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'Never Say Die,' Susan Jacoby's tough look at the realities of aging
By Judith Viorst
Friday, February 4, 2011
NEVER SAY DIE
The Myth and Marketing of the New Old Age
By Susan Jacoby
Pantheon. 332 pp. $27.95
If old age isn't for sissies, then neither is Susan Jacoby's tough-minded, painful-to-read and important book, which demolishes popular myths that we can "cure" the "disease" of aging and knocks the "g" right out of the golden years. Forget about those dreams of dropping dead on the tennis court, or in a lover's arms, at age 95. Such happy endings could happen to us, but the odds are great that they won't, in spite of how frisky we currently feel and in spite of our dedication to a vegetable-eating, non-smoking, moderate-drinking, daily-exercising life style.
Instead, if we live long enough to join the ranks of what are called the "old old"- the late 80s and the 90s and beyond - we are likely to become (choose several of the following) socially useless, financially strapped, physically disabled, mentally impaired, desperately lonely and demeaningly dependent. But even if we have already previewed the miseries lying ahead by having seen our parents' sorry decline, we might be tempted to tell ourselves that their fate need not be ours, tempted to believe that by the time we reach their age, 90 will be "the new fifty."
Jacoby, who tended her lover through Alzheimer's disease and watched her spunky grandmother, almost 100, grieve because she could no longer do "most of the things that had given her life meaning," has no illusions about what she regards as the dubious blessings of longevity. Indeed, she is enraged by the self-help gurus and the drug companies who merrily market an age-defying old age, where octo- and nonagenarians are touted as flourishing teachers, composers, skydivers, or as richly blessed with the "wisdom of old age." These exceptions can be admired, but they aren't how most stories will end.
Jacoby grants that, in the past, older women and men were the victims of negative stereotypes and too readily devalued and dismissed. But she sees the reversal in attitude over the last 40 years as a misleading and damaging correction, with the "hucksters of longevity" purveying the untruth that no one need fear growing old anymore because science - any day now - is going to fix whatever it is that ails us.
Not so, says Jacoby, supporting her arguments eloquently and persuasively with historical, sociological, scientific and economic research. For, contrary to all the media hype, age is not just a number. Almost half of Americans living past age 85 will suffer from Alzheimer's. Fifty percent will wind up in a nursing home. And only 25 percent of Americans living past age 65 have annual incomes of over $33,667. Furthermore, by the year 2030 some 70 million Americans will be older than 65, making up 20 percent of the population, compared with 13 percent today. And among that 70 million will be 8.5 million people over age 85, the over-85ers being the fastest growing part of our population.
Thanks to advances in medicine, we are living longer and better - up to a point. But unless we are genetically blessed, we cannot expect to indefinitely escape the degenerative, chronic and irreversible diseases of advanced old age. And unless we are economically blessed, we may not be able to afford it, either.
Jacoby is well aware that some - many, I suspect - will object to her grim view and will question why she so passionately insists on debunking the myth of a healthier, happier, vastly improved "new old age." In response, she cites the late, great gerontologist Robert Butler, first director of the Institute on Aging, who cautioned, "I'd love nothing more than to wake up one morning and read a newspaper article announcing a cure for Alzheimer's. But we have to plan for aging as it is - not as it might be if a magic potion appears. . . ." Jacoby adds, "Only when we abandon the fantasy of beating old age . . . will we be able to develop more humane ways of caring" for the oldest members of our society.
Jacoby recommends a number of social policy changes - more accessible and affordable housing for old people, public subsidies for home-care services that would allow many more of them to remain in their homes - that could significantly improve the life of the elderly. She also has some words of advice for those who are, or will be, the old old. Don't retire to one of those car-dependent resort communities; live instead in a city where you can get where you want to go even via a wheelchair or a walker. Do some kind of useful work - paid or volunteer - as long as you can. Don't feel that aging successfully requires you to be a serene, above-it-all, smiley-faced optimist. If what you really are is a "discontented work in progress," go for it. And, if you can do so, find some pleasure in the world as it actually is, without counting on the imminent triumphs of science to allow you to be skydiving in your 90s.
Judith Viorst's most recent book is "Unexpectedly Eighty and Other Adaptations."
View all comments that have been posted about this article.
