Geriatric denial

Issue: BCMJ, vol. 52, No. 10, December 2010, Page 497 Editorials

Never before has our society included in its ranks so many individuals over the age of 65; being in your 90s is no longer a feat—over 100 is the new prize. This shift in demographics is partly due to better preventive measures such as im­proved nutrition and decreased smoking, and partly to better management of chronic diseases, especially cardiovascular disease. Many seniors are keeping fit and managing to live by the mantra, “age is just a number.”

However, physiologically age is not just a number but a very reliable predictor of future health problems. For example, many of us forget that one of the biggest risk factors for cancer is age itself. The same can be said for hip fracture. In spite of this, seniors continue to challenge previously held notions of appropriate behavior for their age, and seniors’ increased levels of activity and involvement are the beneficial result of the belief that age is just a number.

Balanced against this benefit is the risk of geriatric denial—denying risks to the extent that this denial has negative effects on health and lifestyle. Let me give some examples. 

• A retiree opting for a pension plan with higher income but no spousal survivor benefit; good idea until sudden death several years into retirement. 

• An individual with severe osteoporosis ignoring advice to remove obstacles in the home known to increase the risk of falls with the comment, “I just won’t fall.” 

• A senior with dizziness and several falls refusing to use a walker out of the home because “it makes me look old.” 

• Another senior who, upon losing a driver’s licence because arthritis prevents looking over either shoulder, declares, “I just won’t back up.”

Denial and ignoring the age factor can be beneficial, and somehow we all will need to work out where on the continuum we balance these factors against the reality of getting older. As I approach becoming eligible for my Old Age Pension, I find myself in­creasingly aware of being caught in this optimism/pessimism conundrum. Maybe that’s because the balance point differs among individuals and shifts with time.

Use your body and use your brain for as long as you can. Acknowledge that running today may have to switch over the years to cycling or walking, but that the important thing is remaining active. The Sudoku puzzle may take longer to solve, but keep at it. And remember, maybe the best mantra is, “Plan for the worst and hope for the best.”

Lindsay M. Lawson, MD. Geriatric denial. BCMJ, Vol. 52, No. 10, December, 2010, Page(s) 497 - Editorials.

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