Excerpts from Ourselves Growing Older

AGING IS NOT A DISEASE

There is a crucial difference between aging and disease. Both happen at all ages but health care providers and researchers don’t always distinguish between the signs of aging and symptoms of disease.

If we recognize that a particular problem is probably a symptom of disease rather than a normal part of aging, we will be more likely to seek solutions for it. Even if a cure for the disease is not available, specific interventions may help us live more comfortably.

Recognizing the distinction between aging and disease also helps us identify the effects of environmental and social factors on aging. Industrial laborers experience certain health problems earlier than white-collar workers. Similarly, poor women are more susceptible to diseases associated with old age than middle-income women, who have more opportunities to take advantage of preventive services and to deal with health problems before they interfere with daily life.

On television, treatment of injuries and acute illness is portrayed as a drama with heroic doctors winning a life and death battle. Western medicine emphasizes trauma and acute conditions, not care for chronic conditions. In reality, by age sixty five most people have developed at least one chronic health problem; these rarely limit mobility or functioning but often require long-term management to prevent them from becoming worse. Our personal attention and much of the resources of society would be better spent on prevention of disease, on the reduction of complications from disease, and on rehabilitation and continuing care. Many healthcare practitioners dismiss older people’s complaints with the classic put-down: "what can you expect at your age?" Equating aging with illness and pain often causes physicians to overlook manageable complaints and problems.

Four years ago, after a coma from a virus, I couldn’t walk. Neither my doctor nor the physical therapy department knew how to help me. The doctor wanted to put me in a nursing home. When I insisted on a referral to a rehabilitation hospital, the social service department helped me find the best one in the area. After five weeks of special physical therapy I could walk again—not as well as I used to, but I am walking. If I hadn’t insisted on rehab I’d be immobile in a nursing home today. [a seventy-six-year-old woman]