Why we all need to make an Ageing Plan

In the Bible, many great men and women are said to have lived incredibly long lives. Noah is said to have reached a monumental 950 years. But even Abraham, Sarah and Moses are said to have lived to 175 years, 127 years and 120 years respectively.

So you’d think the Bible would have a lot to say about ageing. But it doesn’t.

And this is really because ageing is quite a modern phenomenon - that has come about through great and wonderful medical advances which enable us to stay alive when, in years gone by, we would surely have died.

In the past, life and health would putter along quite nicely for years. Then illness would hit and that would be the end of things. Someone would be perfectly well one day and the next he would be struck by a heart attack and would be gone.

Now, we don’t so much ‘fall off a cliff’ at the end of our lives, we experience a long slow descent. As our bodies begin to break down and fail us.

Doctors, however, have multiple ways to help us. Reducing the blood pressure here, beating back the osteoporosis there, controlling this disease, tracking that one, replacing a failed joint, valve, piston etc. And we struggle on. We manage.

But there comes a day when something critical happens – perhaps a fall or a stroke - and the question then is, What now?

We, at this point, are probably in hospital. But our children, much concerned, will gather together at some fashionable restaurant in Soho and ask themselves - what should we do about Mum?

And this is when – if we haven’t made an ageing plan, if we haven’t had some pretty clear conversations with our children about our preferences – some bad (albeit well-meaning) decisions may be made.

The thing is that our culture seems to suggest that the most important goal for old and frail people is to keep them safe.

What if she falls again? someone asks. What if she’s lying on the floor for three days next time, unable to get up? We need to make sure she is safe.

Children are worried that they will feel bad and others will judge them if their parents are not ‘well cared for.’ But, if they know that there are things we value far more than safety and we have told them this, then they need not have these concerns.

For most old people, safety is not paramount.

The important thing is their desire to continue some form of meaningful existence. To be able to decide what time they get up in the morning, when they want to eat dinner, when they want to have some privacy. They want to be able to have a gin and tonic before supper – whether their doctors consider this advisable or not.

As Atul Gawande puts it in his fascinating book Being Mortal, ‘Our most cruel failure in how we treat the sick and aged is the failure to recognise that they have priorities beyond merely being safe and living longer.’

At the end of our lives, we want to share memories, pass on wisdom and keepsakes, seek reconciliation in relationships, make peace with God and ensure those left behind will be OK.

Finding ways to do this – even if it means foregoing surgery and procedures that might prolong our lives but make our lives even more debilitated – are often more important.

Just because you are frail and dying, you shouldn’t have to submit to life in an asylum, as many nursing homes feel for people, or spend your last couple of weeks in an intensive care unit.

Fortunately there are more and more options for people who are ageing and dying slowly – schemes for assisted living and hospice in the home, creative homes that put people’s desire to retain autonomy over their own lives before safety and longevity.

It’s not nice to write an ageing plan, just as it’s not nice to write a Will. We don’t like to face up to our mortality. And it takes courage to have the strength to face the things we fear. But, if we want our children and loved ones to make the best decisions for us in the future, we must do this – for their sakes as well as our own.

So make an ageing plan. And encourage those you love and care for – especially your parents, grandparents and older friends in your community – to do this too.