When I first started teaching gerontology in the Seventies, it was already an established field in that there were already textbooks that had gone through multiple editions. There were other books to be used as well, such as Nobody Dies of Old Age, which gave the perky impression that most of the problems of old age could be managed because people died of particular illnesses rather than just because of being old. To a certain extent that is true. Get rid of bed sores and broken bones, both of which happened at nursing homes that were badly managed, and people could go on for a long time. But it is to neglect the problem, of course, that old age is an existential condition. We don’t know the biology of why people get old, but it sure does happen to everybody and nobody gets out of this life alive.
What that book and the textbooks did was to treat getting old as a social problem. That meant old age was a condition that could be alleviated even if not eliminated—although an ideal solution would be that people would be happily old until they just teetered over and died, which is what people still want: to die without all the fuss and mess of prolonged chemotherapy. So old age was broken down into the ways in which it created bad feeling among the elderly and for those around them and social mechanisms could be constructed to deal with those just as mechanisms such as social security and welfare (this before the days of welfare reform) could be developed to deal with poverty, and such new fangled things as Medicare and Medicaid to deal with health care for those who could not afford it. The same applied to other groups that were considered, in the parlance of the time, as “deviant”: drug addicts and the mentally ill and prostitutes. The categories of gays and blacks and women had by that time escaped from the area of social problems and were seen as kinds of oppressed groups, or at least the last two were.
That was before gerontology developed into a set of community studies about the elderly. What was it like to live in a retirement community? What was it like to develop and sustain friendships among elderly people? What duties fall on children when parents get old? And that was before gerontology developed further just into a study of whatever programs and policies were there to be applied to the elderly, which is what social workers study because those are the programs and policies that they will have to administer to their clients.
I taught gerontology on the basis of book knowledge in that I had worked on policy questions concerning the aged and on leveraging financial support for the aged but had not provided clinical care to the aged. And so I come to the questions posed by those books differently now that I am among the aged (71) and have some experience of the matter and of how the experience has an impact on my life and the life of my friends. What I have decided is that in three particular areas and doubtlessly in others the textbooks back then got what it was to be aged just wrong. Let me count the ways.
A major theme of the textbooks was what was called “disengagement theory”, which was not really a theory, in that it was not a set of interrelated definitions and propositions, but a single proposition: as people got older, they withdrew from more and more of the relationships that were important to them. They left work; they stopped going out to meet casual acquaintances and then even old friends; they no longer belonged to various voluntary groups such as Y’s or baseball leagues or informal coffee klatches. They just sat at home, shedding their interests and enthusiasms as they also shed friends and colleagues. They dotter around the house and are ever more comfortable only in those narrow confines, and so wait to die. Mind you, the textbooks did not say this is what happened only to people without the internal resources to cope with a life more isolated than the world of work; this is what happened to just about all old people.
That has not been my experience or the experience of the people I know or of the people I do not know very well who come to this age without the advantage of much higher education. Everybody joins Facebook and e-mails. Everybody goes out for coffee and joins the Y or does exercises at a gym that have been prescribed by some physician. Everybody plans and accomplishes trips. So where is the disengagement? The answer, I think, is that every generation imagines a threat of disengagement, which is to be separated from society in a way that is detrimental to one’s mental health and physical well being. Durkheim imagined the whole of the modern industrial world to be such a place, people in it crying out inarticulately to find a family or tribe to rejoin, never mind that Simmel understood that voluntary friendships and associations did family and nation one better by providing a freely chosen and therefore more individual kind of association that did just as well without the drawbacks of going to Thanksgiving Dinner and birthday parties with people you don’t really like. Yes, people today may live alone, but that means they get to decide with whom to party and who they want to invite back to spend the night. Not perfect, but not so terrible.
It is the same with disengagement. There is something to be said for wandering around one’s apartment accompanied only by the memories and associations stirred up by a deceased spouse. There is something to be said for having organized one’s life well enough so that one has what one needs in one’s study and available on a music system, visited often enough by children and others so that one does not feel too lonely. A person can do without the constant jangling that accompanies the day to day routine of work life and the presence of young children. There was a time for that, and it was a good time, but there is also a time for this, and this can be a good time. (Since I am lucky enough to still have my wife, my evidence here is widows and widowers I have known.) My physician during my yearly check-up may ask whether I still get out and see people because doctors of his generation put that on their checklist but I think this may not be the right question to ask to probe if a person is happy or not with life. I don’t know what the right question would be. Happiness is too difficult an emotion to access that easily.
An assessment question easier to answer was also made reference to by the old gerontology textbooks. Check out the hearing of old people. Often, so it was said, what seems to be a diminishment of mental acuity is simply the result of being hard of hearing. People are asking others to repeat themselves not because they can’t get it but because they can’t hear it. I thought that a great insight until I became old enough to lose some of my own hearing and so I now repeatedly ask people to repeat themselves. But I don’t take that as much of a loss; indeed, it is something of a gain. Being old is excuse enough for not listening to something you did not want to hear in the first place. The same is true of losing words or even a strain of thought. When I was young, that was a source of embarrassment; now, it is a foible of the elderly, easily excused so long as people know what they are talking about when they remember what they were talking about. The frailty to be avoided is not to know when one is no longer as sharp as once was in posing a question or delivering an answer. One does not wish to lose a step at whatever game one happens to play. But that may be only be the result of the verbal games that I have played all my life. Bill Bradley said part of a basketball career was appreciating one’s play when one was slowing down at the end of a career. How did one still contribute? I guess I worry this too much.
A third point made by the gerontology textbooks was that elderly people were preoccupied with their health. How could it be otherwise given that they by and large have more visits to doctors and more ailments that threaten their continued high or medium or low functioning? Well, I beg to differ. The way I read it, most of the elderly I know are not particularly health conscious, except as circumstances warrant and far less than circumstances should warrant. Old people do their checkups and have their operations and worry about this value or that value on their blood tests. But unless they are sick, they put that out of their minds to get on with their lives, and those who are to some degree incapacitated by health ailments do their best to put that out of their minds between bouts with the surgeons or fight like the dickens to maintain whatever level of health they have so that they can get on with their lives. Old people don’t move into the anteroom to death; they only take hospital rooms when they have to. They focus on what they have always done with their healthy lives rather than on what are their states of disability.
Maybe I have been lucky so far, but all that means is that a lot of old people are lucky for a long time, continuing to be concerned about the things they cared about when they were young rather than closing down to a narrow set of concerns that lets very little daylight into their lives. So you live until you die and then it is over. I was not that cheerful when I contemplated death when I was younger.