On the third Thursday night of each month, except during the summer, we have a Conscious Aging Group. I have learned so much being present with the people who attend this group as they share their personal reflections on aging with one other. Last Thursday night we watched a film by Atul Gwande, author of the book Living Mortal. The press release of his book includes the following: “Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering. Gawande…addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families” As we in the Conscious Aging Group watched Gwande’s video, we heard that the young--or those who have young-focus or those whose lives have a young signature—these folks want to grow social networks. Their desires focus on achievement, and acquiring recognition. An Elder--either physically or psychologically an elder--has a different signature. Our elders want smaller networks of people, narrower, but deeper, more intimate relationships with those in their network. They are less concerned with acquisition and more concerned with simply being. They also want to make a difference in the lives of those people to whom they are most connected. Elders feel poignancy, a feeling most younger people don’t possess. Poignancy is being able to feel positive and negative emotions at the same time. In addition, elders experience more happiness as they age, even though they had more health problems, limitations and disabilities, losses in function. Gwande reported that people are less likely to be depressed and anxious at age 70 than at age 40.
Our Conscious Aging Group was asked to consider the questions that Gwande feels are most important questions as people grow older, more frail, closer to dying: What’s your understanding of your health? What are your fears and worries for the future? What are the goals you have when your health worsens? What trade-offs are you will to make and not willing to make as your health worsens? What would be your priorities beyond just being alive when your health worsens? These are important questions for all us to consider, even if we embrace a “young signature”. Your answers at 40 will be different from your answers at 24; your answers at 60 will be different from your answers at 80. At each stage, you will be leaving the boxes you’ve created in your life, crammed with roles and responsibilities, rules and fears, crating your own unique way.
Most people, as they become older, more frail, more limited, more ill, often want autonomy vs. the restrictions that often come of an extension of their life or protection from harm. However, the adult children, the doctors, hospitals, and nursing homes want to extend a beloved elder’s life and protect the elder from harm, no matter what restrictions might put into place as a result. Gwande beleives it is important to talk about quality of life, rather than extension of life. And the thing is that an improved quality of life generally results in a longer and happier life. He tells a story of a very ill elderly man in a hospital who is on a pureed diet that he hates, so he steals and hordes cookies. The staff of the hospital doesn’t want him to have the cookies because he might choke on them. He is miserable. Gwande says just give him the damn cookies. Let him have a life of quality and enjoyment.
“We must honor our Elders, and care for them, for they have the knowledge of a thousand winds.” The winds can sing a thousand songs, yet there must be ears to hear these songs, to listen to that knowledge, that wisdom. Our Elders can offer themselves as beacons for others to create their path, but we must have eyes to see their shining lights.
Let me end with this quote from Ashton Applewhite, an activist and writer: “The sooner growing old is stripped of reflective dread, the better equipped we are to benefit from the countless ways in which it can enrich us.” Namaste.