Ageing in the 1st Person

Ageing is a process. It is a journey, not a destination. The final destination is our appointment with death. The journey can be a long drawn one, perhaps eighty years or more in Singapore. Every one of us is at a point somewhere along this journey of life. We all have aged, are ageing and will continue to age with the passage of time. Hence, when we talk about the elderly, though we may mean those who are currently in their 6th, 7th or 8th decade of life, we actually and really are referring to ourselves in the not-to-distant future. We all have a vested interest in ensuring that there is good quality of life when the time comes when we are old and dependent. We cannot talk about the elderly in the 3rd person anymore.

The needs of the elderly, or to use the politically correct term, the older person, is immensely complex for the simple reason that each person is unique. We become more different from one another as we age. What we turn out is dependent among others on our genes, our environment, our psychological make-up, our life experiences, what we eat, our social interactions and many more. That is why there is no such thing as ‘milestones’ for the elderly, as we have for infants and children. The elderly population is really a heterogenous lot. However, as the twilight years and the end draws near, there seems to be a final common pathway of decline, functional impairment and dependency. This period varies among individuals.

One of the goals of geriatric care is not so much the prolongation of the life expectancy but rather, to delay the onset of disability for as long as possible. This is what many gerontologists and geriatricians term ‘compression of morbidity’ where the dreaded but inevitable onset of physical, mental and emotional impairment are kept at bay for as long as possible so that the ageing person can enjoy a quality of life right to the end.

However, even despite our best efforts in the area of primary and public healthcare, the laws of nature cannot be held back indefinitely and age we all must, and the laws of physics dictate that we must wear ourselves out sooner or later. This is when the disabilities and illnesses of old age catch up on us. The human body ages at differing rates among individuals and, within the same individual, different organ systems age at varying rates. Consequently, while one person may suffer dementia at the age of 80, another suffers from kidney failure, while yet another suffers from heart failure, all the result of the differing rates of ageing of the organ systems. This underscores the heterogeneity of the elderly population.

The approach to ageing has to be a holistic one. We cannot look at ageing from a merely physical dimension because if we do that, we will meet with futility and failure; because the physical being must surely deteriorate with time. Caring for the elderly requires that we look at their social, emotional, mental and spiritual wellbeing. The person who cares for the older person should also be looked after in a holistic manner in order to empower the latter to care for the elderly person.