Aging in Sneakers

This blog is about outrage against stereotypes of age, sex and marital status. I also rant about the medical profession and talk about comedy. When you put these together, being old, single and female completes the perfect trifecta, making you a target for society in general and the medical profession in particular.

I’m not amused when a fifty-something author jokes about not remembering her ATM pin number. I know my pin number. I also know my library card number and my credit card numbers. It makes life easier.

I’m even less amused when someone asks me if I use email. I tell them I build websites.

I don’t laugh at jokes about old people. Google “old people having fun funny.” Now try, “black people having fun funny.” We laugh at children, cats, and older people who are just being themselves.

It’s time to stop accepting a second place, subservient role just because you’ve had a birthday. Instead of quiet acceptance, let’s belt out the old George Jones anthem, “I don’t need no rocking chair.” Let’s recite Dylan Thomas: “Do not go gently into that good night. Old age should rave and burn at close of day …”

This is a blog for raving, for gym memberships instead of rocking chairs, and replacing calm acceptance with a few well-chosen four-letter words. I want to be blown out like a candle, while I’m still burning.

Why sneakers? I’ve worn nothing but sneakers for the last fifteen years (with a few brief exceptions for dress-up occasions). Sneakers are associated with having fun, relaxing and being yourself. Stilettos have become associated with female success; books have titles like “Success in stilettos.”

The idea is that people, especially women, should accept pain and discomfort in exchange for beauty. In the 21st century, when women are landing fighter planes on Navy carrier decks and running major companies, this idea seems a little dated, to say the least.

Associating high-heeled shoes with success incidentally associates beauty with success, and for most people, beauty equals youth. Part of the pain of aging does indeed come from looking in the mirror. Even worse is the experience of being judged by one’s appearance. Compliments are conditioned by “for your age,” as in, “It’s impressive to see a woman your age who is bungee jumping, running a marathon, doing stand-up comedy or simply surviving without medications.”

Aren’t those accomplishments impressive at any age?

I may have to go down for the count but I don’t have to go there quietly.

Simplistic article on suicide in the elderly from Milesetones

Milestones is a tabloid type newspaper published by the Philadelphia Corporation for Aging and distributed free in Philadelphia and downloadable online. It’s the usual party line pep talk stuff.

Their November 2017 issue included an article about suicide. Here’s how I responded.

I was appalled by your article on suicide among the elderly. Milestones reaches a large, diverse audience with a tabloid type newspaper. You have a rare opportunity to share accurate information and raise concerns. Instead, you present a simplistic view of a complex subject, in a way that could actually harm the very people you are targeting for help.

(1) The article conflates suicide with depression. The truth is, not all suicidal people are depressed, and not all depressed people are suicidal. Yet following an opening paragraph on suicide, the article segues into a discussion of depression, without making this distinction.
For many people, suicide can be viewed as a rational response to a diagnosis of Alzheimers or any other condition that removes the person’s opportunity to live pain-free and with dignity. Pain is not always responsive to treatment and side effects of medications can be so horrific as to take away all quality of life. The view of all suicide decisions as irrational is based on values, not medicine or science.

Last year, the New York Times Magazine reported the suicide of Sandy Bem, a distinguished research psychologist diagnosed with Alzheimers. She was perfectly sane; she just wanted to avoid the miserable life that lay ahead. In her book Never Say Die, Susan Jacoby describes a man who could no longer live alone, after living in solitude for many years and valuing his privacy; he stole his caregiver’s car keys, drove to a bridge and jumped. She argues that he should have had easier access to death, not psychiatric treatment.

To put this in context, at one point the CIA gave cyanide tablets to spy pilots who were in danger of crashing into POW camps. For many innocent elderly people, a nursing home will resemble a POW camp, but with no possibility of rescue and no opportunity to live a good life afterward. About 1/6 of nursing home residents are subject to abuse, and that’s a conservative estimate, omitting behaviors that deprive people of their peace and dignity; tying someone to a chair in front of a television set is considered normal.

