Tag Archives: aging

the End of Old Age (a book, not a proclamation!)

[Over dinner this evening I was telling my husband about this book and my review. His response turned out to be the perfect succinct comment about Marc Agronin and this book. My husband said, “he has a growth mindset about aging.”]

In making his case for aging, geriatric psychiatrist Marc Agronin is first and foremost a passionate optimist. This book combines Agronin’s action plan for making the most of our lives as we age with interesting and often uplifting stories of people who are aging.

He poses two sets of questions, the first being When do you think you made better decisions – when you were 21-years old or now? This question is designed to help the reader realize that with age comes wisdom.

The second set of questions are rhetorical, answered by Agronin, and based upon his description of five core strengths that I’ve noted below.

Why age? To grow in wisdom.
Why survive? To realize a purpose.
Why thrive? To create something new.

Agronin believes we have a repository of strengths, and his action plan is designed to tap into those strengths, some of which we may have forgotten we have, some of which we may have not realized we’ve tapped, and some which will be tapped or retapped in new ways. These strengths are:

Knowledge, the Savant that “learns, sows, and teaches”
Judgement, the Sage that “weighs and decides”
Empathy, the Curator that “cares and connects”
Creativity, the Creator that “imagines and makes”
and finally, Insight, the Seer that “accepts and communes”

This book is a practical and positive roadmap to taking stock on one’s life, no matter how abysmal it may be at the moment, and acknowledging who you were up to that point and who you want to be moving forward. This is all well and good but it presupposes that there are adequate resources available, be they monetary, people, treatment centers, and community. For the people in Florida who have the good fortune to work with Marc Agronin, this is likely a positive way forward for them in their aging.

My life experience with both my parents has shown me a different path through aging. I did not have access to some of the adequate resources that make a difference. For instance, I dealt with a doctor who cruised through nursing homes and did not establish relationships with family members, nursing home staff and rehab staff who were underpaid and overworked (despite both locations being known as “high quality”), and a basic ignorance on my part of where to even begin. Had a doctor been available or known to me with Marc Agronin’s apparent compassion and belief in positive aging, including in the face of illness, my skepticism about “the End of Old Age” might be non-existent.

[Reprinted from my Goodreads book review.]


Falls Awareness & Prevention Guide

Falling is the nemesis of older folks. Yes, falls can be an issue for anyone at any age, but for older folks it can mean broken bones – especially hip bones – that take a long time to heal, require physical therapy to be able to resume activity, and are all too often the harbinger of further problems.

The American Academy of Orthopaedic Surgeons and The Orthopaedic Trauma Association have put out a Falls Awareness & Prevention Guide that I recommend for anyone, regardless of age, and absolutely recommend to anyone living on their own, particularly if they are older (and you can take “older” to mean whatever age you feel like having it mean!)

My Mom lived alone for about five years, and in her last year of life she fell several times, the first on New Year’s Day 2010. We were getting ready to leave a family gathering at the home of a relative. Wearing shoes that were like slippers and did not offer much by way of support, she tripped on a towel that was near the front door and meant for wiping wet shoes. The shoes and towel were a nasty combination, causing her to lose her footing and fall to her left. As if it were happening in slow motion, several of us tried to reach out and catch her or lessen the impact of her fall. Alas, a trip to the ER showed a broken left humerus. This would be the first of two shoulder breaks, with the next one happening to her right humerus.

If you look at the Falls Awareness & Prevention Guide, you will notice inadequate footwear and all throw rugs and area rugs that are not properly secured (could just as easily apply to towels on the floor) listed as risk factors. It could have been anyone who fell on that rug, but I suspect my mother’s age also had something to do with it.

So, take a look at the guide and see if it provides some tips for you or for someone you know. Being a little proactive now can mean a lot in terms of later prevention.

And from the National Council on Aging, an info graphic to herald Falls Prevention Awareness Day, which happens to be September 23, 2014.