'Never Say Die,' Susan Jacoby's tough look at the realities of aging
By Judith Viorst
Friday, February 4, 2011
NEVER SAY DIE
The Myth and Marketing of the New Old Age
By Susan Jacoby
Pantheon. 332 pp. $27.95
If old age isn't for sissies, then neither is Susan Jacoby's tough-minded, painful-to-read and important book, which demolishes popular myths that we can "cure" the "disease" of aging and knocks the "g" right out of the golden years. Forget about those dreams of dropping dead on the tennis court, or in a lover's arms, at age 95. Such happy endings could happen to us, but the odds are great that they won't, in spite of how frisky we currently feel and in spite of our dedication to a vegetable-eating, non-smoking, moderate-drinking, daily-exercising life style.
Instead, if we live long enough to join the ranks of what are called the "old old"- the late 80s and the 90s and beyond - we are likely to become (choose several of the following) socially useless, financially strapped, physically disabled, mentally impaired, desperately lonely and demeaningly dependent. But even if we have already previewed the miseries lying ahead by having seen our parents' sorry decline, we might be tempted to tell ourselves that their fate need not be ours, tempted to believe that by the time we reach their age, 90 will be "the new fifty."
Jacoby, who tended her lover through Alzheimer's disease and watched her spunky grandmother, almost 100, grieve because she could no longer do "most of the things that had given her life meaning," has no illusions about what she regards as the dubious blessings of longevity. Indeed, she is enraged by the self-help gurus and the drug companies who merrily market an age-defying old age, where octo- and nonagenarians are touted as flourishing teachers, composers, skydivers, or as richly blessed with the "wisdom of old age." These exceptions can be admired, but they aren't how most stories will end.
Jacoby grants that, in the past, older women and men were the victims of negative stereotypes and too readily devalued and dismissed. But she sees the reversal in attitude over the last 40 years as a misleading and damaging correction, with the "hucksters of longevity" purveying the untruth that no one need fear growing old anymore because science - any day now - is going to fix whatever it is that ails us.
Not so, says Jacoby, supporting her arguments eloquently and persuasively with historical, sociological, scientific and economic research. For, contrary to all the media hype, age is not just a number. Almost half of Americans living past age 85 will suffer from Alzheimer's. Fifty percent will wind up in a nursing home. And only 25 percent of Americans living past age 65 have annual incomes of over $33,667. Furthermore, by the year 2030 some 70 million Americans will be older than 65, making up 20 percent of the population, compared with 13 percent today. And among that 70 million will be 8.5 million people over age 85, the over-85ers being the fastest growing part of our population.
Thanks to advances in medicine, we are living longer and better - up to a point. But unless we are genetically blessed, we cannot expect to indefinitely escape the degenerative, chronic and irreversible diseases of advanced old age. And unless we are economically blessed, we may not be able to afford it, either.
Jacoby is well aware that some - many, I suspect - will object to her grim view and will question why she so passionately insists on debunking the myth of a healthier, happier, vastly improved "new old age." In response, she cites the late, great gerontologist Robert Butler, first director of the Institute on Aging, who cautioned, "I'd love nothing more than to wake up one morning and read a newspaper article announcing a cure for Alzheimer's. But we have to plan for aging as it is - not as it might be if a magic potion appears. . . ." Jacoby adds, "Only when we abandon the fantasy of beating old age . . . will we be able to develop more humane ways of caring" for the oldest members of our society.
Jacoby recommends a number of social policy changes - more accessible and affordable housing for old people, public subsidies for home-care services that would allow many more of them to remain in their homes - that could significantly improve the life of the elderly. She also has some words of advice for those who are, or will be, the old old. Don't retire to one of those car-dependent resort communities; live instead in a city where you can get where you want to go even via a wheelchair or a walker. Do some kind of useful work - paid or volunteer - as long as you can. Don't feel that aging successfully requires you to be a serene, above-it-all, smiley-faced optimist. If what you really are is a "discontented work in progress," go for it. And, if you can do so, find some pleasure in the world as it actually is, without counting on the imminent triumphs of science to allow you to be skydiving in your 90s.
Judith Viorst's most recent book is "Unexpectedly Eighty and Other Adaptations."
View all comments that have been posted about this article.
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Re: Review: 'Never Say Die: The Myth and Marketing of the New Old Age' By Susan Jacoby
Thu, February 24, 2011 - 3:29 PM"But we have to plan for aging as it is - not as it might be if a magic potion appears..."
