our college days, now we have money to spend. I imagine when we move back to the U.S., we will think back fondly on these carefree expat days, forgetting any of the problems, just like we did with college memories. "Those were the days, my friend. We thought they'd never end." I love that upbeat- sounding part of the song. It does get a little more real and melancholy, of course: 

"Just tonight I stood before the tavern
Nothing seemed the way it used to be
In the glass I saw a strange reflection
Was that lonely woman really me?"

You may be thinking my ability to ramble is starting to betray my age. Let's get back to the topic of the Dutch seniors in the Netherlands. They say that 60 is the new 40, or something like that. They also say, "You are only as old as you feel." From the looks of things here, the senior set feels pretty young. I see them riding on bikes, skating (on rinks, not on the canals, Katie Couric) and trudging through the city on foot. While biking has taken hold in the U.S., you certainly don't see many elderly people getting around on bikes there. Here, it's a common sight. Is that safe? It seems that the majority of bike fatalities on the recently popular e-bikes involve elderly riders. For those of you who don't already know, an e-bike is a bike powered by electricity and by your own two feet. It's like having a big hand pushing you forward, just when you need it. Soon after we moved here, I was passed - on what counts as a steep uphill here (a bridge) by two older riders. Once I swallowed my pride and looked closely, I realized they were on e-bikes. It makes sense that there are more accidents involving e-bikes with elderly riders, because they no doubt make up the majority of the e-bike rider population. The head of the Dutch police road safety unit has called for elderly cyclists to take a course to learn to ride their new-fangled toys. Hopefully that will help make e-bikes safer for riders-of-a-certain-age.

I spent a few days in our neighborhood just missing out on photos on all manner of dapper older men and women on bikes. By the time I got my iPhone out to snap the photo, these surprisingly speedy riders were already well past me. I finally managed to get a shot of this guy. I was particularly impressed by his cycling not just because he was biking on a day that was snow-covered, but also because it was about 20 degrees outside. Maybe old people (notorious for wearing sweaters in the dead of winter in Florida) are at an advantage when there's a polar vortex in town.

In addition to the proposed e-bike classes, there are apparently classes here for learning how to fall safely. This recent article in the New York Times made readers in New York City very envious. Apparently, there are enough such classes now in the Netherlands that the government rates the effectiveness of each. I especially love the last photo in the article, in which a dozen or so elderly people are splayed out on gym mats. They looked like they have dozed off, or worse. I plan on following David Bowie's approach to getting old: "Put on your red shoes and dance." O.K., he wasn't writing about getting old, but it's good advice nonetheless.

Thanks to my Dutch friend Johanna - it's a sad state of affairs that I can count my Dutch friends on a few fingers, but that's a subject for a later post - I have some insider information about elder care in the Netherlands. Unfortunately, she knows firsthand what happens when older people can no longer safely live independently in the Netherlands. She explained to me that in general, the Dutch government wants elderly residents to live at home. Until recently, they provided more money to help pay for that care. Recently, due to budget cuts, the role of "organizer" of all the home-care services has turned into a volunteer position. The Dutch word for the role, is mantelzorger, literally coat-carer. Johanna is the coat-carer for her parents, making contact with all the service providers and ensuring they all arrive when they are supposed to. If the elderly person has no child, this role sometimes fall to other family members, friends, or in some cases, even neighbors. Before her parents entered an nursing home, their insurance paid for home-care. That included someone who came to the home for help with cooking, taking medications, and bathing. The neighbors also came in to help, since Johanna lives in Germany and her parents are in the Netherlands. There were some near-accidents, and then one day, her dad fell down the stairs. At that point, her parents finally reluctantly agreed to live in a nursing home. In the Netherlands, a person must give their consent to living in a nursing home. An official visited their home three times. Had it not been for the fall down the stairs just before the third visit, they may never have consented. Although the Dutch are notoriously non-litigious, families can resort to a court proceeding if living independently at home poses a danger to the elderly relative. I had some notion that nursing homes here were far superior to ones in the U.S. Johanna explained that in her experience they are understaffed, not as clean as she would hope for, and not the centers of activity I imagined. She describes the place she finally settled on for her parents as "a sad place" and wishes she could find a small house for her parents with a live-in care-giver. Unfortunately, she said, those people are hard to find.

It seems my assumption that elder care was far superior in the Netherlands to what we have in the U.S. is not really accurate. U.S. News and World Report ranked the Netherlands #6 on a Best Countries For Aging List. The U.S. comes in at #9. They looked at factors like access to health care, social connections, and financial stability. If those rankings are as suspect as the college rankings they come up with, we should read them with a grain of salt I guess. 

I remember the days when 64 seemed so impossibly far away. Those were the days, my friend.

