February 6, 2011
Posted by Elizabeth Han
Aging in the Age of Social: 3 Hops
Photo credit: Aging by BobAuBuchon on Flickr
In an archived episode of the always-excellent 1:2:1 podcast from Stanford School of Medicine, Paul Costello and Dr. Laura Carstensen discuss how life is longer than we think.
Consider. In the last century, mean life expectancy has increased by twenty years, and yet most of us complain that we have less time than ever. We must, therefore, be talking about less time in a particular bracket. The extra years are going somewhere, but perhaps “the end” is hardly in the most comfortable place.
It seems that we are experiencing a squeeze: an obsession with cramming everything —including school, job, mate, family — into the middle of life. I’m as guilty as any other! Yet then that leaves us only with “retirement”, that long grey ellipsis, with which we consume the extra years.
However, Dr. Carstensen, the director of the Stanford Center for Longevity, posits an idea that I find infinitely compelling:
Hop #1. “You can take those extra years and put them wherever you want.”
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I love the agency in that line. This is not like eating a chocolate cake, whilst hoping it will go your chest instead of your waistline. You really do have the power to take something that’s over there, and put it over here.
That’s the first hop.
So what would happen if we stretched out roles across life? Instead of exhausting our energy, enjoyment, and dramatis personae in the middle, we could intersperse all those wonderful verbs (connect, learn, share, grow, etc.) throughout our lives – and become more successful overall.
Indeed, I’m starting to be convinced that this is the remarkable gift that our generation has been given: the opportunity to improve life at all ages.
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Hop #2.
Now that we’ve established that this would be something worth doing, take another hop. And think about what this paradigm could mean for health care.
When you stretch life out, you can fit small, healthy behaviors alongside the traditional to-do list.
I won’t pretend to know what all those behaviors might be, but I want to talk about a few simple ideas.
Five Rules.
Now, In doing research for this post, I remembered particularly Atul Gawande’s outstanding 2005 commencement address at Harvard Medical School, where he listed “five rules” for his rapt audience. If you read it, you’ll see that he’s talking mainly about doctors. But in this age of participatory medicine, these are also rules for patients. Invert each of Gawande’s examples and there are incredible possibilities. Here’s my take:
1. It starts with measuring. Gawande said it very simply: count something every day. I think this is the most important step. When you pay attention to your health, even simply by observing, you learn amazing things. Count the steps you take. Count the minutes you spend at the gym. Count the healthy meals you cook. In my research, I work with wearable physiological monitors every day, and I believe they will soon be ubiquitous…then you can count it all!
2. Ask. More time means more time to ask questions about health. Perhaps the most notorious example: don’t leave it to the end-of-life to talk about end-of-life. Carstensen mentions that people don’t want to plan for a period of life that they think is miserable, but that is a self-fulfilling prophecy. Aside: Carstensen cites research that older people are actually more happy than young folks!
3. Create. Write something, says Gawande. Bear witness. Know your story, your passion, your life, because remember: that is what we in health care ultimately strive to defend. You never know how useful it could be. Also, making something public introduces accountability.
4. Connect. One of my favorite quotes from Ralph Waldo Emerson goes like this: “A thought is the blossom, language is the bud, action is the fruit.” Don’t forget to act. Socializing and forming meaningful relationships is especially important as we age.
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Hop #3.
And then take another hop: Medicine 2.0. When I look at the list above, I just know that these can all be facilitated by social technologies. Examples:
1. Track your nutrition and exercise using a tool like DailyBurn.
2. Ask your doctor a question through a secure email portal.
3. Start an e-patient blog.
4. Connect with similar individuals at PatientsLikeMe.
It starts with the aware individual, but Medicine 2.0 is an amplifier. It has spread and reach. That’s what we need.
Because if only a small set of the world ages well, there will be ramifications for all.

