Growing old in America

In recent years I’ve covered quite a few meetings that have addressed the issue of how to best care for older adults living in our communities. The general tenor has been that we need to do more, especially with millions of baby boomers on the brink of retirement.

A listening session in Willmar last week with Sen. Al Franken’s staff was no exception. The main message: This demographic is growing, the need for services is growing and the funding unfortunately is shrinking. There was another message, though, that I think is just as important: Cookie-cutter solutions aren’t necessarily the answer because every individual, and every community, is different.

We make a lot of assumptions about the old – how they should live, how they should behave, how they should receive their health care. (What should we call this age group, anyway? The elderly? Seniors? Retirees? Older adults? Golden agers? Nothing really seems to fit.)

There’s a tendency to view them as a monolith. Yet when you look more closely, this age group is just as diverse as middle-aged people, or young adults, or children. Not all older adults are frail, doddering and forgetful, just as not all older adults are, or want to be, vigorous mountain climbers and marathon runners. The very old are not at the same place in their lives as the younger old.

Chronological age is not a reliable predictor of what to expect. Many people remain hale and hearty into their 90s, while others begin declining in their 60s.

Why do we insist, then, on lumping them together in a category labeled as “old” and presuming what they need or want?

Consider just one example – how older adults are often treated in the health care setting.

Why is it assumed that because someone is in her 70s and takes seven or eight prescription drugs, she can’t keep them all straight and needs a nurse calling her each day to remind her?

Why is it assumed that older people are resistant to technology or too uncomfortable with it to ever use it in their health care?

Why do otherwise well-meaning caregivers dole out activities and socialization as if they were medicine?

Why do health care professionals call older patients “dear” or “gorgeous” and get away with it? (Something that seems to happen almost exclusively when the patient is an older woman, I’ve noticed.)

Why is there something unacceptable about an 85-year-old who wants chemotherapy for cancer or aggressive treatment for some other disease?

Why is the identity of older patients so often reduced to little more than a lengthy list of health problems?

Age + polypharmacy does not equal confusion. Just because someone fits this profile doesn’t automatically mean they need extra help.

It’s a generalization to assume older adults have no interest in exploring new technology. Many of them are open-minded and adventuresome and would welcome – and use – telehealth services.

Socialization and activities have value but they’re not something to be pushed on people as if they were spoonfuls of cod-liver oil. Whatever happened to the right of older adults to be left alone sometimes?

If you wouldn’t call a younger male patient “dear”, then don’t say it to an older person either.

Aggressive treatment may be neither helpful nor appropriate for patients who are in their 80s or 90s, but it’s unfair to dictate the health care choices we think they should make. The life force can burn just as strongly in an older person as in someone who’s younger. It’s a mistake to insist they should be ready and willing to forego treatment that would be considered acceptable in a young patient.

Health issues can mount as people age, but that doesn’t mean this should be the only prism through which they’re viewed. The older patient with coronary artery disease, hypertension, kidney disease, arthritis, osteoporosis and hyperlipidemia is more than just the sum total of the medical labels that have been pinned on him or her.

To be sure, aging is not for sissies. It’s worth asking, however, whether societal attitudes, beliefs and stereotypes have made it harder than it needs to be. Everyone is an individual, first and foremost, no matter how many birthdays they’ve had.

West Central Tribune file photo by Ron Adams

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