I’ve recently read two books, “The Happiness Curve—Why Life Gets Better After 50,” by Jonathan Rauch, and “Elderhood,” by Louise Aronson, both laden with study results, observations, and anecdotes about getting older.
I’m not sure what to think.
In the first book, Rauch says, “We are in the process of adding perhaps two decades to the most satisfying and pro-social period of life.” He says studies show that, in spite of infirmities, old people remain surprisingly happy, especially those with no cognitive decline. He calls it “the paradox”; as we get older, age seems to be able to lessen our negative feelings about our functional health. That is like saying “if, at 74, I had had these aches and pains at age 30, it would be very disturbing. Now it is a bit annoying, but I can deal.” He says our emotional health gets stronger, our priorities change.
“Surveys of happiness conducted in developed countries consistently show a U-shaped pattern, with people on either end having the greatest satisfaction,” according to the Kaiser Permanente Washington Health Research Institute. Our situations are not necessarily better, but we have lowered our expectations and accepted that there are always going to be bumps in the road.
Happy as we seniors seem to be in the happiness polls, I’m not convinced that it is that rosy.
A geriatrician and professor, Aronson describes her experiences in the world of caring for those in their dessert years. She explains that geriatrics is relatively invisible during medical training in spite of the fact that old age is lasting longer and longer. She labels this a clinical, cultural, and social travesty.
She notes, “The problem with knowing very little about a topic is that you don’t know how much you don’t know, and the problem with valuing one social group less than others is that your ignorance about them doesn’t bother you. In the classrooms, clinics, and culture of medicine, even a small dose of geriatrics strikes most people as more than enough.”
In 1914, an Austrian-American doctor, Ignatz Nascher, published “Geriatrics,” the first book on aging. Aronson laments that even today, many doctors think that “…for all practical purposes the lives of the aged are worthless, that they are often a burden to themselves, their family and to the community at large. Their appearance is generally unesthetic, their actions objectionable, their very actions often an incubus to those who in the spirit of humanity or duty take upon themselves the care of the aged.” And today, in visiting many long-term care facilities, one gets the impression that most residents are and will remain isolated and despondent until they die, a poor end of life.
Aronson’s book describes an exercise given to medical students to write down — by free association — words that come to mind when hearing “old” and “elder.” Not surprisingly, “old” was associated with frail, bent over, lonely, wrinkled, etc., while “elder” corresponded to respect, power, wise, knowledge. Old is clearly a negative state.
She implies that we should get rid of the word “old” in a geriatric sense and, instead, change our thinking to expecting a three-act life: childhood, adulthood, and elderhood. She thinks of these acts as the three primary colors, with substages in between. In elderhood, she recommends that physicians evaluate the whole patient; instead of limiting treatment to the pathology, the focus is on identifying what a patient needs to be able to do to be safe and happy, often making changes beyond only medical advice.
Her insights are well worth considering: “Part of what makes old age hard is that we fight it, rather than embracing it as one stage in a universal trajectory. We also fail to properly acknowledge its upsides: the decreases in family and work stress or the increases in contentment, wisdom, and agency that accompany most years of old age.”
She says that endings may be hard and sad, but “the best ones leave us with a sense of completion and satisfaction.”
Muriel Cole is Co-Chair of the Kent County Commission on Aging and was, for ten years, a volunteer long-term care ombudsman for Upper Shore Aging, Inc.
Title image: Pond at Pickering Creek Audubon Center, Talbot Co. Photo: Jan Plotczyk