On being Very, Very Old: An Insider's Perspective

Elaine M. Brody, MSW, DSc (Hon)

Disclosures

Gerontologist. 2010;50(1):2-10. 

In This Article

My Present Perspective

I have spent many years, first becoming young–old, then old–old, and then very very old. I now live in a condominium building in a world of older people. The building has a pleasant dining room and amenities, such as a swimming pool, lectures, parking valets, transportation to theater, and concerts, but no health services. My neighbors are not representative of all older people nor are they like the older persons with whom I worked professionally. Most are better off financially and are mentally intact and physically able to care for themselves (though some have caregivers). Most are college graduates, many still drive cars, and most are widowed. Though the age requirement is 60+, the average age is about 85, with many people in their 90s and a handful 100 or older.

My "present" is firmly linked to my past because many of the people in my building (the 85+) share my past. They, too, remember the Depression (and often have stories to tell of their experiences during those years). Almost all have benefited, as I have, from the prevention and cure of infectious diseases and now experience the chronic ailments that are the "failures of success." We saw Social Security, Medicare, and other beneficial programs come into being. The women are the very ones who read Friedan's book, formed discussion groups to talk about it, and entered the work force in large numbers. The 85+ group has not forgotten those experiences. They (we) are those very same people grown old.

We are different from the very old of the past. We have had more education and better health care since early childhood. Many more women in our age group have done out-of-home work than did our mothers. Transportation, communication, and technology have exploded in our lifetimes (although some of us do have trouble with the latter). We, the very very old, are a new frontier—for ourselves and for you to know and understand. We are the most rapidly growing elderly age group. By 2050, we are expected to constitute almost 20 million people or about one fourth of all elderly Americans.

We have all been marked by the Great Depression. Many of us, even those not at risk, spend money or rather do not spend money, as we learned to do in the 1930s. A typical example is the man who laughed at himself as he told me he had purchased things at the grocery store that morning that he did not need, just because he had some discount coupons.

Though my personal life is very different from what it had been while I was married and working, I have not been able to get out of the habit of "listening." Although I no longer listen as a social worker or engage in the organized listening of research, in my old age, I cannot keep from listening to what my friends and peers say—the ups and downs of their lives, their concerns, worries, problems, and joys. As an individual, I will report some of that unorganized listening. As a gerontologist, I can safely leave the organized listening—the research—to you. I will paint their concerns in broad-brush strokes, ignoring the smaller upsets and annoyances, such as a low bridge score or a "bad hair day."

My present perspective, then, is that of an 86-year-old woman who, I suppose, was prepared for old age intellectually but not emotionally. Even my children are growing into the stages of life I studied. Common experiences of old age, such as illness and losses, were unexpected, even though expectable.

I do not remember becoming old. All of a sudden, I was there. Others perceive me as old. Cars stop to let me cross. People offer to help carry my packages. My grandchildren "check up" on me when my children are out of town and hold my arm when we cross a street. People my age walk more slowly and fatigue more quickly. Our waistlines thicken and our hair thins. Our balance is not great. We develop lots of wrinkles. One of my granddaughters is observant in detecting which of my friends have had what she calls "a little work done" on their faces (though having such "work" is by no means limited to the old). Some have had to give up driving—with the accompanying loss of independence and feelings of competence that entails.

Our perspective on age has changed. One day, three people in succession said to me, "Did you hear about poor Harold? He was too young to die. He was only 83." A 92-year-old man died suddenly. Until that moment, he had been a regular member of his Neighborhood Security Patrol. As Jerry Seinfeld said, "Who dies at 70 anymore? It's old-fashioned." A woman who had recently moved into our building looked closely at three of us who were chatting with her and said, "I can see that I will bring down the average age in this building." With the three of us glaring at her, I told her, "You just made three good friends."

What are Very Very Old People like?

Gerontologist Bernice Neugarten found that "as one grows older, one grows more like oneself." The difficult thing is to sort out the concerns of the people I know that are due to each one's unique and continuing personality and life situation from those that are related specifically to our advanced age.

My favorite example of continuity of personality is my own mother. She was a dedicated world-class worrier all her life. A bad back hospitalized her when she was well into her 80s. My son visited her and asked if the doctor had prescribed any medicine. "Oh, yes," she replied, "he prescribed Valium, but I do not take it." "Why not?" my son asked. "Well," said my mother, "if I take Valium, I can't worry."

In addition to the economy, health is an omnipresent concern. I do not know anyone my age who has no ailments. You know so much about that subject that I will not dwell on it. I will say, however, that it is impossible to keep track of the multiple ailments of each of our friends, so there are a number of subterfuges we adopt. On meeting a friend, it is safe to ask, "Tell me, how is your condition?" Or "What did your doctor say?" When I asked a friend who had been ill but was now recovered how she was feeling, she answered, "I'm bored." Then, she hastened to add, "but boring is good."

