In her article ‘How Americans’ refusal to talk about death hurts the elderly’
Sarah Kliff suggests that the debates surrounding death, including talking about the process of how we choose to die, confuse the conversation – the word “death” often invokes a strong emotional response of fear and anger. Kliff says the focus should shift from death to maintaining autonomy and the things that make life worth living.
Kliff examines opinions on ageing from Ezekiel Emanuel who, in a recent article
in The Atlantic stated that he will not seek medical treatment after the age of 75, unless it was purely palliative to ease pain or assist with other disability. Emanuel observed the changes in his 77-year-old father after a recent heart attack and subsequent by-pass surgery, and felt that despite his father being able to do the things he had previously done, they were now completed at a sluggish pace. Emanuel said that his father’s life could no longer be viewed as vibrant, because as our bodies slow so too do our minds. Through our medical interventions all we are doing is prolonging the process of death.
Emanuel’s observations are interesting, but controversial, as they seemingly paint all older people with the same brush. There is no designated age at which people begin to experience physical/mental decline, and to state that people’s lives are less vibrant simply because they are slower is somewhat pessimistic. For many older people, their later years are full and rich with activity and purpose, despite any physical or mental barriers. Focusing on how to maintain what we are capable of as we age is more important than focusing on what we may have lost.
One academic article revealed that while our “fluid intelligence” may decline as we get older, “crystallized intelligence is maintained into late life” (Phillips and Davidoff, 2007)
. By reducing risk factors and maintaining regular, moderate exercise, the risk of disease, mortality and morbidity are reduced, even for people over 85 years of age. The same article said that ageing successfully isn’t just about avoiding disease and disability, or even prolonging our lives, but “pursuing challenging cognitive activities, continuing exercise, and maintaining social contacts”.
The most important thing for many people when considering how they want to live throughout their senior years is achieving independence and being able to care for themselves. The ultimate goal is to achieve a functional, healthy life, and maintaining a sense of autonomy for as long as possible.