TIME MOVES IN ONLY ONE DIRECTION

(Published in the East Bay Psychiatric Association Newletter, May 2007)


When my Dad turned 80 some years ago, a friend of mine gave him a book entitled “Getting Old Is Not For Sissies.” I didn’t fully realize then the implications of the title, as I was still in my late 40’s at the time. Now, as Medicare and Social Security loom around the bend for me, I am beginning to appreciate better the hard work of getting old that lies ahead. The march of time takes its toll on everyone, and everyone needs to train him or herself to be old in order to avoid certain pitfalls. Getting older requires major attention to one’s emotional, attitudinal, and physical wellbeing.

The emotional side of things is probably the subtlest. People have to learn to be comfortable when they no longer have a schedule, when they no longer are earning an income, and when they are spending more time alone. For most people this is a radical change, as one’s earlier adult years were usually spent maximizing income within the context of a job with a schedule and social interactions. Leisure time, although previously yearned for, may now feel unnatural; and time alone, rather than being enjoyable, may be experienced as isolative.

A shift away from one’s earlier sense of purpose begins to occur between ages 50 and 70. It is during this period that one needs to behave more like we did as children--to be able to play, to enjoy whiling away the time, and to pursue activities just for the sheer pleasure of them. One has to strategize about these new realities or one will be bored, no matter how much money and freedom one has carefully planned for. I’ve known retirees who can’t find enough hours in the day to pursue all the interests they have, but I’ve also known those who complain that “retirement is not all that it was cracked up to be,” and they dread the boring days that stretch out before them.

For those living in the transitional stage going from “working hard” to “hardly working,” it is important to take the time to understand your new needs, to assess your physical, emotional, and financial health, and to develop a plan to address your new realities. Retirement can be a time of creativity, newfound freedom and interests, and revitalization, but alternatively it could become a time of stagnation, isolation, and decline. There are academic courses to be taken, arts and crafts to explore or master, cultural interests to pursue more extensively, more time to spend with friends, and time to travel more extensively.

Attitude can be critical. A year ago my wife and I took an adventure trip to Costa Rica and Panama. It was a small boat cruise with elective physical activities every day, including kayaking, snorkeling, hiking—you name it. One of our travel companions on this trip was a 90 year-old man named Sidney who had taken the trip with a much younger female friend (his wife had died many years earlier), knowing he could no longer partake in the challenging physical offerings on the cruise, but wanting to continue to travel nonetheless. Every evening after the rest of us were pleasantly fatigued from our day’s activities, Sidney and I would sit on deck with a cocktail and he would wax eloquent about his past years of growing his own business and about all the other places he had traveled to. He reported that he had turned over the ownership of his company to his son years ago, but still went to his office regularly to keep busy because “my son was kind enough to give me an office to go to.” Sidney’s companionship greatly enhanced my trip, and I know that he had a wonderful time that week as well. But it was Sidney’s attitude of continuing to engage life so fully that impressed me the most.

The other major challenge of old age is attending to one’s physical wellbeing. The major tactic for helping oneself is this area is developing the habit of exercise. If there is one single thing to do for oneself that can enable you to look better, feel better, and live longer, it is to exercise regularly. This doesn’t mean running marathons. It’s a simple matter of a three-mile walk or its equivalent four or more days a week. Forget all those other claims of revitalization that are advertised. Exercise is as close to the fountain of youth as you can get.

Despite maintaining a regular schedule of exercise, the ravages of physical decline with age may become overwhelming nonetheless. There can be losses that can change everything for the worse, and these losses may mount up and become overwhelming. Your own good health is one crucial requirement for happiness, but for those who are in a long-term committed relationship, the life and health of one’s partner is as critically important as one’s own. If you or your partner’s health seriously declines, or your partner dies, retirement becomes a far different experience than you may have anticipated or predicted.

I would recommend a recent article in the New Yorker magazine (April 30 edition) by Atul Gawande, the Harvard surgeon who is also a gifted writer. The article, “The Way We Age Now,” describes the physical aspects of the body’s inevitable deterioration and what can be done to manage these changes. Gawande is particularly concerned about that lack of trained geriatricians who know how to treat the physical and emotional needs of the elderly, as opposed to the average internist who is best at primarily treating disease entities. Geriatric patients are mainly at risk for depression, social isolation, malnutrition, and the danger of falling. Having a personal doctor who looks after you with regard to these risk factors is important if and when you get to be in your 80’s and 90’s.

To the degree that one does have some control in life’s later stages, it would seem best to exercise that control to maximize one’s happiness. Some things are, after all, out of our control, and since time moves in only one direction, the one thing we know for certain is that eventually we will all run out of time itself!


Hugh R. Winig, M.D.