© Charles D. Hayes
Human genetics are a roll
of the dice, and nothing highlights life’s unfairness like health issues. Some
people sail through life in great health while others never seem to get a
break, having one illness after another until they finally succumb. Needless to
say, health is a major topic of interest among seniors.
Far too much attention is
paid to the economic juggernaut but false promise of products and services
offering eternal youth. What we ought to focus on is the reality of our
demographics: Because of our aging population, we are facing an economic and
human needs train wreck of epic proportions.
Let me say first that I’ve
always promised never to let my physical condition become the dominant focus of
my conversation. But now at an age some consider elderly, I find that reaching
a period in one’s life when one seems at times to be literally falling apart is
interesting in itself to observe. At the same time, it is also a wake-up call
about America’s long-term health care predicament because millions of people
are having similar experiences, many with grave consequences.
The sudden appearance of
new ailments cracks open a critical window on reality. The more often the
occurrence, the wider the view, and the greater the need to pay attention to the
politics of health care.
In 2011, Laura L.
Carstensen published A Long Bright Future:
Happiness, Health, and Financial Security in an Age of Increased Longevity. More
recently, she wrote a piece for Time magazine
suggesting the baby pictured on the cover could live to age 142. The evidence
is clear that we are living longer, but what we aren’t doing as a society is
preparing for it.
The baby-boom generation
comprises 78 million individuals, with more than 40 million already over age 65
and four million more adding to that number every year. The elder bulge will
continue to expand until 2029. Elsewhere I’ve written extensively about this
subject, mostly with positive expectations. We have many dedicated people
working tirelessly to meet the economic demographic challenges of aging, but we
aren’t even close to making acceptable progress. Time is running out.
If you are introspective
and curious as you reach advanced age, you may, like me, become hyperaware of the
seasons of life: the cycles of existence, falling leaves, sunsets, magnificent
trees, and winter. All seasonal reminders of mortality and similar patterns
begin to stand out. Conditions that match your expectations seem to pop up
everywhere for perspective, and new incidents of physical pain give rise to serious
moments of thoughtfulness.
These experiences bring
to mind the Brahodya competition, something that religious scholar Karen
Armstrong describes as having occurred among tenth-century Indian priests. In
it, a group of priests would compete to describe and capture the essence of reality.
The contest winner was the one whose comments could render the others
dumbstruck. This brief moment represented the Brahman—something akin to the
highest form of consciousness one can achieve.
Dumbstruck silent is a
condition similar to what I refer to as a time-out for thoughtfulness,
contemplation, and perspective, especially when we consider what the future
portends for aging citizens. Geriatric health care is ripe for a Brahodya
competition.
As we age, seniors read
the obituary section of the newspaper more frequently because more and more
people we have known show up there. In so many of these cases, the individuals
featured awoke one morning with an ailment and a few months later ceased to
live. So it’s not surprising that one’s new aches and pains come with a few moments
of dumbstruck wonder, prompting the questions, “Is this it? Is this what will
take me out?” It’s an experience worthy of introspection.
Armstrong offers another
example of reflective silence when, at the end of a symphony, the last note is
played and one is left with a moment of stunning serenity. I find this
comparable to watching a great movie and realizing the end has flashed on the
screen. Stirring music is playing, the credits are rolling, and you’re still
lost in thought with at least a subliminal awareness that everyone’s story
comes to an end. These, too, are opportunities to think.
Inspirational moments often occur when
listening to beautiful music. A crescendo of emotion can be so overwhelmingly
exquisite that it seems too good to be true, beyond the capacity of music to
arouse. Such moments of stunning exhilaration are times to reflect as well.
I’m not suggesting that
all of the circumstances giving pause for thoughtfulness are the same, only that
they are related, or that they belong to the same category of openness to
experience. Dumbstruck moments can be called an aha, a flash, an inspiration,
an epiphany, or simply a time-out, but they all yield a similar opportunity to
take stock and truly appreciate the reward of still being alive—a reminder to
help raise awareness to the problems that beg public attention. We owe this
effort to the younger generations, whose lives will be affected by the current tidal
wave of aging citizens.
In The Age of Dignity: Preparing for the Elder Boom in a Changing America,
published this year, Ai-Jen Poo is launching a movement promoting some very
kind, thoughtful, and practical ways to address our aging health care concerns.
