Old age and death

Old age is not easily defined. It begins at different times for different people, although what exactly 'it' is, is hard to say. Clearly it is a time of decline, although arguably every year from the early twenties onwards might be described similarly. It is also to some extent a matter of attitude. Some people reach a particular age, say 60, and regard themselves as officially old at that point and so start behaving in an 'old' way. There are stories of people of that age who are perfectly fit and healthy booking themselves into rest homes simply because they think that is the right thing to do at that point. They become old overnight.

There are obvious changes that occur with advancing years, both physically and psychologically. One way of looking at such changes is that they either represent or reflect a growing disengagement with life in general or, perhaps, a disengagement with one's own capacities to deal with life. This might well be so for some people as they age. However, an alternative way of looking at the ageing process is that disengagement is forced on the person through lowered physical capacities, retirement and/or illness. In spite of this, with increasing age, some people strive to become even more involved with life in spite of whatever decline they might be subjected to.

A common reaction to increasing years is what has come to be called socio-emotional selectivity. That is, people become more to enjoy the present rather than planning for the future, for obvious reason - the future appears to be shorter than it has previously. So, greater emphasis is placed on having strong relationships with family and friends, rather than casual social encounters. Some people become more socially focused and less likely to engage in perfunctory social encounters. Couples who develop this approach to ageing also tend to become closer in their relationships. In this social sense, ageing can be a beneficial process.

A dominant aspect of ageing is death. With increasing years, people's thoughts inevitably turn to their own ending more than they did in earlier years. The fear of death, if it occurs at all, tends to peak in the fifties and then to decline. The reason for the peak is that people see the deaths of those around them as the incidence of heart attacks, strokes, cancer and other life-threatening events increases. Thereafter, there are a number of approaches to the possibility of death. Some people withdraw from the world a little and enter the world of memory and reflection. Others do not, but remain actively engaged to the end. One's style of approaching death probably reflects one's style throughout life.

Elizabeth Kubler-Ross (1969) describes five stages of impending death, not dissimilar to her stages of grief. However, not everybody experiences these stages and those that do, do not necessarily go through them in the same order. They are: denial, anger, bargaining, depression and acceptance.

It is possible to take an entirely positive approach to old age, rather than accept what it brings and play any of the roles that society might expect of the elderly. For example, a great deal can be done with diet and exercise to offset both physical and psychological decline. Obviously, it cannot be halted or reversed, but it can be slowed down. Decline due to diet or to lack of exercise is relatively straightforward to remedy and can make a huge difference to quality of life.

The possible changes to social life in later years have already been mentioned. In some ways, after retirement there is more time per day (even though there might be less time overall) in which to consider things social. Improved social lives can be built on the many experiences that people have had as they have gone through the previous stages and crises of life. In general, during these later times, people also know themselves better than they have previously. This can even help in one of the most difficult times of all, when a long-time partner or spouse dies.

One of the most interesting aspects of later life is the cognitive. The general belief is that capacities such as memory and problem-solving decline with age. While this might be so in some cases, there is also strong evidence that this type of decline can be offset by keeping motivation and interest high. So, for example, keeping on reading and doing crossword puzzles or playing word games keeps a person's word-finding and word usage ability high into old age. It is thought this type of activity can even repel the onset of such conditions as Alzheimer's disease to some extent.

One way of dealing with the cognitive (and other) ravages of increasing years has become known as 'selective optimisation with compensation'. What this rather clumsy phrase refers to is the recognition of losses and the selection of psychological capacities that might compensate for them. For example, a greater experience of strategies in board games or card games might be used to compensate for slightly slower decision-making. Or, if an older person is still engaged in sport, then a good knowledge of strategy and tactics can help to compensate for reduced speed and reaction time. More generally, a decreased capacity to react quickly can be considerably compensated for by a longer time of preparation. And the decreased demands on one's time that come with retirement and advancing years mean that there is more time to prepare, at least in the short term. This is simply a matter of sorting out what has declined and what has not and optimising one's strengths.

Finally, it is important to say that it is never too late to develop new interests and activities. Whenever a capacity or ability declines or in some way drops off, it is possible to see this as an opportunity to develop something new that falls within one's capacities. This is not a matter of foolishly fighting the inevitable, but more of optimising one's life at all stages and through all crisis points, not merely those to do with ageing and eventual death.

In general, then, passing through the adult part of the lifespan is no easy matter. From a child's or an adolescent's perspective, adulthood might seem to be a time of relative stability; perhaps it is in comparison with the identity turmoil of adolescence. However, issues that surround establishing (or not) a long-term relationship, having children (or not), establishing and progressing through a career (or not), coping with bolts from the blue, such as redundancy or any other form of major loss, facing retirement, dealing with the death of partner or spouse, dealing with the inevitable declines of old age, and facing one's own eventual death, are none of them easy.

One way of looking at these difficult times and events of transition is that our ways of coping with them depend largely on the approaches that we might take. As the Buddhists would suggest, there is suffering involved in everything; it is an inevitable part of life. How we deal with suffering is up to us. If each of the major life events of adulthood is seen as providing opportunities for learning and as interesting challenges for personal development, then passing each milestone can be viewed as an achievement. There is also the constant comfort that, whatever else might decline with age, our social skills are likely to go on steadily improving, if we allow them to.

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