I'm completely out of my element when it comes to dealing with the elderly. I've spent my working life with children, who also happen to be closer to my maturity level. My sister Jennifer, on the other hand, has devoted her social work career to the other end of the age spectrum. She has been the head healthcare social worker at a retirement community in Towson, Maryland for over 30 years. However, her focus on the elderly began long before that. From the time she was a child, she has followed the habits of the senior set: early-bird dinner time, early bedtime, and early rising. She's probably the most selfless person I know, so being a social worker is part of her DNA. We used to joke that the game we played with the buttons on our clothes: "Rich man, poor man, beggar man, thief, doctor, lawyer, Indian Chief" meant that she was really an Indian Chief, since my brother is a doctor and I was a lawyer. Whether Indian Chief or social worker, her selflessness serves her well when dealing with the endless problems she has to solve on a daily basis. She understands what makes seniors tick, and how to help them enjoy their last act. The world could use more Jennifer Vines.

A lifetime of wearing matching outfits meant I wore mine, then I wore Jennifer's when she outgrew hers. Thanks, mom.

My sister is the one who sent me this article about Hogeweyk, nicknamed the "Alzheimer's Village", a residential facility in Weesp, just outside Amsterdam. The common areas are designed so people with memory loss can find their way to places like the on-site grocery store and restaurant. Residents choose from among various "lifestyles", with decor and food to match the style you choose. Your options include "Cultural" (for residents who like art and literature) which means you go to concerts and museums and get wine served with your dinner; "Indonesian" (for residents who have a connection to Indonesia), with Indonesian food served most of the time; and "The Gooise" lifestyle for "posh people". Hogeweyk's website explains that residents who choose The "Gooise" lifestyle "favor French cuisine and enjoy going out for dinner as well." For those of you who don't live in the Netherlands, Het Gooi is a wealthy area about a 30 minute drive from Amsterdam. I "visit" it regularly, thanks to my friend Vera who introduced me (and a bunch of other American gals) to the T.V. series Gooische Vrouwen. It's the Dutch version of Desperate Housewives/Sex in the City, and we watch it (allegedly) to practice our Dutch. If I ever had to live at Hogeweyk, I would definitely not live in "Gooise". I'll take the Indonesian lifestyle with the Indonesian food instead, please.

Another interesting experiment in housing, Amstelhuis, allows seniors ages 70 and above, "with or without care needs" to live right on the banks of the Amstel River in Amsterdam. There, residents have access to cultural, social, and health programs in a shared meeting space which also boasts a spectacular view of  the river. The program is not just a residence for the elderly. It also serves as a "practical environment" for the Amsterdam University of Applied Sciences (AUAS). Students, lecturers and researchers work together to organize activities for the residents, who are part of a "living lab". I recently peeked in the floor-to-ceiling glass windows at the facility and saw a chamber music group playing to a large group of elderly people. Only a few had their eyes closed. Most were completely engaged. It looks like a really nice place to call home.

When I wrote last year about the healthcare system here, I included some information about innovative programs designed to benefit both the elderly and young students. At a TedEx Education conference I attended, a young man spoke about his experiences living in a retirement home. The students live rent-free in exchange for their commitment to interacting with the elderly residents. The purpose of the arrangement is to provide the elderly with contact with young people. Most people praise the young man for sharing his time with the elderly. He explained, however, that he gets back much more than he gives. I'd say it's an even trade.

There are certainly some wonderful places in the U.S. for elderly residents to call home. My sister works in one. The first part of the video, below, shows some music students who live in Edenwald, the facility where she works. It's a similar program to Humanitas, the intergenerational residence in the Netherlands I just described. These lucky music students are both saving money and learning valuable lessons about life from their older roommates. I wish there were more places like this in the world.

As I mentioned earlier in this post, expats can seem to lead a carefree life, a sort of college life 2.0. However, that "carefree" life isn't free from the same issues we would face if we were living in the U.S. We're old enough now that it's sadly common to hear of parents, or even friends our own age, dying. Two dear friends have died since we moved here. This is one huge downside to being so far away: you sometimes can't get back to the U.S. in time for funerals. No one mentions that depressing detail when they talk about the life of an expat, but it's an achingly sad reality. There's also the stress of dealing with medical issues from afar. And those of us lucky enough to still have parents worry about them, even when they aren't sick. We worry from afar, which isn't exactly very helpful to our siblings and other family members who are bearing the brunt of the day-to-day care. 

Just before we made our own move to Amsterdam, my mom moved to a retirement community. Just like I did, she was moving to a new place, where she knew no one. At least I was moving with Peter. I'd say her ability to adjust and make new friends is easily the more impressive feat. At first, she was met with quite a bit of mean-girl behavior, the likes of which are best left back in middle school. She persisted, and has ended up finding her niche, as the go-to person on any political issue. Since the Dutch are not exactly known for their friendliness to newcomers, I can only imagine what goes on when you are the the kid on the block in a Dutch retirement community.

This cartoon is from the simultaneously hilarious and heart-breaking memoir Can't We Talk About Something More Pleasant? by Roz Chast, the New Yorker magazine cartoonist. She chronicles her relationship with her aging parents and will make you laugh and cry as you connect to her experiences. 

