I am often asked when am I going to retire? Since I have achieved the age denoted as "senior citizen" it is a fairly legitimate question. Yesterday as I was pondering what I would like to write about in this month's Health Points, I came upon a lead article in the "Wall Street Journal" entitled "The Case Against Early Retirement". To delve into the philosophical - I have often thought there are two phases to later life; and I define them as, "living or waiting to die". As Richard W Johnson states in the opening of the article, "Most people look forward to retirement, a reward for decades of hard work. But like many other pleasures, it may be bad for your health. It may even kill you."
"How can that be? How can working longer be good for your health? After all, many people dream of-- and plan for-- retiring early. Strenuous, stressful work can wear people down and damage their health. On the other hand retirees can relax and reinvigorate themselves. They have time to follow their passions and pursue activities that enrich their lives." -Richard W. Johnson
The reality is many retirees lose a sense of life purpose that they derived from their chosen employment. They lose the social interactions that occur in most workplaces and they become sedentary and inactive. Our jobs subtly force us to maintain a high level of mental agility that defers and delays those signs of aging such as forgetfulness and memory loss. From a societal perspective there is a transformation from being a provider to being a consumer. As we alter our self perception as a valued contributor we increase our sense of mortality. This increases our sense of vulnerability both physically and financially. In many instances we have too much time to think and each minor change in how we feel becomes exaggerated as an impending health event. This sends us increasingly to doctor’s appointments for both real and perceived health events.
For those who have retired and moved to retirement communities in Florida, Arizona, California their visits to physicians become an important activity. The critical issue becomes does the physician hear them or does he/she become more insensitive as a result of the volume of aging patients they consistently examine. I recall very early in my career as a lawyer I tried criminal cases, as appointed counsel, in what was known as Recorders Court that only handled criminal matters. I, being a young lawyer, pursued those cases with all the enthusiasm and a sense of justice that had been inculcated in law school. Soon I realized that the judges had become cynical and jaded. The concept of “innocent until proven guilty” was not the premise upon which the cases were heard. More often than not it was "guilty until proven innocent".
The physicians who treat aging patients face the same challenge as they listen to aging patients, many of whom are lonely, explaining their aches and pains. The doctors face the dilemma of trying to determine if these are actual or perceived health issues. That is why we see so many cases of overmedication in senior citizens.
The physicians who are pressed for time seek the path of least resistance and will write a prescription for the perceived illness. The patient who is visiting various doctors is then uncertain as to whether the problem is resolved or exacerbated by the medication.
One could then argue, as we work longer we extend our lives because we have less time to be consumed with the aging process and its maladies. We have the benefit of responsibilities to others to focus our attention. Our state of mind has such an incredible impact on our physical health. As we continue to feel productive and useful we preserve our health and defer our decline. A Study published in the Lancet concluded that a a longer lifespan could be linked to a sense of meaning and purpose in life.
Too often, at Curus, we have seen that less would be better than more in the prescribed medications being taken. Too much medication has a tendency to lead to both cognitive and physical decline. It is entirely possible that too much time on our hands can indirectly lead to too much medication being prescribed. We at Curus pay particular attention to the list of medications our older members have been prescribed. Our clinical pharmacist plays a particularly pivotal role in the evaluation of the health status of our senior citizens.
If the prescription for healthier aging is a sense of self, contributing to others and meaningful social interactions; working longer should be an important part of this prescription.