When I started interviewing for the book, I expected to find that all of those I interviewed would have many health problems. So, I was surprised that there was a sizable group of those whom I interviewed who, like me actually, had few or no health issues. This was one of my first “aha!” moments. Eightysomethings can be healthy. However, of course, most people in their eighties do have health issues. One of these eightysomethings summed up her life as “patch, patch, patch.” And a whopping 52 percent of people in their eighties have four or more chronic conditions, according to the Consumer Reports National Research Center. It is how they cope with their health issues that interests me most.
Doug, at eighty-six, is an example of a healthy man. He takes no prescription medicines at all. A former engineer, Doug and his wife have lived in the same house for over fifty years. Three years ago, one of his daughters and two small grandchildren moved in with them. He loves having them in the house and he happily helps out, taking one of the children to daycare each day. He admits that he has somewhat less energy nowadays, so he only goes on walks about twice a week. And he only skates a couple of times each winter. After telling me this, he commented, “I am almost embarrassed by my good fortune; I will probably fall apart all at once.”
Hugh, eighty-eight, a Christian Scientist living in Connecticut, is another amazingly healthy person. A trim man, Hugh was wearing shorts the February day I interviewed him and he was just back from his daily walk. He told me that he has not been to the doctor since 1964. I must have looked shocked because he added quickly, apparently to reassure me, “I have been to the dentist though.” When his wife died several years ago there was no funeral service and no mention of her death. He explained to me that she had just moved to another stage of life.
I couldn’t help but wonder about the factors that explain Doug’s and Hugh’s amazing good health. Is it merely good genes and good luck? In Doug’s case, I can’t help but believe that being immersed in a multigenerational family where his help is needed contributes to his well-being. And for Hugh, I believe that his faith has much to do with his continued good health.
After interviewing many other eightysomethings who were less healthy, I discerned that people fall into five main groups according to how they cope with their health issues. Deniers, Stoics, Complainers, Worriers, and Realists. The coping style does not seem related to the severity of their health problems.
Deniers refuse to acknowledge their problems even when they are obvious to all those around them. They ignore chest pains and refuse to go to the doctor when they have shortness of breath. They continue to drive despite cataracts that should have been removed months before. They continue to eat quarts of ice cream despite their obesity. They drive their spouses and children crazy.
Andrew, eighty-eight, is a good example of a Denier. He is a small but intimidating man who was the CEO of a large company. He retired twenty-seven years ago. Five years ago, he was diagnosed with Parkinson’s, and he and his wife moved to a retirement community in New Hampshire. His daily routine includes time in the wood working shop each morning. Despite his tremors, significant cognitive impairment, and tearful pleas from his wife, he refuses to stop using the power tools. He insists he is careful.
Unfortunately, it usually takes some kind of a calamity to get Deniers to pay attention to their bodies.
Stoics make up the largest group in my eightysomething sample. Stoics are like the literary character Pollyanna—remaining good-spirited and cheerful, even when they face situations that are painful and life-altering. At my retirement community, Stoics come to the dining room sporting bandages, crutches, and slings. As one woman said to me, “Why miss dinner just because you have a black eye and a large bandage around your head?” For these Stoics, it is definitely “stiff upper lip’” and “keep on moving.” Regina and Cassy are both Stoics, and both have many serious health issues.
Regina, who was born in Italy, now lives with her husband of sixty-six years in a retirement community in upstate New York. She weighs a mere ninety-four pounds and takes dancing lessons three times a week. She mused, “I think the main reason I have lived so long, and am so healthy at eighty-four, is that I have taken care of my body. My mother was a nutrition nut. My whole childhood was her telling me ‘eat this fish for your eyes, those carrots for memory.’ I was given tonics and I survived typhoid as a child, so I must be a tough cookie. Today my hearing is not so good and my heart has major electrical problems. Even so, I keep dancing and am very energetic.”
Yes, Regina is a fine example of a Stoic. She knows she has health problems, but she minimizes them. I have a hunch that as long as she dances she will survive for many more years.
Cassy, another example of a Stoic, is an eighty-seven-year-old diminutive woman with bright blue eyes and a radiant smile. She lives in New York state, about a hundred miles from New York City. She told me, “Everything changed for me in my eighties. I have had two hips replaced and gotten two new knees. My arthritis is a problem. I have done the falling thing, too, and was on a walker for several months. Now I can walk just fine, but I have serious lung and breathing problems and I’ve had skin cancer. Doctors’ appointments keep me busy. Still I try to exercise forty minutes a day and I can see just fine—that’s a gift. I have been so blessed.” Cassy is so filled with joy and good spirits that she had me believing she was okay despite the many issues she was dealing with.
Complainers are those who tell anyone who will listen about their back pain, their acid reflux, their recent diarrhea, and on and on. This is an extremely tiny group at my retirement community where complaining about your health runs counter to the prevailing culture and puts you on an imaginary black list where people may begin to shun you. It is okay, however, to complain at length about the weather and the fact that the chairs on the terrace are uncomfortable. Complainers are also a small minority of those eightysomethings around the country whom I interviewed.