Your article totally ignores this issue, suggesting that people want to die to avoid being a burden. Some just want to live a life free of pain and misery. Think of Patrick Henry’s “Give me liberty or give me death.”

(2) In lieu of Patrick Henry, the article quotes someone named Patrick Arbore, an Ed.D. Apparently he says, “depressed older adults often respond positively to intervention,” and, “In most cases their depression can be treated.”

“Often” and “most” aren’t exactly scientific terms or precise quantifications. Often could mean 51% or even “not rare,” i.e., 10-30%. Why aren’t you quoting statistics, which are easily available on the Internet?

Anything can be treated, but not all treatments have good outcomes. The truth is that only the most severe cases of depression respond to medications. There’s a strong placebo effect. Treating depression isn’t like giving someone aspirin for a headache; you have to work with the medications, trying one and then making modifications. Talk therapy has been indicated as more desirable for sadness associated with life events, such as bereavement.

(3) The article suggests that older people avoid therapy because of the stigma. People who came of age in the sixties — who are now in their sixties and seventies — grew up with therapy. They know that therapists differ widely in skill and experience. And they can’t find the good ones, let alone pay the going rate.
The New York Times has reported that only 55% of mental health professionals accept Medicare, compared to 86% of other medical professionals. Anyone seeking treatment faces an uphill battle to find a provider, let alone someone who’s competent and experienced with the relevant age group.

Another NY Times article found that 27% of people with depression were not receiving treatment. At the same time, about 29% of those being treated for depression were not clinically depressed; they were receiving unnecessary, potentially harmful treatment.

When readers get exposed to simplistic articles like this one, they may be tempted to push healthy people into treatment that’s at best a waste of time and at worst leading to side effects that would make anyone depressed. I personally know two people who presented with physical illness, yet were misdiagnosed as mentally ill, leaving them traumatized from receiving unnecessary treatment and suffering from delayed intervention in their genuine medical conditions. And according to Steven Hatch, MD, author of Snowball In A Blizzard, psychiatric diagnoses are prone to systematic flaws that can be summarized in one word: Rosenhan.

Practical measures should include fighting to make assisted dying more widely available. We need more awareness of the difference between depression-related suicide and the desire to die with dignity. And if someone truly is depressed, they need access to competent professionals, instead of the bottom of the barrel therapists willing to accept Medicare.

Simplistic articles like this one do a lot of harm. The elderly are abused because they’re not taken seriously. Many are depressed because there’s no place for them in society; that can be cured with a pill or a year of talk therapy. Writing in a simplistic tone about a complex, challenging situation can be viewed as dismissive, exacerbating the problem. I hope you’ll reconsider your editorial policy and start to do some good.

Answer to an article

Here’s what I sent to the author of Milestones, a tabloid for “seniors.”

The story on “elder orphans” raised several questions for me.

The term “elder orphans” is deeply offensive to many people who are aging without family. An orphan is a child without parents. We’re talking about adults without children. The term is infantilizing.

Additionally, the problem of planning for end of life as well as care during illness is not limited to elders. Anyone’s spouse could die or decide to leave; I know a woman who was “dumped” in her mid-fifties. Children can be unreliable, far away, or estranged. There’s no guarantee that children will carry out your wishes; we’ve all heard stories of the grown children who fly in and start making decisions even when they haven’t seen their parents in years.

As for care, something like 90% of elder abuse comes from family.

Your story also implies that older people who live alone are lonely. Many of us would rather be dead than share our living space. In her book, Never Say Die, Susan Jacoby describes a man who’s forced to start living with a caretaker. He steals the caretaker’s car keys, drives to a bridge and jumps off. Many older people can relate.

