When I turned 60, it took more than a year before I claimed my senior citizen’s card. I felt I didn’t need it. I was not taking any maintenance medicines nor did I need regular diagnostic tests, for which a 20-percent discount spells a huge difference in price. It was the substantial S.C. discount at restaurants that finally convinced me to get the card. I’m trying to recall when exactly I began to feel some slowing down in my physical and cognitive performance. I think it was sometime after I turned 65. I started to have great difficulty driving at night. My riding instincts likewise seemed less sharp. My arm and leg muscles appeared not as strong as before. I first sensed this whenever I had to lift up my motorcycle from its side stand. More crucially, I noticed that my sense of balance, so important to a rider on two wheels, also began to decline.
I suppose that, at a certain age, there occurs a disconnect between what you think you can do and the actual capability of your body. That’s when you think you can keep the body from declining by choosing your food well, taking supplements and doing regular exercises.When I meet old friends and former classmates, I am brought to the harsh realization that all these are the inescapable accompaniment of aging. Particularly at reunions, when the talk turns from reminiscence to comparison of ailments and medications, one realizes finally what it means to be in the throes of old age. You recognize the same symptoms, the same prescription drugs, the same medical procedures and the same desperate turn to herbal, acupuncture and ayurvedic treatments. You compare notes about the best medical specialists, cleanest hospitals and alternative procedures. Most of these discussions are spiced with anecdotal accounts that, depending on the state of your own health, either leave you hopeful or depressed.
But there are systematic ways of assessing the experience of aging, outside of the common illnesses that afflict older persons. There are indicators designed to measure the impact of aging as a stage in life that have been used to compare data from different countries. Here, I refer to the extremely valuable study recently reported by a team from the Demographic Research and Development Foundation and the University of the Philippines, led by Dr. Grace T. Cruz. In future columns, I will highlight the important findings from this report, titled “2018 Longitudinal Study of Ageing and Health in the Philippines.”
What does it mean to be old in the Philippines? The most common measures pertain to the incidence and severity of pain, falls and sleeplessness experienced by older persons. But there are other measures that focus on functional health. Of these, three are particularly worth citing—namely, Activities of Daily Living (ADL) difficulty, Instrumental Activities of Daily Living (IADL) difficulty and Washington Group Short Set (WGSS) difficulty.ADL includes the following: taking a bath, dressing, eating, standing from/sitting on bed or chair, walking, going out and using the toilet. Twenty-two percent of older Filipinos report having at least one difficulty, the most common being going out by oneself.
IADL, on the other hand, refers to the following activities: preparing own meals, purchasing items/medication, taking care of financial matters, using the telephone, light housework, using public transportation and taking medication. Twenty-seven percent of all Filipino senior citizens in this survey reported having at least one of these difficulties. The most common is using public transportation, which is consistent with the finding in the preceding paragraph.
WGSS difficulty would refer to any of the following: difficulty in seeing even if wearing glasses, hearing even if using a hearing aid, walking or climbing steps, remembering or concentrating, self-care and communicating. Much of what we usually mean by being old refers to any of these. Not surprisingly, 68 percent of all older Filipinos have at least one of these difficulties — the two most common being walking or climbing steps and remembering/concentrating. Of the three sets of indicators mentioned here, I personally think the ADL indicators are the most salient symptoms of aging as a form of disability. I dread them all, including the mildest of them — i.e., difficulty going out or finding one’s way outside one’s home. They all involve, in varying degrees, a decisive loss of autonomy. One becomes a child all over again.
I had a small taste of this on a trip to Malaysia just this month. Returning to Kuala Lumpur from a short side visit to Penang, I felt so distressed that I could not find my way out of the KL International Airport. Retracing my steps, I missed the exit sign twice. Finally, I had to ask for directions. Thus distracted, I had difficulty deciding whether to take an airport taxi or to book a Grab car. Reading the Philippine aging and health study, it gave me some comfort to know that, apart from hypertension and an enlarged prostate, getting lost in an airport is all the difficulty I worry about at age 73.
As of the last census of 2015, Filipinos aged 60 years and above formed 8 percent of the country’s population. This makes us a relatively young society, based on the United Nations definition of “aging populations” as those whose “older persons” (60 years old and over) constitute 10-19 percent of their people. But it won’t be long before all the problems of an aging society start to hit us. And, when they do, amid mass poverty, we may finally realize what it means to be old and poor.
[public.lives@gmail.com]