April 2012

you could know now what they knew then

At 50, Karl Pillemer had a revelation about his career.  After 25 years as gerontologist, he found himself focused almost entirely on problems like elder abuse and isolation: “the Book of Job for older people,” as he put it at the 2012 Age Boom seminar for journalists. This conformed to the general portrayal of olders as frail and debilitated, and was reinforced by researchers “because focusing on problems is how we get funding.” But not only had this stopped feeling fulfilling, it didn’t jibe with his actual experience, and so an outreach project was born.


“First of all, I was meeting lots of vibrant, intensively active, enjoying-life elders. Also, there’s this fact that older people tend to be happier than younger ones, and that in general mental health improves with age,” he recounted. “Despite decades studying the problems of older people, I had a nagging suspicion that there was more they could tell me about how to life the good life.” That second sentence is a quote from what the outreach project turned into:  a book called 30 Lessons for Living: Tried and True Advice from the Wisest Americans. It’s based on over a thousand two-hour interviews with a diverse group of men and women over age 65, many way over. (The oldest, 108, told Pillemer, “I remember my first day of work so well, because it was they day World War One ended.”) 


The project reflects the gerontologist’s understanding that late life, like adolescence or middle age, has to be seen as a stage of development, and that two things make older people developmentally different. One is their limited time horizon, which helps olders make better decisions about how to use their time. This boundary makes it easier to live in the moment, which in turn makes people happier. The second thing that sets this cohort apart is their extraordinary life experience, especially those around for long enough to have lived through the Depression, World War II, and the civil rights struggle. Pillemer was motivated by a fundamental assumption: “Older people are the most credible experts available to us on how to life well through hard times.” Since no one had systematically solicited their practical advice, he set himself the task, asking intimate and profound questions like,  “What is the purpose of life?” “What do you wish you’d done differently?”  “What do you regret?” and “What are you afraid of?”  Here is the essence of their responses.


Lesson #1: Live like your life is short. One woman turning 99 told Pillemer, “I don’t know what happened. The next thing you know, you’re a hundred!” What does this involve?  Find work you love (instead of opting for money or security, surprising counsel from veterans of the Depression). Say it now. Travel more.


Lesson 2: Happiness is a choice not a condition, a matter of personal agency. Younger think happiness occurs because of things, said Pillemer, “but when they’re older, people know that happiness occurs in spite of things.” This is quite consistent with cognitive behavioral therapy, he pointed out, “and they’ve come upon it naturally.” In other words, age itself confers very effective coping mechanisms upon ordinary people. These weren’t bodhisattvas or philosophers. “Everyone over 70 has occurred the kind of losses that younger people worry about. If you can’t make happiness a choice, you’re going to have a lot of trouble finding happiness,” said Pillemer. The choice was often expressed in terms of a turning point, as in the case of a woman who grieved for two years over the death of her 22-year-old daughter, Bubbles, then made a conscious decision to pull herself out of her tailspin. Instead of worrying or holding onto grudges, she and her peers recommend savoring the small things, letting go, and practicing gratitude. 


Lesson #3: Aging is better than you think it is. “Our fears are not borne out by the oldest Americans,” says Pillemer. Treat your body like you’ll need it for 100 years. Learn to be social (even, or perhaps especially, if you’re an introvert). Find multiple ways — as worker, spouse, volunteer, caregiver - to connect with the world and stay in contact. Respondents, especially widowers, strongly endorsed moving into senior communities.  


Lesson 4: Take a lifelong view of relationships with children.  People used to die reasonably soon after their last child left home, Pillemer pointed out. Now, in an unprecedented shift, baby boomers are likely to have twice as much time with their adult kids than they spent with them as children. Paradoxically, higher divorce and lower birth rates mean that boomers confront a higher risk of social isolation than the oldest Americans now.  The moral? Cultivate family relationships. Spend time with the kids. Avoid rifts. “The most unhappy people I talked to were those who were permanently estranged from a child.”


Lesson 5: How to avoid regrets.  When it came to what they wish they’d done differently, Pillemer expected pangs over business deals gone wrong or educations unfinished. Instead, over and over again, people said, “I wish I hadn’t spent so much time worrying.” A group that married young and often quickly, respondents frequently advised putting off marriage. They consistently endorsed risk for younger people, and were often envious of the opportunities that younger women enjoy today.  “Step out.” “Don’t get stuck in a box.” “Don’t try to please everyone.” “Say yes to opportunities.” In other words, it’s not mistakes that seem to haunt, but opportunities not acted upon.  Not that many people seemed haunted, which may reflect another developmental change in older people: they process negative information less deeply than positive information.