I realized one day that most of the animals that are the older people's pets are also advanced in age and have chronic health problems. One dog has arthritis, another has a bad heart, a third has breathing problems, a cat named Libby has high blood pressure, and so on. Animals, too, have increased in life expectancy. Pet pharmaceuticals have become a major industry.

Certainly, our reactions to our ailments show continuity of personality. But now, we have more ailments to be continuous about. We are all on a slippery slope, and we know it. We feel ourselves sliding. Most do what we hope will slow the process—exercise, swimming, yoga, walking, and golf. In the main, what we try to do continues our past lives and is as diverse. The change is in the speed and the amount of those activities. We have trouble accepting the fatigue and other limitations that arrive more quickly.

The specter of Alzheimer's disease hovers over all of us. My friend Ann arranged a meeting of three friends to discuss the fact that a fourth had become very forgetful. The latter had no family. So, what to do? But Ann, who had convened the meeting, forgot when it was to take place.

Despite gallant efforts at activity and humor, inevitably people become ill or disabled. And we often have to make new "best friends" because old friends, to say nothing of family members, die. "I keep losing pieces of myself," one man said. The question, "Hi, how are you?" is too often answered by a glum, "Well, I'm here" Or "I woke up this morning."

What is impressive, and in keeping with the theme of this conference, is the resilience of some of my peers. The very oldest are greatly admired, and many function very well. A 90-year-old woman had a hysterectomy, and during her convalescence, she continued to plan her own birthday bash. Another birthday party was given by 98-year-old Betty, a former judge, who chose a gourmet menu preceded by cocktails and hors d'oeuvres; arranged the seating with due attention to her guests' friendships; and then worked the room, visiting each table and chatting with each of the 100-odd guests. She wore an elegant suit made for her in Switzerland when on recent travel with a somewhat younger "boyfriend."

Also on the positive side, most of the very old still have a capacity for enjoyment. We love socialization and recreational activities. All—men and women—enjoy dressing up (in current fashions, of course) and going to a party—particularly if there is music, dancing, hors d'oeuvres, and an open bar. And we go to the theater, reading groups, movies, and so on. Bridge is big.

Women outnumber men, of course, as in the total older population. But it is touching to see couples who have been married many decades dancing smoothly together, relaxed, and holding each other gently. There have also been marriages of couples who met and fell in love in our building. And … some liaisons.

Most of my peers are also resilient in adapting to their new environment. One woman told me she is an artist and had always painted life-size lions and tigers. When she moved to our building, however, she no longer had enough room for such large productions. Moreover, the canvases and frames had become too heavy for her to lift. So she adapted, albeit in her own fashion. Now, on smaller canvases, she paints only the heads of those animals.

Some of us are adept with computers and cell phones. Some of us are not. A cartoon in the "New Yorker" captured the dilemma some of us feel. Titled "How Grandma Sees the Remote," the cartoon showed Grandma looking bewildered. Her large remote had buttons labeled: "TV explodes," "Launch rocket ship," "Tidal wave starter," "House blows up," "Drop the big one," and so on. When I was having trouble with my computer one day, and my son was attempting to help me via the telephone, he finally said, "Mother, go outside and wait until a 6-year-old boy comes along. Ask him to look at your computer, and he'll fix it in five minutes."

In addition to the economy and our health problems, the very very old worry about family matters, mainly children and grandchildren. The sudden awareness that our children are getting old, or are old, comes as a shock. "My son (daughter) is retiring. I can't believe it."

When I talk about some of the worries my peers have about their aging children, you will ask, "Didn't they worry about their children when they were younger?" The answer, of course, is yes. There is no magic age that is worry free. But the seeds of concerns often present in earlier life now stand out in bold relief, and our worries rise in importance and urgency. And the content is different. No longer worried about their children's school grades or measles and mumps, for example, but about their heart attacks and the ailments and disabilities associated with middle age and young–old age. Almost every one of my friends has a "child" who is having some health problem: the need for a hip replacement, breast cancer, heart problems, and so on. No longer worried about how their children did on college entrance but about their failing businesses and divorces. Some have a grandchild with a serious ailment or disability. Most bitter of all, how to recover from the death of a "child?"

And, in the context of the current economic crisis, many are seriously worried about the financial prospects for our near-retirement-age children as well as their own dwindling assets, which they have no way of replacing.

Then, there are those who are sadly concerned about middle-aged or young–old children who may be retarded, physically disabled, or mentally ill. Such people live longer nowadays, and who will take care of them when the elderly parent dies?

When the old person has economic resources, the worry is often about how to allocate those resources among his or her children in the will. Should assets be divided equally or equitably? Should a rich "child" be left less than one who is poor? Should stepchildren or step-grandchildren share equally in whatever estate will be available? Should those who have a disabled child leave more money to that one than to the other(s)? For widows, the weight of making such decisions alone is heavy.