I like my realism sunny-side-up, it's true... but I'd still rather deal with "what is" than "what might be, if" - unless I'm the one doing the "if". -
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Re: Review: 'Never Say Die: The Myth and Marketing of the New Old Age' By Susan Jacoby
Thu, February 24, 2011 - 5:01 PMYes. I've also heard Jacoby interviewed about her book <www.kqed.org/a/forum/R201102241000 > and she is very savvy. I'm in my mid-70s but IMO what she writes is even more important for those now in their 40s or 50s or even younger!
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Re: Review: 'Never Say Die: The Myth and Marketing of the New Old Age' By Susan Jacoby
Wed, September 14, 2011 - 9:16 AM"Only when we abandon the fantasy of beating old age . . . will we be able to develop more humane ways of caring" for the oldest members of our society."
My parents are 85 and have arrived at this stage where they are ill, mentally and physically disabled, need help with ADLs, and have no life outside the home except going to the doctor. They are still in the home I grew up in, which people seem to consider a good thing but it doesn't seem so great to me (they have a daily home health aide, M-F and sometimes on weekends when I can't be their aide.) (Their being in their home seems not so great because it has 3 levels of stairs, it requires a lot of care and maintenance which they can't do, and it hasn't been redecorated in 40 years and is depressing. I have begged my mother to let me buy some new things but she says no.)
I have thought a great deal about what set-up I would like when I get to that stage of life, and honestly I don't know. If you are mentally and physically disabled, what is there to do except struggle through your ADLs with the help of whomever will help you? Going to the bathroom, bathing (on rare occasions), getting dressed (sometimes), eating, watching TV, opening the mail, getting the paper, paying attention to your money, ordering your medications, calling the cleaning service, sending in your taxes, paying bills, and going to the doctor, make up your day and even your entire life. (Things like paying attention to their money are things my mom can do, because she is physically disabled but not mentally; my dad has dementia and barely knows how to put his clothes on, but physically he is not so bad.)
I feel that they do have "humane" care. They have savings and even an income -- my father's pension. They do have enough money to pay for their home health aide (though my mother hates, hates, hates spending the money on it).
The only way aging is going to be more humane is for people to be physically and mentally healthy, and then just drop dead one day. That is what we all want, but few get.
Jacoby's "solution" of government subsidies to allow people to stay in their homes, or something else that the government should do -- the "government" should or could "solve" something like this? How bizarre. The "government" is not like that, is not capable of addressing a problem such as this. The "government" cannot solve human problems such as profound disability. My parents HAVE enough money. They HAVE help. My mother cannot get out of bed and walk to the bathroom on her own. She can't make meals. She stays in bed almost all the time. She has NO friends. She does not want to move to assisted living because it would cost more than the arrangement she's got, and, SHE DOES NOT WANT TO BE AROUND THOSE PEOPLE. You know, all those decrepit old people!
All in all, I think Jacoby is accurate and did a service by telling us the truth. Aging SUCKS. Can I just say it, Will? Isn't that why you started this tribe? You know it is really bad, and it is coming up for you. (And me and all of us, but since I am 51 I have a few more years before it is directly before me.) -
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Re: Review: 'Never Say Die: The Myth and Marketing of the New Old Age' By Susan Jacoby
Wed, January 11, 2012 - 4:25 PMMy mom fell and broke her arm. Then she fell and broke her hip. She had the surgery (hardware installed). She went to a short-term (3 month) rehab stay where she was supposedly going to be able to walk again. i visited her almost daily. My father, which dementia/Alzheimers, stayed with me (my family) from dinner overnight to breakfast. He had home health aide during the day. I took him to his many doctors, and also accompanied my mom in wheelchair transport vans to her further surgeries and doctor appointments. One surgery takes a lot of phone calls and prep, lab work, someone to stay with her in the hospital, then many follow-up visits. I tried to take my father to exercise classes. i took over paying their bills and keeping track of their finances and investments. i talked on and on with the PT people, the social workers, the nurses, the many doctors of my mom's and my dad's (each have about 8 doctors including dental, podiatry and stuff like that). My dad had to have 4 teeth pulled and then he collapsed (he had severe periodontal disease), which then meant hospital stay, tons of every kind of test, MRI, exray, CT, lots and lots of pills, they find he has pneumonia then they cure him of that. He gets out of bed in the hospital so he has to have a babysitter!!! Medicare pays for a SITTER so dementia patients don't get out of bed. I am appalled, appalled at the huge huge huge amounts of money going down for all of this. Then he goes to rehab. I have to visit him there, talk to the social workers, the PT people. At this point