Tarnished golden years
The shades of old age span a spectrum of frailty and strength, of depression and cheer, of confusion and clarity.
When President Reagan died in June at age 93, eulogies lamented that he had spent his last decade in the haze of Alzheimer’s disease. Yet Verona Johnston, 113, of Worthington, Ohio, was sharp enough to handle media interviews when she was named the oldest living American in May.
Scientific advances soon may push U.S. life spans even beyond Johnston’s. But what are the ramifications? Even as some professionals work to add years, others worry about the quality of extended lives and society’s ability to care for its most senior elderly.
“Science is going to stop the aging process, and we haven’t really had any public discussion about it,” warned Dr. Donald Louria, past chair of the Department of Preventive Medicine and Community Health at the University of Medicine and Dentistry of New Jersey.
In 1900, Americans could expect to live an average 47 years, according to federal estimates. By 2001, with improved sanitation, medicines and nutrition, that average had leapt to 77 years.
Today, scientists envision ever-longer lives, boosted by experimental techniques like these:
“ Nanotechnology, which sends tiny robots into the body to strike disease, managing molecules and potentially slowing or even stopping aging.
“ Calorie restriction, the low-calorie, nutritional diets that adherents believe will glean them many additional years.
“ Genetic manipulation, by which genetic material is rearranged, erased or added to change the course of illness or aging.
While the aim is to extend both life and health, some worry that people will live longer with no guarantee that the added years will be good ones. Critics fear prolonging and complicating the suffering that countless older adults experience today.
The crucial variable is quality of life.
Charlotte Orr, 101, still lives in her own home in Sturgis, S.D. She visits with friends often and sings weekly in a choir.
She said living so long is “great, if you feel good. It’s a gift from God.”
Bethany Wilson, 63, of Florence, Ore., said her father died too young and her mother died too old:
John Brooks Thomas Jr. passed away at age 56 in 1974, about six months after his cancer diagnosis.
Louise Lovett Thomas died in 2002 at 87, never remarrying, never getting used to being old, depressed and frustrated by the loss of her eyesight and independence. She had two unsuccessful surgeries for her vision and reluctantly gave up her home to live with another daughter.
“The last seven years of her life,” Wilson said, “she was miserable, and she made everyone else around her miserable.”
Everett “Shorty” Schnack knew that when his time came, he wanted to go quickly and quietly. He signed a legal document saying he wanted no extraordinary medical care to keep him alive.
When a stroke put him on life support in 2001, his family knew it had to stop treatment.
“He was clearly getting worse,” said his daughter, Mary Schnack, 48, of Sedona, Ariz. “Every day, he was clearly suffering.”
She said Schnack, who was 85 when he died, often told his family that he did not want to wither in a nursing home, kept alive but unaware.
Issues such as these prompted Louria, the New Jersey doctor, to organize a conference, “Creating Very Old People: Extending Life Expectancy and its Potential Consequences.” The April event, held in Teaneck, N.J., drew about 400 physicians, researchers and other professionals to discuss the country’s shifting demographics, developing medicine and possible outcomes.
“Are we going to have people who are reasonably in good health, with reasonable financial security, involved in their community?” Louria posed. “Or are we going to have people who are bored, depressed and with great physical disability?”
Dr. Sherwin Nuland, professor of surgery at the Yale School of Medicine and author of “How We Die: Reflections on Life’s Final Chapter,” said pushing the human life span may have grave ecological, social and economic consequences as young and old compete for resources, including jobs and space.
“The reason this Earth has survived for 4.5 billion years … is that there is this economy in nature,” Nuland said in an interview. Tinkering with mortality, he said, alters the balance.
Others contend that society has adjusted historically to growing populations of the aged. After all, Americans live 30 years longer than a century ago, and the nation is still here.
Leonard Guarente, biology professor at the Massachusetts Institute of Technology, is a founder of Elixir Pharmaceuticals, a Cambridge, Mass., company developing drugs to slow aging. In his view, the nation is already considering how aging adults will affect Social Security, long-term care, the labor force.
The discussion anticipates the retirement of the mammoth baby boom generation, which promises to spark a youthful, active spin on old age.
Already, today’s old are “healthier, stronger, more resilient and better able to handle disease than ever before,” said Vincent Mor, who chairs the Department of Community Health at the Brown University School of Medicine in Providence, R.I. “There are some indicators that even though the older population has aged, the proportion of people who are impaired — unable to do certain activities — has not grown at all and may have even shrunk a little bit.”
Various conveniences have made it easier to be old, he said.
Elevators and escalators eliminate the need to climb stairs. Food-delivery services make shopping simpler. Microwave ovens have cut time and effort to warm meals.
Mor said advancing medicine and technology may continue to help adults remain active and independent at older ages.
Still, argues Jennifer Davis-Berman, professor of sociology, anthropology and social work at Ohio’s University of Dayton, “we have to get comfortable with the fact that we all age. We all die. It’s a fact of life.”
Helen Richards, 102, another active centenarian in Sturgis, S.D., accepted that fact long, long ago.
“I’m ready to leave at any time,” she said. “I’ve had enough. I have good family, good friends, and I’ve enjoyed myself.”