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The Vicissitude of Extreme Old Age

Nowadays because of improvement in medicine and living conditions, more and more people become living to an extreme old age (which I define to be over 85 and way beyond life expectancy). However, we all accept the fact that death, mental, and physical declines are inevitable. The issue is how do we cope with these changes. As I myself just began to enter this stage and observing my cohorts, here are some of my personal observations:

·       The old Chinese saying, “a good death is still inferior to being alive but miserable in old age 好死不如爛活着”. Very few of us choose to commit suicide, i.e. choosing the timing and manner of our own death, in exchange for a few months of extra time on earth however miserable.

·       But physical and mental decline set in sooner or later. We stop being able to do things we use to enjoy doing and find doing certain mental task more and more demanding. For example, in my own case, many DIY tasks are now too dangerous, beyond my physical capability, and must be out-sourced. In social parties, I must sit down after conversing with friends standing up for 15-20 minutes (previously I think nothing of giving an hour or two lecture standing up).  Balancing our checkbook and manage our retirement finances now takes more time and bother than before.

·       In more extreme cases, people become wheelchair-ridden or must walk with mechanical help. Mentally, they often can become confused, seeing things that are not there, and making unreasonable or stubborn demands. Men seems to be more prone to such issues than women.

·       I attribute these phenomena, particularly for successful people, to the desire of being in control of their lives. Unfortunately, in extreme old age, this is one thing that we all must learn to give up gradually and rely on others for help.

·       Otherwise, consciously and unconsciously, we take out our frustrations on those who are closest to us, namely our partner and/or children on everyday basis. We become more irritable, stubborn, and demanding particularly when coupled with mental decline. Again the old Chinese saying “久病无孝子 no children can become a minute-by-minute long term care-giver and demand-satisfier to their parents”. I have begun to see such behaviors in my cohorts, both men and women, who are perfectly successful, reasonable, and nice persons in earlier lives. In a way, I can understand such behavior of avoiding nursing homes as a last resort given the horror stories we have heard about them (these are often true).

·       Of course, there are exceptions. Some people learned to accept and adapt to such changes; retain mental clarity and remain engaged; refuse medicine and let death take place naturally without extreme measure to prolong life (a form of slow suicide and letting go).

·       As they say “We write to express and not to impress”. As I enter my extreme old age stage and making these observations, I am grateful for still having my life partner with me and hope I have the knowledge and learned wisdom to adapt myself to be happy in my remaining time on earth.