How to turn old age into the prime of your life

Originally published in September 2019.

Ever heard the age-old message that looks really aren't that important? Well, Dr. Marc Agronin says actually, they are! But not in the way you might think. 

As a geriatric psychiatrist in Miami, Fla., Agronin says he's seen the best and worst of aging, and says he's figured out how you can not only survive, but thrive during old age. He's the author of The End of Old Age: Living a longer more purposeful life.

Here is an excerpt from his interview with Tapestry's Mary Hynes.

You have tried to make the case for vanity — not as a deadly sin, but as something you want in your tool box as you're getting older. Let's start with a definition. What do you mean by "vanity" and why is it so important to "rock it" in your older years?

Vanity can have many connotations, but I think we tend to think about someone as being somewhat arrogant, very self-focused. And certainly that's one component of vanity. But I also look at it in terms of a healthy sense of oneself. You could maybe call it a healthy narcissism, in which you realize that you have accomplished a lot. You have value and you have dignity.

That's part of vanity. And so I quoted this in response to an interview about individuals who love to wear beautiful clothes and adorn themselves and dress up as they get older. Sometimes we denigrate individuals who do that as if they're trying to stave off the ravages of aging. I don't think we should look at it that way. We should look at it as someone who is celebrating who they are and what they've accomplished. 

I think it's wonderful when I see older individuals who want to show off, who want to brag, who want to make a big deal out of being older. That's amazing! Because what happens is, when you see that, when you're around that, you think, 'Oh my god, that's what aging can be about!' I can tell you in my own life I have two uncles in their 90s who, you know, one is still skiing, one is golfing, one has a new girlfriend. You know, it's amazing. And so my view of aging is based on them. And it fills me with a deep sense of awe and hope over the aging process. And I'm certain that that will have an impact on how I age and how view my own aging.

The danger here, I think, is sounding like Pollyanna, because there are some very hard truths at the heart of this. I think of someone I love who has just turned 89. She is brought to tears because she hates not being able to do the things she once did easily. Opening a jar, walking down a hall without feeling that her balance is iffy. What do we do with some of the really painful facts about human beings getting old?

In some ways, this is the most important question that you've asked me and this is exactly the issue. For the past 25 years, I've only worked with older individuals. The average age close to 90. And so I see all of that every single day. Mental disability, cognitive loss, physical suffering. This is a part of aging, although I have to say, with good medical and psychiatric care, you can minimize how much a part of aging [that] is. But this is true. We face these changes. 

So the perspective on aging doesn't erase that. It just says: Let's balance it out because maybe the person who can't open — or struggled to open — the peanut butter jar can also sit down and write the most beautiful poem you'd imagine. Or can speak in five different languages or can counsel a younger person in the family in ways that are really profound. So then that issue of the peanut butter jar or the daily aches really recede into the background. You realize in some ways, those are somewhat trivial compared to the great value and meaning that people have. But you have to really have your eyes open to this. 

It was important for me in writing this book to include every single person aging, even people who are severely debilitated from Alzheimer's disease or related disorders. And what I talk about is, there is still wisdom even in those circumstances. But it's different. And often it requires us to try to bring it out, to enhance it, to recognize it, in that mutual interaction with them. That's where the real magic happens. And if you've ever been around an older, iconic individual or someone with great accomplishment, someone who maybe is debilitated in one area but has a strength in another. You see how still it's so amazing and beautiful and profound. We need to focus on that as much as we get lost in all the other aspects of aging.

Existential crises

You mentioned the societal distaste for getting older. For mocking it instead of cherishing it. How much of this do you think is existential? Because we all know what comes after getting old, right? If we engage with aging, don't we have to engage with the fact that we're all going to die?

It's true. I would say the existential issues we face are absolutely death, although I will say that, as you get older, the fear and the terror and panic of death for most people — not everyone, but for most people — begins to recede. I work with people in their 80s and 90s, it's not something they talk a lot about.

But the deeper existential issues they do talk about have to do with loneliness, feeling bereft — especially when pain is mixed in there — and that sort of suffering. And that's exactly where I feel the formula that I've worked on comes into play. And it's not my formula in particular, but it's just the general formula of when you get to know someone on a deeper level,  when you celebrate aging, by necessity, form a connection with them. That is the great salve for the existential aspects of loss and loneliness. 

The individuals in their 90s and above are pioneers. So we have the chance now to come up with the ways in which we're going to ritualize and celebrate that.- Marc Agronin

Nothing is going to solve the issue of death. That's a separate issue, and we often need a sense of spirituality to help guide us through that. But for the most part, that's not the main issue that we end up dealing with as we get older. It's those other issues I mentioned. And a positive view on aging is clearly a good formula to deal with that. 

I'm curious about an idea of yours: that if we embraced ritual — the right kind of ritual — as people enter older stages of life, there would be a really profound shift in the way they think about getting old. Tell me what you have in mind. What kind of ritual could be helpful here?

This is an important point, because we have rituals and ceremonies for most of the major transitions in life: when someone is born, when someone dies, when someone gets married, all sorts of things. It makes us pause, engage in some actions that say, 'This is important.' We don't do that when we get older. So I think when someone, for example, moves into a nursing home, instead of looking at it with a sense of doom, we should celebrate that fact. And to me, a ritual gives us a sense of order, a sense of meaning that's so important. It's only been in the last hundred years that people routinely live into their 70s, 80s and 90s. So to some extent, this is a new frontier. The individuals in their 90s and above are pioneers. So we have the chance now to come up with the ways in which we're going to ritualize and celebrate that.

I wonder if that thought in itself could help, because I've never heard people in their 80s and 90s referred to as pioneers. That very term carries with it some bravery. You're exploring, you're really on the cutting edge of something. There's nothing feeble about that!

Not at all. This is why people celebrate youth, because we think about strength and creativity and hope. But late life is like that as well. I work with individuals and let me tell you, you see courage, you see passion, and it's true that they are pioneers now. Whenever in history have we had so many people turning 100? It's never happened before! How many of us can say what it's like to turn 100? We don't have role models for that. So the current 100-year-olds, they are our role models and they're doing it for literally for the first time in human history. And that's exciting!

This interview has been edited for length and clarity. For more from Mary Hynes' conversation with Marc Agronin, click the listen button above.