Embracing Graceful Aging: A Journey into Old Age with Preparation and Purpose

The world stands at the threshold of a longevity revolution, with the elderly population set to reach unprecedented levels. While some seniors embrace this milestone with grace, eagerly anticipating the years ahead, others view it through a lens of negativity, cursing the last chapter of life. Rukmini Ananthamurthy, a fellow Rotarian, challenges the notion that 71 is the key age to focus on, asserting that the aging process begins decades earlier. “Most people avoid discussing it, but the reality is that we need to contemplate aging and consider how we want that phase of life to unfold while we are still young,” emphasises Rukmini. The narrative of Rukmini Ananthamurthy serves as a compelling example of preparedness.
As gerontologists, our examination extends beyond individual aging to encompass the broader context in which individuals age, exploring how this environment shapes the outcomes. We have honed our focus to support residents of Bangalore in aging well, whether through “aging in place” or transitioning to institutional settings. Aiming to promote graceful aging, we conducted several seminars which cater to older adults and those responsible for their care. This article delves into the factors influencing perceptions of aging and underscores the significance of maintaining a positive outlook for graceful aging.

  • Roshan J Mundapallil, Sowmya Lakshmi

The prospect of longevity presents both opportunities and challenges. Baby boomers are now likely to enjoy extended lifespans, reaching into their eighties and nineties. The question is, are you prepared for such a prolonged innings? Many seniors face avoidable challenges during their twilight years. Drawing on our experience as social gerontology practitioners, we affirm that aging well and in place is possible, but it demands careful planning, a shift in mindset, and adherence to expert recommendations. Crucially, an individual’s attitude toward aging significantly influences their outcomes. Simply put, maintaining a negative outlook on life leads to a less favourable aging experience. We don’t idealise aging as an entirely rosy phase; challenges such as spousal loss, career transitions, and physical decline are inevitable. However, we advocate for a well-managed old age that can still foster a good quality of life. While the risk of health issues does increase with age, it’s not an unavoidable consequence of aging. Additionally, the living environment plays a crucial role in graceful aging, encompassing factors like location, built environment, and the availability of services and resources.

Let’s initiate our discussion with the first factor known as ‘aging in place.’ Many individuals believe that graceful aging is achievable only within the confines of one’s home. Numerous people express a strong desire to remain in their homes for as long as possible, a sentiment that resonates well, particularly when independence is maintained. We acknowledge the sentimental value attached to one’s home, with its memories and possessions. Undoubtedly, the familiarity of our own space brings comfort, and the thought of being unable to reside there can be daunting. However, the reality is that as we age, frailty gradually sets in due to chronic conditions, and the risk of developing a disability increases. In such circumstances, staying in the home becomes impractical unless there is proper assistance available. Professional support is crucial for maintaining skin health, ensuring adequate nutrition, managing medications, promoting mobility, addressing incontinence, and preventing falls.

As you progress in age and encounter diminishing support systems, it is not advisable to insist on ‘aging in place.’ Opting for institutional care, such as continuing care communities, nursing homes, or assisted living facilities, becomes a wiser choice. These settings are professionally managed and provide mostly controlled environments. While sentimental attachments to your home are understandable, clinging to it in the presence of physical and psychological deficits may not be prudent. Advanced age brings the risk of infections and falls, necessitating professional support and monitoring.

It’s a well-established fact that advancements in medicine, science, and technology have allowed today’s older adults to enjoy longer and healthier lives compared to previous generations. However, many seniors fail to connect healthy behaviours today with their impact on later life. Numerous studies highlight the distinct advantages of both aerobic and weight-bearing exercises. We recommend that individuals tailor a program suitable for their needs. Regular screening programs can lead to preventive measures and early interventions, significantly reducing the impact of illnesses in older age. Diet is another crucial factor; nutritional status has the potential to influence and impede the progression of many diseases. Our past experiences underscore that individuals who maintain a healthy diet often enjoy overall good health.

Elderly individuals often live with chronic conditions, imposing a significant health and economic burden through prolonged illness, diminished quality of life, and heightened healthcare expenses. This underscores the importance of addressing health, lifestyle, and financial matters for graceful aging. Seniors’ quality of life is intricately linked to sound health practices and effective financial planning. Additionally, factors such as lifelong learning, volunteerism, caregiving to spouses, grand-parenting, leisure pursuits, second careers, and transportation pose routine challenges (opportunities ) for many Indians. Regrettably, many seniors fail to recognise that decisions in these areas play a crucial role in preparing for their future. Hence, we reiterate the significance of thorough preparations and planning to navigate the challenges of old age smoothly.