Bunny, an eighty-five-year-old woman, is one of the Complainers. She began our encounter with the proverbial organ recital: “Katharine, I am having an awful time. My back aches all the time so I can’t walk. I can’t eat anything that tastes good. My heartburn is horrible. My hearing is so bad I really can’t have a conversation. And now, my daughter has moved to Colorado and left me high and dry. I can’t believe she did that to me. I have no one to talk to now.” It is hard to be empathic when there is a never-ending tale of woe. Her daughter told me when I interviewed her a few months later that it was quite a relief to be able to be out west.
Maud is one of the Worriers I spoke with. She lives in affordable housing in western Massachusetts. During our interview in her tiny apartment stuffed with furniture and artificial flowers, she told me, “I can hardly get up when I am on my knees and I worry about what I will do if it gets any worse. I stopped traveling because I was afraid I might get sick and, of course, I can’t afford to travel, anyway. I don’t go out often because I am afraid I might fall.”
I know this type because my husband John was one of them. Although in public he appeared relaxed and carefree, in private, he was a Worrier. In his early eighties, when he was still fairly healthy, he worried about falling. So, he always walked with two hiking sticks to feel secure. He thought they made him look sporty rather than impaired. He worried about getting sick, so he took his blood pressure every day for years and would take to his bed with the slightest runny nose.
A short riff about falling. Almost all people in their eighties (except the Deniers) worry about falling. Eightysomethings hold onto the railings when going up and down stairs and rarely emerge out-of-doors if there is ice on the streets. And for good reason—because 40 percent of eightysomethings fall each year. Falls are the leading cause of fatal and non-fatal injuries in this age group. Everyone who is over eighty has a friend who has fallen and broken his or her hip and never really recovered. It is part of the culture of aging.
Lastly, we have the Realists. They are those wise souls who appropriately acknowledge their health conditions and their seriousness. They acknowledge their pain but don’t dwell on it. They complain if it’s bad. They pay attention to how their body feels and note changes and new symptoms. They go to the doctor and the dentist and they are not reckless. You do not have to second guess a Realist.
Ralph is a good example of a Realist. He is a tanned man with curly white hair. His energy level, however, is totally different from his ninety-year-old girlfriend’s, as she continues to climb mountains and to ski. He spoke in a husky voice so softly that I had to keep asking him to repeat what he had said: “I had prostate cancer two years ago, needed an operation. Since then I have had urinary problems and sex with my girlfriend is not at all the way it was before the operation.”
After the cancer, then the next thing that happened was that my balance was off. I kept teetering around and banging into walls. It turned out I had fluid in my brain and I needed a shunt. The procedure has worked quite well and my brain seems okay. I also have neuropathy that has affected my feet. I take fourteen different kinds of medications each day and I can only walk about a block.
We don’t drink alcohol or eat red meat. Put bluntly, though, it’s a lot of work. It’s very tough. But each morning I wake up and say to myself I’m here, I am alive.
Some of the ways we cope depend on our ethnic background and culture. I recommend Monica McGoldrick’s book, "Ethnicity and Family Therapy," for anyone interested in pursuing this topic. For example, she explains that Irish people are likely to deny they have any pain while English are just stoic about the pain they feel. She has lots of fascinating material about how different groups experience and deal with health issues.
By the way, I see myself as a Stoic. My father didn’t go to a doctor for thirty years. No one in my family got much attention for being sick, so as a child I didn’t take to my bed or stay home if I felt a little off. As an adult I used to go to work when I was sick and several times my colleagues would take a look at me and send me home. Now in my eighties I like to think I am more sensible. I do go to the doctor much sooner now, but I probably still carry on a bit past the point that it is reasonable.
What else did I learn from my 128 interviews about eightysomethings and their health? First, I am convinced now that their attitude and usual coping style have more impact on their behavior than their actual health status. And most importantly, I observed that a decline in health in one’s eighties is not always—in fact, is not usually—accompanied by a similar decline of good spirits. Many in their eighties feel happy—some happier than they have ever been before. This is the little-known fact about eightysomethings that we will explore and expand upon throughout this book.
Younger family members often have trouble understanding how their eightysomething relatives actually feel. They are sure they would be totally depressed if they had half the health issues that their eightysomething parent or relative is living with. Yet Cassy glows with joy and Ralph reports he has never been so happy in spite of how tough it is for him. Somewhere in the decade of their eighties, many people begin to see the glass half full. If they do not have dementia and are not in constant pain, eightysomethings count themselves lucky. They are able to take pleasure in what remains—they are alive.
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Excerpted with permission from "Eightysomethings: A Practical Guide to Letting Go, Aging Well, and Finding Unexpected Happiness" by Katharine Esty, PhD. Copyright 2019 by Skyhorse Publishing, Inc.