What are the primary challenges of aging during the second half of life? The journey into old age requires each one of us to adapt to a range of age-related difficulties. Each human life is a variation on the theme of aging; the age-related challenges that emerge over time are unique to each individual. How we respond and adapt to the physical, psychological, cultural, and spiritual challenges of aging is a primary factor in our quality of life. The challenges of aging are the raw materials in our creative pursuit of living a life worth living.
Artistic representation of human age[/caption]A challenge is a primarily source of stimulation, motivation, inspiration, and interaction. As a source of inspiration, aging is a powerful and unique call to adventure that constantly broadens and expands as we journey deeper into the second half of life. The origin of this call to adventure originates deep within the mysterious realm of senescence (i.e. the biology of aging or the science of growing old). It is the force of impermanence that summons each one of us to creatively adapt to the challenges of aging.
Aging is an elemental force of nature. To clarify and work with the challenges of aging is to embrace the arc of life. To propose aging as a challenge is to meet it with a sense of creativity and imagination. Our task is to gently lean into our difficulties as students of life. Each time we journey through a source of fear we inevitably discover new sources of resilience that were previously unavailable to us.
The intensity and trajectory of an age-related challenge can vary widely. Some challenges we experience may be relatively inconsequential while others may completely alter the course of our life in shocking and unexpected ways. Developing awareness and clarifying the challenges of aging can better prepare us to creatively interact with age-related adversities when they do arise. In this sense, the challenges of aging offer an important opportunity to establish deep conversations with the nature and trajectory of our own existence.
The primary challenges of aging invite doubt, despair, difficulty, discomfort, uncertainty, and anxiety; they harbour something unwelcome, undesirable, yet unavoidable that we are required to experience. There is a deeply primal sense of adversity lurking inside age-related challenges and a frighteningly powerful intuition of being summoned to something too large for us to imagine.
For the sake of convenience, I have grouped the challenges of aging into four categories: physical, psychological, cultural, and spiritual. However, the interplay of a single challenge across all four categories is significant. For example, a challenge identified as physical will naturally have psychological, cultural, and spiritual dimensions as well. It is the expression and character of the challenge that is primary while the category itself is just an initial starting point.
Physical Challenges of Aging
- Senescence: Senescence, or normal aging, is an unavoidable reality of everyday life. The word senescence originates in the Latin senescere meaning to grow old. It is used today to refer to the biological processes of aging, more specifically, the science of becoming old. Senescence is the primary directive and physical essence of the human body.
- Functional Decline: The human body becomes increasingly vulnerable over time. For example, our sense perception (hearing, vision, touch, taste, and smell) gradually declines during the second half of life. Vision and hearing are often the most affected areas of perception. We adapt to functional decline through lifestyle changes and/or the use of technology to provide corrective measures. We also experience a generalized functional decline that reduces our mobility, strength, balance, agility, leading toward increasingly levels of frailty.
- Age-related Disease: Aging is not a disease, but normal aging increases our vulnerability to chronic, incurable, and progressive diseases. Age-related diseases include dementia, cardiovascular disease, osteoarthritis, osteoporosis, diabetes, cancer, strokes, age-related macular degeneration (AMD or ARMD), and glaucoma. Chronic disease is often a contributing factor to functional decline.
- Age-related Adaptation: Normal aging eventually impacts our ability to successfully negotiate the activities of daily living (ADL) and the instrumental activities of daily living (IADL). As the body becomes increasingly frail, our primary task is to successfully adapt to more profound levels of functional decline, frailty, and dependence. For example, aging-in-place and age-friendly communities, and assistive technology are expressions of age-related adaptation.
- Age-related Health Care: Geriatrics is a branch of medicine focused on the care of older persons. Gerontology is the multidisciplinary study of old age and the problems unique to older persons. Medical care remains largely focused on polypharmacy, or the use of multiple drug interactions that are not fully understood. It is a curious feature that the medical community does not treat food as medicine and offers no meaningful counterforce to the food industry.
Psychological Challenges of Aging
- Dementia: Dementia is a collection of symptoms that impair thinking and social interaction. Alzheimer’s disease is the most common form of dementia. One characteristic of dementia is memory loss, however, memory loss alone does not indicate the presence of dementia. In a deeply painful sense, dementia is a brutal assault on our sense of identity that impairs our ability to recognize, participate, and interact with the world around us.
- Grief: Over time our experience with grief and bereavement becomes more pronounced. The loss of our parents, spouse, children, or other family members can impact our lifecourse in unsuspecting ways. Learning to navigate the difficult terrain of loss, absence, tragedy, grief, and bereavement is a basic challenge in life.
