Society needs to plan for the reality of longer life expectancies and an active older population, writes Catherine McCann
We age from the day we are born. Yet when the word ‘ageing’ is used, people assume it refers to the older years. What in fact are the older years? Those who are considered old in one culture will not be in another.
Definitions of the older years will also vary among individuals within a culture. Until recently, many considered the older years to begin at the time of retirement which generally meant at 65. A light-hearted answer says that an old person is someone who is 15 years older than me.
A well-known saying is apt: ‘We are as old as we feel’. The experience of most people is that they feel young inside even when certain physical limitations are present. It is important that society in general and each one individually, fosters keeping alive that ‘young inside’ person.
Only towards the end of life may a change from this outlook become noticeable. The usual manifestation of this is weariness, at both the physical and psychological levels of the person. Such fatigue is often an expression that a person is now tired of living and is readying to leave this life. This phase may be preceded by a period of frailty that moves towards passivity. It is a time when they are unable to be other than this way.
A false ‘enlightened’ view of ageing does not always allow for this period in people’s lives. Those around can try to cajole such a person to be and to do what they are no longer really able for.
At present life expectancy in the western world is into the mid-80s. Many obvious factors have led to this: improved sanitation, nutrition, housing, education and discoveries of all kinds, the most recent including the huge modern technological and pharmacological advances.
The one great achievement that has caused life expectancy levels to rise has been the dramatic drop in infant mortality. Death in modern society is now largely due to old age. This does not mean individual members of the race are living longer. People in previous ages of history have lived to over a hundred.
The difference now is that more people are surviving into their older years. The number living over 70 has trebled in recent years. The statistics from the recent 2016 census shows 30% of the Irish population are over 50; 18.4% are over 60; 5.8% are over 70; 2.8% are over 80 and 0.4% are in the 90+ years.
Problems will undoubtedly exist if nations and individuals do not take cognisance of, and plan for, this reality. Planning is required in many different areas such as good pension schemes, health and social care systems, suitable housing, education programmes that prepare for and allow for fulfilled living in these years.
These realities should be considered the norm for the vast majority of people.
The fact that a greater number of people survive inevitably makes huge changes in society. It can change consumer power, for example advertising. The arrangement of supermarket shelves is now geared towards older people’s needs. The greater number of frail older persons will mean more people leaning on a state’s limited resources. Some are fearful that this need will happen at the expense of other groups who also require care services.
Many complicated and difficult problems are already occurring and need to be faced by societies and their politicians. Overall government and other groups in society need to provide a suitable environment, in the general meaning of this word, for people to grow old.
Planners must see that preventative measures are in place for health, social and financial care, as well as providing adequate and appropriate housing, leisure and other facilities. Older people themselves should be included in the formation of all policies related to their care.
The EU selected five priority areas in relation to older people: the role and potential of the active retired; improving the situation of older women; management of an older workforce; transition from work to retirement, access to care for dependant older people. Their overall orientation is seeing older persons as a resource and not a burden, and to implement this fact in all policies related to older people.
While most are adapting to people living longer, ageism is still a reality. Like other ‘isms’ its removal takes time and action such as the rooting out of attitudes and changing of structures and laws that buttress its continuation. Attitudes towards ageing develop from various sources but come particularly from our personal experiences with older people and from experiences we have had with close older relatives. If that experience was negative it can affect us for the rest of our lives.
Older people can be victimised in many ways by ageist attitudes and they themselves can perpetuate the problem by unknowingly participating and continuing in false roles and behaviours that colour all aspects of living. Misconceptions can include equating the older years with sickness.
Old age is not a pathological state. People can become ill when old as they do other age groups. True, older people tend to have more than one complaint but many of these are likely to be chronic conditions. These can be managed, but the person is not ill because they are left with certain limitation of functioning. Small children cannot carry out all tasks for themselves, hence they are dependent on others, but we do not consider them ill as a result.
On the more positive side, education needs to promote personal responsibility for adopting a healthy lifestyle and how to manage financial affairs realistically. Planning for adequate pension, insurance and other saving schemes needs to be introduced early in life and be evaluated throughout the middle years.
A large part of all education is to normalise the ageing process, by neither denying it nor allowing it become a disempowering stage in life. It is essential healthy attitudes are promoted. The most fundamental attitude is to approach ageing as something we create ourselves rather than view it as a passively given reality. In other words, we ‘make’ our own older years to a great extent. It is a period when we need to work at making things happen, as well as allowing for and accepting those happenings over which we have no control.
There are certain established criteria for ageing well. These include good morale, self-esteem, experiencing satisfaction in our ordinary everyday living, having control over our lives.
Erik Erikson, the great American psychoanalyst, speaks of certain features in later life which help to make the above experiences possible. The abilities we need to develop are the following: to be able to adapt to change, to accept the past, to transcend self-preoccupation and to lose a fear of death. People will come in their own way to degrees of achievement of some or all of these.
One thing is definite: the most vital element in ageing well is to keep a sense of purpose to life and one could add a sense of humour. It means not constantly giving into our inner voice which could say something like, “stay on in bed today, the weather is too bad”. Awareness of purpose may grow dim and narrow at times due to illness or stress, but fanning it into flame again and again so that it is personally real in the nitty-gritty of everyday happenings is what gives energy and meaning to living life fully to its completion.
Catherine McCann is a physiotherapist, counsellor and spiritual director. This is an edited extract from her new book Love Life, published by Currach Press (€12.99).