What’s needed are three things:

1 – A way to allow the elderly to see meaningful employment — something that gets rewarded for good performance. Not every elder wants to leave a legacy Many older people are isolated because of age discrimination in the workplace. One of Trump’s lawyers is 84 years old. Nancy Pelosi is in her late 70s. Most people their age would be considered too old for any job except greeter in a big box store. Getting paid means being recognized and valued. Many older people have trouble reaching out and getting involved because they don’t have money — and because working creates bonds.

I’m older than the people you mentioned in the article. I work on the Internet; there’s no way I could get a meaningful face to face job. And when I meet people, they don’t ask what I do; they ask, “Are you retired?”

2 – Currently age discrimination is not considered politically incorrect. Older women are disrespectfully addressed as “Gramma” or referred to as “grannies.” Jokes about older people needing diapers don’t help. Think of the song, “Grandma got run over by a reindeer.” Imagine a similar song about black people or gays.

3 – Everybody – not just the elderly – needs to be able to set up advance directives for end of life care, stored in the cloud. Those who set this up could get a bracelet or tattoo with the URL holding these wishes. We need strict laws to prevent overeager medical people from violating these wishes. This is the 21st century. I did my last mortgage without touching a piece of paper. Our ability to die as we wish should not depend on a live medical proxy.

And we need assisted dying. There’s no way to maintain quality of life in most nursing homes. Without constant vigilance by a capable advocate, the inmates will be abused.

Good article here:

Tracking Aging Concepts

Back when I was doing improv, we were at the last class. One of the guys says, “It’s nice to see you playing with the kids.”
“Kids? That guy over there has white hair. He’s not a kid. Anyway, what difference does it make?

7/15 – In the Clay Studio I tell the joke about telling tourists my dog is an authentic colonial dog. Nice guy says, “They think you’re this crazy old lady.”
Me: Crazy? I’m going to come here and make a crack about gays.
Him: “I’ll probably agree with you.” OK…I’m on that one.

7/17: Image on LinkedIn: “Software so simple even a grandma could use it.” Ageist AND Sexist.

7/18 – Today I’m watching a CreativeLive video on vlogs. The charming, very young presenter (who speaks with the usual “young people’s accent”) says, “You vary your presentation for your audience. If they’re older, you might want to go slower.”

Yet another age stereotype of “careers after 50”

Baby Boomers Look to Senior Concierge Services to Raise Income – by Liz Moye

What I wrote to the Times:

As an aging Boomer I’m appalled by this article. The headline suggests that baby boomers could “raise income” by working as low-paid service workers.The rest of the article reinforces the stereotype of “seniors” as caring and nurturing people who are more concerned with doing good and leaving a legacy than earning money.

This stereotype encourages discriminatory attitudes among prospective employers and clients in the mainstream, profit-oriented business world. Not everyone wants to play a nurturing role, nor are many suited to perform these duties. Yet prospective employers, most authors of books about careers after 50, and even organizations like AARP, assume that seniors aren’t interested in demanding, competitive jobs with pay commensurate with their skills.

Additionally, the article suggests ghettoizing the elderly. The idea is that people of the same age will find a “social bond.” The NYT would never suggest that people will find a bond on the basis of race, ethnicity, religion or gender. Just being part of the same demographic doesn’t mean you have anything in common or even want to spend time together. .

Think of all the 70+ legislators and politicians who run this country. They’re not exceptional in physical or mental capability. They’re exceptional because they aren’t forced to walk away from meaningful, challenging jobs that bring them enough income to hire their own repair and transportation services. They have access to good medical care, not desperate doctors who force them into rounds of unnecessary tests and debilitating drugs. They’re taken seriously in conversation with people of all ages.

Get real.


Comments on Cialdini’s Pre-Suasion

The book is generally good, though not as ground-breaking as Influence. The impact of pre-suasion has been identified elsewhere and is commonly practiced by marketers.

However, four pages in this book – 122-126, together with the related footnote, seem particularly disturbing.

