By Judith Graham MARCH 8,
2018
We’ve
all seen it happen: An older friend or family member retires, is diagnosed with
a serious illness or loses a spouse. Suddenly, this individual’s world is
altered, sometimes seemingly beyond recognition. He has reached a fork in the
road; will he get stuck or find a way to regroup and move on?
In a
new book, “The End of Old Age,” Dr.
Marc Agronin, a geriatric psychiatrist, calls this moment an “age point” — an
event that disrupts an older person’s life and challenges the person’s ability
to cope while also offering the potential for new growth.
Growth
is one of Agronin’s primary preoccupations. As director of mental health
services at Miami Jewish Health Systems,
he says he frequently sees older adults rise to difficult challenges,
demonstrating their adaptability and resourcefulness. Yet the oft-repeated
narrative of decline associated with aging — that this stage of life is all
about loss and deterioration — doesn’t recognize these positives, he argues.
In a
wide-ranging discussion, we talked about aging, resilience and how people can
prepare for this stage of life. Our conversation has been edited for length and
clarity.
Q: How
did you become interested in aging issues?
I grew
up in a small town in Wisconsin surrounded by lots of older loved ones. Two
sets of grandparents. A set of great-grandparents. Many aunts and uncles. I
never looked at aging in a negative way. I look at it in terms of what people
gained: wisdom.
Q: A
key theme of your new book is that aging brings strengths. What kind of
strengths?
As we
get older and experience a great variety of things, including adversity and
loss, we continue to develop and mature in terms of how we view the world. We
tend to be better able to weigh competing points of view and find ways to
understand and accept them.
We also
tend to be less emotionally reactive as the connections between the brain’s
fear center, our amygdala, and our frontal lobe become richer and more
developed. We’re better able to reflect upon our experiences. And we tend to
use more parts of our brain simultaneously when dealing with problems, so
there’s greater synergy.
Put all
this together and it adds up to wisdom — a key strength of aging.
Q: What
do you mean by wisdom?
We can
think of wisdom the same way we think of multiple forms of intelligence. One
type is based on expert knowledge — things that we’ve learned to do really
well. Another type relates to expert decision-making — being really good at
understanding and dealing with problems. For some people, wisdom is all about
empathy and caring — connecting with other people. For other people, it’s about
creativity or spirituality — a transcendent view of life.
Q: Are
these strengths reserved only for people in good health or who have enough
money to be comfortable? What about seniors in poor health who are barely
squeaking by?
A lot
of theories of aging leave this group out. They don’t account for people
suffering from dementia, other major losses in life or serious illnesses or
disabilities.
Those
are the individuals I work with every day. I’ve seen over and over again that
we can help these people. Expectations have to be adjusted, obviously, when
dementia or serious illness enters the picture. We have to adapt and rethink
what our purpose is — what can make life meaningful.
I’ve
found that if we try to get these seniors involved in activities, to help and
support their families, to make sure they’re on the right medications, to
provide empathy and care, we can make their lives better.
Q: You
highlight the importance of resilience in your book. What makes resilience
possible?
Resilience
is the ability, in the face of adversity, to assimilate what’s happened and
rebalance oneself.
As we
get older, we tend to be less physically resilient. Undeniably, our bodies are
physically slower and more vulnerable to disease or injury. But psychologically
it’s just the opposite. Because we’ve dealt with more adversity, we’ve learned
coping mechanisms and survival skills.
If we
apply that psychological resilience to physical insult, we can do better. The
mind can lead the body. Conversely, if we don’t have faith in our resilience,
that can undermine our health. I see that day in and out: Individuals who do
very poorly not because of their conditions, per se, but because they don’t
believe they can get better.
Q: You
talk about age points in the book and outline a process people go through. Can
you describe that?
Initially,
confronting an age point — retirement, the loss of a spouse, a serious illness
— can be a stunning and sometimes paralyzing experience. We don’t know what to
do. We go through a process of trying to figure that out. Then comes what I
call a “reckoning,” facing up to what needs to be done. When we find a
resolution, we’re a different person and there’s great potential for growth.
People
should know that there’s hope, that something good can come of this, that all
of us have choices in how we respond. I’ve seen all kinds of reactions: older
people who experience greater freedom and less fear after an experience of this
kind. People who cast aside pretenses or rigid beliefs and let it all hang out.
Other people become more spiritual, deeper in their beliefs.
Q:
Another term you coin in the book is “geropause.” What’s that?
I work
with a lot of older adults who just hit a wall. The wind gets knocked out of
them and they lose a sense of hope. They’re stuck. There’s no term for that, so
I created one.
The
first thing to do is recognize that you’re stuck. Some people can’t do that;
they don’t have a vision of what life can be beyond their situation. You have
to have a vision or a dream to get moving again, to have the motivation to
change.
Q: Your
book ends with an action plan. What advice do you give?
If
you’re stuck and want to move forward, reflect on your life and take stock of
your interests, abilities and experiences. Don’t do this alone: Do it with
other people who can point things out to you along the lines of “Mom, you did
this, you love this, you’re so good at this.”
Next,
think about your age points. How did you cope and what motivated you to move
beyond difficult situations in the past? Again, do this with other people who
know you and are eager to help.
Then, I
ask people to think about what they’re going to do next and come up with a
concrete plan that can get them more involved and engaged.
Finally,
I encourage people to celebrate their aging — to create new rituals that make
them feel good about themselves and make a big deal out of it. Think of all the
goofy cards out there that make people feel bad about turning 50 or 60. Where
are the cards that make people feel good about themselves? It’s time to create
new traditions.
KHN’s coverage of these topics is supported by John A. Hartford Foundation andThe SCAN Foundation
Judith Graham: @judith_graham
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