Lynne Segal on ageing

I’ve written numerous posts about aging because the process intrigues me. I watched my parents age, and now I am aging. Fact is, we are all aging from the moment we are born, but “aging” or “ageing” refers to the process of becoming what society thinks of as “old”. And even “old” does not have a specific jumping off point; depends who you ask.

A child may say “old” is someone who is 30. Someone in their 50s may feel “old” is someone in their 80s. With that said, I am 59 (as of a week and a day ago 🙂 ) and my Aunt is 81 as of this past October, and I do not see my Aunt as “old”. I just see her as older – older than me and older than she was a few years ago.

My Aunt is in relatively good health, with numerous “not working quite right” parts, but overall everything is functional. She goes into Manhattan via bus on a regular basis, plays bridge, works out once a week, is an avid walker on a daily basis, is quite literate and informed about the world, uses her computer to research, send emails, do iChat with me, and has even tried shopping online, drives during daylight hours, participates in social events, and actively manages her personal affairs. Plus she has a grand sense of humor that comes out in spoken word and in email.

This morning I stumbled upon The Economist’s radio interview of Lynne Segal, author of numerous books and most recently of Out of Time – The Pleasures and the Perils of Ageing. Here is the nine minute interview: The paradox of growing old.

As for me, I find myself in a wonderful combination of positions, all as a result of the many years of working in my given field – teaching in school – and learning in the field to which I am ever so gradually transitioning – leading chair yoga sessions. My husband, ten months older than me, has taken his years in IT and teaching and combined them to continue teaching, which he loves, while doing it online so that he has more time to pursue his other passion of art, design and creating. We both are healthy and active, which I think is a huge piece of overall positive aging. So if you ask me how I feel about aging, about growing older, at this moment I will smile at you and tell you it feels good and satisfying, and as my husband just uttered (in another room, oblivious to my writing), “pregnant with possibilities.”

What are Old People For? How Elders Will Save the World

William Thomas is the most optimistic advocate for aging I have yet to encounter. He believes in the power of the oldest of the old, and has called that phase of our lives “elderhood”, the natural successor to adulthood.

Old age has richness and complexity that, when appreciated, provide a powerful counterweight to the measurable, progressive, steady decline in bodily functions. In old age, the body instructs the mind in patience and forbearance while the mind tutors the body in creativity and flexibility.

History & Culture of Aging

What Are Old People For? is Thomas’ treatise on old age, beginning with a brief history of the hunter-gatherers and continuing thru to old age’s transformation by modern culture. This was the first time I heard the word “senescence“, defined as “growing into old age”, as compared with adolescence, which is “growing into adulthood”.

The upper limit of longevity may be defined by human genetics, but the experience of living into old age is defined almost exclusively by the customs and mores of one’s culture. An individual’s ability to live a long and bountiful life depends, most of all, on society’s aptitude for making such a life possible.

If you take a look at the various media cultural artifacts (television, magazines, newspapers and the like), you cannot escape the many advertisements for anti-aging products and multiple medications, all being marketed to a very large baby boomer generation that has fully entered adulthood.

Not only are adults impacted by this swath of advertising, but there is a huge trickle down effect, whereupon youngsters and teenagers are inundated with messages about staying young. Modern culture does not embrace the distinctive lines of age – the wrinkles that appear as a banner to living long. There is a huge market for medicine and medical procedures designed to eradicate any banners of aging.

Long-Term Care Environments

From discussing culture, Thomas goes on to describe the “plagues of loneliness, helplessness, and boredom” that accompany oldsters who are relocated, by choice or against their will, to “long-term care environments”. Rather than sit by the sidelines, William Thomas and his wife, Judith Meyers-Thomas, have created an approach to eldercare living called The Eden Alternative. You can read more about it here or listen to this 2002 PBS NewsHour interview: Nursing Home Alternative.

