Care Of The Heart In The Aged
( Originally Published 1921 )
There are no rules for the care of the heart in the aged that do not apply at other times of life. The tendency of old people to become bedridden and to lose their initiative should always be remembered, as the recommendation of less activity might lead to cessation of all activity.
The old person who gives up all forms of physical activity is sure to drift into a condition of health that will eventually terminate life and will make life not worth living while it lasts. So, in general principle, it is better for old people to keep on going, even if it involves some slight risk of accident from over-exertion. It is better to wear out than to rust out, but as a matter of fact the destruction of tissues by exercise stimulates its replacement by new tissue, and so leads to renovation.
People who lived to a great age generally had good hearts to begin with, and ordinarily it is not the heart that finally causes their death. The most common cause of death in very old people is some intercurrent infection. Quite often this infection in men has its origin in the bladder, and the heart secondarily becomes inflamed after blood poisoning has set in, or the person develops pneumonia.
It has always seemed to me that people who died in the nineties died very hard sometimes after weeks of unconsciousness from degeneration of the circulation in the brain. The heart always held out and did not show signs of failing until the last. This tendency of these old hearts to keep on beating makes us bold in letting old people have a good deal of liberty, and this pays very well, because old people are much happier if they are not restricted.
I have made it a rule, in caring for old people, to let them have their own way, in great measure, at least. If they have formed some habit such as wearing woolens in bed, or something like that, it is often quite a shock to them if they are made to do otherwise. I have seen many old people made unhappy in hospitals because the rules of the institution forced them to do certain things. The young nurse likes to have her ward look like a regiment of soldiers on parade each patient's pillow just like his neighbor's, and the bed clothes thrown across his chest. Think how uncomfortable this must be in the case of an old lady who for fifty years has always thrown a shawl around her shoulders when she thought she felt a draft.
There is a great deal to be said about the care of old people, as to the way to keep them in health and keep them happy; but as a rule the heart does not need special attention on account of age.