Some older adults find the physical loss of aging the most significant part of the process. Many suffer from terminal illness and painful treatments that last for years.

We all know of people whose loved ones have been cruelly and often pointlessly kept alive for years after they can no longer function, in awful suffering. We see animal lovers doing the same thing, a strange reality.

In my hospice work, I’ve seen families keeping their mothers and fathers alive even when they are ready to go, and even begging to go, and doctors administering life-changing medications that prolong a painful life without purpose or pleasure.

But there is another story, and since it happened to me. I have diabetes and serious heart disease, and by experience and history,  I would have been dead long ago.

A recent Longitudinal Study of Aging and the National Health Interview Survey found that rates of disability among older people are declining steadily and recovery from acute disabilities improves from year to year.

People sometimes approach me as if I were about to drop dead; people who know me are amazed at how much younger and more active I am than they expect from someone my age. Only seven percent of people between seventy-five and eighty-four need help with personal or institutional care. That is something I had never heard.

The modern media is corporate-owned and driven. It does an awful job of preparing people for old age. We are on our own.

The health care system has often plowed ahead with new technologies that are poorly considered for older people. In his terrific book “Being Mortal,” Dr. Atul Gawande writes about the agony of older people who are offered surgeries that end up torturing the people they are meant to save.

“You don’t have to spend much time with the elderly,” he writes, “or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. They are spent in institutions – nursing homes and intensive care units- where regimented, anonymous routines cut us off from all the things that matter to us in life.”

Gawande is right, but it isn’t the whole story.

_________

__________

At 79, I need Maria’s help with things I always did myself, but I am active, busy, and happy, and rarely in pain or needing help walking or driving through my town. I am mindful of making sure she leads her life, not just mine.

The ratio of active to dependent life expectancy – of healthy and active old age as opposed to simply getting older and older – is increasing at rates unheard of just a few years ago. Clearly, life does not have to end quickly.

Some medicines are miracles, some don’t work at all. My doctors have made good and thoughtful choices with my medicines. Every older adult seems to have some.

I’m writing more than ever, taking better photos than ever, and doing more good than ever. My doctor smiles when he sees me and says my heart, blood pressure, and blood sugar are excellent.

I have been fortunate – and wise, maybe  – to find doctors I trust who will listen to me and guide me. They were all hard to find but worth the trouble. Everyone agrees that older people should be careful about hospitals. They aren’t for everyone. Older people don’t heal easily or well. They can keep us alive longer, but often with painful recovery and longer healing.

I don’t ever complain about my health care; my doctors have guided me through danger to health, at least for now. They tell me attitude is often everything, and I embrace it: acceptance and grace. I have also learned that doing good for others is not just the right thing; it is the healthy thing.

They also support my decision to give up on serious surgery at this point in life.

I am amazed by all this; I never expected to live this long, but I am also living a rich, loving, and active life. I know this has to be temporary, and one day the doctor will have other news for me.

I know that there is only one ending to this period of life, but that isn’t today or tomorrow; (I think) the rest is simply beyond my control. Modern medicine has learned a lot, but no miracles await me.

I credit medicine with keeping me in good shape for now. I’ve learned what healthy eating means and have embraced it.

I’ve figured out how to exercise safely, meaningfully, and consistently.

We love going to museums, and when we do, I always find a place to sit and look at the art while Maria finds the exhibits she loves and needs to consider. It works for both of us.

I’ve learned to rest when I need it, drink when I’m dry, take my medicine, and work when I should. I forget things a lot, but I can work around it. I understand the fear about AI softward, but mine has helped me write and research in ways that would have been difficult, even impossible. I am paying attention to the warnings. And there are no more typos.

I also have an understanding and loving partner in Maria; she helps me patiently and lovingly, but never gives up her art, freedom, or friendships. She is a major reason I am alive and active today.

I’ve developed what my doctors say is a healthy attitude. I count age as a period of gains, not just losses. I am a better man than I was when I was young; that is a shocking but truthful thing to say.

As I’ve written before, the major challenge of this new stage of life is not to fear the fear.

So far, so good.