Ourselves, Growing Older: Women Aging with Knowledge and Power - Softcover

Chapter 1

AGING AND WELL-BEING

by Marilyn Bentov, Dori Smith, Diana Laskin Siegal, and Paula B. Doress-Worters, with help from Eve Nichols Special thanks to Joleen Bachman, Ruth Hubbard, Jane Jewell, and Faith Nobuko Barcus Sharing Touch -- Massage by Sylvia Pigors, Marilyn Bentov, and Diana Laskin Siegal 1994 update by Diana Laskin Siegal

Resources for this chapter on pages 447-50

At My Age

Last summer our vegetable garden yielded small bounty: round pink tennis ball tomatoes ripening among the marigolds in an inferno of sun, captives of ninety degree days, of unwavering heat, fitful squalls of rain that released, not a drenching cool, but drops of water that glanced off tight shiny skins the way globules hiss from a sizzling fry pan.

One day I looked into the patch and there was one tomato seamed and split, a deeper fruitier juicier red inside, but with a frayed and largely open look.

I wanted to cup it into my hands and not lose a drop.
Doris Panoff

A Plan For Aging Well

Many of us want to live long lives, but fear the infirmities or disabilities that may come with advancing age. In this chapter we will emphasize that aging well is more than the absence of disease. It is a harmony of mind, body, and spirit. Each of us can take an active role in our well-being as we age -- a holistic approach that involves sharing with others, reducing stress, and participating in community, among other methods.

The reason wellness is so important to me is that I have so many things I want to do, and I have to be well to do them. I don't want to live to be eighty or ninety unless I am well enough to be active. I don't want quantity of life without quality. [a fifty-seven-year-old woman]

Whether I am healthy because I can be busy and happy or whether I am busy and happy because I am healthy is a question. I can do many things that I never had time to do before. Among my activities, I play the recorder in two groups, make ceramics, take part in a book group and a financial-planning group, go to concerts, plays and lectures, garden with the help of a young man, and volunteer at a food collection center. For the good of my somewhat achy leg, I swim three or four times a week, take a yoga class, and sometimes bicycle. Life gets some-what hectic but there's nothing I want to stop because I really enjoy the things I do very much. [a seventy-four-year-old woman]

At any age, we may have disease or disability to contend with, but we also have resiliency and recovery. We can still be as healthy and active as possible.

I am multiply disabled -- legally blind, with chronic pain syndrome from head and neck injuries. I am very sold on the pain program at my local hospital. Instead of drugs (I was using narcotics), much of my pain can be relieved by physical therapy, particularly the aerobic treadmill, jogging, and the stationary-bicycle program. Every day, in addition to the aerobics, I do forty-five minutes or so of muscle stretching and isometrics, push-ups, sit-ups, etc. I am taught that these changes I am making in my lifestyle must be permanent, daily, lifelong. [a forty-one-year-old woman]

The self-care necessary to be well begins with self-value. Deciding on wellness reflects and fosters that self-value. We can prolong our healthy, active years by paying attention to good nutrition, activity and movement, solitude and rest, good relationships, and our links to the communities in which we live and work.

I'd been depressed and anxious and using sleeping pills for a number of years. With the help of a friend who was a therapist, I became aware of a lot of anger I'd been holding toward my mother and father -- and toward my husband. I started adopting some new habits -- like taking care of myself physically. I was all out of shape -- I started jogging and I took yoga to learn to relax. Feeling better physically bolstered my self-esteem and gave me the courage to confront my husband about the inequities in our relationship and to push for changes. [a woman in her fifties]

Studies show that older people who give themselves a better health rating than their physician does frequently prove, in time, the greater accuracy of their own intuitive feelings about the state of their health.

The best way I know to stay healthy and alive is to stay away from pills and out of the rocking chair. [a ninety-year-old woman]

To keep involved and growing, we must recognize and fight ageism in all of its manifestations. We can deal with ageism more effectively if we have energy and strength.

I realized that in another year I'll be on the senior citizens' list for my town, because once you turn sixty you automatically get the mailings. And you know, this is silly, but my mailman is someone I know personally, and I feel it's none of his business how old I am, but he would see those mailings.

Aging Is Not Old Age

There is a difference between "aging" and "geting old." Aging encompasses all the biological changes that occur over a lifetime -- for example, increase and decrease in height, onset and cessation of menstruation, and shaping of the young-adult and middle-aged body. Changes in thymic hormones are sometimes used as a sign of the aging process because the thymus gland, a pyramid-shaped gland beneath the breastbone involved in regulation of the immune system, begins to shrink slowly after the age of two. The pace of biological aging differs among individuals. In all people, some organs age faster than others. The impact of genetic and environmental factors on biological aging is just beginning to be understood.

Getting old, on the other hand, is a social concept, and our feelings about it may only be slightly related to the biological processes of aging.

It is not surprising that women have such strong feelings about being identified as aging; our culture has a strong prejudice against older women. Traditional cultures often hold their elders in high regard, seeing them as storehouses of wisdom to be transmitted to the next generation; older women, especially, are often seen as healers. The Pueblo Indians, for example, believe their elders' rituals help the sun to rise each morning. Imagine how it would feel to believe oneself so vital to life itself!

For as long as I can remember, I've cherished an image of my future self as a "wise old woman." I can see myself now -- my silver hair provides softness around my face. I live in a log cabin by a stream, and my fireplace walls are decorated with welt-used iron skillets and copper pots. I'm preparing to receive young guests who come regularly to visit me. I find my fulfillment in teaching them the wisdom gained over my lifetime. This image has sustained me through many dark hours in which I feared I would never make a contribution to life. [a forty-three-year-old woman]

It is especially important to distinguish physiological aging from the capacity for intellectual growth and social participation. Even very ill or frail old people can continue to learn and to be socially involved. If aging well is our goal, it is important to view health as the World Health Organization defined it in 1946: "A state of complete physical, mental, and social well-being, not just the absence of disease or infirmity." Continued engagement and productivity is the best way of delaying the onset of frailty in the older years. Robert Butler argues that "health and productivity are interacting conditions: the unproductive human is at higher risk of illness and economic dependency and the sick person is limited in productivity and is, therefore, at higher risk of dependency."

