{"id":467,"date":"2017-03-27T15:55:49","date_gmt":"2017-03-27T19:55:49","guid":{"rendered":"http:\/\/www.silvercentury.org\/?p=467"},"modified":"2018-09-21T16:50:59","modified_gmt":"2018-09-21T20:50:59","slug":"planning-to-live-a-long-life-think-ahead","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2017\/03\/planning-to-live-a-long-life-think-ahead\/","title":{"rendered":"Transitioning Out of the Fast Lane"},"content":{"rendered":"

\u201cOld age\u201d doesn\u2019t descend on you all it once; it happens in stages. Here, journalist Liz Seegert explores them, along with ways to make the most of the years ahead. A Journalists in Aging Fellowship, sponsored by the Silver Century Foundation, supported Liz\u2019s work on this topic. The fellowship program is a collaboration between New America Media and the Gerontological Society of America.<\/em> The article first appeared on the <\/em>New American Media website on January 15, 2016<\/em>. It\u2019s reprinted here with permission. You can hear Liz\u2019s interview<\/a><\/em> with Dr. Toni Miles on WBAI radio\u2019s \u201cHealthCetera\u201d program.<\/em><\/p>\n

Are you a go-go or a go-slow? Or maybe even a no-go?<\/p>\n

It\u2019s not some new Dr. Seuss book, but another way to describe the various stages of growing older. Barring a catastrophic event, older adults typically fall into one of five major life stages that take them from active and healthy to completely dependent on others. <\/p>\n

The catchy phrasing\u2014originally developed by Duke geriatrician Harvey Cohen, MD\u2014was quickly adopted by the aging community as an easy-to-explain concept to describe an elder\u2019s functional ability. <\/p>\n

When \u2018Life Is Limitless\u2019<\/strong><\/p>\n

The first group is the go-gos. These are older adults who \u201care in excellent health and can do anything they want,\u201d said Toni Miles, MD, PhD, director of the Institute of Gerontology, University of Georgia, Athens.<\/p>\n

They are the ones portrayed in the active-senior advertisements, like those for Viagra. They live in the community and often move in retirement into fabulous homes or retirement communities. For them, said Miles, \u201cLife is limitless.\u201d<\/p>\n

But everyone eventually begins slowing down. \u201cGeorge H.W. Bush was a go-go,\u201d Miles noted. The former president even jumped out of an airplane to mark his 80th birthday.<\/a><\/p>\n

Today, at age 91, she added, \u201cHe\u2019s being pushed around in a wheelchair by his son. He has clearly transitioned.\u201d <\/p>\n

While not every go-go gets their kicks from skydiving, they eventually do move on to the next phase, go-slow. These are people who still live in the community, are still in fairly good health and can generally manage their own affairs. \u201cThey\u2019re slowing down but, importantly, recognize it themselves,\u201d Miles explained. <\/p>\n

Perhaps they no longer like to drive at night. \u201cWhat they\u2019re telling you is, maybe they have a vision problem, or they\u2019re anxious.\u201d The good news, she said, is that they\u2019re aware and begin self-limiting their activities. <\/p>\n

Eventually, people segue from being self-limiting to needing assistance with instrumental activities of daily living. These \u201cslow-gos\u201d might visit a clinician every few months to manage multiple chronic conditions. They may have a neighbor who checks in on them regularly, or hire someone to mow the lawn, or have their groceries delivered\u2014activities that require a complex blend of both cognitive and physical performance.<\/p>\n

A Little Help from Family, Friends<\/strong><\/p>\n

Although gerontologists note that people may experience the phases differently\u2014with someone of 91 still walking all over town and another of 71 well into decline\u2014even very healthy older adults need to plan for the later stages of aging, given the vicissitudes of old age. <\/p>\n

Miles continued that the next step down from the slow-gos are the slow-slows. \u201cThese are people whose relatives are worried about them and might suggest they move into assisted living.\u201d Slow-slows generally rate their health as only fair and have problems managing several critical activities of daily living. That might include medication management, or help with dressing, eating or bathing.<\/p>\n

The last group are the no-gos. \u201cThat\u2019s the group, unfortunately, that a lot of people have in mind when they say \u2018old,\u2019\u201d said Miles. \u201cBut there\u2019s all these other stages ahead of them. <\/p>\n

\u201cThis group no longer makes their own choices,\u201d she explained\u2014for instance, because of mental impairment or debilitating illness. \u201cThey have people making choices for them,\u201d such as a spouse, adult children or another health care proxy designated to make their decisions. <\/p>\n

One step boomers can take: make learning a lifelong process.<\/p><\/blockquote>\n

Miles, who has worked on federal elder-care policy issues, said that government, clinicians and nonprofit organizations need to think about how all of these pieces fit together and to collaborate to create the best frameworks for every stage of aging. <\/p>\n

She observed, \u201cSelling a no-go lifestyle to a go-go is hard, so we need to have home and community services already in place when they suddenly find they need [them].\u201d<\/p>\n

Some older adults have planned well but others have not. As baby boomers begin the transition from go-gos to go-slows and beyond, that could strain social safety nets.<\/p>\n

\u201cWe haven\u2019t had the conversation yet about how much responsibility [for ourselves] we have as we enter old age\u2026. I am responsible for how I arrive at old age and what resources I can bring, and then the social contract says in our society we owe each other something,\u201d she said. <\/p>\n

Just what that \u201csomething\u201d is has been the topic of much debate<\/a> within the gerontology and policy worlds. It is intensifying as more baby boomers begin reaching the go-slow and slow-go stages.<\/p>\n

Engaging Brain and Body<\/strong><\/p>\n

Regardless of life stage, it\u2019s never too early, or too late, to plan for old age. \u201cYou have to envision your future, debilitated self,\u201d Miles explained. \u201cThat is so hard. No one wants to do that.\u201d <\/p>\n

One step boomers can take is becoming more intentional in how they live their lives\u2014finding a work-life balance and taking time to de-stress. Another is to make learning a lifelong process. <\/p>\n

One of the biggest antidotes to debilitation at any age is education, according to Miles. \u201cYou should always be learning new things\u2014and it doesn\u2019t have to be academic-type learning, it\u2019s whatever makes you happy.\u201d She stressed, whatever the activity, give it all you\u2019ve got, so both brain and body are engaged. <\/p>\n

What else can we do to help ourselves to perhaps slow down the transition from go-go to no-go? <\/p>\n

\u201cEat your vegetables. Exercise as often as you can. And get a good night\u2019s sleep.\u201d Those three things, said Miles, are keys to preserving cognitive function. <\/p>\n

If you have a brain that works, she said, \u201cthen you can accommodate your own disability, you can make the decisions that you need to make.\u201d <\/p>\n

But, she cautioned, we need to anticipate that even that organ may eventually fail. So find a surrogate brain\u2014your proxy\u2014who can take over when needed.<\/p>\n","protected":false},"excerpt":{"rendered":"

Are you a go-go or a go-slow? Or maybe even a no-go?<\/p>\n

It\u2019s not some new Dr. Seuss book, but another way to describe the various stages of growing older. Barring a catastrophic event, older adults typically fall into one of five major life stages that take them from active and healthy to completely dependent on others.<\/p>\n

Read more Transitioning Out of the Fast Lane<\/span> ›<\/span><\/a><\/div>\n

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