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"The worst pandemic in modern history was the Spanish flu of 1918, which killed tens of millions of people. Today, with how interconnected the world is, it would spread faster." —Bill Gates
"It's the advantage of the virus to spread, and you can only spread when you infect people and they infect other people without necessarily killing them. So if you had 100 percent mortality, the potential pandemic would almost self-eliminate itself." —Anthony Fauci
The novel coronavirus has altered daily life and disrupted our routines. Things are especially challenging because we are advised to stay inside, minimize family contact, and avoid social activities including religious observations. We also know that older people are especially vulnerable to severe illness and increased mortality, although there is considerable variability. So how should we maintain a healthy lifestyle while the pandemic sweeps through our society?
For me, five basic principles underlie healthy aging and help ground me to get through the uncertainties of the pandemic: appreciate the reality, challenge your body, stimulate your intellect, manage your emotions and nurture your spirit.
Appreciate the reality
My basic point is that, COVID-19 or not, we still have considerable choice in determining the quality of our own old age. What we are up against is ageism—the mistaken belief that all old people are the same and that they all are falling apart. We have bought into this myth and it causes personal, social, economic and health care tragedies. We see how COVID-19 has exposed these myths and other vulnerabilities in our society.
Demographic changes have occurred so rapidly that many of us are still living in the past with negative attitudes and outmoded beliefs and stereotypes about aging. The way we usually view aging is terribly wrong. Interest in aging and in the well-being of elderly people is evident throughout recorded history. Care for elderly people is inextricably linked with medical knowledge, available technology, religious doctrine, health beliefs and socio-economic forces. Today, politics has become a major confounder in reinforcing stereotypes.
Challenge your body
Physical fitness is probably the single most important thing within our control to age successfully. The key is regular physical activity because, if we do not exercise, we lose physical function. This can be an issue when we are advised to stay inside. The issue is not just getting into shape — we must stay in shape. We are never too old to start an exercise program and significant health benefits have been documented for octogenarians.
Normal aging in the absence of disease is a remarkably benign process. In terms of physiology, normal aging involves the steady erosion of organ system reserves and homeostatic controls. Our physical goal is to keep our bodies in working order until everything falls apart at once at the very end of life. As we age, we become more unique and differentiated and less like one another. Because of this increasing biologic variability with aging, our approach must be individualized. A “one size fits all” strategy simply will not fit.
An integrative exercise program uses elements of the four basic exercises: aerobic exercises help the heart and lungs, strength training helps with mental function and improves functional reserve, flexibility exercises improve movement and bones, muscles and joints, and balance exercises reduce the likelihood of falls and injuries. Excellent examples of integrative exercises are yoga, tai chi, chi gong, Pilates and various martial arts. Fortunately, these exercises can be done indoors.
Stimulate your intellect
Changes in mental function are perhaps the most feared aspect of aging. Significant mental dysfunction threatens our lives and our independence since we use our brains to perceive and act on risks in the environment. In most people, this fear of becoming mentally incompetent is groundless. This lesson of successful aging, to stimulate our intellect, stresses the point that in creativity, deepening wisdom, and sensibility, we become more as we age, not less. Mental function doesn't have to decline and learning capacity can continue through life.
With age, we can become trapped by our memories and in our own uniqueness as individuals. But we cannot escape from who we have been. A long life can hold us captive, especially if we cling to the unchanging past and are experiencing our life by looking through the pre-COVID rearview mirror. Sometimes this is necessary and pleasurable, but it does not lead us forward. Our memory may get worse with aging, but mainly this occurs because we allow it to deteriorate. We let that happen to ourselves and our memory because of ingrained habits and the comfort, security, and predictability they provide.
Our memory depends to a large extent on our overall health and on our degree of attention and intention. Attention is how well we can maintain our mental focus, while intention is the conscious will to participate in what we focus on. While each of us has differing mental capabilities, training and motivation appear to optimize our mental productivity and accomplishment. Often, we get in our own way and allow laziness, inaction or environmental distractions to keep us from full achievement. I believe that living in isolation over time because of COVID-19 can produce a kind of mental fog, pandemic brain. We need to work hard to stimulate our intellects.
Manage your emotions
The influence of aging on our biological and mental processes all takes place in a rich cultural context that defines roles and expectations for us as we age. We interact with societal ideals, and societal value gives us emotional significance. With the stresses of the pandemic, this cultural landscape is shifting. Our personal satisfaction depends upon what we, our family and our society consider is necessary and contributory to achieving fulfillment.
Old age is no refuge from an empty life, and ultimately, we are obliged to live in old age whether we have developed a satisfactory image of ourselves or not. The acceptance of limits and a finite future is a quality of maturity and not a matter of resignation or defeat. We have a choice in the attitude we take about limits, and this will be very important in affecting the success with which we age.
How do we deal with the changing interpersonal relationships at home and at work caused by COVID-19? The connection between generations is a powerful influence on our lives. In an ideal relationship, older people receive support, care, respect, status and a sense of purpose. In return, they provide cultural meaning, stability and continuity with the past. Satisfactions from work are central to self-definition, self-esteem and social status. Often our views of meaningful contribution are too narrow. Individuals seem valuable to society only as long as they are profitable. What should we do when we are laid off or forced to close our business because of the pandemic? Our views must be enlarged to include a wide variety of alternative occupations, personal projects, volunteer activities, and community contributions.
The evolution of our emotional control is not a mechanical evolution but a sense of conscious and volitional evolution. In some ways, managing our emotions requires the elements of virtue: honesty, patience, self-discipline, and restraint. We may need a framework to help us see through the barriers. Our emotions are an integral part of our operating equipment and we cannot deny them, but we must re-channel, supervise, manage and control them. We need specific ways to better understand and address such negative emotions as worry, anxiety, fear, feelings of inadequacy, stress, anger, aggression, pride and vanity. We also need ways to handle confrontation and strategies to increase harmony and empathy.
Nurture your spirit
Our transition to a new perspective on aging will not be complete until we appreciate the meaning and social importance of life’s stages that end in death. One key idea is the power of limits that give meaning to life—the ultimate limit being death. Our lives have value as long as we value the lives of others through love, friendship and compassion. We share our destiny of continual aging and ultimately death with all living things and we are aware of this destiny, but we must continue active participation in the service of others for as long as possible.
In essence, nurturing our spirit is the purification of experience through unselfish service to others. Conscious aging involves experiences in our inner and outer worlds mediated through our experiences in sleep and wakefulness. While our bodies and minds tend to rest in sleep, it is at night that our spirits grow and allow us the potential to expand our inner lives and consciousness. During the day, we practice our skills and apply our knowledge to live in our outer world. But it is in the still of night, the landscape of the spirit, that our life experiences reverberate through our inner being. There are many personal ways to nurture our spirits, including the need to define our intentions with precision, creating a sanctuary, visiting sacred spaces, walking in a labyrinth, self-observation and reading sacred texts. And one final point: Our spirit has natural, life-long immunity to the novel coronavirus.