As social gerontologists, engaging in challenging conversations is a regular part of our work, and discussions about preparing for aging, specifically ‘Ageing Gracefully,’ and caring for an aging partner or parent fall into this category. A few days ago, at the request of their daughter, we visited an elderly couple near Basavangudi in old Bangalore. In our conversation with Rukmini and her husband, Col. Ananthamurthy, we broached the topic directly. We asked Rukmini directly, “Are you ready for the possibility that your husband may outlive you?”

The inquiry caught 71-year-old Rukmini off guard. Her husband, at 82, is a decade older. A car accident a few years ago resulted in multiple leg fractures, a miraculous escape, but he has been wheelchair-bound since. Recently, arthritis has set in. Rukmini reflected, “Before the accident, he assisted me in the kitchen, fixing meals. Now, I handle the cooking. He used to manage his own laundry and wash the dishes, but post-accident, he no longer drives and frequently relies on a wheelchair.” In contrast, Rukmini recently joined a laughter club and, after her morning walks in the newly renovated park, engages with women from the area. A nine-year cancer survivor, she manages pain through exercise and socialisation, not medication. When not tending to her husband, she remains active, participating in Rotary club meetings and social events.

Still, we had a point: Be prepared.

“I’m someone who prefers not to be caught off guard,” Mrs. Rukmini explains. “Recognising that I am my husband’s primary caregiver, it became crucial for us to plan for scenarios where I might not be present. Given that my daughters reside in the US, we need to establish contingency plans, and that’s precisely why you both are here. I simply asked to my daughter to set up a meeting with you.”

During our encounter with the couple, we learned that Rukmini’s eldest sister, residing in Pune, had passed away just two weeks prior at the age of 83. “She was a Parkinson’s patient but stayed at home, albeit with her son, not like us,” Rukmini shared. “Her experience made me recognise that aging is a project, something to carefully plan and make the most of.” She noted that many of her friends tend to shy away from discussing aging. “Most Indians, in general, avoid confronting the realities of aging and death,” she observed.

We both agree. Rukmini Aunty is right that we simply don’t face ageing in a desirable way in this country. Aging is an inevitable part of life, and avoidance is not a viable option. However, numerous seniors prefer to avoid thinking about it until their health deteriorates, making them incapable of participating in decision-making. This leaves children or other family members with the responsibility of making decisions that may or may not align with their preferences at the end of life. Rukmini is notably proactive, understanding that preparation is the key to aging gracefully. From our perspective, caring for elders like Ananthamurthy and Rukmini is a seamless and privileged engagement, given their nuanced understanding of aging.

The primary reason for inviting us to assist in preparing for her husband’s and her own aging was to identify a suitable living arrangement. Both Rukmini and her husband are cognisant that aging in place is no longer a straightforward option. Their efforts extended beyond a simple Google search; Rukmini visited numerous ‘old age’ homes, compiled lists of in-home care services, and personally visited each option, leaving no stone unturned in the pursuit of suitable arrangements.

However, Rukmini remained dissatisfied, primarily due to the presence of unqualified and inexperienced staff, coupled with profit-driven management. The inconsistency in personnel, dictated by the bottom line, became a significant issue, leading to a lack of continuity in care. Upon investigating various ‘care homes,’ she uncovered prevalent national problems in long-term care. Rukmini emphasised, “The care home situation boils down to profit. They engage in collaborations with major hospitals, offering commissions to doctors for patient referrals under the guise of rehabilitation. Their first move is to cut back on staffing to avoid financial losses.” She deems this as “the most concerning aspect of our long-term care.” Witnessing her extensive research and efforts to find the best care home left us astonished.

After dismissing the option of ‘aging in place’, she carefully selected the advantAGE skilled nursing facility. She expressed, “This seems likely to be our choice,” highlighting the presence of a “super-trained staff who behave like family members, not just nurses and carers.” Rukmini justified her decision, stating, “If we both have to relocate somewhere, this would be the place.”

As we age, much like Rukmini and Ananthamurthy, we encounter significant life transitions such as career shifts, retirement, empty nests, the departure of loved ones, health challenges, and the potential loss of independence. The key to graceful aging often lies in how we navigate and grow through these changes. Coping with change is challenging at any stage of life, and it’s natural to feel a sense of sadness for the losses endured. However, it’s essential to learn to let go and move forward. Counterbalance the sense of loss with positive factors and continuously reinvent yourself as you navigate the milestone ages of 70, 80, and beyond.

For many seniors, aging triggers anxiety and fear, raising questions like, “How will I care for myself in my later years? What happens when I lose my spouse? What lies ahead in the end?” Numerous misconceptions about aging contribute to these fears. However, the reality is that you possess more strength and resilience than you might realise. Embracing the following aspects can aid in maintaining your physical and emotional health, enabling you to thrive regardless of your age or circumstances.