“the process of growing old” is described in very negative terms, mostly physical: “erode your ability to see, hear and think clearly…dulled sense of taste…compromised digestive system…vulnerable to an array of other afflictions, such as coronary heart issue, stroke, atherosclerosis, pneumonia, arthritis and heart disease.”

These “afflictions” affect people who are quite old and often near death. Many older people suffer more from the misguided effort of the medical professional to address these conditions, although medical intervention doesn’t always extend mortality or raise quality of life. In fact, some research suggests that diagnosis of diabetes after 65 doesn’t affect mortality.

Cialdini goes on to say that, “on average elderly individuals experience significant losses…yet they don’t let the declines undermine their happiness.” He cites one set of research studies, yet refers to “seniors,” not “seniors in the study.”

In his footnote, he does note that the “positivity paradox doesn’t usually extend into the very last phases of life…” because at that point the elderly lose control of their lives.

Yet considerable research as well as evidence from practicing physicians suggests that depression is significant among the old and younger old. Reported incidence of depression varies widely, possibly due to measurement flaws and motivation of the medical provider to prescribe drugs.

The tendency to focus on the good in a marriage may be related to length of time in a marriage, or experience of being married generally.

Age discrimination takes a huge toll. Many older people are able and willing to work. While a 70-ear-old can be president of the US, a competent person over 50 will have trouble finding an ordinary responsible job; at 60, the options dwindle to jobs like greeter at big box store. Older people often are treated with rudeness and condescension. Not all have spouses or siblings who can be sources of support and advocacy. People who experience these realities have every reason to be “grumpy” — an ageist term that should not appear in the pages of a psychology book. Images of cheerful, tolerant elders are as harmful to the aging population as images of happy slaves were to the treatment of African-Americans.

I’d suggest reading Never Say Die, by Susan Jacoby, for a realistic view of the aging experience, and also Goddesses Never Age by Christiane Northrup, about the possibility of aging in good health. Northrup is optimistic but does not dismiss the realities of age discrimination and stereotypes. Read Mary Pipher’s Another Country (which has become somewhat dated due to weaker family structures in the western world).

Most Disgusting HashTag: “ElderlyBooks” Reinforces Stereotypes of Aging

For a while Twitter had a hash tag, #elderlybooks. The purpose apparently was to reinforce stereotypes of aging.
Fortunately, it seemed to disappear on its own. Some examples:

50 Shades of Gray Hair.
Cartoon of an older lady: “Tracking my cookies? They will never get my recipe!”

Charlotte’s Lack Of Understanding Of The Web

The Five People You Are Going To Meet In Heaven Very Soon

What to Expect When You’re Expiring

Tuesdays With Who?

Is 85 too old to climb Mount Everest?

From a WashPo article – Should Nepal impose an upper age limit on climbing Mt Everest?

A study of climbers 1990-2005, showed that overall climbers made it to the top 31% of the time with a 1.2% chance of dying. Those 60 and up? 13% chance of reaching the summit and 25% chance of dying. Recently an 85-year-old man died, apparently of altitude sickness, while waiting to climb. Much better than living with the aftermath of a heart attack or stroke.

My response: If you’re over 60 you get to choose your risks. Dying at 85, surrounded by fellow climbers, in the fresh air of a beautiful mountain … why is this worse than living a few more years to die in a nursing home, surrounded by indifferent caregivers, eating bad food, forced to accept invasive medical procedure you probably don’t need, and possibly tied to a bed or a wheel chair, subject to verbal or physical abuse?

Patrick Henry said, “Give me liberty or give me death.”

What’s wrong with, “Give me freedom to stay out of a nursing home or give me death.”

Review of Senior Moments by Willard Spiegelman

At first I was put off by the title of this book. “Senior Moment” comes with negative connotations. People of any age have moments of forgetfulness. Saying, “I’m having a senior moment!” puts yourself down and reinforces the stereotype.