- Depression: The raw experience of becoming older can incite depression. For example, functional decline can express itself in the mind as an attack on our identity, an impairment of meaning, and a denigration of purpose in life. The body is echoed in the mind and when our inner life conflicts with the truth before us we may find ourselves mired in a malaise of age-related despair.
- Isolation: Another psychological challenge of aging is an increasing sense of loneliness, withdrawal, disengagement, exile, and abandonment over time. Isolation takes the form of an absence of belonging in the mind in which we feel outcast from meaningful participation and experience the horrific feelings of being undervalued as a human being.
- Reconciliation: Accepting the truth of our circumstances, leaning into our wounds, navigating the harsh terrain of grief, and pursing a meaningful sense of participation at any age is another challenge in the second half of life. Mindfulness and acceptance of our body’s journey over time is a cornerstone of belonging. In the midst of harsh realities, our challenge is to seek out a sense of meaning and purpose in our suffering. In this sense, reconciliation means that we must lean directly into the dark places we would rather not go into and cultivate the conversation we have tried to avoid.
Cultural Challenges of Aging
- Ageism: Ageism exposes the toxic and virulent elements of the human condition. Ageism is a form of prejudice that targets older persons. Like racism, ageism is an arrow of profound ignorance that triggers the abuse (emotional, physical, and financial) and neglect of older persons. For example, the vilification of an aging population as an economic burden reveals the remarkable trivialities of economic progress and the perversion of our collective conception of success.
- Population Aging: Demographic transition to an elder society is a defining moment in human history. If we treat an aging population in the same manner we treat the environment, the soul of humanity will suffer deep, painful wounds. The challenge of population aging is a magnificent opportunity to reclaim our humanity over economy, meaning over materialism, and purpose over consumption.
- Cultural Infrastructure: A vibrant and vital society places the needs of people and the stewardship of life as its prime directive, and then sets out to build a meaningful sense of economy focused on that aim. The ethical infrastructure required to provide for the stewardship of life remains buried underneath the obesity of economic obsession. Culture must be rescued from the abrasive grip of corporatism, materialism, consumerism, and consumption. The development of a meaningful cultural infrastructure to support an aging society is primarily a challenge to find a better way to live together.
- Social Networks: Population aging is a challenge that will require societies to coordinate a multidisciplinary array of skills and services into a coherent network of support. Emerging issues to focus network activity include optimal aging, the new retirement, hospice-palliative care, care giving, nursing home care, elder poverty, advanced care directives, assisted-suicide, the right to die, and end of life care.
Spiritual Challenges of Aging
- Impermanence: We are all guests here moving through an uncertain and fragile amount of time. As we become older, our sense of mortality enlarges; our body begins a deeper conversation with time and the feeling of senescence seeks our attention and awareness. We realize that one day we will be a memory. Impermanence requires us to build a spiritual relationship with change, transience, fragility, perishability, disappearance, absence, and loss.
- Thresholds: Thresholds are points of no return in our lifecourse. Scattered throughout our lives are unexpected moments when the comfort and familiarity we desire suddenly transfigures itself into an uncertain and frightening future. For example, the midlife passage and midlife crisis are two potent thresholds that catapult us through an unavoidable point of no return. Our passages through the various thresholds of life are spiritual portals into the very essence of what it means to be alive.
- Belonging: Belonging is our source of relationship, participation, interaction, motion, belief, work, and striving. As we journey through the second half of life, the physical, psychological, and cultural challenges of aging inspire us to question the deeper nature of our belonging in the world. We begin to gain a sense of freedom from our cultural conditioning; we find precious openings that offer an opportunity to question the assumptions that motivate our attitudes, beliefs, and actions. Belonging inspires the quest for a uniquely personal relationship with the deeper mysteries of life.
- Elderhood: The word “elder” is a term of endearment, veneration, and respect. Elderhood is a profound achievement in life; it is not an entitlement attained merely by virtue of chronological age. In many cultures around the world, an elder is a source of living wisdom, insight, and consolation. For example, elderhood is intimately connected to the care and stewardship of the earth for all living beings. In this sense, elderhood is the summit of what old age means.
- Legacy: Our legacy is the enduring resonance of our journey through life after death. It is the felt-meaning we leave behind in the hearts and minds of those we are required to leave behind. A legacy is also a heartfelt expression of gratitude for the simple fact that there is something rather than nothing at all.
In the end, the challenges of aging are opportunities for creative adaptation and improvisation to the sometimes surprising situations and circumstances we find ourselves in.
May your journey into the challenges of aging inspire new potential for living a vibrant and fulfilling life.
Are there other challenges of aging not listed here? I welcome your thoughts and ideas.