25 Comments

Appreciate the recognition that euphemisms don't work, Don. I've long been agog at how old Americans (people with oldness? 😂) are described. As you surmise, changing the label won't help when the attitudes remain.

Since I reached my fifties, I've occasionally been treated to "young lady", and refused it, pointing out that it's condescending, and that I'm proudly old. The people who used it had the gall to take offense, but whatevs. 😂

I mean, elder implies respect, but I'm sure that if it's widely adopted, it won't.

Ever see Waiting for God? Old BBC sitcom about aging disgracefully. The main character, a sharp and funny woman who suffers no fools, reminds me of an old teacher of mine.

She was a WWII era product, a Cambridge grad who inspired me and so many others: She spoke freely ,

didn't give a damn what people thought, never dyed her hair, terrified stupid adults, and was a fantastic role model to teenage girls. We adored her.

That's what we need. The mealy-mouthed euphemisms don't work, and those of us who aren't yet quite so vulnerable need to pointedly remind people who use them in treacly tones that we're not fooled, and they're out of line. It's interesting how often the offenders tend to be approaching the end of middle age themselves, and I wonder if this is them desperately trying to cling to association with youth? Hmm.

Expand full comment
author

For a long time I've said I'm writing about aging gracefully. Maybe I should rethink that. Aging disgracefully sounds like much more fun!

Expand full comment

Don, I turned my redoubtable old teacher into a character in my novels, where she has reached so many more people! I would love to have heard her take on 2023. It would have been informed, pointed, and hilarious.

Expand full comment

I just read David Wallace-Wells piece "Too many Americans, in almost all groups, are dying" all about how the U.S. is woefully behind in medical care for almost everyone in almost all areas of medicine EXCEPT cancer treatment and keeping older people alive. Maybe you're not talking about just staying alive...but actually living!

Expand full comment
author

Yes, of course. We want to promote the healthspan, not just the lifespan.

Expand full comment

So, when do we march on Washington, DC? Walkers and canes optional.

Expand full comment
Oct 21, 2023Liked by Don Akchin

Drugs in children are by necessity weight based. Children under 6 months also have different drug clearances than do older pediatric patients, thus necessitating certain dosing modifications by age. To say that similar pharmacological guidance does not exist for the elderly is incorrect. Please review merckmanuals.com for a lengthy discussion of drug dosing in the elderly based on variables such as a patient’s body water content, volume of distribution, and time of a pharmaceutical to clear (often longer than in young patents). To get practical, seasonal influenza vaccine antigen is approximately 4 times higher in people over age 65.

Expand full comment
author

We need to prepare signs. How does "Respect Your Elders" sound?

Expand full comment

For a description of cutting edge research, clinical care, and resources in geriatric patients with cancer please see old-prod.asco.org. Many oncologists specialize in geriatric oncology. I can report the experience in adult palliative care that in many older individuals with aggressive cancer CHOOSE limited or no treatment based on overall health and worry over potential side effects. This is a very different phenomenon than implying that older patients are overlooked by the healthcare system.

Expand full comment
author

Thank you for keeping me honest. I stand corrected.

Expand full comment

Aronson’s book Elderhood was one I read preparing to live with my mother. As I move into elderhood myself it may be time to read it again. It is an excellent source.

Expand full comment

Excellent article, my elder old friend.

Expand full comment
Oct 21, 2023Liked by Don Akchin

Aronson's book Elderhood is excellent, my copy is full of highlighted passages. I was in Urgent Care last week & the doctor examining me hurriedly corrected himself when he said I needed to go to the ER b/c of my age. I corrected HIM, by saying I knew I was old and had no problem with it at all. He still felt the need to assure me I was on the "young side of old", whatever the heck that is in light of my injury. The only thing I don't like about being old is the invisibility - yesterday a teenager nearly knocked over my husband & when I chastised him for his carelessness he said, "I just didn't see him!" (Mere inches away....) Feh.

Expand full comment
author

Oh! You mean literally invisible! I assumed it was just a metaphor.

Expand full comment
author

Thank you, my not-that-much-younger old friend.

Expand full comment

Maybe: Wise Ones. Yoda Generation. Sir or Mam. Not: Old Balls.

Expand full comment
author

You mean we're not still the Pepsi Generation? What a cruel disappointment.

Expand full comment
founding

Excellent column. thank you. I'm with you on elder, which connotes wise (and that's always nice!). I do my best to proclaim my age and satisfaction with it at appropriate moments and to educate people who feel I need to be coddled and infantilized. In fact, I'm turning 70 in a few months--maybe I'll declare that my Year of Happy To Be Old, Wise, and Here! (Unless you as the wordsmith can come up with a way to use "elder" instead...)

Expand full comment