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