About the Guest
Are you aging well? Dr. John Dunlop, a doctor of geriatrics in Connecticut, explains what it means to age well in all spheres of life--physical, mental, social, financial and emotional. While mounting losses make it more difficult to think about the blessings we do have, Dr. Dunlop advises patients to focus on the Lord and all He has already done.
John DunlopJohn Dunlop (MD, Johns Hopkins University) practiced medicine in Zion, Illinois for 38 years. He holds a master’s degree in bioethics and serves as an adjunct professor at Trinity International University. Currently Dr. Dunlop practices geriatrics in New Haven, Connecticut, where he is affiliated with Yale School of Medicine. He is the author of Finishing Well to the Glory of God: Strategies from a Christian Physician and Wellness for the Glory of God: Living Well After 40 with...more
Are you aging well? Dr. John Dunlop, a doctor of geriatrics in Connecticut, explains what it means to age well in all spheres of life–physical, mental, social, financial and emotional.
Bob: Dr. John Dunlop says if we live to be 90 years old, there is a fifty/fifty chance that we will have some degree of dementia; but he also says when it comes to brain health, we’re not helpless.
John: There is an awful lot we can do to maintain good function in the part of the brain that is still whole. And the things that I think have been proven to help that are good, vigorous physical exercise—exercising our brain. If you don’t use it, you lose it. And many of the things that are preached for good heart health will also help the brain health.
Bob: This is FamilyLife Today for Monday, August 3rd. Our host is the President of FamilyLife®, Dennis Rainey, and I’m Bob Lepine. We’ll talk to Dr. John Dunlop today about how we can pursue wellness for as many years as God would give us. Stay tuned.
And welcome to FamilyLife Today. Thanks for joining us. I scheduled this for you. I thought a little time with a doctor would do you—
Dennis: I thought you scheduled it for you!
Bob: No, no. No, it was you. I’m fine. I just wanted to see how you were. [Laughter]
Dennis: Well, we do have a physician joining us, here on FamilyLife Today—Dr. John Dunlop. Welcome to the broadcast, John.
John: Well, thank you. Thank you. It reminds me—I saw a patient last week who was getting kind of demented. I introduced myself, and she said, “Dumb Doc? Did you say your name was Dumb Doc?” [Laughter]
Dennis: That’s excellent. [Laughter] Well, John was a physician—I guess you still are—right?—
John: I am.
Dennis: —for more than 38 years. He graduated from Johns Hopkins University. He and his wife Dorothy have been married for 43 years—have two sons and four grandchildren. He has written a book called Wellness for the Glory of God. And we’re going to talk about some relevant subjects on our broadcast this week—
—subjects like memory loss, how to stay healthy—emotional healthy / physical health.
You begin your book, though, John, with the story of a patient by the name of Henry. Share with our listeners what you learned from Henry.
John: Oh, I remember Henry walking down the hall—with his walker and his oxygen—and his daughter walking behind, carrying some papers. After my assistant had done her thing with him, I walked into the exam room—said, “Henry, how are you doing?” He bolted up out his chair, shakes my hand vigorously—says: “I am well! Praise the Lord!”
Makes you stop and think—95—that is how old he was. I was 65 at the time. Now, what does wellness look like at 95 when you are on your walker and you are on your oxygen? And how can I feel well 30 years from now? It makes you stop and wonder.
Bob: This is your specialty. You are working in gerontology—so, you’re working with us older folks; right?
John: Yes, I am a geriatrician who is a geriatric.
Dennis: So, who qualifies for that? Bob said—“Us!”
John: Officially, it starts at 55.
John: But we usually don’t start thinking about it until 65 or 70.
Bob: And this is the branch of medicine that deals with what happens to all of us who live this long. We start to age. Aging is a normal, natural process. You help us—you, as a gerontologist, help us know how to age well; right?
John: I think so. Yes, people come; and they say, “I’m getting older.” And I say: “Well, let’s remember what that means. That means two things. Number one, you’re not old yet—you’re still getting there. And two, you haven’t died yet.”
Dennis: Yes, let’s talk about what you illustrated with Henry—you kind of rushed by it.
You said, “What is wellness?” That can differ, I would suppose, according to what kind of season of life you are in; right?
John: It does. And I gave a lot of thought to it—particularly, in a Christian world: “What, really, does wellness mean?” After going through a number of different definitions, my definition is that: “It’s the blessed state of experiencing all spheres of life, functioning in harmony with God’s eternal and ordained purpose.” Now, that’s a mouthful—but it is—wellness is a blessing from God, and it involves all spheres of life.
