Monday, December 22, 2008

New Aging

In her book Aging, the Health-Care Challenge, Carole Bernstein Lewis notes that “old age is a new concept and a relatively new phenomenon.” She quotes Leonard Hayflick as saying of aging that it is “…a process for which evolution never prepared us. One might conclude,” he adds, “that aging is an artifact of civilization.”

Our prehistoric ancestors were lucky to live to 30. Only in the past few centuries has the allotted time for a reasonable lifespan been extended to the familiar three-score and ten. Living beyond 70 into one’s eighties or nineties is new, thanks in large part to public health improvements resulting from increased food production, sewage treatment, water purification, vaccination, and antibiotics.

But along with these improvements in age extension, a host of new problems has arisen. We need to remember that a tribe taking care of three elderly people is different from three young people taking care of an elderly tribe. This extends beyond the financial burden placed on the children and grandchildren of aging baby boomers, ranging from home-care expenses to medical emergencies and future Medicare and Social Security obligations. It also extends into emotional and ethical territory, where questions about eldercare inevitably lead.

We need new ideas to begin to deal with this new phenomenon. We need to ask new questions. Seek new answers. Clarify new values. Experts may propose and debate the issues, but we all are living in this new reality and we all need to join the discussion. We need to confront the hard realities of resource production, availability and allocation. We need to come to a consensus about values. How much do we value the elderly?
How will we provide the resources—medical, financial, physical, emotional, psychological—to care for a large population of people living into their nineties?

I have found that sharing stories of actual experiences helps create programs that work. We need to confront the hard realities, clarify our values, and create solutions that work. Share your stories!

Monday, December 15, 2008

Past Perfect

In the Huffington Post Complete Guide to Blogging (, Arianna Huffington observes that “perfect” can often be the enemy of “done.” The pursuit of perfection can be an excuse for not getting things done. The time and energy expended in this elusive pursuit could be used to better effect.

In undertaking this blog, I’ve been introduced to new ways of sharing ideas over the internet. I’m learning how to shift from essay mode to blog mode—communicating ideas and questions now—not pursuing some elusive perfect expression or resolution. Just share the idea. Ask the question. Start a conversation.

What has this to do with caregiving? Well, often caregivers, like new mothers, try to do everything perfectly, despite the fact that they may have no training or experience in providing this type of care. Family members and friends may back away from providing assistance because they worry that they won’t perform the service perfectly. Sometimes this quest for perfection becomes a convenient excuse for procrastination or neglect.

Whether it’s making a meal, cramming a wheel chair into a trunk or keeping vigil in a sick room—if you wait for perfection to arrive, nothing will happen. Life is messy. You can make mistakes. It’s okay. Just do something.

The same holds true for needed conversations that don’t occur because nobody wants to have them—about advance directives, “Do Not Resuscitate” forms, disposition of assets, funeral arrangements, etc. There is no perfect time to talk about these matters or to complete the forms and get them on record. There is no perfect speech to deliver on any of these topics. You just have to start the conversation and live in the moment. Get past “perfect.”