A Long, Bright Future

Laura L. Carstensen PhD
PublicAffairs, Perseus Books Group, 2011
293 pages (pb)
ISBN: 978–1–61039–058–3

By Deborah Gale

This is a second printing for Dr Carstensen, founding director of the Stanford Center on Longevity in Palo Alto, CA. Her books importance, indeed its timeliness, is underscored by its new release. The subtitle: Happiness, Health, and Financial Security in an Age of Increased Longevity sounds innocuous, while the call to action, directed at the baby boomers (generally agreed to comprise those born between 1946 and 1964) is anything but. In meticulous fashion, she endeavors to replace the accepted discourse on old age with a positive one about long life.
 
Global ageing (or aging in Ameri–speak) is no fringe topic.  It is irreversible, inevitable and the scale, range and complexity of economic adjustment lack any precedent. Carstensen concentrates attention on the social systems in the US as she explores, explains and deconstructs our misconceptions about ageing. Critically, she makes us think about how we can contribute to our own misunderstandings. Reminding us that the benefits of longevity are not distributed in an equitable fashion, the choice of how we want to age assumes far greater importance. As the first and largest generation able to choose, she separates the perceived problems of ageing from the process itself. She does so without sidestepping the undeniable problems associated with longevity, particularly for those without means. However, she deftly succeeds in challenging boomers to reconsider the intrinsic value that is imbedded in the extra years, their “bonus decades”. These are years that so many people, have never previously lived and this makes planning a necessity. The results of her review on the present state of longevity and its impacts on relationships, work, learning and health has a galvanizing appeal. The message is clear: if lives of contribution and significance are to be lived far beyond 50, then we share collective responsibility for devising fresh constructs and age appropriate solutions

Setting the stage, she highlights myths of ageing. Short shrift is given to the “miserable old” stereotype by citing results from her research and theory of socio–emotional selectivity. This theory purports that as we age, our appreciation for the finite condition of life and accumulated experience with change has an impact on the social relationships we engage in and commit to, through life. She concludes that except in cases of dementia, older people are happier because stress, worry and anger all decrease as we age. Her examination of contemporary patterns for marriage, family life and grandparenting is also compelling. With fertility ratio’s declining, an increasing number of adults are living without any young children present. This is primarily due to longer lives with empty nests, being childless by choice and by living alone.

In addition, she debunks the notion that DNA is destiny and putting genes aside, explains how we are all complicit in our health outcomes when diet, stress, chemical exposure and lifestyle choices are considered.  The good news is that it is never too late to change but it is also impossible to erase away inheritance or a lifetime of bad habits. Epigenetics, and the study of environmental contributions to how genes are expressed holds promise in support of longer, better lives – provided that we can successfully modify environments and behaviours. Studies with twins show identical genes react differently to different life experiences. It appears that regardless of your genetic heritage and the branches on your family tree, individual circumstances and choices matter.

Carstensen next champions a total overhaul of traditional work lives. She questions the typical behavior that demands the work–harder–so–that–you–can retire–harder goal orientation. With living longer, we need to dis–invent conventional retirement in support of phased retirement. In so doing, she posits that a moderately paced career cycle would reduce the strain on the middle years, particularly for women, when childrearing and elder care demands can coincide. In tandem, Carstensen negates intergenerational conflict concerns in two ways. First, she discounts both the drain on resources and the lump of labor arguments as flawed. If older, healthier populations continue working and their skill sets and bandwidth of experience is different, then they are not taking jobs away from younger workers. Thus, when everyone who can work is working, everyone in the economy wins. She argues that we should incent and reward those older people who are able to continue working because they delay receipt of social insurance benefits.

Turning attention to the entitlement programs of Social Security and Medicare, she describes the effects of expansion on both imbedded systems and their inability to keep pace with longer lives. In the wake of the global financial crisis, this problem has been exacerbated. Now, the debate has shifted and unhealthy links have formed between deficit reduction and program reforms. She argues for program changes to Social Security that would encourage people to stop viewing it as their default retirement plan and start saving more. As for Medicare, automatic eligibility for taxpayers over 65 along with provisions guaranteed by the pro–pharmaceutical Prescription Drug Act leaves that program categorically untenable. Looking ahead, the costs of providing continual care and technologically innovative treatment to longer living populations only aggravates these existing deficiencies. That said, the potential to enjoy very long lives is not guaranteed either, should a viral pandemic or the incidence of chronic disease accelerate. Likewise, whether socially engineered or culturally reinforced, some groups will be systematically disadvantaged regardless and in the end, no one is going to get out of this world alive.

On a positive note, she uses the term longevity science to describe a perspective whereby future interdisciplinary efforts are devoted to optimizing human functioning in old age. This approach would concentrate medical and technology efforts on health and well being in older adults to achieve a compression of morbidity. For example, by early detection, intervention and halting the progression of age related problems like arthritis; we could improve the quality of life in the years before death. Having already made vast improvements to the health and prospects for infants, this approach would anchor healthcare at the end of life and in the process, contribute to positive outcomes across the life course.

CONCLUSION:
In this undeniably positive read, Carstensen rally’s ageing boomers and nudges them to explore new pathways to healthy, older, longer lives. The permission to check out, granted to previous generations, is simply no longer an option. The perception that “older” people cannot be expected to contribute while others, including the state, care for them is unsustainable.  Anachronistic hallmarks associated with ageing including silence, passivity, complacency and dependency are no longer applicable as the demographic profile shifts.

In the shift, the outliers have become the norm now that two–thirds of the over 65 year olds who ever existed, are still alive and they exceed the under 15’s. Now’s the time, the author says, to craft new ways to experience ageing, nourish important relationships to limit isolation and embrace life long learning to maintain cognitive integrity. For every boomer turning 65 over the course of the next quarter century, real strength lies in their impressive numbers, along with their tendency to shake things up. This should give them a loud enough voice to engage, live full lives and choose the way they will make their exit.

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