Elderhood summary

“I’m 93,” wrote beloved sportswriter and long-time New Yorker contributor Roger Angell, “and I feel great.” Contrary to popular belief, this is often the case. Aronson hears it time and again from her patients – life after 65 is great.

And the data backs this up. Studies conducted in the United States and Western Europe show that, at around age 60, people’s levels of well-being are similar to that of twenty-year-olds. After that age, those levels just increase. As Roger Angell wrote of himself and other people older than 75, “we keep surprising ourselves with happiness.”

In a popular TED talk, Harvard psychiatrist Robert Waldinger asks a profound question: “What makes us happy and healthy as we go through life?” According to the more than 80 years of data collected by the Harvard Study of Adult Development, the answer is as simple as the question is profound – relationships.

By “relationships,” we don’t mean a bunch of Facebook friends. Quantity isn’t important. What matters is quality. Anywhere between one and a few close, reliable relationships will suffice. Having a loving, stable partner doesn’t hurt, either. Second to relationships is a sense of purpose or a reason to get up in the morning.

During the first year of her medical training residency, the author made a mistake. She assumed, like many doctors and doctors-in-training, that treating an elderly patient wasn’t so different from treating an adult patient.

As a new internist, she’d inherited a group of patients from the senior residents who’d graduated. Among these patients was a woman named Anne. Anne was almost 90, and she always had a huge smile on her face. She and Aronson quickly became friends.

A 95-year-old once went to see his doctor about knee pain. After a cursory look at the knee, the doctor asked what the man expected. His knee, after all, was almost 100 years old. “Yes,” the man responded, “but so is the other one, and it doesn’t bother me a bit.”

This anecdote points to an unsettling fact. More often than not, people, doctors included, regard age itself as a kind of disease. A knee that’s healthy at 95 is considered an aberration, a surprising exception to the rule. But equating elderhood with certain symptoms can have devastating consequences.

Aronson once had a patient named Dimitri. At age 79, with advanced Parkinson’s and a slew of chronic diseases, including dementia, Dimitri took ten medications, many of them multiple times daily. That might seem normal for someone Dimitri’s age, but, far too often, patients take drugs to treat side effects caused by other drugs. This can have disturbing consequences. 

When Aronson first met Dimitri, he was almost unresponsive. Lying in bed with his eyes closed, he could hardly reply to Aronson’s questions. What was his name? He silently moved his lips. Was he in pain? No response.

For most older people, the ability to function is more important than life itself. In a recent study of elderly patients with serious illness, the “inability to get out of bed” and “needing around-the-clock care” were listed as worse than death.

But in the United States, many of the resources that would help aging individuals remain independent – such as walkers, hearing aids, dentures and glasses – are considered “nonmedical.” Therefore, health-insurance providers don’t cover them.