These fundamental lessons were universal across class and race, “but the ways people got there differed,” Pillemer observed.  For example, African American respondents had had to deal with discrimination on their path to happiness. He found nuanced differences across cultures. Another observation was that the older people were, the less they feared death. “All the time, interviewing these people, I asked, ‘Where’s the terror?’” Pillemer recounted. “Another lesson was ‘Don’t worry so much about dying, because we don’t worry about it.’” 


I wrote admiringly about Pillemer's Cornell Legacy Project earlier this year, but took him to task for aiming the book expressly at young readers, which struck me as a little, ahem, ageist. That’s probably unfair, since in his talk Pillemer defined ageism compellingly and described some of the ways in which it works powerfully against the interests of the old. (One example was the extent of age segregation in our society. “Americans are more likely to have friend of different race than friend 10 years older or younger,” he said.) I’d argue that people in mid-life stand to benefit the most from 30 Lessons, especially from the advice to worry less about aging and dying. That makes it a lot more appealing to become “an old person in training” and to think clearly about the decades ahead – the topic of my next post. 


Feeling over-the-hill at 40? Cheer up. For a while.

Most animals, from shrimp to shrews, decline swiftly after reaching sexual maturity.  Humans, on the other hand, experience middle age: a several-decade plateau during which most biological systems deteriorate very little. This stage of life, argues writer and zoologist David Bainbridge in this excerpt from Middle Age: A Natural History, represents a remarkable evolutionary achievement that should gratify, not depress.

 

Yes, we need reading glasses to read and to inspect our sagging jawlines, but breeding is behind us, brains work fine, and learning continues. The middle aged cooperate, innovate, and contribute much of the skilled labor that life in an information society requires. “These changes strongly suggest that middle age is a controlled and preprogrammed process not of decline but of development,” Bainbridge writes. Instead of wannabes worried about wear and tear, “middle-aged people may be seen as . . . an elite caste of skilled, experienced super-providers on which the rest of us depend.”

 

What’s my beef? I’m irked by the defensive nature of his basic argument, although it’s understandable given the prevailing dismal view of life-after-youth. That’s what makes his an uphill battle, despite the many benefits the middle years convey: earning capacity, mobility, sexuality, kids newly independent and parents still so. My bigger beef is that Bainbridge has kicked the ball down the field but nowhere near far enough. He makes a fine case for the value of middle-aged humans “as super-providers and master culture-conveyers,” but after midlife? Only decline. Mid-life is desirable partly because late life appears much less so. His is still a deficit model that benefits one generation at the expense of another. Middle-aged people might not be “evolutionarily crucial” like young adults, he says, but neither are they “evolutionarily irrelevant” like old adults.  

 

True, evolution has had some 65-100,000 years in which to make middle age “relevant,” while human lifespans have lengthened significantly only in the last century – a blink of an eye in evolutionary terms.  It will take millennia for natural selection to shape this transition. That may render olders “evolutionarily irrelevant,” but late life is no less a socially and culturally constructed period of development than adolescence or middle age. Olders are well suited to the central task of modern life as envisioned by Bainbridge: the propagation and transfer of complex information. Instead of letting ageism blind us to this potential, we need to envision the institutions and structures that will support it, and in so doing benefit people of all ages. 

aiming at ambivalence

I attended my first Age Boom Academy for journalists in 2008 and have returned several times since. This year was particularly rewarding, because now I’m able to put the speeches in context and because I’m honing in on a specific question: why are Americans, individually and collectively, so deaf to all but the negative messages about old age? After all, no one wants to die young, and no one disputes that the elimination of premature death is a remarkable achievement.

Speakers referred to “a new stage of human history,” “the most important phenomenon of our time in the world, more than the bomb, the Pill, or the internet,” and “potentially the biggest achievement in the history of the species.” 


Yet the global longevity boom is more typically portrayed as a disaster in the making.  And unless we prepare wisely for this demographic shift, we could “snatch defeat out of the jaws of success,” in the words of Linda Fried, Dean of Columbia University’s Mailman School of Public Health, which co-sponsored the 5-day seminar.

 

“So why are we at best ambivalent?”

This theme — why it’s so hard to galvanize a positive national conversation around longevity-related issues — has surfaced at past Age Booms, and this year several speakers addressed it directly and compellingly. The most compelling was Fried, who referred to “a disease as a society –  a scotoma, or hole in our vision – around aging.” When she asks her undergraduate students whether they want the 30 additional years of life granted to us lucky Westerners during the 20th century, just about everyone says yes.  “So why are we at best ambivalent about whether this population aging is a good thing or not?” she wondered aloud. 