An almost universal experience is the shift in the balance of dependence/independence between elderly parent(s) and adult child(ren). When the older person begins to need some help, the issue for him or her is the fear of losing autonomy—control over one's own life—and no longer having the essential sense of mastery. The beginning dependency of the elderly parent may initiate a struggle (mild or severe) that is reminiscent of the struggle between a parent and an adolescent. The adult child tries to "take over" and to make decisions, and the parent resists. The shift in independence/dependence is a central issue and reactivates unresolved conflicts about dependency in both generations. The siblings may become involved in the problems that ensue. In some families, the issue is resolved in a relatively orderly manner; in others, it may become an acute crisis. The struggle for control between the elderly parent and middle-aged child is similar to the adolescent struggle. Yet, despite adolescence being generally foreseen as inevitable and expectable, it still daunts us. A parent's dependency is different in that it presages more dependence rather than independence as with the adolescent.

When a group of my friends were discussing dependence/independence problems, one said plaintively, "When did we become afraid of our children?" That question was greeted with a burst of understanding laughter.

Some older people experience a nagging fear that their "old" children will not have the capacity to care for very old parents. Almost 50 years ago, I wrote about the increasing number of families that contained two generations of older people (Brody, 1966a). Nowadays, many daughters aged 65 years and older are primary caregivers of disabled old people. And more than one third of people aged 60–74 years have a surviving parent.

When very old, one is likely to have grandchildren and great-grandchildren, thus increasing the number of descendants about whom to be concerned. My father, a reflective man, wrote an essay published in The Gerontologist called "Even Unto the Fourth Generation" (Breslow, 1980). He wrote that events—negative and positive—in the lives of his grandchildren affected him doubly because he cared so much about members of both younger generations. He also wrote that he was sometimes critical of the way in which his children were bringing up their children but that his gentle criticism was often politely ignored.

My mother was less restrained, often remonstrating with my children about how they were bringing up their children (her great-grandchildren). When my children asked me to talk to her and get her to stop, and I did, my mother looked at me in amazement. "Why should I stop?" she asked. "Because it's interfering and intrusive," I replied. My mother thought about that for 3 seconds, then said, "But I do not mind being interfering or intrusive."

There is a happy and gratifying side to family relationships, of course. For those whose number of descendants increases, there are the gatherings that surround births, christenings, bar mitzvas, graduations, weddings, and so on. Our children and grandchildren provide us with the gifts of babies and young children.

And we keep trying to take care of our children! Even when we are very very old, the help still often goes downward through the generations. I have seen people older than 85 years travel across the continent to help an adult child who is having surgery or is suffering from cancer or who had a heart attack. Many old people help their children financially if they can. And we avoid spending money on ourselves so that we can leave it to the next generation.

Most adult children are reliable, dependable, show affection, and support. Their behavior bears out the huge amount of research on the subject of intergenerational relationships. They mobilize to help the old person move and get settled (not an easy job). They arrive (sometimes from other continents or across the United States) when the parent is ill. They keep in touch. They gather and make birthday parties. And they give the elderly parent what is wanted the most—the sense of connection, of having someone who cares. The "backup system" is also extremely visible and active. Grandchildren, stepchildren, nieces, and nephews fill in when children are not there. (Part of my backup system is here with me today.)

Despite the well-documented increase in family help to the older people, some are now again accusing adult children of "putting more of the burden onto government." Schultz and Binstock (2007), in their recent book, pointed out that people they call "Merchants of Doom" keep pitting the generations against each other. Long ago, Shanas and colleagues (1968) called such attitudes a myth like a Hydra-headed monster. Again the monster has grown a new head.

"On balance, is it good or not so good to live to be very very old?" Most who have done so say that it is good and not so good. "IT DEPENDS." Advanced old age dictates neither pessimism nor Pollyanna optimism. Recently, a man of 104 years old—a former movie mogul—was given a special award at the Academy Awards ceremony. He held his arms out to the applauding audience and said, "This is the good part of getting old. I don't recommend the other." However, we should not glamorize getting very very old because most who do are not able to attend Academy Awards and/or to express themselves in that way.

Getting Very Very Old has a Price!— A large survey received enormous publicity when it reported findings to the effect that happiness increases as one grows older, so that the oldest Americans are the happiest (Yang, 2008). Of course, that is counterintuitive when one is acutely aware of the myriad of health problems and interpersonal losses that occur so frequently in old age. But the survey findings were tempered by the facts that the people who were found to be happier had more income, were married or had a confidant, were in good or excellent health, were not in nursing homes, and had survived selectively. IT DEPENDS.

And, of course, it also depends on one's "expectations." I am reminded of a scene in a movie when an about-to-be-married but ambivalent son asks his father, "Are you happy?" When the father replied in the affirmative, his son asked, "What is it that makes you happy?" The father replied, "A nice pot roast, a good chicken …. " Expectations. IT DEPENDS.

Recently, while chatting late at night with one of my granddaughters, she asked me, "Are you happy, Grandma?" When she saw that I was struggling for a response to that existential question, she said, "I'll ask the question this way: Are you glad to be alive today?" I was able to answer that question at once. YES! I call it the Karpman Kuestion, naming it after my perceptive granddaughter, Hannah Karpman.

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