Old Age

By Renee Meyer, MD

Even if we are enjoying a vigorous middle age, somewhere in our sixties we begin to sense our mortality. A quiet, persistent reminder arises from deep recesses of our thoughts, or stirs the air behind our shoulders. It breathes “but time may overcome you,” when we indulge in long-term planning or think fondly of undertaking a reckless new adventure. That reminder is about our future, a call from our old age.

Most people are familiar with the many infirmities of old age. We observe in older relatives and friends how the senses seem to withdraw. Poor vision increases self-doubt and fear of leaving familiar places. Hearing loss can lead to isolation; phone conversations become frustrating, and dinner invitations are turned down due to inability to hear the other diners. Old ears lose the high frequency sounds found in consonants, so that conversation sounds like a shapeless string of vowels. The elderly person may complain that other people mumble. As communication falters, there may even be a tinge of paranoia, suspicion about what others might be saying. Balance is more uncertain; new illnesses arise and last longer; cognition and movement are slower; there can be new pain and weakness. Furthermore, there may be a daunting loss of support and context as life partners and longtime friends have died. Few people may remember or value the older person’s past contributions to the world. A sense of loneliness and abandonment can prevail, perhaps with longing for the past, for things to be as they were.

For friends, relatives, and caregivers of the elderly, understanding subtle sensory losses can be informative and helpful. As with other senses, the sense of life, of well-being, weakens. In his insightful book The Fulfillment of Old Age, Dr. Norbert Glas points out that any further disruption (whether a toothache, eye pain, rash, or new joint pain), can disrupt the sense of life for the whole being. The elderly person may report a level of distress and overall malaise that exceeds what one would expect from the new problem alone. Caregivers may become alarmed and fly into action, only to find that the symptoms improve rapidly and with minimal care. Although new symptoms are not to be ignored, a sensible course may be to treat the symptoms at face value and give them some “tincture of time” before concluding that more intervention is necessary. The sense of warmth also decreases with age, and with that, the elderly may display decreased warmth in feeling and sometimes a shocking loss of empathy. It is helpful to remember that feeling cold for a prolonged time can narrow anyone’s interest in the surrounding world. Paying attention to restoring outer physical warmth has a positive effect on our own feeling life, and will help the elderly, as well.

As time moves on and former abilities flounder, there is a clear sense that, “I’m not who I was.” Mourning and yearning for a former time, when life’s activities and deeds were in full swing, is a common reaction. However, the only way into old age is onward, moving with diminished physical and social capacities into a new relationship with the world. Dr. Glas notes that the elderly “must stand alone, and must no longer call on the forces of youth for help.” To attempt to rejoin the young risks sacrificing dignity, and courting absurdity and scorn. The past is not there to be relived, but it is there to be examined, for the purpose of understanding the life we have led. In carefully observing our past, we may recognize what was good, and also discern our great life errors. A reckoning and inner judgment can arise regarding the course of our own lived-through destiny, including honest encounters with our misuses and wrongdoings. Owning, accepting, and forgiving our shadow selves can be a great breakthrough, a turning point in forgiving enemies without and within. We may gain the ability to see what good has stemmed from injury from ourselves or from others, and to begin to accept the world with gratitude and peace. Shakespeare’s King Lear and his Prospero from The Tempest are timeless literary characters perceptively described in Old Age, Journey into Simplicity by Helen Luke. Both Lear and Prospero lived with power, greatness, and folly. As old men they gradually made a joyful peace by letting go of both achievement and error. Through viewing the world with compassion and joy, we can gain a path to inner freedom, even as outer freedom wanes. To the extent that elderly people accomplish this transition, they radiate kindness in their environment and help save the world. The advice of many old people is sought and treasured for its dispassionate and harmonious wisdom. Even if sage advice is lacking, those who accomplish successful aging seem to have an inner magic combination of resilience and resignation, which attracts admiration and visits from their friends and relations. The radiant quality of kindness can be evident in nursing homes, where the staff will eagerly assist gentle, grateful residents even if they are totally disabled and require much physical help. The same staff may be reluctant to work with a more able-bodied resident who is physically easier to care for, but who is also frustrated about needing help, snappish, and clinging to a bygone past.

A great gift to elderly people is to help make an active life possible. Gardening of any scale, regular walks, painting, handwork, playing musical instruments, and baking are all meaningful activities that become enriched when done together with others. Glas notes that regular watercolor painting may slow sclerotic (stiffening, hardening) tendencies. Playing with small children for short intervals can bring delight, as well as gratitude from the child’s mother. Glas also suggests that the rückschau, an evening practice of visualizing the day in reverse, is especially suited to the elderly. The practice is more closely related to image thinking, which tends to predominate over abstract thinking in old memories.

Glas, Norbert, The Fulfillment of Old Age (Hudson, NY: Anthroposophic Press, 1970).
Luke, Helen M., Old Age; Journey into Simplicity (Parabola Books, 1987).

Renee Meyer, MD, trained in internal medicine and geriatrics. She practiced and taught at the Veterans' Hospital and Medical University in Charleston, SC, for twenty-five years. In 2009 she opened the South Carolina-based, anthroposophically-oriented Primula Internal Medicine practice, where she continues to meet patients. She has been part of the Physicians’ Association for Anthroposophic Medicine (PAAM) board since 2006.