Demystifying Medicine One Month at a Time

Boomers 2011

Happy New Year!

Er, almost.

A closing thought as 2010 becomes history:

Click on the graphic to watch the baby boom bulge over the last 60 years (image from Wikipedia)

In 2011, the first wave of baby boomers will turn 65 years old. Sixty-five still has currency because that’s the age at which non-disabled Americans are eligible to be covered under the Medicare program (now itself having reached middle age).

As our economy continues to recover (hopefully) from the Great Recession, the entrance of millions of Americans to the Medicare rolls over the next decade and a half will be a formidable planning challenge.

So is the promise of Health Care Reform (the “PPACA“), which will enlarge Medicaid by an additional 16 million Americans–about half of the projected growth in coverage for those currently uninsured.

A couple of recent patient encounters got me thinking about these phenomena, and how we are very much in historically uncharted territory:

Never have we had so many living so well for so long.

We have an entire generation of people reaching “seniority” who will continue to want the most out of life, without many guideposts on how to achieve it.

As an example, take a patient of mine I’ll call Ted. He’ll turn 65 in 2011. He’s retired, healthy, and financially secure. Every year I see him once or at most twice for a physical and preventive care. He is motivated to exercise and undergo cancer screening, since he wants to enjoy his “dotage,” and not succumb to some of the ravages of aging. I say some, since each year in anticipation of his physical, he sends me an update on his health status.

His numbered list this year was about a page and half, with copious detail on various ailment and insults. But it was number six, the last item, that really grabbed my attention. His prose has a poetry all its own:

Finally, I’d like to comment on the aging process again, if I may. I have alluded to “death by small cuts” in the past as a way of describing what I was experiencing as I think about myself.

This past year I’ve noted several specific things: my drop in motivation to exercise; my arthritis has become more pronounced; a notable decrease in my speed in walking…; I am slower on steps than before, but still able to do as many as I need to; I find a distinct difference in how my sons and son-in-law always take the heavier boxes, packages, air conditioners, etc…; [I see] distinctly more courtesy from those so inclined, in public, as doors are opened, or I’m allowed to leave elevators first, for example; it takes longer to do chores in the yard, and I must pace myself very differently than in the past; I nap for 20-30 minutes in the afternoons, when I’ve done something physical earlier that day.

There’s nothing to prescribe, I’m afraid, short of a daught form the Fountain of Youth, but I thought you’d like to know some specifics on what I’m seeing as another year goes by. It does seem to change a bit every year. I’ll tell Dr. P. [a geriatrician relative of his], of course, but I really don’t think I’m bringing any breakthrough ideas to the field of Geriatrics, as I begin my eligibility for that class.

A man with too much time on his hands? Perhaps. But someone in touch with his body and its rhythms, trying to capture the emotions of aging. I tell him that he’s “in the 99th percentile” of my patients, in terms of his health awareness and motivation for healthful longevity, because it’s true.

I was ruminating about Ted, and what to advise him, when I had a similar sort of encounter with Sally [not her real name]. Sally is also 64, and stuck in the Middle. She cares for an aging mother, and no longer has her children to care for since they’ve been married off.

Sally’s main issue at her visit, other than preventive health (she’s also retired and financially independent), was her anxiety about where to focus her energies.

Then, like a lightning bolt, she asked a simple question:

Doula: a birth attendant

Had I ever heard of a doula?

Yes! what a GREAT idea! She could volunteer her time and serve as a doula.

Voila: an idea. Let’s have Boomers fortunate enough to afford retirement give back to their communities. Volunteering. Teaching. Attending.

This recent Times column raises the whole question of adult education as a ‘new frontier.’

What would you suggest for our Boomer friends?


  1. pathdoc

    Volunteer at a Hospital and hold the babies no one comes to love on. Play with the toddlers whose mothers are in prison and have only an aunt who visits once a week in the hospital. The healing of touch is amazing.

  2. Perrin

    She still has energy? Gawd. By the time I’m old enough to retire, I’ll probably be too physically and mentally worn down to enjoy it.

    But my advice would be for people to find something they can be passionate about. There’s no one-size-fits-all formula for this. Volunteer, devote themselves to a hobby, find a new avocation, explore something they’ve always wanted to do – anything that helps nurture the inner life and inspires them to wake up happy each day.

  3. Heartpatient

    I too will turn 65 this year, but unlike your patients, continuing to work, AND spending a lot of time volunteering. Having worked in healthcare all my life (in the finance arena), I find myself giving back to that as a volunteer, including the American Heart Association, my former employer hospital as a fund raising volunteer and a Service Line volunteer, along with a local health consortium volunteer. There are many many ways to volunteer, and I don’t seem to have enough time to do everything I would like to. Age-ing, while I know it’s happening, doesn’t seem to slow me down too much. Maybe someday I’ll want to take afternoon naps, but I’m a long way from that.

    Having a heart attack didn’t slow me down too much, in fact, it made me wake up, take my health seriously, and get healthier.

    I heartily recommend volunteering, you get back much more than you give!

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