Tuesday, 18 February 2014
Defining Age as Sickness
From the beginnings of my research into aging nearly 20 years ago, I was shocked and then disheartened to see that pretty much all writing – academic, popular, personal and professional – started from and ended with the belief that getting old is entirely about disease, debility and decline.
That is the reason I started this blog – because I refused to believe then, at about age 55, that my future was so grim and I wanted to report on what aging is really like.
That is not to say I am a fantasist or an idiot. Certainly, as we age, the physical and, sometimes, mental challenges can pile up.
It is, for example, well known that what are called the diseases of age – cancer, diabetes, Parkinson's, rheumatoid arthritis, dementia, heart disease and more – begin to kick in big time in people's mid-70s.
Even when we escape those most frightening of conditions, the lesser ones take up much more of our time than when we were young and middle-aged. Colds and influenza, for example, hit harder and last longer.
And aren't skin tags, liver spots or those seborrheic keratoses fun enhancements to old age.
Nevertheless, for all these years it has appeared to me that there is a whole lot more to old age than all that decline business that is positive and good and life-enhancing.
So I was surprised to read the result of a recent study:
”Only about a third of Americans ages 65 and older are fully able to take care of themselves and go about their daily lives completely independently...”
That's from a December report at Medical News Today (MNT). The report itself was published in the February 2014 issue of American Journal of Public Health (abstract only here) and actually, the number is 31 percent – a bit short of one-third.
Since there are about 41 million U.S. citizens age 65 and older, that's more than 27 million of us who, to greater or lesser degrees, need help with some of the basic tasks of daily life.
There were 8,077 participants in the study, a representative sampling all age 65 and older, and the researchers asked them in face-to-face interviews about seven activities of daily living:
Getting around inside
Getting out of bed
Getting cleaned up
Using the bathroom
Here is how the two-thirds who need some amount of help in daily activities shake out:
”About a quarter succeed in accomplishing what they need to do on their own using walkers or other assistive devices
“Another 18 percent say they have trouble even when using these devices
“Six percent cope by reducing their activities - bathing or going outside less often, for example
“21 percent manage by receiving help from others.
Vicki Freedman, a research professor at the University of Michigan Institute for Social Research and the study's lead author told MNT:
"'Nearly 80 percent of all older adults find ways to manage on their own without assistance from others,' [she] said.
"'The group using devices on their own without difficulty is especially interesting. They seem to be able to participate in activities they enjoy and report well-being as high as those who are fully able to care for themselves.'”
I would like to know more about that 80 percent of ALL older adults who “manage on their own” but since the full report is behind a paid firewall, it helps to some degree that the MNT story tells us, as would be expected, that
”...the proportion of older adults able to function independently varies greatly by activity and by age. For example, 90 percent of older adults are fully able to eat by themselves, while only 54 percent are fully able to bathe by themselves.
“About 45 percent of those ages 65 to 69 are fully able to carry out all activities independently, compared with only 4 percent of those ages 90 and older.”
It seems apparent that those who need the most help with daily activities are the oldest old and it would have been helpful to have a further age breakdown – perhaps into three groups: 65-75; 76-85; 86 and older to truly understand who it is in greater need of aid.
But without that, I suppose I must stand corrected in my belief that most of us are not as impaired as the aging literature reports. To repeat,
"Only about a third of Americans ages 65 and older are fully able to take care of themselves and go about their daily lives completely independently...”
It's a question to explore another day, but for now that does make one wonder how our right wing politicians think raising the eligibility age for Social Security and Medicare is humanely possible.
At The Elder Storytelling Place today, Marcy Belson: Mexicali