Never too early

Funny how we think of preparing for our senior citizen years in terms of looking good (or even looking better), what with hair dyes and concealers and moisturizers and nip and tuck surgeries.

Well and good, but don’t forget that’s all skin-deep. There are more important things to do to feel good, and that means keeping fit with better diets, more exercise (mental and physical), and keeping an active social life.

All that is top of mind, but when we’re asked about what we’re doing to prepare for our loved ones, we get a bit edgy. We point to investments and trust funds. A will, or a power of attorney? We insist: I’m too young.

We get into all kinds of rationalizations when it comes to “preparing,” and underlying it is this irrational fear that if we prepare for serious emergencies, dying and death, then all that will happen sooner!

Let’s face up to the realities of our mortality and deal with “end-of-life” issues, which could fill up a book. But I’ll try to keep it down to two columns, starting off with a medical case study today to show that end-of-life issues involve more than medicine and physicians. In fact, the idea for today’s column came from a session last week at the Philippine Neurological Society’s convention called “End of Competent Life Issues.”

I was part of the panel, along with neurologist Jacqueline Dominguez and lawyer-physician Patricia Leticia Syson. Jackie started off presenting the case of a balikbayan patient who was 76 years old when she first went to Jackie for a medical consultation last year. The patient had lived in the States for 41 years and never married. She worked as a nursing assistant until her retirement at age 65. She had kneecap and hip replacements, and although she was not on any maintenance medicines, she and her relatives talked about how her health had declined since the hip replacement, and her becoming increasingly dependent on her relatives. She had two siblings with a history of dementia (forgetfulness, difficulty in making decisions and analyzing problems, and other problems with the brain’s functions).

She has a boyfriend back in the States and had sold her house to set up a business with him. She had also transferred her pension to his name. Every month, he transfers some funds to her, here in the Philippines.

The questions raised for the session had to do with this patient’s capacity to engage in business, engage in a relationship, and make medical decisions around her own care, and to make a will.

After Jackie presented the medical facts and the questions around competence, I was asked to talk about social and cultural aspects related to the topic. I started out noting how life expectancy had gone up through the years, so that today the 60s are described as the “new young.” The longer life expectancy is, the more we discover new potentials for the senior population — as well as problems.

Medical advances have surged ahead compared to social and cultural responses. We venerate the elderly, but automatically presume that once you get a senior citizen card, it’s all going to be downhill. We sequester the elderly, keeping them at home, limiting their mobility. They might fall, we argue; but the more you keep them at home, the faster their muscles will atrophy and their brains stagnate, increasing the chances of falls as well as other health problems.

Look at me using “they,” when I’m 67 and have been agitating fellow senior citizens to speak out against injustices and joining mass actions!

People smile when they see us at rallies, happy but anxious. Younger people still think senior citizens should just stay home and limit our social activities. And if senior citizens have romantic relationships? Uh-oh. There’s bias if it’s Lolo (presumably a widower) falling in love, but if it’s Lola (or that gay elderly Tito) having a boyfriend, we immediately think that’s a sign of dementia. It’s so bad that when a Lola decides to dress up and wear makeup, we say, nag-uulyanin si Lola, she’s dementing!

It all boils down to discrimination against the elderly, an underestimation of what we are capable of doing.

Which is why it’s never too early to start doing what needs to be done, because the older we are, the more likely people will question our mental competence when we draw up that will or power of attorney, or set out to do something usually associated with younger people. On Friday, I’ll discuss what we can and should be doing, including sharing valuable insights from lawyer and Dr. Patricia Syson about what the laws say.

mtan@inquirer.com.ph