Kaiser Health News ran an article this week about “the secret happiness as you age.” It features the story of a 76 year old man who, despite severe heart disease, diabetes, glaucoma, and osteoarthritis, describes himself as a “happy guy.” He can’t see well, he can’t drive, and he has to rest after walking short distances—really short, like 10 yards. So how does he manage to be happy?
His secret is that he focuses on those things in life that do bring him joy—listening to music and audiobooks, and writing. He also derives pleasure from helping others in small ways. The article concludes with a quote from a geriatrician who says that “the real key to happiness at every age and stage—particularly old age—is not material things, but gratitude for life’s simple blessings, like laughter among friends or watching a sunset with a loved one.”
The message that frailty doesn’t have to spell misery is a refreshing one. Readers of this blog know that I spend a great deal of time discussing frailty: defining it, advocating screening for it, and promoting an “intermediate” approach to care for people who have it. I lament the disproportionate time and energy spent on addressing robust old age and dying, two important states but not where most older people spend most of their time. The Kaiser Health article is an important reminder that we don’t need to hide frail people from view as though they carry an unbearable, unmentionable stigma. But what is missing from the piece is the recognition that while individuals who are frail can take steps to make their lives rewarding, the larger society has an important supportive role to play.
Creating and disseminating the technological aids that can make life enjoyable are crucial: without his audiobooks and his virtual assistant (in the example given, Amazon’s Alexa), achieving satisfaction might have been impossible. We need to make age-friendly environments, like those promoted by the World Health Organization’s “Age-Friendly Cities and Communities Program.” This means building walkable communities, providing appropriate transportation, and linking service providers to individuals. It means developing accessible housing and means for civic participation, along with access to medical care. It means joining the AARP Network of Age-Friendly Communities or local organizations, such as the Massachusetts Healthy Aging Collaborative. Only then will happiness among frail elders be the norm rather than the exception.