Scientists have learned a great deal about senescence, the biological changes that occur in different cells and tissues over time, but they still have fundamental questions about how and why these changes come about. Some think that aging is controlled by a genetically programmed "biological clock," but others think that aging results from cumulative damage to certain systems in the body. It may be many years before we know which theory or combination of theories explains biological aging.

Research is currently exploring factors that seem associated with longevity in the hope of finding a formula for extending human life or minimizing conditions associated with aging. We must be careful to differentiate between test results in the laboratory and what happens in our own bodies. For example, rats and mice placed on a diet containing 30 to 50 percent fewer calories than the normal diet for caged laboratory rodents but containing essential vitamins and minerals live longer than control animals. But studies of the relationship between longevity and weight in humans have produced conflicting results.

Commercial manufacturers sometimes take advantage of highly publicized laboratory results to promote products that have no proven value. Superoxide dismutase (SOD) supplements sold in stores are a good example of this. Research has discovered that SOD, an enzyme involved in the repair of cellular damage, is found at higher levels in animals with long life spans than in those with shorter ones. Advertisements touted SOD as an antiaging drug, but in fact, SOD is broken down during digestion and cannot be reassembled in the body. Thus, these diet supplements have no effect on human longevity and are a waste of money.

Laboratory studies of the effects of vitamin and mineral supplements on the aging process also must be evaluated carefully. The possible anticancer action of vitamins E, C, and beta carotene, and the antiaging actions of the mineral selenium deserve further investigation, but the evidence does not support the contention that these supplements extend life.

It is unlikely that researchers will find a single intervention to stop aging. Indeed, any promise of extraordinary benefit probably indicates something of which the buyer should beware. In the future, scientific advances in many areas may delay specific aging processes, such as the decline in immune function, but until then, caution should be used in assessing claims for the life-extending or rejuvenating properties of any antiaging agents or regimens.

The term life expectancy refers to the average number of years of life expected for an individual in a given population. Life span is the maximum number of years of life possible for a species. Researchers involved in efforts to increase understanding of the aging process have found ways to increase both the life expectancy and the life spans of experimental animals.

The average life expectancy in developed countries has increased steadily during the past two hundred years as a result of improvements in housing, nutrition, health care, and sanitation. In the United States today, the average life expectancy at birth is seventy-nine years for a girl; for a boy it is seventy-two years. More people are living to an old age than in past centuries, but the human life span has remained fixed at about 115 years for all of recorded history.

Although the prospect that the life span might be increased is exciting, we believe that the present focus of aging research should be to improve the quality of life for all members of society. The ways to do this are by perfecting techniques for the prevention and treatment of disease (including illnesses previously thought to be unavoidable signs of aging) and by changing the view that old age is a sure predictor of declining function.

Women and Research

The major problem with most clinical studies on aging is that until recently very few of them have involved women. For example, the Baltimore Longitudinal Study of Aging, which began in 1958, did not admit women volunteers until 1978. This omission was due to the traditional tendency to view males as the norm for the species. Processes that occur only in women have generally attracted less interest than male-related processes. In addition, studies focusing on one gender are less expensive, recruitment of subjects is easier, and data analysis is less complex.

Women are increasingly included in research and drug trials, but there are still not enough older people, women and men, included. Trials for drugs to treat arthritis, for example, rarely include people of the ages most likely to be using them. Recognizing that four fifths of persons over age seventy-five living at home disabled by physical frailty are women, the National Institute on Aging did start the Women's Aging Study in 1991 to assess the conditions and diseases responsible for frailty. In 1995 look for results that, for the first time, will include minority women. We must continue to monitor proposed research both for its attention to older women's priorities and for inclusion of women from diverse groups.

Health statistics indicate that life expectancy at birth is greater for women than for men in most parts of the world, but that the length of time varies significantly depending on the country. For example, both women and men live longer in Sweden than they do in the United States, but the longevity gap between the genders is much smaller in Sweden. Research designed to help us understand the reasons for these differences could help improve the quality of life for all people.

Changing Health Habits

Science is developing information about the aging process that strongly suggests that our health choices -- positive or negative -- greatly affect how we age. Growing old well -- maintaining, even improving, physical and emotional health -- is something over which today's women in midlife and beyond have more control than ever before.

There are no magic wands or potions for good health, no fountains of youth, no products that cure all ills, no vitamins that prevent all ailments. A wellness program requires effort, planning, and persistence, but it is an investment that pays back with unbelievably high interest. When we feel good we are more likely to exercise, eat well, and take care of ourselves, all of which in turn are likely to make us feel better. Thus we create a "virtuous cycle."

Habits are like the backbones of our lives -- the firm structures upon which we can rely. It helps not to have to think about every step we take -- to have comfortable routines in our lives. But as we grow older, some habits may no longer serve us well. The morning mad rush routine that helped us get ourselves and a whole family off to school and work may no longer be necessary. We may be happier and calmer with fifteen minutes of quiet meditation before starting our day. Illness may require us to change from a vigorous exercise program to a more gentle one. Or we may be inspired by new information or changes in our lives to pay better attention to ourselves, to pursue renewed health and vitality by dramatically altering our pattern of health habits.

It is not true that as we grow older, we become less flexible, less able to change. Change and renewal are possible at any age.

In my later years, my concept of time has changed, as has my use of it. In my late sixties, I...