The essence of graceful aging is found in few wellness areas and listed here. Neglecting any one of these aspects can potentially impact wellness in other areas:

1.Physical Wellness:

Physical wellness is crucial as you age, emphasising increased mobility and continuous activity to counter the drawbacks of a sedentary lifestyle. Many older adults tend to limit their physical activities, assuming decreased capability. However, maintaining an active lifestyle is pivotal for graceful aging and overall health. Addressing health issues affecting mobility and adopting preventive measures can significantly enhance both physical and mental wellbeing. Adequate nutrition, especially in older age, plays a vital role in sustaining health, preventing chronic diseases, promoting vitality in daily activities, boosting energy and mood, and preserving functional independence.

2.Emotional Wellness:

While there is a notable focus on the physical well-being of older individuals, mental health is equally crucial but often overlooked. Contrary to common misconceptions, mental illness is not an inherent part of aging; in fact, mental health disorders are more prevalent among younger adults. The primary mental health concern for the elderly is severe cognitive impairment or dementia. Depression and mood disorders are widespread among older adults, frequently undiagnosed and untreated. Anxiety disorders, including hoarding syndrome, obsessive-compulsive disorder, phobias, and PTSD, often coexist with depression. Approximately 8% of individuals older than 65 have been diagnosed with an anxiety disorder at some point in their lives.

3. Social Wellness:

Social isolation becomes a reality as we age, influenced by factors such as decreased mobility, diminished faculties, reduced socialisation, or the loss of loved ones. Drawing on our experience as social gerontologists, we recognise isolation as detrimental to the overall well-being of older adults. Researchers consistently highlight that those in chronic isolation are more prone to health-related issues, underscoring the positive impact of socialisation efforts in fostering healthier and more fulfilling lives.

4. Intellectual Wellness:

The importance of exercising the mind is well-established, echoing the sentiment “use it or lose it.” This principle applies to the brain, emphasising that enhancing intellectual activities throughout life keeps the mind stimulated, encourages creativity, and contributes to a happier, healthier self. Engaging in intellectual activities can not only arrest cognitive decline but also slow the onset of dementia symptoms, highlighting the significant role of intellectual wellness in maintaining cognitive health.

5.Vocational Wellness:

In the context of aging seniors, vocational wellness extends beyond career satisfaction seen in younger populations. Seniors deserve recognition for their talents, skills, and wealth of experience. This acknowledgment can be achieved through various roles like professionals, caregivers, mentors, teachers, and volunteers. Aging individuals can continue to contribute intellectually and occupationally to their communities, sharing their skills and gifts through work, volunteering, or mentorship opportunities. Indeed, older adults who engage in meaningful activities report enhanced feelings of health and happiness.

6.Spiritual Wellness:

The interest in spirituality grows with age, supported by substantial evidence linking positive health outcomes to spiritual and religious participation. The extended longevity in modern society elevates the spiritual needs of older adults as a top societal priority.

7.Financial Wellness:

Finally, financial wellness emerges as a paramount factor that, if not handled diligently, can disrupt the golden years. The significance of finances in old age cannot be overstated. It is advisable to make informed financial decisions early on, especially considering the increased susceptibility to physical and mental impairments. Elders need financial literacy, defined as the knowledge, skills, and confidence required to make responsible financial decisions and comprehend their impact. Financial risk heightens during challenging life events in these years, such as dealing with illness, disability, loss of a spouse or partner, or caregiving responsibilities. As one crosses the age of 60, the financial landscape shifts, emphasising the importance of being financially savvy.

Key advice for young adults: Embrace proactive engagement. “While it might seem absurd at 50’s to contemplate being 80, it’s a consideration worth making.” We met Sateesh Pandit, senior executive in his early 50’s who came to admit his mother in our advantAGE skilled nursing home and we broach the subject of ‘graceful aging’.

“At 52, I find it to be a wonderful age. Actually, I love it. For me, 40 was the milestone when I anticipated finally feeling like a successful adult, and that expectation was fulfilled,” shares Sateesh Pandit, clearly relishing his middle age.

“I am proud to be 52! I may raise eyebrows as I talk about aging gracefully. However, I believe I am well-qualified to discuss this topic. I vividly remember my younger self at 10, 20, 30, and 40, and now, at 52, I witness the aging process within myself—observing the emergence of wrinkles and grey hairs, much like the changes I saw in my parents and grandparents.”

