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Thursday, 20 February 2014

If You've Seen One Old Person...

...you've seen one old person.

Because the statistics so surprised me, on Tuesday I wrote about a recent study reporting that

”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...”

Your responses in the comments were enlightening. Some saw it as – at last – honest reporting about how hard aging is. “Statistics don't lie,” wrote Vera.

”I live in a 55+ apartment complex and it's like living in an assisted living apartment,” wrote Tuli Reno. “The figures you quoted would work here.”

But most, from personal experience, found fault with the numbers. Carol in Colorado gave us an inspiring anecdote:

”I bought a folding exercise bike. I put about 5 miles on the bike before I found it hurt my back so I sold it to my neighbor down the hall who was 95 when she bought it. She's 97 now and has put several hundred miles on the bike.”

It is Darlene Costner, who will soon be 89, who captured what I (this one academic study notwithstanding) most believe about how people age and I'll quote her elegant response at length:

”As many of you know I am on my way to being 89 years old and I am dependent on others for transportation. Other than that, I am doing it "my way.”

“I am slower, use a walker if I am feeling weak or need to step down from a curb, use a cane when needed (not in my house) and do not keep the outside as well groomed as I used to. Does that make me typical?

“I have two neighbors that I will use for comparison. One walks her dog twice daily, keeps her outside and inside immaculate without help and has no debilitating diseases. She is one year younger than I.

“Another is pretty much housebound, has a severe back disability, relies on her daughter for transportation and has a housekeeper come in weekly to clean. Yet she still cooks for herself and is able to take care of herself in all other ways. She is 97 years old.

“I have another friend who is fighting cancer and is in her forties. Without her mother to help her, she would probably be in a nursing home.

“So which of we 4 women fit into the neat box of a statistic? My point being it that we can find all sorts of differences in all ages.”

Judith Graham, a journalist who specializes in aging, emailed Tuesday to remind me that she wrote about this study a couple of months ago in The New York Times New Old Age Blog. In that report, she further explained the categories into which the researchers divided the elders:

”The first are the 'successful adapters' who change their home environments or how they approach activities, and get along well on their own. Think of older adults who install grab bars in the bathroom, use a cane, install a seat in the shower, or rely on a hearing aid — and who otherwise seem unimpaired.”

I take issue with the researchers labeling these people “adapters” who “otherwise seem unimpaired.” I think they ARE unimpaired.

Grab bars in the bathroom (like all aids initially created for elders) are good for people of all ages – anyone can slip in the tub or on a wet floor. Many people I know, and some not so old, take a cane or walking stick with them when they leave home not because they need the support, but as a precaution against falls.

And a hearing aid? I classify that as I do eye glasses and cataract surgery when they are needed: hardly different from replacing worn-out tires on a car.

At the end of her Times story, Graham addresses just this issue:

”What about the fifth group in this study — seniors who receive some kind of personal assistance?” she writes. “Some experts classify them as dependent, while putting seniors who use assistive technology in the 'independent category.'

“But H. Stephen Kaye, a professor at the Institute for Health and Aging at the University of California, San Francisco, argues that this is a false distinction.

“'I have a fundamental problem with the notion that the use of technology is different from the use of personal assistance,' he said. 'Both represent a way of getting help, and both can be a successful accommodation to disability, depending on a person’s circumstances.'”

UPDATE: It has been brought to my attention that I misread the above quote from Professor H. Stephen Kaye. His point is that people who use personal assistance to adapt to disabilities should not, as is widely believed, be thought of as more disabled than those who use devices to get along.

I could not agree more and extend my apologies to Professor Kaye although, unrelated to his point, I still have reservations about the study that is the subject of this post.

That sounds to me like one more ageist way to define old age itself as a disability. By Kaye's reasoning, anyone wearing eye glasses or contact lenses would be categorized as disabled.

After reading your comments and Graham's story plus some time discussing this with friends on Wednesday, I've given this study some additional thought and am sorry now that I bothered to write about it because I think it is flawed.

In particular, the five-point range of ability to disability does not begin to cover the nuances of aging which is more complex than any other stage of life.

It has been known for a long time that people age at dramatically different rates from one another. Although childhood development – rolling over alone, walking, talking, etc. - can be predicted to specific weeks of life and are cause for concern if the kid doesn't match those predictions, nothing like that occurs in old age.

Instead, there is a wide spectrum; some 50-year-olds are decrepit and some 90-year-olds are healthy and active.

So I think this study was too simplistically conceived and before we accept the disability figures for people 65 and older, we need a study that better considers the realities of aging.

Meanwhile, to repeat: if you've seen one old person, you've seen one old person.


At The Elder Storytelling Place today, Clifford Rothband: Dogs Can Bark Even From the Dead


Posted by Ronni Bennett at 05:30 AM | Permalink | Email this post

Comments

Good summary, Ronnie. A more nuanced study with more possible categories along with some better descriptive narrative would be good. It may be that the researchers themselves need to be older and more experienced with the vagaries of life in order to do this research well.

Thanks for your follow up.

Ronni,
Thank-you so much for discussing this subject yesterday and today. I would like to know what some people think happens to our Individuality. Do they think it is right to lump us all into neat little groups? I do not. I live in an over 55 building and have seen that individuality demonstrated every day for years. I have also observed that many young people wear glasses and hearing aids and have health issues. Let's remind everyone that if they must judge human beings,they should not lump all old people together anymore than anyone else. We are unique individuals and should appreciate that for ourselves and others should as well.

