BLOG: The importance of what 80-year-olds think about
All day long, we doctors see patients who are much older than we are.
Without hesitation, they confide in us with their most intimate problems — something that later, less trustful generations may hesitate to do. Profoundly, they depend upon us and we upon them for our livelihood.
But how often do we consciously consider what matters most to our older patients — the thoughts that occupy them most? Doing so should inform how we relate to them, educate them and understand their motivations.
Studies of the sentiments of older adults reveal some surprising and not-so-surprising trends. No universally accepted list of the top five worries for seniors exists, but a paper in BMC Geriatrics suggests that health issues tops the list. Losing financial security ranks second, followed by social isolation, dependency on caregivers and end-of-life planning. No surprises there.
For us doctors immersed in the many unsolvable problems of our aging patients, it’s human nature to avoid thinking about our own eventual senescence, but there’s actually reason for optimism about our own aging and that of our patients. If we’re wise, this should also inform the way we relate to aging patients.
It turns out that a majority of people in their 80s are actually happier than in their earlier years. A 2020 interview study of 128 octogenarians published as a book and performed by Katharine Esty, PhD, who herself is an almost 90-year-old psychologist, revealed that most aging brains are actually kinder and often psychologically thriving compared with their younger counterparts. While those confined to nursing facilities and completely dependent on others had a less optimistic view, even those with pain and chronic illness generally had a positive perspective.
One variable that correlated most strongly with peace of mind was a sense of purpose. Whether volunteer or for profit, work engagement correlated with positivity. Whether working or not, most 80-plus-year-olds had a more mindful approach to life. Recognizing their limited remaining time, Esty concluded, put them at ease with decisions they had made in the past and life’s everyday challenges.
Knowing all this, with what approach do we best serve aging patients who have good reason for fear but enough life experience to be sanguine? For me, the answer is humor. My older patients love relating humorous stories about the challenges of aging, marriage and raising kids. Those universal struggles cross every social, economic and racial divide, and they build bonds of trust and appreciation between us and those we serve.
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References:
- Eightysomethings. https://www.katharineesty.com/eightysomethings. Accessed April 16, 2024.
- Ploeg J, et al. BMC Geriatr. 2017;doi:10.1186/s12877-017-0431-6.
- Romo RD, et al. ANS Adv Nurs Sci. 2016;doi:10.1097/ANS.0000000000000139.
- Schulz R, et al. Family caregiving roles and impacts. Families Caring for an Aging America. https://www.ncbi.nlm.nih.gov/books/NBK396398/. Published 2016. Accessed April 16, 2024.
- Topa G, et al. Front Psychol. 2017;doi:10.3389/fpsyg.2017.02338.
- Wickramaratne P, et al. PLoS One. 2022;doi:10.1371/journal.pone.0275004.
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