Thomas quotes a passage from Erving Goffman’s 1961 book Asylums, where Goffman lists five traits that define a “total institution”. It is a scathing description that, as Thomas notes, can be equally applied to life in prisons, state psychiatric hospitals and concentration camps. Alas, concludes Thomas, this list is also applicable to our long-term care facilities.

While the intention of these organizations is clearly different from that of penitentiaries, they share a common, rigid division of people into the guardians and the guarded, the therapists and the sick, the staff and the residents.

My Dad lived in assisted living, followed by a nursing home, for a combined seven plus years. My Mom was hospitalized several times within the span of six months, followed by a three week stint in a rehab facility, followed by round-the-clock care at home for several weeks. I know first hand of what Thomas describes.

But all does not have to be glum! The full title of Thomas’ book is What are Old People For? How Elders Will Save the World. Stay tuned for that second part!

for more on William H Thomas:

Five Wishes (not what you might be expecting)

There is a hearty conversation going on around Michael Wolff’s A Life Worth Ending article in the May 28, 2012 issue of New York magazine. I have already commented once (you can see that in my previous Neurons Firing post) and just this morning added a second comment, which is copied below.

We first heard about Five Wishes from my brother-in-law and his wife, Pat. Pat happens to be a nurse practitioner and clinical coordinator in pediatrics at MIT, and is a former director of nursing at Children’s Hospital Boston. I point out her credentials by way of saying that a medical practitioner gave us our first copy of Five Wishes. I have since purchased additional copies to share with my brother and his wife.

Some form of health care proxy and living will is crucial for family members to have when they find themselves in the position of caring for not only an elderly family member, but for anyone in their family who is of age to be considered an independent adult. Rather than be put off by having conversations about end-of-life care, it is my hope that people will see these conversations as a way to more consciously provide the love, care, respect and dignity that hopefully accompanies the relationships between the cared-for and the caring-for.


I previously commented about my Mom and her use of Compassion & Choices. Now am sharing about the organization Aging With Dignity – http://www.agingwithdignity.org/index.php – which provides a form called Five Wishes. This form helps people begin the conversations about their end-of-life wishes. When filled out, the form provides guidance to family, doctors and other medical personnel as to the wishes of the prospective patient. My husband and I are using this form, and I have ordered copies for my brother and his wife.

Regards, Laurie

Successful Aging

Oh dear, yet another large print book. I have nothing against the concept of large print, ideally this makes it easier to read for people with vision issues. However, I wish the publishers did a better job with layout and leading, the latter essentially being the spacing between lines. Lines of large type clumped on a page does not, actually, make for easier reading (for me).

John W Rose, MD, and Rober L Kahn, PhD, compiled the results of a MacArthur Foundation Study on aging and the result is the 1998 book, Successful Aging. Given that this book was published 14 years ago, there was nothing new in it that I had not already seen in some other format.

There were, however, two items that did particularly strike me. The first was the wonderful optimism the authors exude in describing both the results of the long term study and what the findings could mean for the future. While they break down the study and discuss multiple aspects of aging, I think the book’s message can be summed up quite simply. To paraphrase Carol Dweck’s findings about mindsets, those with growth mindsets will find it easier to deal with aging and, as such, will likely have a positive impact on their own aging process. Those who have a fixed mindset will find that when the going gets tough, they may be less flexible in managing repercussions, which will likely have a less positive – and perhaps negative – impact on their own aging process.

The idea of mindsets holds true, as well, for younger peoples’ perceptions of older people. As a teacher, I have always believed that students rise or fall to the level of expectations held for them. Similarly, if younger people can have a positive mindset about older people and the process of aging, this is more likely to have a beneficial impact on their interactions with older people and on their own aging process.