But, in spite of our best efforts, the reality of aging demographics portends a
fast-approaching social catastrophe.
Ai-Jen Poo calls our
attention to the economic estimates made by the Alzheimer’s Association that
the total health care costs for Alzheimer’s over the next four decades could be
$20 trillion. That’s not a train wreck. That’s a nuclear blowout. It can’t
happen. It’s out of the question. We either have to cure Alzheimer’s or take
drastically different steps in the way we address the care of patients.
In thirty of fifty
states, the shortage of nurses is expected to increase for decades. The
shortage of doctors in the field of geriatrics is shocking. Medical
professionals say we need a doctor-patient ratio of 1 to 300, but by 2030, the
current estimate is 1 to 3,800. That’s a derailment.
Medicare is already so
inadequately funded that it’s become harder and harder to find physicians who
will accept new patients. Eligibility for Medicaid requires proof of abject impoverishment.
We don’t even have the political command to address the long-term viability of
Social Security. More and more seniors are struggling just to get by, even as the
costs of health care escalate.
Families increasingly
can’t meet the whole burden of caring for aging relatives, and the cost of institutional
care continues to skyrocket. As a workforce, health care givers are underpaid
across the board, and the turnover rate is appalling. We have to think and act our
way out of these dilemmas. Without a political effort nationwide to meet the
demand for services, millions will suffer needlessly.
One of the things I’ve
learned from living, studying, and talking to aging peers is that with a long
life comes affection for one’s own life
experience. More often than not, the idea of changing places with someone in a
younger generation is rejected as undesirable. In and of itself, feeling a
sense of ownership of one’s experiential knowledge is worthy of a time-out for introspection.
This might seem like a
stretch, but when you acquire new aches and pains that are inevitable with
aging, I suggest making the best of them. Consider listening more often to your
favorite music and creating an insightful emotional and intellectual rhapsody
of the whole experience. Apply some perspective to having been afforded the
life of a human being, because when you consider the odds of it ever happening,
you are inevitably dumbstruck.
Whenever we feel a new
ache or pain, we should be aware that, for every one of us still in good enough
health to be thoughtfully reflective, there are literally thousands of others
in worse shape. In nursing homes across the country, aging citizens are routinely
shot so full of stupor-inducing medication and so dependent on intrusive feeding
tubes that, in effect, they live a hydroponic existence—wearing adult diapers,
spending their days struggling simply to breathe and swallow, unable to speak
or sit up—and they do this for weeks, months, even years.
Nature seems cruel in
many instances, where aging and sickly wild herd animals end up in the jaws of predators
while still alive. And it was the custom in many tribes of ancient people to abandon
their elderly, leaving them to die in the elements without provisions. In
comparison to the nursing home scenario described above, however, nature and the
traditions of some ancient tribal cultures seem much less diabolical. If you
doubt this, visit a few care facilities, especially in low-income areas.
In her book, Carstensen
warned about failing to meet the challenges of aging in America. I’ve always
shared her observation about taking dire warnings with a grain of salt, but a
trainload of salt is inadequate to describe what the future portends if we stay
the present course without taking immediate actions equal to the range of problems
we face. We aren’t prepared for people living as long as they do now, let alone
far past the century mark.
Of course, myriad
technological breakthroughs, from remote monitoring to distant diagnostics, can
give us hope. They include robotics and innovations in assisted living
arrangements to help aging seniors. But these are expensive, and they also
leave us open to crisis during power outages and technological failure.
So, you may think it trite
or disingenuous of me to speak in terms of a rhapsody of falling apart,
considering all I’ve said, but death is an inevitable reality for each and
every one of us. It’s long past time that we have grown-up discussions about
the realities of aging. Products and services promising endless youth are not
the answer, and those who promote them are selling illusion.
Every time we experience
a moment of reflection for whatever reason, it’s an opportunity to think
seriously about the future, to engage in dialogue with our elected
representatives and social media, and to urge people to wake up and speak up.
Aging demographics are on
track full speed ahead, and unless we make some serious adjustments, we are bound
for an economic disaster that is likely to play out as a political blame game.
Millions of seniors will pay a price of needless suffering simply because our
political parties refuse to deal with the economic and social realities of
aging. It’s already happening, but too few are calling attention to our
collective denial.
My Books and Essays on Amazon
New Fiction: The Call of Mortality
My Other Blog
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