Later life is frequently seen as a time of entitlement. After long years of working or child-rearing the retiree is presumably entitled to abundant leisure, an ample pension and discounts or subsidies such as free travel or a TV licence.
Expectations and reality tend to collide frequently in life, though, and old age is no different. Most of the privileges associated with the age of pensionhood are in reality poor compensations for the devalued status of older people, who are struggling to emerge from the crisis of Covid-19 and rebuild networks and social connections.
The notion that older people have anything useful to contribute to society is seldom entertained and because we fear our own demise intensely, indicators of the often cosmetic aspects of ageing, worry many who perceive unwanted reminders of our own mortality.
Society tends thus to distance itself from older people, whether by failing to support older people’s independence through adequate home care, thereby leading to institutionalisation in nursing homes, or by dismissing and stereotyping all older people as decrepit, dependent and infirm.
Older people often collude with this stereotype and gracefully withdraw from many areas of life to make way for younger blood, but by doing so are they putting the dividend of their extra years of life expectancy at risk?
Survival of the wisest
There is little doubt that older persons experience scapegoating for many of society's ills such as hospital overcrowding or scarce social welfare provision and additionally may have to endure multiple losses that can accompany later life.
Whether this is a decline in physical health, sensory impairments, the death of long-time friends or the loss of role and status since retirement and diminishing physical attractiveness – these losses may be encountered simultaneously and seem to validate the statement: “getting old is not for sissies”.
Some older people resort to melancholy and complaint in response to these insults on their selfhood and in revenge for society’s efforts to render an entire section of the population irrelevant and invisible. It does not take too much of an imaginative stretch to see how these losses stack up and accumulate, each threatening to chip away at our psychological defences and self-image.
Mental illnesses such as major depression not infrequently affect older people in the context of this extreme discouragement and such ensuing depression threatens to strip away quality of life, not just from the individual but also from those closest to them.
While acknowledging the reality that later life can be a testing time, in writing the book Mindcrafting: How to Mentor Your Ageing Mind we wanted to showcase the benefits of continued activity and engagement and consequently the sense of meaning and pleasure that is attainable in later years.
Opportunities for full participation by older people in society depend on their ability to remain hopeful and at the same time accepting of change and loss with grace and determination. The demonstration of continued zeal to reach out and try new things (even the dreaded technology) that might improve their lives and above all to remain enthusiastic and committed, is for many the secret sauce of successful ageing.
The key emotional and psychological needs
Despite all the fears of and efforts to fight off the ageing process, on many levels remarkably little changes as we grow older. We are not evicted from our bodies, nor from our passions and interests, and most people still feel largely the same on the inside, even if the exterior wall paint is cracking a little.
Key components of human happiness are quite simple and they are something to do, something to look forward to and someone to love. If these and other key emotional and psychological needs are met and balanced in a healthy way, it is my view that much emotional and psychological distress and even clinical depression is either absent or significantly reduced in intensity.
Throughout the book Mindcrafting: How to Mentor Your Ageing Mind, we refer to the set of organising ideas known as the Human Givens, originally devised by Joe Griffin and Ivan Tyrrell. This framework is a useful and practically applicable description of how humans function in terms of meeting key emotional needs and how our innate resources such as intuition, memory and enhanced awareness, to name but a few, are deployed in meeting these needs.
Meeting our universal emotional needs healthily and sustainably, such as the need for autonomy and status, among many others which may be especially imperilled during later years is akin to living off a well-balanced diet for the mind. In fact, this foundation of needs and resource awareness is a sound basis for flourishing in old age – not just for individuals – but also for wider society.
If older people could begin to appreciate that many of their higher-order brain abilities such as reason, empathy skills and intuition actually appreciate with age, they may regain the confidence to stave off loneliness and isolation through active reconnection with and involvement in their communities.
Invest in your future self
As humans we tend to think of our future selves as different people and combined with a tendency to underestimate the pace at which time passes, we may be suddenly disorientated when confronted with the reality of our chronological score. This may happen when we are politely offered a seat on a bus or a train or find ourselves meeting criteria to be admitted under geriatric services in hospital, or even the shock of a health event when all those assumptions we had about our bodies standing up to years of punishment are finally shattered.
All is not lost, however, and old age does not have to be equated with inevitable disability and disease. Older people can recover from many acute illnesses, in reality, just as well as younger people given adequate time to do so. The development of many specialist services for older persons is all about restoring independence and full functioning, through intensive rehabilitation and the bringing together of expertise from many healthcare disciplines.
Altered lifestyles and habits such as healthy eating, movement and exercise even undertaken in later life can significantly improve one’s quality of life. The ultimate challenge is to move away from overcoming the inherent nature of old age and its association with death but to transcend any infirmity through our attitude, our behaviour and especially our social institutions.
Charter for action
In essence the idea that motivated the book Mindcrafting: How to Mentor Your Ageing Mind was to encourage older people to take controlled risks in their lives rather than adopting a safety-first approach, to continue to view their lives as an adventure and to commit to see what was around the next corner by remaining enthusiastic and engaged in as many aspects of life as possible.
Setbacks in the form of illness and loss are inevitable to some extent, but for those who struggle to define themselves in the absence of a career and paid employment, over identification with illness and disability can block the attributes of resilience and wisdom which allow us to retain good humour and interest in other human beings.
Even as the curtain closes, the example of dignity and tenacity that older people can display is of inestimable value to the next generation. The search for meaning and the meeting of key emotional needs, against a backdrop of an affirming social environment, are surely the best ways to ensure our elders can squeeze every last drop out of life.
Dr Declan Lyons is a consultant psychiatrist at St Patrick’s Mental Health Services Dublin, and clinical associate professor at Trinity College Dublin. Dr Conor Murphy is a registrar in psychiatry at St Patrick’s Mental Health Services Dublin. Mindcrafting: How to Mentor Your Ageing Mind by Dr Declan Lyons is out now from Beehive Books, €19.99, available in book shops or Beehivebooks.ie
