Elderhood Summary

Why is aging, an inevitable part of life, treated as a problem to be solved rather than a phase to be embraced?

1. Language Shapes How We View Aging

Everything starts with the language we use to describe aging and old age. The word "old" often brings negative imagery, such as frailty, wrinkles, or decline, to mind. For most people, these descriptions come from our biases against aging inherited from a culture fixated on youth and productivity. Bias against aging becomes especially problematic when it is invisible or unchecked.

Changing our language can transform how we perceive and experience aging. Professor Guy Micco's annual exercise with medical students reveals that the term "elder" evokes significantly more respectful and positive associations, such as wisdom and experience, than the term "old." Words are essential tools for rewriting the narrow narratives surrounding elderhood to reflect its diversity and richness.

Louise Aronson advocates for framing aging differently by labeling this life stage "elderhood," just as childhood and adulthood are celebrated as distinct phases of life. It is not a period to fear or devalue but an opportunity for growth, reflection, and continued contribution.

Examples

• The US Center for Disease Control (CDC) groups all individuals over 60 into one category, ignoring vast differences in ability and health needs.
• Most people fail to see "elderhood" as distinct and valuable compared to childhood or adulthood.
• Medical students themselves show a shift in perception when asked to consider aging in terms of "wise elders" versus "old people."

2. Happiness Peaks in Later Life

Aging isn't necessarily the descent into sadness or decline that people often assume. Many people over 60 report being as satisfied with their lives—or even happier—than younger people. Studies show that happiness begins to increase after 60, and many older individuals describe later life as a surprisingly joyful and fulfilling phase.

Data from the United States and Western Europe reveal that well-being levels after age 60 rival those of twenty-year-olds. This phenomenon is sometimes called the "paradox of aging." While physical health might decline, the mental and emotional benefits of accumulated life experience often offset the negatives.

However, societal tropes and discriminatory attitudes complicate this contentment. How others view aging and treat the elderly—whether through patronizing language or systemic neglect—can rob elders of their dignity and make old age harder to navigate than it needs to be.

Examples

• Roger Angell, a writer in his 90s, reflected on how he routinely "surprised himself with happiness."
• Medical research shows emotional well-being improves in later years, defying stereotypes of decline.
• Phrases like "young at heart!" undermines the celebration of achieving elderhood.

3. Relationships and Purpose Are Vital

Relationships are central to happiness and health across all stages of life, but they become even more vital in old age. Research from the Harvard Study of Adult Development confirms that close, meaningful relationships—not wealth or success—are the key to feeling fulfilled.

Additionally, a sense of purpose enhances an elder's quality of life. Older individuals who have reasons to wake up every morning—be it family, hobbies, or meaningful work—tend to fare better emotionally and physically. Unfortunately, nursing homes and care institutions often fail to fulfill these needs, contributing to feelings of isolation.

Isolation is a silent killer among older adults, raising mortality rates by 26 percent. Many elders placed in institutions without adequate consideration of their emotional well-being experience this as cruelty, even when done with the best intentions.

Examples

• Elder Neeta declined rapidly in a nursing home that neglected her therapy, leading to malnutrition.
• Data shows loneliness significantly increases the risk of early death.
• Patients with access to functional social bonds recover faster from illnesses.

4. Medications Act Differently on Elderly Bodies

It's a common but dangerous misconception that older adults respond to medications just like younger patients do. Louise Aronson learned the hard way when her depression treatment for an elderly patient, Anne, caused complications due to low sodium levels—a side effect particularly risky for older bodies.

Because older adults were historically excluded from drug trials, most protocols were designed for younger bodies. Prescribing drugs for elderly patients without considering unique metabolic differences can lead to confusion, lethargy, or even death. Individualized approaches to treatment are essential.

Anne's case highlighted a broader systemic issue: the medical community often fails to recognize that the elderly are not simply older versions of young adults.

Examples

• Older bodies handle common medications, like antidepressants, differently, which could lead to unnecessary hospitalizations.
• Anne's grieving was mistaken for depression and mismanaged with medication.
• Most drug trials traditionally exclude elderly participants, leaving glaring knowledge gaps.

