Some More About Old Age, the Elderly, Ageing…

If we concentrate on living a good life, who knows that it might be a long life too

By Dr R Neerunjun Gopee

This article is a continuation of the thinking about growing old, which I shared with readers last week. There are social, medical and biological aspects of the phenomenon of ageing, which are, of course, all interconnected. The first two are the ones that are most apparent to us as they require handling with a certain immediacy for which we are not always prepared: either we postpone such preparation or are in denial until we are jolted out of our complacency by some event that impacts our individual or family life.

In the… olden days, it was taken for granted that as one grew old one would live with one’s children, one way or the other, and most probably it was in the same house where one had lived and had brought them up. It was familiar surroundings and familiar faces, so there were no seismic adjustments to be made. But this cosy and smooth transition has been affected by societal changes driven by both local and global forces and attitudes. Thus, the advent of nuclear families, children living abroad for shorter or longer periods if not actually migrating, the elderly living longer and preferring a certain independence, in other cases the need for prolonged caring, homes for assisted living and for the elderly being set up and regulated by national authorities – these are some of the major factors with which all of us are now personally familiar and are called upon to cope with one or several of them.

The perception of and attitude towards older people has also changed, for which again there are complex reasons, one of which must surely be the fact that the way they now dress and behave frequently tends to approximate to that of the younger sections of society. Formerly, being old corresponded to being regarded as elderly that is mature and wise. Respect was practically automatic when one came across such persons, who were also self-respecting.

But nowadays this is no longer necessarily the case, and having greying hair and a balding head doesn’t mean much to the impatient youngster revving his SUV when an elderly happens to inadvertently sidestep a pedestrian crossing, or is taking a bit longer than usual to go across. I have personally witnessed such a situation where a senior citizen was being copiously abused by a younger person.

But it is also a fact that public displays of confrontational and aggressive behaviours by the elderly when they are expected to show restraint in their language and gestures leads to a corresponding disappointment on the part of those who would wish to see them as role models. Instead, they are disdained and looked down upon as they are seen not to deserve the respect that they would otherwise have earned.

The most visible indications of ageing are physical and mental decline, with vulnerability to injury, disability and disease, more than one of which may be present and thus adding to the complexity of treatment. Many of the diseases of old age have been known to doctors for long, and treatments too have been available, and they are constantly under review and updated as newer diseases are discovered or fresh understanding of the known diseases comes to light.

In fact the range of modalities and techniques for treatment has expanded so much – and continues to do so – that there is a real danger of what is known in the medical jargon as ‘therapeutic overkill’, that is, to put it simply, trying to kill a mosquito with a hammer: doing more investigations or proposing more expensive or complicated treatment than may be required. For some, medicine has become business, and this is a conundrum which society as whole must seriously reflect upon and work out a way forward collectively.

There is more knowledge and treatment available for physical than for mental problems associated with ageing, but progress is being made as regards the latter too especially in understanding some of the fundamental mechanisms of their causation at a deeper level. This does not imply that treatment is forthcoming, accessible or affordable. That is why caution is necessary so as not to involve either the country or the person in a spiral of expenditure which may result in little beneficial effect. Hence the accent on healthy living through a combination of health promotion and disease prevention activities.

Overall the world has witnessed growing life expectancy because of improving socio-economic conditions and developments in health and medicine that have allowed us, essentially, to mostly overcome the infectious diseases which are the real killers in the short term. The traditional view is of man’s lifespan being three-score and ten (70 years), but there are some countries with more people living much longer, and even becoming centenarians in larger than usual numbers when one compares them to other places.

One such cluster is in the island of Okinawa in Japan, which is reputed to have the largest number of active centenarians per 100 000 population. The main reasons advanced for this happy situation is their simple way of living, close to nature, on a diet of fresh vegetables free of pesticide or fertilizer residues, regular walking and avoidance of vehicular transport, doing regular meditation and following ancient cultural practices which lead to body-mind balance and thus sane living.

There are those who think that we are not fated to age, and that it is possible to live over 100 years. One protagonist is Dr Christophe de Jaeger, who occupies the first ever European Chair of Longevity at the University of Applied Sciences in Belgrade, and who categorically states “Nous ne sommes plus faits pour vieillir” which is also the title of his latest book, subtitled ‘Vivre 120 ans en bonne santé’. He is convinced that, based on profound assessment of a person’s physiology, it is possible to propose measures that will allow that “nos contemporains puissent continuer à vivre debout, autonomes, qu’ils puissent continuer à créer, entreprendre et aimer, bien au-delà de cent ans”, an objective attainable by anyone who decides to do so – which demands more than attention to the skin, as he points out:

‘…la peau est un miroir de la qualité de notre vieillissement général et que la tendre, la combler ou la stimuler par mille techniques de médecine ou de chirurgie esthétique ne résout pas le fond du problème. Cette “fausse impression” nous éloigne des réalités du vieillissement, qui ne fait que s’accélérer et cette illusion ne trompe personne (il suffit de regarder le cou ou les mains pour s’en apercevoir !)’. Those who wear wigs must beware of the telltale signs of the goose feet wrinkles in the temple area, and perfect jobs must be done on whitening hair so as not to expose the strands that surface without warning and catch the attention of the discerning. It is understandable that women may wish to camouflage their age as much and as long as possible, but men?

One need not seek to hide one’s age by superficial means, for there is such a thing as ageing gracefully, whether one aspires or not to be 100 or beyond. As the Greek philosopher Seneca said, ‘A life is like a tale, not how long it is but how good it is.’

If we concentrate on living a good life, who knows that it might be a long life too?

* Published in print edition on 11 May 2012

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