Fried described this as an “interesting conflict” between individual desire and collective apprehension, but I think we’re profoundly ambivalent as individuals as well.  We yearn to grow old yet dread the prospect, and ageism takes root in that dread. It was dispiritingly on view during the opening remarks and introductions at this very seminar, with the lame icebreaker, “I know that this isn’t true of anyone else in the room, but I’m aging,” and comments like, “She’s been my friend for more years than I care to mention” and “You didn’t need to mention [the year I graduated].” That’s ageism. By denigrating and stereotyping the no-longer-young, it provokes ambivalence in all of us.


Powerful historical forces are at work as well. Anxious times feed what Fried calls a “deficit accounting of what it means to be an aging society.” The list is long: the recession, a broken healthcare system, a shredding social safety net, decaying public schools, unemployment, religious wars, global warming — huge problems worsened by a political system that values the corporation over the individual and the individual over the community.  We lack the infrastructure to exploit the only natural resource that’s actually increasing — the social capital of millions more healthy, well-educated adults — and to provide the assistance they’ll need in their last years. No wonder we’re nervous.


science leapfrogs culture 

Founding director of the Stanford Center on Longevity, Laura Carstensen thinks big, and I liked her explanation about why the transition to longer lives makes us so uneasy. The leap in lifespan, she explained, is because of extraordinary advances in science and technology and behavior change that our ancestors made a hundred years ago. But, she explained, “this feels very sudden and often uncomfortable, because the culture we live in is still the one we had when lives were shorter.”  We’re creatures of culture, and we’re unsettled by legitimate anxieties —  the prospect of sensory loss, frailty, dementia — that we need to address fast and well. Part of the solution involves reconceptualizing these challenges.  “When we used to talk about polio, we didn’t say, ‘Oh, kids, they’re so frail and fragile, they can get this and that,’” Carstensen pointed out. “We said, ‘We’ve got to solve that problem.’ And separate what’s a problem of biology (disease) from those created by the society that we live in.”  


The longevity boom calls for massive investment into the biology of aging and related medical issues.  But the longevity-boom-as-calamity scenario is socially generated and perpetuated by tenacious myths. (See this MacArthur Foundation paper.)  A few of the biggies: 

  • physical and mental capacity inevitably decline with biological aging.
  • in an aging world, olders and youngers will inherently be pitted against each other.
  • funding Social Security and Medicare are huge problems with no upsides.

One I encountered early on, when I was writing about people over 80 in the workforce, is the “fallacy of the lump of labor:” the notion that older and younger workers compete for a finite number jobs. In tough economic times this surfaces like Whack-A-Mole. In fact skillsets differ. Also, the bigger the economy the more jobs for everyone, and conversely, the larger the workforce the more productive the economy. There's also the myth that older workers are less productive than younger ones. “If you know you’re going to retire, you try to wind the shop down,” said Carstensen, explaining a drop in productivity for many workers in the years before retiring at 65. But it turns out that it’s being in the same job for 30 years that slows output.  “Put that person in a new job, and he’ll come up with lots of creative ideas. A lot of other things we think are age-based are context-based,” she said. These myths are reinforced by ageist attitudes that surface ever earlier, distorting and demeaning the life course. Job discrimination now kicks in at 40, which has everything to do with appearance and nothing to do with ability.


throw facts at people, right?

“We probably need data to show people,” commented Carstensen at one point.   “Information is the way to counter stereotypes,” offered Jack Rosenthal of Atlantic Philanthropies, one of the seminar’s sponsors. As a social scientist I love data, and at the beginning of this project I charged at that challenge like a bull at a red cape. Much of my early excitement was fueled by how many of my (invariably negative) preconceptions about old age were inaccurate or just plain wrong – so much so that for a while my working title was It’s Just Not that Bad.  But information alone doesn’t change people’s minds.  We know that from the dismal record of the political left, and Berkeley’s George Lakoff, author of Don’t Think of an Elephant!, has explained the underlying neuroscience.


Nope, reframe the conversation

In order to recast the longevity boom as the remarkable opportunity it is — to achieve more, experience more, have more time with those we love — we need to think about it differently. Carstensen provided a terrific and overarching example: “It involves flipping the idea from growing old to one about living long.” 


Consider what’s implicit in the loaded term “old age dependency ratio.” (That’s the number of people over 65 divided by the number of people under it.) Better ramp up Depends production, right? But suppose we revised the phrase to reflect the fact that dependency runs both ways? Most resources flow from right to left, no matter how old the children are. Many programs that benefit olders benefit youngers too, like Social Security and Medicare payments that keep olders self-sufficient while their kids are busy raising their kids. Ageism crops up here in the dread word burden, “a word that carries its small-government politics inside it like a bomb,” as Margaret Gullette writes in Agewise. Decent government-subsidized pension, healthcare, and caregiver programs would sure lighten the load. In any case, dependence at the end of life should be no more shameful than at its beginning (and most olders suffer little incapacitating illness until the one that does them in). 


