Older than old

It was a new phrase to me. Apparently when you are over eighty five you become a social and

health problem, five times more needy than the sixty five to seventy four age group . Old or older

people have never been more in the news than they are today. People are living much longer

than in the past, but keeping us alive is an increasing strain on the public exchequer and will get

worse. In the U.K. the National Health Service is in crises and is rapidly becoming a political

football. A new independent report claims that £38b will be needed in the next few years to save it

from collapse. People living longer is a major reason for pressure on the service.

If I live longer enough I shall soon be in the statistically dangerous area of post 85, but recognise

the symptons already. The ‘older than old’ person is two different people ­ the one you have

always been with the same attitudes, opinions and beliefs that have defined your life, but also this

new person who is restructuring your life in often unwelcome ways.

You have to live with that

schizophrenia, holding on to the basic you but recognising the changes that are also taking place.

Simple things like not being able to walk long distances, complicated ones like finding it difficult to

keep up with a conversation amongst friends; putting names to faces; being able to make

decisions often over the most trivial things; dreams when awake as well as when asleep. ‘It’s bad

living with physical illness’ said my 90 year old companion yesterday, ‘ it’s when you lose your

mind that real problems begin’. When the continuing ‘me’ person is unable to reassure the new

confused one, incipient panic can take over, as it did with my tearful friend yesterday.

Atul Gawande is a Boston surgeon. He has written a book called ‘Being Mortal: Medicine and

what matters in the End’, and I saw a review of it a few days ago. ‘We have exalted longevity over

what makes life worth living’ he claims and argues against the ‘infantilisation’ of the elderly who

deserve to be treated as intelligent adults and not the playthings of profiteering companies ( and

vote catching politicians?). Children, he says, are at least allowed to play on climbing frames and

yet we are obsessed about the elderly taking no risks. Doctors should tell them the truth about

their condition, and more and more care homes (with equal emphasis on the home as well as the

care) and hospices should be more readily available as people age.

So, for better and often for worse, we are in the news : a problem for wider society as well as for

ourselves, but one in which we should be involved and consulted. Participants in the debate

rather than silent recipients.