Optimum Aging - Easier Than You Think

 

The Five I's of late life care, a term coined by Dr. Bernard Isaac, are prevalent in the practice of geriatric medicine. They are Incompetence, Incontinence, Immobility, Instability, Iatrogenesis [Polypharmacy], and Invisibility. All five should be avoided to age successfully, retain autonomy, and maintain independence. While some people believe the Five I’s are inevitable, they are NOT. The Giants of Geriatrics is not a model of health, it is a model for institutionalization. Healthcare in old age is moving from the hospital back to the community. Longterm care requires a different mindset, as people do not get well. Longterm care model is the asylum model revisited, the beginning of the “slippery slope.”

In a Harvard talk to healthcare workers, Donald A. Davidoff, PhD, presented his topic, A Cognitive Perspective of Normal -vs- Successful Aging. To age well, people must be:

1. physically active,
2.  mentally active, and
3. have social networks.

Embracing this three-legged stool seems so simple, yet people yearn for a magic pill or secret formula. Keep it simple!

In a study of physiologic factors and neurogenesis, the mice who were "put to work" lived longer than the mice with lots of leisure time. The "couch potato" mice not working died sooner than those mice with a purpose. The physically active mice had increased neurogenesis! Of course, mice studies cannot be extrapolated to  humans, but this example demonstrates the value of remaining active over choosing a sedentary lifestyle.

Health care in old age is remaining active and engaged, getting diagnostics on time, and when necessary, moving from the hospital or rehab facility back to the community. Long-term care requires a different mindset, as people do not usually get well. Long-term care model is the asylum model revisited, the beginning of the “slippery slope.” The facility mandates mealtimes and food choices [called “feeding”] and schedules are not personalized to the patient. Decisions about care and treatment are standardized instead of person-centered. This is why Americans dread the thought of nursing home admittance.

It is confounding to me as a gerontologist that older people believe they can live on fast food, maintain a sedentary lifestyle, and drink alcohol with abandon. Taking charge of your life and making simple changes may help you avoid the Five I’s. More later. AgeDoc

Photo Credit: Philippe Leone, Unsplash.