Dennis: Let’s talk about that for a moment. What do you mean by spheres of life?
John: Okay, there’s physical wellness. There’s mental, social, financial, spiritual—
—and emotional. All six of those have to be considered in the question of: “Are you well?”
Bob: So, if Henry says, “I’m well,” but he’s on a walker, isn’t there something about his physical existence that’s not well?
John: There is.
Bob: So, wellness is kind of an aggregate score in all of those spheres you are talking about.
John: It is. Yes.
Bob: That’s a—
John: And some of those things—in fact, most of them, as we get older, are likely to be on a little bit of a downslide.
Dennis: It seems to me, life is one long process of experiencing losses. I mean, there are a lot of gains along the way; but as you get older, it seems like the losses begin to mount up. What would you say to the person, who is listening to us right now, and they are acutely aware of something they’ve lost?—maybe, it’s a loved one; maybe, it’s a child; maybe, it’s hearing; maybe, it’s their eyesight—
—but they are in the process of facing some losses. What would be your advice to them?
John: Well, first, I’d acknowledge that a loss is a loss; and it requires grief. Grieving is good. So, we want to start with that. Then, we want to think about some of the good things that we have. Honestly, I don’t think we can do any better than to focus on the Lord Jesus on the cross—on what He has given up for us.
Bob: You know, as you say that, what flashed into my mind was the grieving that was taking place in Horatio Spafford’s life as he was crossing the Atlantic, reflecting on the fact that his daughters had died in the shipwreck as they had gone on to England before him. Horatio Spafford’s the man who wrote the hymn that we’ve all sung—It Is Well with My Soul.
In the midst of his grief, what brought him to a place of wellness was to reflect on some of the other spheres of life and to know, even in the grief of this loss, “There is still wellness in my soul.”
John: You know, as Christians, we have the unique ability of mingling joy and sorrow together. I don’t think, in a non-Christian framework, the two fit that well together; but when we really are walking with the Lord—when we realize His love and His care and His providence over our lives—we can mingle that joy and sorrow.
Bob: “When sorrows like sea billows roll, whatever my lot, [Thou hast] taught me to say, ‘It is well with my soul.’”
Bob: Yes. Tell us about Eddie, the patient you were caring for who was diagnosed with colon cancer. You talked about wellness with her; right?
John: Yes. Yes. She was far advanced. Her colon cancer widely spread to her liver.
Her life expectancy was measured in weeks—and I, as gently as I could, tried to tell her that. She looked at me—she slapped her hand on her thigh—and she said, “Well, you don’t get to heaven by being healthy; do you?!” [Laughter]
Bob: She was ready for what was next.
John: She was indeed.
Dennis: I love Galatians, Chapter 2, verse 20—it says: “I have been crucified with Christ. It is no longer I who live but Christ who lives in me, and the life I now live in the flesh, I live by faith in the Son of God who loved me and gave Himself up for me.” When you know your life is found in Christ, that’s going to outlive your body because that goes past the grave to the Savior we someday will see face to face.
And when you know that Jesus Christ is your Lord / your Savior—
—who died for your sins to redeem you from the price of your sins / from the cost of your sins—to declare you: “Not guilty,” and that you are going to heaven because you’ve placed your faith in Him, then, you can face the bad news of a diagnosis with hope and expectancy like Eddie did.
John: And actually, that can help very much to inform the decisions that you make—in terms of the medical care that you get toward the end of life.
Bob: Yes, I want to explore that with you a little bit because you touched on this in another book you wrote called Finishing Well for the Glory of God. When we are facing end-of-life decisions, as a Christian—when we are looking at what kind of heroic measures / what kind of extraordinary measures we’re going to use to preserve life—how do we make those kinds of decisions?
I’m imagining somebody who, today, is facing a question of:
“Should I go through another round of chemo for this disease that doctors say: ‘Well, this might work. It’s an experimental protocol. We don’t know.’” How do you decide whether to say, “Yes,” and keep fighting or to just say, “You know, I think the Lord is calling me home”?
John: Basically, I think we start by praying and seeking God’s wisdom. In James, it talks about calling the elders of the church to pray. I think we need to do that—to call our spiritual mentors to pray with us, asking for God’s wisdom—asking Him to heal if He would—but for wisdom. We have a long talk with the doctor. We try to define what the potential benefit of the treatment is relative to the potential burden:
“What is the chance of it really helping, and what do we mean by helping? Do we mean getting better and returning to normal?” or “Do we mean just living longer with our pain?”
John: Then, we kind of come down to making a decision. Now, I’m going to go one step further than that because I think it’s important to think through this—but I very strongly encourage people to have advance directives—
Dennis: You’re talking about a living will.