Due to the date of the book, 1998, I tended to question some of the statistics the authors noted, especially regarding the prevalence of Alzheimer’s in the aging population. I am reasonably confident that the numbers of people with, and expected to exhibit some form of dementia or Alzheimer’s is far greater than what they forecast back in 1998. You can read more about the Latest Alzheimer’s Statistics in the United States in this article on the Texas Alzheimer’s Research and Care Consortium site. In any case, both resources note that dementia and Alzheimer’s are not part of the normal aging process.

Similar to what I have gleaned from other books on aging, and from attendance at various Learning & the Brain conferences, Rose and Kahn note there are several factors a person can engage with to help their brains and bodies age normally. Turns out we do have  some control over how we age, it’s not all in the genes.

  • engage in physical activity – good for the body and for the brain, as exercise helps stimulate BDNF, brain-derived neurotrophic factor
  • fertilize your social network – showing care for and an interest in others, and allowing them to do the same for you makes for a strong support system
  • believe that you can manage whatever comes your way – while this may not always be the case, having a “cup half full” approach to aging can help you handle the blips

According to research, focusing on the above three elements will help an individual age successfully. Essentially, this approach translates to preventive care, and preventive care can aid with (in the words of the authors) “avoiding disease, maintaining high cognitive and physical function, and engagement with life.” Alternatively,

Disability in older people results from three key factors: 1) the impact of disease, or more commonly, many diseases at once; 2) lifestyle factors, such as exercise and diet, which directly influence physical fitness and risk of disease; and 3) the biological changes that occur with advancing age – formally known as senescence.

For more on healthy aging, here are some of my prior posts plus an article by Elkhonon Goldberg.

The Summer of a Dormouse

In early April I shared my recent foray into literature about aging, as seen through the eyes of those older than I. The Summer of a Dormouse is book number two, and I have just made a discovery that, although entirely fitting, has me somewhat indignant. But first, some background.

Turns out that my local library only had access to one version of this book, the large print version. Having never seen a large print book, I was curious to know if it would make reading easier. What I discovered is that the text overwhelmed the pages. A bit more white space or leading between lines would have made a positive difference; better yet, access to a standard print size would have been greatly appreciated.

John Mortimer is the author, and he already had one claim to fame with me as the writer of Rumpole of the Bailey, a PBS series about an English barrister, lovingly portrayed by Leo McKern. In The Summer of a Dormouse, Mortimer entertains while sharing reflections on a year of his life in his seventh decade.

Now for the indignant portion, of which there are two! Only this morning, in checking out various amazon.com versions of the book, did I discover that The Summer of a Dormouse is “the third installment” of Mortimer’s memoirs. Am wondering why that isn’t noted anywhere on the book’s back cover blurb. But here is the stronger reason for indignancy – the title is off! In the concluding paragraph of the New York Times obituary (yes, alas, John Mortimer died in January, 2009 at the ripe age of 85, and here is The Guardian’s obituary), Mortimer is quoted from this book – The Summer of a Dormouse: A Year of Growing Old Disgracefully. Why is it that the second part of the title was left off of the large print version?

Well, disgraceful as it may be to switch titles on different publications of a book, Mortimer’s memoir is anything but disgraceful. Mortimer reminisces on politics, writing, socializing, family, building a theatre, and finding a statue to sit on an empty plinth in Trafalgar Square, among other topics. In his humor and seriousness, he shares a healthy approach to aging, seizing it for all it is worth and making the most of his time. What especially struck me was Mortimer’s statement on old age.

The real trouble with old age is that it lasts for such a short time.

He goes on to say:

All worthwhile projects are investments in the future. … After you’re seventy, it’s probably too late to establish another career, create a mature garden, or discover a new way of writing. The old, grabbing time by the forelock, have to go for immediate results.

Worst of all, there’s not time to see a child grow up.  [Mortimer is talking about his youngest child, a daughter who was born when he was 62.] … For me life becomes insupportable, and inoperable pomposity is liable to set in, unless there’s a fairly young child about the place. Having such a child makes it essential not to die until it’s absolutely necessary.