I have completly lost my own life. But there is more. Then my mom has to go somewhere after her 3 months in rehab, so I do all the work to get her into assisted living. She still has many things I need to do for her. She is at the highest care level and it is very expensive. She has constant pain because she has scoliosis, arthritis, and her leg and arm hurt (arm has a plate in it, too; as well as the leg). She can't walk at all. But it hurts her to sit in a wheelchair because of her severely curved spine, which compresses her lungs so she can't breathe well. She is 86 and will probably live with this until 96. Maybe 106? As far as I can tell, people do not die. Then I do all the work to get my dad into assisted living, on the special care unit for dementia. He is there for 2 weeks then has the dental debacle and ends up in hospitial then in rehab. Now I have to do their taxes, insurance, bills on their house which I have to sell. I have to FIX THEIR HOUSE and sell it. I had a contractor there getting rid of a rodent infestation (just mice, not rats) and had to have the attic stuff sucked out and I spent one whole night worrying that it would put toxic something in the air throughout the house (not to mention it cost $5,000) and would poison my daughter who is living there while we are getting ready to sell the house. I am going to write on this topic: YOUR STUFF IS YOUR RESPONSIBILITY. That means, we have got to get rid of this traditional idea that "the kids" will "clear out your house" and sell it. NO. Your stuff is your responsibility. Deal with it yourself before you get old and disabled.
Oh, I know, you don't believe you will be mentally and physcially disabled. You will just be healthy, then suddenly "die quietly."
It doesn't happen that way.
If you are in your 70s and still in your home of the last several decades, fix it, sell it, and get out. Why leave that mess for your kids? Your stuff is your responsibility.
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Re: Review: 'Never Say Die: The Myth and Marketing of the New Old Age' By Susan Jacoby
Wed, January 11, 2012 - 4:34 PMIt was funny for me to read in the first post that "I'm 51." Now I'm 52 and my life is slipping away with all this.
I am totally, totally burned out. I have got to do something for myself to recover, but I'm in some kind of dark hole and I can't see any options. You probably think I am a loser but I am not. I have a decent marriage, great kids, and I was a fitness instructor (am) but I have lost enthusiasm for everything that I used to enjoy. I know exercise should help but I go to the gym (was there just last night for zumba) and move my arms and legs, but I have no motivation. I have no idea how I will teach my class tomorrow (I just teach one class) and that is how I have felt for several weeks -- how will I teach my class.
I can clearly see that Rober Ebert would not understand me. That makes me so depressed, that he is just so impressed with his own writing but doesn't really understand the landscape here, and that caregivers are dying another kind of death. -
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Re: Review: 'Never Say Die: The Myth and Marketing of the New Old Age' By Susan Jacoby
Wed, January 11, 2012 - 8:59 PMThanks, Graciela. I am in my 75th year and feel fortunate because I grew up in a mostly functional family. My deceased father was born in Italy and my late mother's stock are from Switzerland. A couple years ago my sister and i were able to visit relatives in both countries and saw how the old are living there. In all cases it was far superior to what we see in the U.S. because they live well and are cared for well, not just by family but by a healthcare system that they have paid into all their lives and are now benefitting from now.
I cringe when I hear phrases like "Obamacare" because I feel American are so brainwashed about "big government" taking over their lives and America becoming "socialist"! Switzerland is one of the most conservative (in the correct sense of the word) counties in the world, and elders there all live in dignity and well. Italy, with a far different system, is about as good. By all standards, the U.S. rates at almost the bottom, largely because of countless stories like those you tell about what has become of their parents such as yours because of no fault of their own!
You seem to see Ebert as being too self-absorbed, but I have to ask, what is wrong with wanting to die in dignity and with as little pain and lingering as possible? That's what I hope for, and what every elder I have known yearns for. Our materialist society seems to want to drain every old person of as much "magic machine" time to make money for themselves, even when the surviving one is no more than in a vegetative state!
I was high school teacher for 35 years and loved it until I was ready to retire, even though I was not yet at retirement age (I taught from age 22 to age 57). During that time I knew many who burned themselves and their students out, much to the detriment of all. I understand what you mean by "life is slipping away with all this" so my only advice is to get in touch with your inspiration, your enthusiasm (which means in its roots "God's inspiration) again! I have no idea why you feel burned out, but I see unfortunately that you show all the signs, and somehow blame yourself and others (like Ebert). You must first get beyond blame and shame and find your course again. Bet wishes for this!
Will
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