I believe that old people are the future. Between 1900 and 1990, the percent of people in this country over age 65 increased from 4% to 12%. With each passing year, I grow older, whether I like it or not. Many forces, some economic and some social, pit the needs and virtues of the young against those of the elderly. In truth, growing older is a natural consequence of successfully navigating childhood and young adulthood.
This “graying” of the population may very well result in problems such as the imminent social security crisis, or likely epidemic proportions of dementia. However, my work as a geriatric psychiatrist has led me to believe that having access to more elders offers me more opportunities to learn useful lessons about the roles of the young and the old. My grandparents worked hard most of their lives in manual labor jobs before retirement and old age. When they died they “passed on” in a physical sense, but more significantly, they passed on the example that old age was dignified and full of love and wisdom.
Erik Erickson, one of the few psychoanalysts to create a theory of human development that includes old age, describes it as a struggle to reconcile one’s accomplishments with one’s unaccomplished dreams. Most of the patients I treat live in nursing homes and many of them have suffered great losses of physical and mental health. Virtually none of them dreamed of spending their final years in a nursing home. I can imagine few greater causes for despair than having to face this reality. Yet I am fortunate to see many older adults overcome this challenge with dignity, love, and wisdom. A particular patient comes to mind. She moved to a nursing home due to several diseases of old age. She adamantly argued that she was not depressed since no one experiencing what she had should feel happy. Over the next several years, while in her nineties, she lost the ability to walk but she learned to drive a motorized scooter. When she could no longer drive the scooter, this fiercely independent woman learned to depend on others, asking them to take her where she wanted to go. She died when 98 years old, at peace with what she had been able to do in her life rather than in despair over what she could not do. I believe I am a better psychiatrist and person because of her. My children will benefit also. As to paraphrase Erickson, children will not fear life’s challenges if their elders can face old age without despair.
Unfortunately, there are patients who are unable to navigate life’s challenges so thoughtfully, especially those with severe dementia. For these elderly, I believe it is our duty to provide the dignity, love, and wisdom that have been passed on to us. We just may be passing on the blue print for how we will be treated in our future old age.
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