Spiegelman reinforces other stereotypes as well. “After all,” he says, “at a certain age one doesn’t sleep well to begin with…” I’m curious to know the age he has in mind. I’m not young and I sleep like a log almost every night, unless I have jet lag or get pulled from sleep when the cat yowls.

On page 125, he writes, “One virtue any senior citizen ought to possess is patience…” and I become very impatient with this sentiment. Why give people an excuse to keep you waiting? Medical offices in particular assume that if you’re above a certain age, you don’t mind waiting, and they are free to squeeze people in ahead of you.

On page 153, he says that at the fiftieth reunion, nobody cares what you do … just how you are, with undertones of health. “Voltaire wisely remarked that after eighty all contemporaries are friends. They know where they are going and they are going there both alone and together.” I’ve got a ways to go before eighty but doubt I’ll agree, ever.

Age doesn’t guarantee bonds of common interest, and this type of statement encourages those who want to isolate older people; an improv class here in my city was targeted to “45 and older.” I’d be more interested in whether they were doing scene work, characters or games.

On page 29, he says, “Here is a formula for staying young well beyond the days of youth: Grow old in a place where you do not think you belong. You will feel like an adolescent, because adolescents always consider themselves outsiders. Then, after decades, just as you have gradually habituated yourself to your surroundings, pack up and leave. It is time for another, perhaps the final, beginning.”

That’s an intriguing idea, although I have trouble following along. I’m not sure why it’s advantageous to feel like an adolescent or why feeling like an outsider triggers feelings and behaviors of adolescence. I’ve lived in places as an outsider and I felt…well, like an outsider.

However, as the author of a book on relocation, I’d add that there’s much to gain from taking advantage of local color. Spiegelman refuses to get involved in sports talk, yet following the Cowboys and the Mavericks and (most recently) the WNBA Wings can be enjoyable and rewarding.

Senior Moments is a collection of essays, a series of first-person opinions. Having reviewed many collections of essays, I am surprised at my reaction.

Most contemporary essays delve into the author’s personal life, showing them in their most vulnerable moments, exposing their most intimate secrets. Spiegelman keeps focused on the bigger picture. Yet I found myself wondering about the more personal side of the story.

For instance, Spiegelman refers to his partner. Many essayists would share the details. While I admire his discretion and outward focus, I can’t help wondering what it would be like to live in Texas as a gay person in the 70s, 80s and most of the 90s. My own experience with the south is that everyone’s very interested in your family, love life and religion.

It’s not clear why Spiegelman devotes so much time and analysis to his 4-day high school reunion. I’ve been to one high school reunion and several college reunions. The best part of my college reunions involved spending time with very smart women and, in some cases, listening to good lectures and talks. The people I seek out now are not the same as those I spent time with as an undergrad; I’ve changed and they have. The bottom line is that everyone’s reunion experiences will be different, people have short memories and it’s not worth over-thinking the experience.

But the collection also brings us some special insights. I love what Spiegelman says about restaurants: even in the most upscale venues, you’re drowned out by noise. I can’t help wondering if that’s why the restaurant industry notes declining participation and declining participation. Why bother going out if you can’t talk to the people at your table?

I particularly resonated with the chapter “Quiet,” as I too search for silence. I feel for his question, “Do we really need CNN in airports or music in restaurants?” I would add, “Why are we forced to listen to television in medical offices?”

We forget that there was a time when people didn’t listen to music continually, due to the absence of portable listening devices. Some people have grown up with noise blaring in their homes during all their waking hours. They can’t handle silence.

I also like his thoughts on cars. As he says, driving can make it easy to be alone and even lonely.

And I resonated with the comments on reading. I also read compulsively, and now read shorter works and nonfiction, as he does. But I don’t share his puzzlement to find that very few people are reading books in flight. Airlines have become so miserable, it is hard to concentrate; I find myself escaping with videos myself. After all, you can’t read without turning up the earphones to a level that risks deafness.