Friday, October 3, 2014

What We Have to Look Forward To

Imagine yourself at age 75, then 85, then 95.  How do you see yourself?  Americans don't like to talk about aging anymore than they like talking about dying. We want to live forever.  But with the Baby Boomers now starting to leave middle age and entering old age, we do need to start talking about it, and how we personally want to live in the future.

The October 2014 issue of The Atlantic features two articles that will help open up the discussion.  Gregg Easterbrook takes readers through all the possibilities of what we have to look forward to, and what resources will be available to us.  Ezekiel J. Emanuel describes his plan, and the reasoning behind it, for his future at age 75 and beyond.  Of the two articles, Emanuel's hit me the hardest.

Emanuel hopes to die when he's 75.  He reasons that we have lost touch with Nature, and we need to let Nature take its course once we reach old age.  He examines how life expectancy has changed over the last century, and how it will continue to increase in the next century.  But long life expectancy does not mean a long, healthy, productive and creative life for most people.  He describes the exceptions that he knows -- people in their 90's who are still contributing, productive, creative and relatively healthy.  For the rest of us, we can expect to deal with chronic illness and the deterioration of our mental faculties.

My paternal grandma at 89
The women on both sides of my family have lived long lives.  My paternal grandmother was one month past her 99th birthday when she died.  The last 7-8 years of her life she had senile dementia and restricted mobility because of a broken hip and osteoporosis. She lived above us, and my father cared for her by hiring a caretaker.  My maternal grandmother was 94, a two-year survivor of breast cancer, when a massive heart attack killed her.  When it hit, she was mopping her kitchen floor, and had been physically active up until then, lived in her own apartment, and required no one to care for her.  She'd been very healthy also, with no chronic illness issues, just the breast cancer which the doctor said was very slow growing.  My mother was 84 when she fell, hit her head and never regained consciousness.  She was dealing with a blood disease at the time, and the treatment made her bleed easily. She lived on her own with some help.  I can look forward to at least age 84 if chronic illness and associated complications don't get me before then.

Emanuel's points about the care people need as they age cannot be ignored.  Unless medicine finds a way to prevent the chronic illnesses and physical deterioration that comes with aging, we will need care when we are older.  Who provides that care is a huge question.  We assume family will step up to the task, but what about people who don't have family who will do that?  Or friends?  I personally do not want to end up in a nursing home, a ward of the state, in my old age.

Ezekiel Emanuel (Photo: Jake Chessum)

So, Emanuel's plan makes a lot of sense to me.  Once he's 75, he plans to NOT seek medical care and will not agree to it, only palliative care.  He wants nature to take its course.  His article is both uplifting and frightening. I am always amazed at individuals who refuse medical treatment, even if they are right to do so.  Could I?  That is what really moved me about Emanuel's article -- it forced me to think about what I'd do and what I want for myself, my family and friends, as we age.

What do you think?  What do you want for yourselves as you age?  Do you want to live into your 90's or would you prefer to let nature take its course?


Ms Sparrow said...

What is surprising is that when you reach the age of 75, you discover how young that still is. There is no real reason a person should give up on themselves just because of reaching a calendar date. If I should need a tumor removed or a heart defibrillator installed, I'd promptly do it. I want to hang around and enjoy my descendants for a long while even though neither of my parents lived past 76.

Gina said...

Different people may choose different ages, different strategies. I think the healthier a person is after 70, the less likely they'll choose a strategy similar to Emanuel's. But I find myself more and more in agreement with him when I think about the incredible expense. And what if an individual has no family, no one willing to take care of her if she needs care? These are all valid issues that we need to think about and discuss more with the people in our lives.....

Daughter Number Three said...

Given how old I feel despite my chronological age, I know Ms Sparrow is right about how I'll feel at 75.

I found much of Emmanuel's argument appealing, but there's an uncomfortable undercurrent. His desire to not have his kids see him as "less" than he is has a decidedly ableist base. It's as if he's saying, if he can't be as he is now, it's not worth living. Which is something that many people thought until something changed in their life and they be came "disabled" -- blindness, paraplegia, whatever.

Gina said...

It's only been recently that I have finally felt internally that I've entered the 30's. For a long time, I felt like I was 25. Unfortunately, my body is at my chronological age. If I make it to 75, I could imagine my body putting a huge crimp in how I feel inside. I think people who are extremely healthy and in excellent good physical shape at 75 are more likely to want to go on compared with those who are not.