John: —a living will or a power of attorney for medical purposes. But I don’t—I suggest they not just check off different technologies—ventilator, feeding tubes, etc.—but write a statement of their values. Now, my value statement and my power of attorney are taken from Philippians 1. What I’ve said is: “I want everything done to prolong my life so long as there is a reasonable hope that I will be able to return to serving people—
—but if for medical, mental, spiritual, emotional reasons—it doesn’t look like I’m going to return to serving people, I do not want my life prolonged.”
Three caveats: (1) “Don’t kill me.” Number (2): “The nature of my service may change.” I may not be writing books and teaching courses. I may be lying in a nursing home, praying for people / encouraging them—but I’m still serving them. And then [(3)]: “On that basis, I want the decisions made—and I want to make the decisions, if I am still able—as to how aggressive to be with that medical care.”
Dennis: For some folks, though, John, it’s not the fear of death that kind of has their attention today. It may be that, in their family, there has been dementia. Their fear is not dying but how they are going to die.
How common is this subject of dementia today in people’s health?
John: You know—it’s common. It’s going to become increasingly common as other aspects of medicine improve and people live longer; but right now, five percent of people at age 65 experience some form of dementia. That doubles every seven years. So, if you do the math on that, at 90, over 50 percent of people will have some degree of dementia—so, it’s increasingly common.
Bob: When does an adult son or daughter start to worry about Mom or Dad? When do you say, “Now, that’s not just them getting older—that’s something worse than that”?
John: When safety becomes an issue, you have to draw the line. You know, I think of the lady who brought her father in and she said: “Dr. John, we’ve got a real problem here. Last week, Dad was out in a town about 50 miles away.
“The police called and said he was lost and they had to bring him home.” He sat there and said: “That never happened! She’s lying!” It did happen—he just forgot that it did. That type of thing is certainly where you have to draw the line.
So often, when people have been diagnosed with dementia, they begin to give up or—
Dennis: More so than with other diseases?
John: Yes. I think so.
Dennis: Why so?
John: Because we all fear dementia so much. Several studies have shown we fear dementia more than we fear cancer. Not only do we give up, but once we’ve been diagnosed with dementia, other people begin to relate to us very differently—very superficially.
Dennis: Your mother-in-law had dementia.
John: She did. Both my mother and my mother-in-law had dementia—as did my father.
Dennis: What did you learn from your experience with both of them?
John: Both of them had significant personality changes.
Both of them were loving, kind, giving people. At least, my mother certainly began to show major problems—striking out at people, hitting people, screaming—just so sad to see that personality change.
Dennis: I spoke recently to a group of dads about what their children needed. I told those men—I said, “Guys, your sons / your daughters need your presence. They just need you to be there—be all there.” You say, in your book, that presence is also a great gift to someone who is struggling with dementia.
John: Oh, it is. They may not know who you are / they may not know what their contact with you is, but they know you are touching them in a loving way.
Bob: Are there things that we can or should be doing, as younger people—
—who do not yet have dementia—that could head off—should I be adjusting my diet to try to protect from future dementia? Should I be doing crossword puzzles every day? What are the things you recommend that might help me not form that plaque in my brain that causes dementia?
John: You know, Bob, I’m sorry; but I don’t think there’s anything we can do to prevent the formation of the pathology of dementia. But there’s an awful lot we can do to maintain good function on the part of the brain that’s still whole. The things that I think have been proven to help that are good, vigorous physical exercise—doing a lot of exercising of our brain. If you don’t use it, you lose it. Many of the things that are preached for good heart health will also help the brain health.
And recognize that, even though when most people talk about dementia, they have in mind Alzheimer’s disease. Alzheimer’s only makes up 70 percent of dementia. Twenty percent of dementia is multiple strokes, and there are all kinds of things we can do to prevent strokes. So, we can do a lot more to prevent that 20 percent of dementia than we can the 70 percent that is Alzheimer’s.
Dennis: One last question about relating to someone who is struggling with dementia. If you have somebody you really love, and you’re sensing you’re losing connection with them, what can we do? Coach us a little bit on how—
Dennis: —an adult child should relate to his or her parent.
John: Certainly. Early in the game—yes, there is a lot of room for grieving / for talking; and there will be some understanding. It may not be remembered the next day. Secondly, I think we need to remember that the cognitive part of our brain—
—that is our thinking and remembering part—deteriorates usually quicker than our emotional memories and our relational abilities. So, even though someone is severely impaired cognitively, they still will experience emotions. They still will experience the joys of relationship.
