The Presumption of Aging
I have never been one to have a fear of getting older. In fact, whenever I am asked my age, I always state a number one year beyond my present age. Right now I am 68 and when asked, I say I am 69. This might be due to the fact that I always had a bit of a baby face and liked to think of myself as older, and it might be simply because I am always eyes forward, thinking that the future will be bright. When others were upset by reaching milestone birthdays from 30 to 60, I just shrugged and thought it was all kinda cool. It is hard not to wonder about the constraints that might come with age, but so far, so good. I have certainly lost a step or two, but I pretty much still do whatever I want. That may be because I am careful not to want to do things that I think might make me feel unable and old. But I’ve never wanted to climb mountains or run marathons, even in my younger days, so I think its fair to say that I do exactly what I’ve always wanted to do. A guy I used to work with once told me that one of the things he liked about me was that despite my size, nothing ever seemed to stop me from doing just about what everybody else did (in those days it was things like skiing, golf and tennis).
I retired in 2020 (or at least as close to retirement as I can claim, since at that point I had no office to go to). I was the age that the Social Security Administration says is the current retirement age, 66. That is a moving target, as anyone approaching that age realizes. It is gradually moving up towards 67 and God knows where it goes from there. Since that time, I have gotten somewhat healthier, I believe. I have been doing a lot more yard work and thanks to the steepness of my hillside, it has proven to be good exercise for me. That, combined with less regular and more moderated intake, has caused me to lose over forty pounds. I have also gotten a new primary care physician, who makes it a point to keep adjusting my blood pressure meds such that my blood pressure is more on an even keel than it has ever been. All of that is my way of saying that three years of aging has seen me getting healthier rather than falling off some aging cliff.
Tomorrow I am scheduled for my annual physical with that new physician. Since I have been seeing her for three years now, I was pretty sure that I knew what was coming and that it would take about 20 minutes tops. One of the things I am accustomed to with the healthcare network with which my physician is associated, is that they are nothing if not efficient with making sure that patients get lots of reminders of their appointments through multiple mediums. I usually get one or two texts and emails as well as an occasional call. But this time I also got a few extra reminders and an array of special instructions. I was asked to fill out a series of risk questionnaires. That was a first.
As best I can tell, these risk questionnaires are prompted by some combination of prep for an annual physical and some sort of age-related protocol. You see, beyond the initial standard questions about any new maladies or physical changes, there were a never-ending series of questions relating to what can only be characterized as the sort of concerns people have about getting old. Do you get dizzy when you stand up too quickly? Have you had any problems walking without falling…or for that matter, falling and unable to get up? Do you remember what you had for breakfast?
The good news is that I could honestly answer to all of the questions that I had none of those or any of the other problems we all fear. But the bad news is that without any personalized intent, the medical profession (at least as expressed by my Southern California healthcare network), has decided that at my age, they had better start checking on me in all those arenas. That may be the clearest signal from a source authority that I am, indeed, getting old. I don’t feel old. I’ve never worried about feeling or getting old. But there is an inevitability to aging such that sooner or later, we will all be old (if we are lucky, as they correctly say). And all those questions are the things that I might have to look forward to at some point.
Kim and I regularly talk about where we will move when we find that this lovely hilltop and 3,700 foot house become too much for us. We know we are not close to that point yet, but we are not afraid to face it as a prospective issue. We watch so much House Hunters on HGTV (in all its permutations and combinations), that we treat it like a housing exercise rather than an aging exercise. That makes it fun and interesting to discuss, even though we have yet to come down on anything resembling a clear decision. We can confidently say that the next place will be smaller and have less maintenance required (that screams condo, doesn’t it?). But the where is a serious issue since presumably all of our older siblings will be further along the aging path than we are (that is not a foregone conclusion, but seems indicated at the moment). Neither Wabash nor Ithaca are any longer in contention and heading back to the cold of NYC Metro seems highly unlikely.
While I can accept the inevitability of aging, the healthcare provider risk questionnaire has somehow offended me for its presumption of aging. I know they are just doing their job and that their system probably triggers the need for the questionnaires after a certain age like 65 or 66 (assuming they are keeping up with the Social Security Administration), but why is this all coming up now in my 69th year? Maybe it gets triggered by turning 70 and they are just getting out ahead of themselves a bit? Do they have to ask these questions as opposed to just observing them? Are people who are aging in such denial that they would not bother to tell their physician if they became afflicted with one of these geriatric conditions? And perhaps most importantly, have I really now passed definitely into the realm of the aged? Am I now technically a geriatric?
A few years ago I remember a very sound explanation I saw somewhere that addressed the issue of aging in a very practical way. It must have been quite a while ago because it referenced the endpoint of life as occurring around 85. This explanation said that the key to aging well is how you spend your time between 55 and 85. The point was that we all end up in the same place at 85, which was dead or virtually dead, and that it was all about how we got there that counted. If we had a slow and gradual decline, that was suboptimal. What we should aspire to is high functioning for as much of that 30 years as possible and then just falling off the cliff at 85 rather than gradually rolling down the hill. It made sense to me as a good objective to have even if the exact dates were more open for debate.
I will ask a few rhetorical questions of my Asian doctor to see what she thinks of these questionnaires and whether she finds the presumption of aging just business as usual or, as I do, a bit….presumptuous.