Here’s another statistic typically accompanied by hand-wringing: in 2015 there will be more Americans over 60 than under 15. How about another way to look at it, with the help of this diagram of the “US age pyramid.” In 1900, the population resembled the red triangle at the center, with  the very old greatly outnumbered by the very young.  Now it’s more like a rectangle. Yes, there are a ton more old people, but there are also a lot more kids surviving to adulthood.  Another way to conceive of this demographic shift, as Fried pointed out, is that “we will have one older adult for every child by 2020.”  “What could be better for kids, who were in trouble when there was a ton of kids and very few adults?” asked Carstensen rhetorically. 

 

protect the vulnerable, whether toddling or hobbling

The shift should be good for olders too.  As the saying goes, you can judge a society by how it treats its weakest members. In the US, those are the poor, a disproportionate percentage of whom are very old or very young. Yet people do care about children’s well-being, and that of their grandparents and great-grandparents. There is no evidence of “intergenerational warfare” in the U.S., and if resources can be allocated fairly (a big if, I realize), there won’t be. That empathy, according to Lakoff, conveys a key strategic advantage. “Behind every progressive policy lies a single moral value: empathy, together with the responsibility and strength to act on that empathy,” he writes in The Political Mind. Empathy alone, Lakoff cautions, will get us nowhere, which is why so many kids and old people are poor.  And why the Occupy Wall Street call to action is finally rallying the have-nots.

 

revising the social contract

Our civilization could be the first in history to reap the benefits of a healthier, longer-lived adult population. Doing so will require a social compact that invests in both olders and youngers. It means rejecting the zero-sum thinking that pits the generations against each other, and that discusses resources as if they were intrinsically scarce rather than the result of policy decisions. It means revising outdated assumptions about age and retirement and capability that limit opportunities for older workers, and drawing on those who can and want to contribute. It means abandoning the tripartite timeline (education/work/retirement – stages designed for lives half as long as most of ours will be) for one in which we work for as long as we can “but not 60, 70, 80 hours a week,” as Carstensen said. “The beauty of a longer but more moderately paced career cycle,” she writes in A Long Bright Future, “would be that we could have more leisure throughout life, more time with our children while they are young, and remain engaged in our communities as we age.” It means coming up with meaningful roles for olders in a culture that presently renders them ugly and invisible. 


These are daunting political and institutional challenges. Can a government that has abandoned the 99% on so many other fronts muster the political will? Can we overcome personal squeamishness and hold politicians to a higher standard around aging issues? Any chance the alarmist demography — by 2030 there will be more than 72 million older persons (65+) making up 19% of the population!!! — will jolt them out of election-cycle myopia? Fortunately some big boys are on the job:  Columbia University's Mailman School of Public Health and the International Longevity Center; 130 faculty members at the Stanford Center on Longevity; the MacArthur Foundation’s Research Network on an Aging Society; AARP. Success would shift the conversation around longevity: from deficit to opportunity, from dependence to interdependence, from burden to gift. “If we can see the benefits,” said Fried in her concluding remarks, “maybe we can treat the scotoma – and our fears.” 


fear ageism, not aging

Fear makes people stupid and passive, and the Fried’s use of the word brought Lakoff to mind again: “The more progressives can activate empathy in the public, the more support will be available to them and the worse conservatives will do,” he writes. “Correspondingly, the more conservatives can generate fear in the public, the more support they will generate.” Fear is what that got me started on this project, though I didn’t realize it at the time.  I’ve learned a lot since then:  that old age takes everyone by surprise; that being 80 will probably be very different from what I imagine, just as hitting 40 was and turning 60 is about to be; and that it’s likely to be way better than I once imagined. As the ‘60s saying goes, I’ve had my consciousness raised. As my apprehension ebbed, awareness of ageism (my own, first of all) took its place. Then my activist genes kicked in.


Some ambivalence about growing older is probably just human, especially at mid-life:  we all feel younger than the face in the mirror, and that might be when the dissonance is harshest. Especially in our youth-obsessed culture, the losses are more apparent than the gifts. But the gifts are real. The enemy is not time but institutionalized ageism that drowns out positive messages about its passage. I’m not a policy-maker, but I know my target as a writer: unreasoned fear of growing old and the ageism that feeds it.  Push back.  It’s fascinating, it’s important, and it’s a lot more fun.