We live longer lives. Life expectancy in developed countries has reached eighty ears and up, which has made seniors a major proportion of the population and aging one of the most important issues in the world. Are we prepared to make life better for an aging population? That’s in a nutshell the topics of Atul Gawande’s latest book, Being Mortal (Ed. Picador, New York, 1997).
The author compares how in the past seniors used to live at home with their families, surrounded by loving and familiar faces, and leading a normal life until their death, and how nowadays they live in nursing homes, removed from the warmth of their families, and cared by detached strangers. He also compares the independent life the elders used to enjoy in the privacy of their homes, to the forced dependency they are submitted in nursing homes or in skilled nursing facilities.
Our society is aging but we live in a state of denial about the need to manage our golden years. It’s as if senility makes us uncomfortable, uneasy, though we’ve done everything to prolong life. As people live longer, there is a need for aging specialists. Our policy makers need to allocate more funding into research and programs on aging. Universities should be encouraged to develop cursus and programs on geriatrics. Besides graduating more geriatricians, medical and nursing schools need to provide training on aging to all healthcare professionals.
The author uses true stories of seniors dealing with senility, bad health, and the inevitability of death. The stories make it easy to understand the challenges of becoming old and fragile. One of the stories is that of an octogenarian geriatrician caring for his elderly wife and trying to help her maintain an active and independent life. Gawande shows how, even for a geriatrician, helping seniors keep their independence and normal life is a daunting endeavor.
In Haiti, with a life expectancy still below 65 years (63.5 years in 2015), our seniors represent a minor proportion of the population. The aging concerns that are nagging policy makers in developed countries are far from our public discourse. Here, politicians are more concerned with educating and creating job opportunities for young people (the largest proportion of the population). We have very few nursing homes and nursing skilled facilities. Most seniors still live at home with their families.
But, we have our own challenges: Many of our seniors lack access to adequate healthcare, and some even live in abject poverty and abandonment, particularly those living in state-run asylum or suffering from dementia. Our seniors may not be yet a major stratum of our population, but we must meet their basic needs for food, clothing, lodging, and comprehensive health insurance.
Senility may seem far away to most of us, but sooner or later we will have to face its ugly head.
Dr Atul Gawande’s book is a stark reminder of our unstoppable march toward the challenges of the golden years.
Mario Malivert, MD, MPH, MSM
Medical Director
Clinique Repheka, Pernier, Haiti.
mariomalivert@yahoo.com
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