My visits to her place are my American frame of reference as I think about life as an older citizen here. No one rides a bike at my mom's place. Many people ride motorized wheelchairs, but just inside on the carpeted hallways of the facility, not out and about like they do in the Netherlands. My mom worked hard to get her place to install a railing in the long hallway leading to the apartments. We dubbed her campaign, "Railing-gate" because of all the intrigue and behind-the-scenes machinations (not to mention the secret promises and alliances that were formed in opposition to her request). In the end, unlike Richard Nixon during Watergate, she prevailed, and the railings went in. You'd think they would want the older residents to walk around, but they probably think it's safer (and less likely to end in a lawsuit) if they just putter around in wheelchairs. Unlike in the U.S., the hidden fear of a lawsuit doesn't seem to factor in here. Please don't ask my mom about her next foray into political activism, Banana-gate, involving the injustice of being charged extra for taking a banana out of the cafe and into her room. 

There is no plaque next to it, but this is the Myra Vine Ramp. Ask anyone at Stonebridge, her independent living facility.

My mom's dream has always been to grow old in New York City, with Broadway, Lincoln Center, and museums at her beck and call. Unfortunately, that dream didn't turn out as she had hoped. She grew up in New York, and often refers to her fighting spirit as "her New York genes". Every time she says it, I can't help but think of Brooke Shields and that sultry ad in which she declared that, "Nothing comes between me and my Calvins". For those of you to young to remember, those "Calvins" were Calvin Klein jeans. I wonder if the elderly residents of Amsterdam treasure being in the city as much as my mom would. Do they feel less lonely and more connected to the outside world than their aging counterparts living in the quiet villages in the Netherlands? Are they willing to put up with the countless steep stairs (actually more like ladders) in their apartments, in order to enjoy the advantages of city life?

More and more, the world seems to be paying attention to the greying population. A museum in Vienna even has an exhibit called Aging Pride . It seems that it's soon going to chic to be old. That's excellent timing for me. Concerts have always been havens for older folks. Amsterdam is no different on that score. I'm going to include this Benny Goodman gem here because we just saw Wynton Marsalis and the Jazz at Lincoln Center Orchestra play at the Concertgebouw. The drum solo alone is enough to take years off your life. Enjoy!

This may look like a baby stroller, but it's actually a walker. This brave soul doesn't seem one bit phased by the maze of construction always taking place in our neighborhood. I think it bothers me more than it does her. 

This hearty opa (grandpa in Dutch) is rolling around the park with his grandchild. I see so many grandparents out walking and biking with their grandchildren in tow. And like the postman in days of old, neither rain nor snow nor sleet nor hail keeps these omas and opas from getting out in the fresh air. 

Not all of my stories about growing old in Amsterdam are happy ones. Last year, our elderly neighbor suffered what turned out to be a fatal heart attack. The ambulance showed up along with a fire truck. He was transported to the ambulance not in a stretcher down the many, many steep stairs, but out the window onto the cherry-picker on the firetruck. That was the first time I truly realized those steep steps are more than just a pain when you leave your keys behind, upstairs. They also make life on the 2nd floor virtually impossible for older people, or anyone with mobility issues, for that matter. Sometimes, when an apartment door is ajar, I've peeked in to see those mechanical chairs that slide you upstairs on the banister. You'd think those must sell like hotcakes here.

Here's the view looking down from my friend Danielle's second floor apartment. This is one precipitous climb and descent, at any age. Can you imagine what an elderly person would do on these? Probably never leave the house.

The other day, I found a book on the shelf that Rachel gave me years ago. Tucked inside the front cover was the card that accompanied the gift. This is probably the most fitting card I have ever received. The message perfectly describes my philosophy of life. 

Well maybe immature isn't exactly the right word. Maybe it's something closer to staying young at heart that keeps you young. Certainly, this opportunity to live somewhere brand new and to experience so many new people, places, and things at a time when I thought I might soon be starting to wind down has kept me young at heart. Amsterdam is a very "young" city, with tons of "young people" enjoying themselves everywhere you turn. Just using the phrase "young people" puts me in the old people camp. I'm at the stage where to some - O.K. maybe just a few -  people reading this, I'm young, but to most of the people living in Amsterdam, I am old. I often get called Mevrouw (roughly, Ma'am or Madame) and I'm even offered a seat on the tram from time to time by some youngster. It's all relative. I'm at the tail-end of the book Moonglow, by Michael Chabon. It's a memoir-ish story about his grandparents; I'm sad to see it come to an end. Anyway, here's a passage from the book that fits right in with my post: "I reflected that it seemed to be in the nature of human beings to spend the first part of their lives mocking the clichés and conventions of their elders and the final part mocking the clichés and conventions of the young." Exactly. I've landed squarely in that second part of life. Here's Neil Young singing about being 24 and realizing, "Old man look at my life, I'm a lot like you were." That's probably what the millenials who offer me their seat on the tram are thinking. 

What really helps you grow old gracefully is to see someone you held as a tiny baby (my niece Alissa) grow up to have her own baby (Simon). We haven't seen my mom glow like this in quite awhile. Being a great-grandmother - or, in my case, a great-aunt - will do that to you. Here's to finding even more grace as the years go on, whether in Amsterdam, or back in the U.S.

"For it's hard you will find
To be narrow of mind
If you're young at heart."

-Young at Heart, by Johnny Richards and Carolyn Leigh