The other thing that is very characteristic of dementia is—our world begins to narrow in, both in time and space. We are living in the present. We’re not so concerned about what’s going on in the outside world. We don’t want to leave home anymore. We want to stay in our room as our world begins to constrict spatially.
But the fact is—people can still enjoy the present / they can still enjoy where they are.
And we don’t necessarily need to talk to them about the past if they don’t remember it. Maybe, we could talk about the distant past because they don’t remember the recent past. So, we can talk about their growing up. And we can continue to help them in their spiritual memories. That often—because it’s more tied to the emotional memories—is more meaningful.
I know with mom—and about my dad too—if we started to quote a verse in the King James, they would finish it. If we started to sing a hymn—even though I can’t sing / carry a tune at all—Mom would love to sing—would sing along with us. We would forget the words, but she would keep going. You could just tell her pleasure at that. In our church, it’s perfectly acceptable for elders to serve communion.
If I would serve Mom communion, she could identify so closely with that. So, there were ways in which we could touch their spirits even, while cognitively, they were in severe decline.
Dennis: What I hear you saying is: “Even though there may not be the normal connectivity of words, back and forth, and a dialogue that we’ve been used to, we can still move toward our parents and love them—hold their hands, stroke their face, kiss them, be near them, hold them—and that there still is joy that is shared in those moments.
Bob: Well, and let me just mention to our listeners here, Dennis, that today’s program would be one of those programs where it might be good for you to go to our website, FamilyLifeToday.com. Either download or stream the program because what we’ve been able to talk about here on air is just a portion of the entire conversation we were able to have with Dr. Dunlop.
Again, our website is FamilyLifeToday.com. You can download the audio from today’s program for free—it’s the extended edition—or you can read the transcript or you can stream the audio on your computer or on your mobile device—but I do hope you’ll listen to the expanded conversation with our guest today, Dr. John Dunlop. He’s the author of the book, Wellness for the Glory of God: Living Well after 40 with Joy and Contentment in All of Life. It’s a book we’ve got in our FamilyLife Today Resource Center. You can order a copy of the book from us when you go to FamilyLifeToday.com and click the link that says, “GO DEEPER,” in the upper left-hand corner of the screen. Again, the website is FamilyLifeToday.com. The title of the book is Wellness for the Glory of God. You can also call to order the book. Our toll-free number is 1-800-FL-TODAY—1-800-358-6329.
That’s 1-800-“F” as in family, “L” as in life, and then, the word, “TODAY.”
You know, as you think about family / as you think about marriage, you think about living in this culture—the challenges that we face—this is a time where I think all of us need to be prayerful about how we live to honor God in a culture that is increasingly turning away from what God says is right and true about marriage and family. We believe prayer is critical. We think it is vital for every married couple / for every family. In fact, coming up later this month, we’re going to be telling you more about a campaign that we are launching during the month of September, where we’re going to be urging you to pray together, as husband and wife, every day for 30 days. We’ll have details coming up in just a couple of weeks.
But we thought this month—we wanted to encourage you to be praying together, as a couple / as a family.
We thought a good way to do that was making available a copy of Dennis and Barbara Rainey’s book, Two Hearts Praying as One. It will give you specific help on how you can be praying together in your marriage and in your family. The book is our gift to you when you make a donation to support this ministry today. Simply go to FamilyLifeToday.com and click the link in the upper right-hand corner of the screen that says, “I CARE,” to make an online donation. Or call 1-800-FL-TODAY to make your donation over the phone. You can also mail your donation to us at FamilyLife Today at PO Box 7111, Little Rock, AR. The zip code is 72223. Be sure to request your copy of the book, Two Hearts Praying as One, when you get in touch with us.
And if this is your first donation to FamilyLife Today this year, we’d like to send an additional thank-you gift to you for supporting the ministry. We’ll send you one of our prayer cards that will give you help in praying for your family during challenging times.
Just ask for the book on prayer when you make your donation; and again, if it’s your first donation this year, we’ll send you this special prayer card in addition to Dennis and Barbara’s book.
Now, we hope you can be back with us tomorrow as we’re going to continue to talk about what wellness looks like as we move into our 60s, 70s, and beyond. Dr. John Dunlop will be with us again tomorrow. Hope you can be back here as well.
I want to thank our engineer today, Keith Lynch, along with our entire broadcast production team. On behalf of our host, Dennis Rainey, I’m Bob Lepine. We’ll see you back next time for another edition of FamilyLife Today.
FamilyLife Today is a production of FamilyLife of Little Rock, Arkansas.
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