As mortal beings, growing older is an inevitability. Despite our best anti-ageing serums and hair-loss treatments, eventually, old age creeps up on us all. Yet few of us really believe or accept this fact, let alone take the time to consider its implications. We think about ourselves growing old with the same nonchalant abstraction with which children decide what they want to be when they grow up: as something we know factually to be true, but never really believe is going to happen to us.
The reality of our inevitable decline is thus relegated to the innermost depths of our minds, a problem for our future selves to navigate while we get on with our daily lives. And who can blame us? The thought of having to watch our loved ones change, grow frail, and eventually pass away, is desperately sad. The thought of the same happening to ourselves? Incomprehensible. Life lived with a constant awareness of our fragile mortality and looming decline would be crippling and unliveable.
While understandable, however, our failure to acknowledge these realities is highly damaging. As persuasively argued by Atul Gawande in his book Being Mortal, in our unceasing pursuit of medical and technological progress, we are creating an ever-expanding ageing population, but failing to provide for its needs. On this medical model, safety takes precedence over happiness, dignity, and autonomy. The will to survive over quality of life. Unable to accept the realities of death, we focus our funds and expertise on the preservation of life, and ignore the problematic questions raised by our progress regarding the point at which life is worth preserving.
A brief survey of the current systems in place for the care of the elderly in the UK reveals a bleak and troubling reality. Nursing homes often remain understaffed and underfunded, thought of by many as a fearful last resort. In their 'Don't Cut Care' campaign, Age UK describes crippling cuts to NHS funding for elderly care, while a Royal College of Physicians report details a fall in training places for geriatric specialists, despite a continuing increase in demands for experts in the field. My own experience of witnessing relatives at the end of their lives has left me with a profound sense that something is lacking in the care options available for the elderly. Supposedly, future generations are going to live to an average age of 150, but what kind of life will that be?
Being Mortal raises challenging and unsettling questions regarding the sacrifices we are willing to make to live longer, and criticises conventional medicine's automatic privileging of aggressive, invasive life-preserving treatments over life-enhancing methods of care. However, the problem arguably runs deeper even than the specifically medical failures identified in Gawande's book. Our denial of the realities of ageing is deep-rooted and societal. Where once the aged were revered and respected as sources of wisdom and knowledge, and cared for by their relatives at home, recent decades have witnessed a drastic shift in attitudes towards the old. Arguably, we are less tolerant of our elders, less equipped to look after them, and more frightened than ever of our own ageing frames.
These changes are most likely rooted in the scientific advances that have shaped recent decades. Where before the old knew more than the young, the internet and its accompanying devices have equipped young people with immediate and unlimited access to information, placing them in a position of superiority over their elders for whom this technology is new and perplexing. Moreover, where before the natural ageing process was an incontrovertible reality about which we had no control, scientific developments now promise the possibility of, if not reversing the ageing process, slowing it down. This year saw scientists successfully alter the DNA of mice to delay the effects of ageing, while in Silicon Valley, executives are said to undergo blood transfusions to keep them young. Closer to home, beauty and skincare brands promise (reliably or otherwise) the possibility of younger looking skin, while everyday cosmetic treatments dye our greying hair, replenish our receding hairlines and restore our decaying teeth.
While these advances are undoubtedly exciting, the anti-ageing rhetoric they have cultivated is dangerous. As the natural ageing process is deemed unnatural, an enemy to be combatted with restorative eye creams and expensive cosmetic procedures, we grow increasingly fearful of our inescapable fates. In a vicious cycle, these anxieties continue to be exploited by pharmaceutical companies and beauty industry giants, who make enormous profits from our deep-seated insecurities.
The challenge we face, then, is twofold. Firstly, as we continue to progress in our efforts to lengthen life expectancy, we must match these advances with tools to improve the lives of the elderly, and increase financial support for elderly care. More broadly, we must face up to the natural and irreversible reality of growing older. Disassociating ageing with fear will not only save us a fortune on beauty and skincare products, but will also make our confrontations with our own mortality less fraught with anxiety. It's possible that science will one day discover a means of reversing the ageing process. Perhaps we'll even find a way of living on Mars to counter the overpopulation nightmare that this would engender. Until then, however, we must accept our fate, and grow old with as much or as little grace as we like.