' Successful Ageing '

I don’t much like this description of how it should be with us as we get older. ‘Success’ seems over ambitious, especially when all energy may be devoted to surviving! But Julia Neuberger uses the phrase several times in her book, ‘Not Dead Yet’, which I am still reading. She refers to a meeting of gerontologists in the U.S.A. where the scientific view was that success is primarily measured by good health. But others who were there - and she would agree with this – were of the opinion that success is a much more complex matter and involves ‘engagement with life’ (healthy or not), with the freedom to do what you like and most of all the freedom to be loved. Having your own home could be a large part of that, with the autonomy that goes with it and the ability to organise your life in your own way (hence the dread of ending your days in an Old People’s Home).

If you ask many older people what matters to them, Neuberger says, it is love : love of a partner, even one maybe now dead, of children and grandchildren, siblings, friends and more distant family and an interest in the world around us. Often success means dealing creatively with that world after the death of someone you love. She refers to where Katharine Whitehorn in her recent autobiography writes about the experience of becoming a widow. ‘Losing your husband has two separate aspects, there’s missing the actual man, the lover; his quirks, his kindness, his thinking. But marriage is also the water in which you swim, the land you live in : the habits, the assumptions you share about the future, about what’s funny or deplorable, about the way the house is run, or should be…you have to learn to live in another country, in which you are an unwilling refugee’.

My experience as a bereavement counsellor confirms this. As you get older inevitably you think about your own death, but its other people’s death that is so painful to us. It can be very hard sometimes to ‘recover’ yourself when someone who has meant everything to you is no longer there. You feel misplaced; a ‘refugee’ indeed.

Apparently there is an official measure by which medics sort us older people out and it’s called ‘Quality Adjusted Life Years’, a system which seems to determine whether an older person who is ill is worth medical care. I’ve looked it up on the internet and where I can’t make sense of it find it incomprehensible, and where I can, deeply insulting. Neuberger calls it a tyranny of definition and urges that it should be dumped. Doctors should take their patients own definition of their health and possible treatment in a broader sense than a fixed qualitative assessment. I guess most older people would agree to that, as I do.

B.R.