But it's also true that people get old, and, in the process, wear out. I would suggest that people age at the same rate--a year is a year for everybody--but the toll that year takes is individual and relies on a whole lot of complicated factors, among which are the genes you're stuck with, the way you live, and just plain old dumb luck.

I wish that researchers were more precise about discussing old people by providing more information about people aged 65-75, 75-85, 85-95, 95+. It would be way more useful than lumping everybody over 65 together. Look at the huge differences between 20, 30, and 40; why should 60, 70, and 80 be any different?

Well stated mary jamison---

and Ronni--- you are such a valuable guide in our struggle to grow old as best we can

Every time I have to fill out a form or questionnaire and I am asked to "check" an age category I am appalled at having to check the box that says 65+. The people who comprise these surveys (probably twenty somethings) think that a 65 year old thinks and feels the same as an 80 year old. While they break the other age groups into narrower segments (18-35, 36-50 etc.)they do not do the same for us older folks. perhaps a better way to segment a demographic is to ask "Were you born prior to or after the WW2".

I love what Darlene wrote. Good question .. "Which one of us is typical."

Not I

I strongly agree with Ronni, Darlene, and Mary..

We are all different so we age differently. I am 85 years old and I am completely the opposite of my 68 year old neighbor.

I still drive my car alone from Philadelphia to Danbury, CT. on a regular basis to spend a few days with my son and his family.As an aside, this drive takes me over the infamous George Washington Bridge. I'm happy I wasn't traveling the day Governor Christie decided to move the lane dividers closing two lanes.Phew!

My neighbor has her son drive her to church and supermarket which are both about 3 miles away.

I really like my independence and try to do as much as possible myself. My two sons and their families who live nearby come over to see me and I enjoy cooking their favorite meal for them while they shovel the snow (56" this Winter) or fix the garage door opener which was broken. That is stuff I can't do, but thankfully, stuff I CAN do, I love to do myself..

No regret for posting the article Ronni. That kind of reporting really gets the neurons firing, and inspires the most insightful comments.
The only truly accurate statistics, are 'age of death' figures.

Syd and I are both in our early 70's and we live in our own home and take care ofour needs. We hire when we need major work done on the house (thank God) right now we are good and we just take each day as it comes. Rather then compare ourselves to others we just do what we can and if a nap at 2 pm is needed so be it. To live is holy and to each day a blessing - if "compus mentus"

Ronnie,

I am not sorry you chose to write about the study. What this did was provide fodder for a lot of individual sharing. We live in a world that likes to tie a package up, put a ribbon on it and say, "That's the way a package looks". However, we are all individuals, and I think those of us who are willing to accept our aging know that the variables of genetics, finances, lifestyle and just sheer luck make each of our aging experience what it is.
I am almost sixty-three. I take an exercise
class twice weekly. I am the youngest in the class, and yes, I have already been diagnosed with one of the "dreaded diseases" in addition to being in a horrific car accident, which left me in a wheelchair for five months, The car accident occurred six months before the breast cancer diagnosis. Not my best year LOL. That was all two years ago. Today I am up and about and living very normally.
The women in my exercise come and go but for the most part always return. Aging slows us down, and most of us do have health stuff that we have to miss class to tend to. But I watch these women in the class (two with macular degeneration, two with lung problems, four of us with cancer diagnoses, knee replacements- you name it- all show up, dance to oldies and laugh. LIfe goes on. I love being part of this group, for these women are showing me the way. The way is to just adapt and keep going.

Funny how it's ok to get help with the housework and transportation if you are rich and just want someone else to do it for you but it's different if you actually need that stuff done.

Thank you, Ronni, for your kind words and thanks to those who agree with me.

Bruce Cooper hit on a pet peeve of mine and that is: when filling out forms of age categories they always list "over 65" as the final choice. I left that age nearly 19 years ago and I am far from being the person I was then.

What it all boils down to is that we are all different and all statistics can ever do is hint at possible averages. Even those averages are fairly meaningless unless your sample sizes are really huge - like for example mortality stats for a whole country. And BTW, Ronni, kids vary enormously as to when they reach those milestones. Some walk at ten months,others at 18 months, some are talking well at 15 months others don't utter a word till they are nearly 3 years old - and those are huge variations when you're talking about such tiny people. Small wonder, then, that some of us are falling to bits at 55 and others are living full and independent lives at 97. Also, just as childhood development tends to happen in fits and starts and sudden spurts rather than at a steady rate, I've noticed in myself that certain aspects of aging seem to happen in a similarly erratic way. Like no change in my eyeglasses prescription for five years then suddenly it's less than a year and things are getting blurry again.

I'd like to join in the chorus of complaints about 65+ being the last age group. That could easily span 25 years, and you don't see the rest of the groups spanning that much. 1-25, 25-50 would be useless and ridiculous. So is 65+. Of course, they could just mean they aren't counting and don't care about anyone over 65 ...

Thanks for putting an honesty into the perspective that is brought to ageing. I often get cross at the people who think you have to fight fight fight ageing all the time. Why can't we just enjoy the health and abilities that we have got and forgive ourselves for the things that are harder. Blessings from Dalamory

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