Life Matters Media
Quality of life at the end of life

On Health Care Decisions Day, a Decision that Could Delay the End of Your Life

Aging Responsibly and with Purpose

BY SUSAN M. MATHEWS, PhD, RN, MSBE

Incredibly, the old will soon outnumber the young.

According to projections just released by the Census Bureau, the population of Americans 65 and older will exceed the number of children in 2035 for the first time in history.

Additionally, this year’s prime-age workforce—ages 25 to 54—is about 630,000 people smaller than it was forecasted to be in predictions made only three years ago.

Baby boomers are retiring at the rate of more than 10,000 a day. According to Pew Research, this influx will more than double Medicare and Medicaid costs by 2020. As our costs increase faster than economic growth, Medicare taxes and our Medicare Part A will cover less and less. Fifteen years from now, the Medicare trust fund may be bankrupt. Taxes may only pay about half of our costs.

A body’s stress response improves when someone has a purpose in life, resulting in fewer strokes, heart attacks, and other chronic and costly conditions.

Retirees have lobbied hard to protect benefits and pressured legislators to shift funding toward these programs, a measure that would drain other public programs. Why would our representatives embark on such a “rob Peter to pay Paul” strategy?

The answer is simple.

“Because elderly Americans vote at high rates,” said Kenneth Johnson, a demographer at the University of New Hampshire.

Does this massive demographic of 74 million people have a responsibility to age responsibly? We do. The economic burden on the young cannot be ignored. Medicare and Medicaid entitlements are looming offenders which tip the scales on the quality of life our children and grandchildren experience today.

Not only are purpose and attitude beneficial to aging, lifelong learning is, too.

This is the week in which we are encouraged to share our end of life decisions with our loved ones and care providers. National Health Care Decisions Day is an initiative which celebrates the gift we give to our families by sharing our medical preferences in advance of a health crisis. The clarity we extend to them is priceless, and it’s also free.

As we consider the care wishes we should share, we can also resolve to make one small, yet meaningful, step to ease the burden of spiking costs that our loved ones are forced to shoulder.

Studies have found that a sense of purpose can outweigh negative physiologic impact of smoking, obesity and diabetes. A body’s stress response improves when someone has a purpose in life, resulting in fewer strokes, heart attacks, and other chronic and costly conditions.

Coincident with purpose is a positive attitude, which has been shown to increase life span up to seven years. According to Dr. Marc Agronin, a leading author and geriatric psychiatrist at Miami Jewish Health, “we simply feel better when we have a purpose.”

How can you expand your conversation on this nationwide day of health engagement to include a personal sense of purpose?

Psychologist Carol Ryff’s Scales of Psychological Well-Being offers a guide. She explains: “purpose is measured by the degree to which we have goals in life and feel that there is meaning to our past and present circumstances. This sense of purpose may be reflected in daily work or caregiving, relationships, core religious or philosophical beliefs, and an assessment of what we’ve accomplished in life and what we want our legacy to be.”

Not only are purpose and attitude beneficial to aging, lifelong learning is, too. The Rush Memory and Aging Project found that the cognitively active were more than two and a half times less likely to develop Alzheimer’s disease and dementia than seniors with less cognitive activity.

Fulfilling the responsibility to age responsibly is a matter of making the decision to do so. As you are asked to consider your end of life care decisions, make a decision to commit to purpose, good attitude and continuous enrichment. Many older Americans enjoy an affluence of time, but not money. Fortunately, not one of these commitments requires any spending.

Volunteering, caring for the young and old, caring for a caregiver, praying, writing, creating, traveling, learning, and teaching are just some of the endless opportunities that create purpose and improve attitude. At the same time, these activities relieve the burden on younger generations by keeping us healthy.

We all know that a sense of purpose, a positive attitude and lifelong learning will not dig us out of the sinkhole of mounting entitlements. But, as Neil Armstrong famously said when he stepped onto the moon, “that’s one small step for man, one giant leap for mankind.”

We have a responsibility to take that one small step by aging responsibly. Best of all, the decision to do so is free.