On aging well: Purpose, responsibility, and intimacy

I recently reread an article from the Netherlands where researchers selected 11 men and 14 women in a group of 144 people with a mean age of 82 who expressed a wish to die by their own hand even though they did not suffer any physical or mental disorder.[1] They considered their lives to be “completed.” The researchers followed this group yearly from 2013–2019. At the end of the study, 16 of the group were still alive, but 9 had caused their own deaths. Those who were still alive expressed somewhat similar reasons for not wanting to die yet. Some found a new purpose in life, by fulfilling a new role of interest to them, or becoming involved in activities that newly occupied them. Others became responsible for supporting the life of friends or family members or were asked to assume some work-related responsibilities. Yet others found some form or degree of intimacy in a new relationship, which fulfilled their yearnings. 

Reading this article made me quite introspective. I am now 93 years and 6 month old. My wife died a year and a half ago, just around our 68th wedding anniversary. In her last 9 years of life she suffered through the most debilitating form of dementia while being kept alive at home, with the assistance of an army of caregivers. Now I live alone and without my “job,” seeking renewed purpose, responsibility, and intimacy, a bit like the surviving subjects of the Netherland study. 

A bit egocentric, I try to look after myself. I eat well and regularly, I swim, and I am still engaged in the sport of rowing. I walk with friends and I take my few medications regularly. Writing blog posts for the BC Medical Journal is a real privilege for me and I take that as a part of my purpose and responsibility. Keeping in close touch with former colleagues in my past specialty of sexual and reproductive rehabilitation and sexual medicine also gives me purpose with minor responsibility. I also have three or four friends whom I have hardly ever met in person, but with whom I have developed rather purposeful telephone or email contacts. Our regular chit-chats or ongoing “email-pal” exchanges are about our lives, families, and the world around us. With all that, the intimacy area of my life is the one most unfulfilled. I recognize my advanced age and other limitations, and I am not looking for a formal partnership. I am not even thinking of a traditional sexual relationship with someone. I do have to admit to yearning for some degree of physical intimacy. My somewhat innocent unfulfilled imagination, which is about the who, what, and how, is focused on the possibility of occasional intimate hugs and sensual adoration of someone with similar yearnings. 

I have no wish to die. In fact, I have a strong wish to live. So far I found the paradox in this wish: a fulfilling aging process is not easy to achieve for one who is old. To keep on going one does need purpose, responsibility, and some intimacy. And of course, some energy. 
—George Szasz, CM, MD

Reference
1.    van Wijngaarden E, Merzel M, van den Berg V, et al. Still ready to give up life? A longitudinal phenomenological study into wishes to die among older adults. Soc Sci Med 2021;284:114180.

This post has not been peer reviewed by the BCMJ Editorial Board.

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