5. Society Sees Aging as a Disease

Many doctors and healthcare professionals regard old age not as a phase of life but as a list of symptoms to be treated. This perspective is not only limiting but can result in poor outcomes for patients, as demonstrated by the story of Lynn, whose treatable stroke was initially dismissed as a natural sign of aging.

Older adults experience unnecessary suffering because their symptoms are often attributed to "just being old." This represents not just ignorance but also harmful age biases in medical practice that deny elderly patients the care they deserve.

Respecting elderhood means grappling with a difficult truth: aging itself is not an illness. Normalizing old age as part of life's natural cycle leads to better preventive care and sets a higher standard for everyone.

Examples

• Lynn suffered a major stroke that could have been prevented if her earlier confusion had been correctly diagnosed.
• A doctor dismissing knee pain by saying "What do you expect at 95?" exemplifies internalized bias.
• Emergency responders often ignore treatable symptoms in elderly patients because of ingrained assumptions.

6. Overprescription Often Harms Elders

Elderly patients like Dimitri often fall victim to "prescribing cascades," where medications intended to treat one issue cause side effects that lead to additional prescriptions. This can spiral into a debilitating overmedication pattern that can deepen health problems dramatically.

The solution for Dimitri wasn't new medicine but stopping several that were contributing to his poor health. Once his medication was pared down, his life improved. He transitioned from near-total immobility to painting and building relationships in an assisted living facility.

This example highlights how the healthcare system over-medicalizes old age, often defaulting to prescription drugs instead of pursuing holistic care approaches.

Examples

• Dimtri's condition improved markedly when eight of his ten medications were stopped.
• Drugs prescribed for Parkinson’s often compound confusion, especially in elders.
• Prescribing cascades create unnecessary treatment cycles without addressing root issues.

7. Preventive Care Is Overlooked

Unfortunately, many basic assistive tools that preserve an elder's independence—hearing aids, dentures, or walkers—aren't covered by insurance in the United States. Policies often prioritize expensive surgeries over smaller interventions that improve daily life.

For example, cataract surgery may be covered, but the cheaper option of getting glasses often isn't. This misallocation of priorities stems from political decisions aimed at maximizing profit for certain industries, leaving many elders to fend for themselves.

Elderly populations often face financial strain just trying to remain functional, even when the solution is simple and affordable.

Examples

• Older patients can access cochlear implants but not affordable hearing aids through insurance.
• Expensive laser eye surgeries are covered more often than basic vision-preventive care.
• Access to essential tools often depends on whether someone is wealthy or impoverished.

8. Ageism Denies Elders Their Humanity

American culture heavily upholds youth as synonymous with beauty and productivity, marginalizing the elderly in the process. This glorification of youth comes at the cost of denying older adults their unique qualities, such as wisdom, patience, and accumulated experience.

Ageism often manifests in condescending attitudes or even outright neglect. Statements like "You're not old!" or infantilizing nicknames are covert dismissals of an elder's identity, reducing their presence to trivial stereotypes.

Elderhood, however, should be respected as a vital stage of life. Just as we celebrate childhood and adulthood, recognizing elderhood's dignity benefits society as a whole.

Examples

• Pervasive cultural messaging glorifies youth and demeans old age.
• The denial of age prompted even the author to dye her hair unnecessarily.
• Ursula K. Le Guin described the dismissal of old age as erasing her identity.

9. Death Must Be Discussed Openly

Society's discomfort with death makes it harder for elders to prepare emotionally, spiritually, or practically. Denying conversations about death prevents closure and essential communication within families during significant life transitions.

Discussing mortality openly offers empowerment. It allows individuals to express wishes, repair relationships, and face the inevitable with courage. Elderhood is not just about preserving life but finding peace in its final stages.

Examples

• Many in elder care avoid the topic of death, making loss harder when it happens.
• Families embracing conversations about death report fewer regrets when loved ones pass.
• Patients gain emotional clarity and control when death is acknowledged honestly.

Takeaways

1. Use respectful and affirming language for aging, such as "elder," to promote dignity.
2. Question overprescription patterns and explore non-drug care methods for elders.
3. Openly discuss death and aging with loved ones to build trust and understanding.