There has been lots of discussion in both academic literature and practical domain as regards the concept of aging and its importance in the life journey of an individual. Aging has classically been defined as the “process of getting older.” Getting older in terms of age or biological number is an inevitable and unavoidable fact of life. Along with physical aging, there is another dimension known as “psychological aging” which is more of a mental construct. It all depends on the attitude of an individual. Some people become mentally old and de-activated at the age of 60 while some others remain evergreen and mentally alert and agile even at an advanced age of 80. One reason could be degree of mental alertness; but the other important aspect is how one perceives journey of life meaning “attitude towards life.” While a negative mindset may prompt one lonely / depressed at a very common physical ailment, there could be others with a strong sense of resilience who can withstand any amount of pressure with a sense of “philosophical detachment.”
Both these aspects of aging namely “physical” as well as “psychological” need to be managed properly by the elders.
There is one additional and important dimension in the whole context of aging. This relates to “stages of aging.” What it means is that aging for majority of elderly people is not a sudden event but a slow “evolving process” of more than 15 to 20 years. For the purpose of this discussion, we are considering the starting and end point of aging process from 60 (beginning of aging process) to 80 years (say end of life).
All these stages have their own uniqueness and special characteristics and need distinguished techniques to manage. What is means is that there is no “omnibus strategy” to manage the process of aging, but we need to have “targeted strategies” for each of these stages.
Stages of Aging and Their Management:
Independent Stage: This is the starting phase of aging commencing may be immediately after retirement (60 years) and may span up to 65 to 70 years depending on body parameters. This is the phase when a person is still active, physically & mentally agile, socially, by and large, connected and still has a feeling of “Youth” in him / her. He / she keeps himself/herself busy in some activity or the other depending on one’s areas of interest. He /she is also connected with family and friends. Barring normal ailments associated with old age, the person is physically/mentally fine.
Here strategy for the individual as well as family members will be to extend this period as much as possible. The elderly should concentrate on his/her area of interest, continue to remain socially engaged and pursue one to two new areas of activity depending on his/her passion & focus. Physical as well as mental exercises need to be caried on religiously and all medicines prescribed by doctors are to be taken regularly. The individual should also get himself/herself checked up regularly. Besides, the person should try to make new friendships, become a member of some groups like walking clubs or senior citizen associations to keep busy and engaged. The objective is simple: keep yourself active, busy, and independent. There are lots of things to enjoy in life and let us go ahead with them. Life is a pleasurable journey and let us enjoy it to the extent possible. This phase is what is classically known as the 2nd / 3rd phase of aging and meant for living a “new life” that was unexplored. “Ikigai” or purpose of life needs to be found out and this phase of life is meant for enjoying to the full.
Early Dependent Stage: This signifies beginning of “real old age syndromes”: feeling weak, slight difficulties in taking brisk walks, setting in impairment of mental faculty in terms of forgetting things, developing “not feeling well” attitude, etc. Though the elderly are still able to do his/her own things independently, he/she may need external help in some tasks like crossing roads, getting medicine, going to bank, moving at night, travel in the flight, to say a few. This phase of life is inevitable and may set in at different times for individuals starting from say, 70 plus years onwards.
The first step in this situation should be to accept reality and take it as a part of life and not curse everyone for it. Old age has its own problems with body parts giving way because of wear and tears. The individual should try to extend this period as much as possible by resorting to modest physical exercises / yoga (on bed / chair) and continue to do soft mental exercises / games to keep cognitive faculties under control. However, it is time to accept reality and take all steps to ensure that unforeseen things do not happen like “accidental falls.” All infrastructure in living/ bathroom should be made elder friendly. The elder, if he/she can afford, can think in terms of keeping a part-time caregiver. The role of family in this phase is crucial. Even if they are not staying together, children should connect with their aging parents once a week physically, if possible. At least they should do video calling once a week to keep their moods upbeat. Geriatric counselors also play an important role in this phase.
Fully Dependent Stage: This is precursor to critical stage where an individual is sick, bedridden, or mentally significantly impaired and primary dependent on external support system. This is a semi-terminal stage of life.
At this stage, quality of life is severely impacted. The individual may be dependent on caregiver, either family or external. For mentally impaired elders, dementia may have set in. At this stage, the entire responsibly rests on family members, government, and society. The strategy must be macro focused with external agencies playing a pivotal role. Professional old age homes, palliative care centers all have their tasks cut out at this stage. All as socially responsible citizens need to take care of these elders “who took care of us in yesteryears and not able to take care of even themselves.”
Conclusions
Aging and its stages may not always be as sequential as stated above. There could be major downsize risks like the onset of a life-threatening disease or accidental fall or serious ailment like dementia. However, the discussion on aging stages will help many elders to prepare suitably to face the challenges of life. Life journey has its own difficulties in old age, and we all need to be ready to face them. As life has its own beauty and pleasure, so does it entail pain. It is, therefore, necessary to know about the pain points of our life early so that we can get mentally prepared for the same. Family members and society at large are also important stakeholders in this journey.
This article is written by By Dr A K Sen Gupta, Chief Trustee, My Retired Life Foundation (MRLF).