“My qualification comes from experiencing aging from its very beginning, at birth, all the way through to its inevitable end, at death. Aging brings changes to our bodies, faces, and abilities, and these transformations are unstoppable. Much of it lies beyond our control. Some aspects test our patience. Nevertheless, embracing aging becomes a matter of acceptance rather than denial due to these inevitable shifts.”

Latika is another young person whom we broached the subject. “I got married for the first time at the age of 36, but it didn’t work out, and we separated. Later, I found Kiran, who is seven years younger than me, and we have a live-in arrangement. Our age difference doesn’t really factor in, unless he playfully teases me, calling me ‘old’ to get a reaction. In response, I jokingly retort with ‘Well, you’re bald’ (which he is). Through this banter, more amusing than insulting, I’ve come to realise that I’m not afraid of getting older, of aging. In fact, I embrace it and see it as a victory,” shared Latika.

At what age do we embark on the journey of aging gracefully? Is it 40, 50, 60, or even 70? We prefer to think it begins around 20’s. Making thoughtful and wise decisions from the moment we become adults is essential to shaping the trajectory of our lives. It’s unrealistic to live recklessly, disregarding well-being, and then suddenly, perhaps at the age of 50, decide to embrace graceful living. Without prior practice, you wouldn’t know how to navigate it—where to start or how to embody grace. To age with grace, we must live with grace from the outset.

How can we achieve graceful aging? The advice is familiar: drink Horlicks, regular exercise, a diet rich in fruits and vegetables, avoiding smoking and excessive alcohol. Stay hydrated, manage sleep, control blood pressure – it’s the well-known mantra ingrained in us since day one.

Following this approach might keep you looking well-preserved, but the journey could be incredibly dull. This model only succeeds if graceful aging is solely about looks and not at all about the ruggedness of true living. We believe it’s more than that – we want the lines of time to narrate our stories and cradle our memories. As Mark Twain put it, “Wrinkles should merely indicate where the smiles have been.” The emphasis on appearance in the pursuit of aging gracefully is evident in our reliance on various creams and elixirs for different parts of our body.

It’s natural to desire a youthful appearance – it’s human nature. Feeling young often translates to wanting to look young, boosting our confidence. There’s nothing amiss with embracing confidence, especially in the pursuit of aging gracefully. After all, self-confidence remains the most appealing accessory one can possess.

Apart from looking our best, what else instills confidence in us? Is it success, wisdom, intelligence, or self-reliance? Have you ever pondered what truly brings about your confidence and contributes to aging gracefully? Our recommendations for young adults like Sateesh include:

Accept change: Embrace the inevitability of aging and the changes that come with it.

Approach life with a sense of humor: As we age, our bodies undergo peculiar changes, and finding the laughter in them can be a better alternative to cribbing and tears.

The past is behind us: Focus on making wise decisions now, and if there were less-than-wise choices in the past, seek forgiveness.

Define your core purpose: What deeply motivates you? Identify what is etched in your heart and mind. Whether it’s touching and enhancing lives or making people feel good and special, pursue it with determination.

Prioritise your health: Adopt a nutritious diet and engage in regular exercise.

Save for your golden years: Develop financial wisdom and plan for a secure and comfortable retirement.

Advocate for yourself in healthcare matters: Take an active role and avoid delegation. Plan for professional assistance during potential disabled years.

Allow us to share a brief and intriguing story about an elderly woman we once cared for. It encapsulates various elements discussed earlier. Meet Kamala Jagannathan, an 84-year-old with both sons residing in the U.S. Her elder son became estranged after marrying a Russian girl against her wishes, maintaining a silent rift for 32 years. The relationship with her second son, Karthick, also experienced a decade-long love-hate dynamic, and it seems unlikely to shift before her passing. Despite not committing any wrongdoing, admittedly, Kamala’s stubbornness played a role in these challenging family dynamics.

She doesn’t deserve to be excluded from her son’s and grandchildren’s lives! As the wife of a former bureaucrat, she is fortunate to receive a decent family pension, which serves as a crucial support. Kamala, now dealing with some dementia, resides in advantAGE dementia care home and is adjusting admirably to new routines and surroundings.

Kamala’s story is highlighted for several reasons:
1. She embraced the changes that accompany aging with grace.
2. Valuing her appearance, she prioritised regular beautician appointments
. 3. Recognising family dynamics, she engaged elder care managers (advantAGE seniors) as her advocates.
4. Despite physical challenges, she pursued her culinary interests and dined out regularly.
5. Proactively, she planned her care and finances while in good health without relying on delegation.
6. Kamala’s ability to forgive made her past a source of strength rather than a sore point.
7. And finally, she continued with her passion for art and antiques.