A Point of View: The paradox of growing old

Elderly woman and young woman's hands

Mary Beard reflects on the way the elderly - and their carers - are treated in society.

Once upon a time, according to ancient Greek mythology, the goddess of Dawn fell in love with a Trojan prince called Tithonus. She was so besotted with him that she went to Zeus, the king of the gods, to ask that Tithonus be made immortal. Zeus agreed, but Dawn had been foolish - she had asked for (and received) eternal life for her lover, she had forgotten to ask for eternal youth. The result was that Tithonus just got older and older and older, though he never died.

Dawn at first looked after him at home, "nourishing him with the food of the gods and dressing him in rich clothing", as one Greek poet put it in the 7th Century BC. But eventually, when he became absolutely incapacitated, Dawn locked the poor man away. Or, as the same poet goes on, "when awful old age pressed down upon him, she put him away in an inner room of the house and shut the shining doors". You could hear his "ghastly babbling" ever after, but he could not move a limb.

Aurora and Tithonus Aurora and Tithonus by Gregorio Lazzarini

When I first came across this story, I took it as a cautionary tale about how difficult it was to deal with the almighty power of Zeus - if you ask a favour from the king of the gods, you had better take care to ask for exactly what you want, or it will be sure to rebound. Now, at 59 and a bit, it's perhaps no surprise that I see the tale of Tithonus also as a parable about old age and the various forms it can take. It reminds us that there is the world of difference between being a sprightly, albeit senior citizen and the degrading state of total dependence.

For most of us, the worry about getting older is not really about the passing years and their minor symptoms (the thickening toenails, the creaking knees, or - as I discovered recently - the uncomfortable truth that it is no longer very wise to try to leap down four feet off a wall). In fact some of these clouds actually have their silver linings. I am very happy to walk unnoticed past a building site, entirely un-whistled at (there were a few years when I fondly imagined that the behaviour of the average builder was improving - but the truth is that it was only me they weren't interested in), and, for every woman who is laid low by the menopause, there is one like me who feels liberated by the idea of never having to deal with cramps or a tampon again. What is worrying is the thought of what might happen to us if we cross to the dark side, to the Tithonus side, of old age. Past the senior railcard, to a world of incapacity, indignity and incontinence.

To put it another way, there are two faces to "seniority" in the West. One is that still enjoyed by the relatively healthy and the relatively affluent (and affluence bolstered by decent pensions is, of course, crucial). The other is that long decline into death, which is suffered by ever more of us - a long and "awful old age" as my ancient Greek poet put it.

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Mary Beard
  • Historian Mary Beard is professor of classics at Cambridge University
  • A Point of View broadcasts on BBC Radio 4 on Fridays at 20:50 BST and repeated on Sunday at 08:50 BST

I can't help thinking here that some of the modern medical profession have made much the same mistake as the goddess Dawn. Why on earth, when so many doctors themselves wish for a quick death from a massive heart attack, do they expend such efforts (and money) in preventing their patients from having exactly that, consigning us to the expensive and nightmare world of the very old and the very decrepit?

These two faces were vividly captured in the news last week. On the one hand, we learned of a big, sell-out discussion in central London, on "How to look hot at 100". This was a kind of "90 is the new 70" event. It featured a man who runs a blog-site, which captures, I quote, "the sartorial savvy of the senior set" and a 76-year-old grandmother keen (as I am) on Doc Martens (to be honest, the whole event brought out the counter-suggestible in me. If, unlikely as it is, I ever get to be 100, I hope I've got something better to do - I thought - than wonder how to be "hot").

On the other hand, there was a series of television programmes and newspaper articles about some of the terrible things - and some of the totally unacceptable regimes of care - going on in Britain's "care homes" for the elderly. I don't think anyone could have watched these programmes without feeling ashamed - to see old people crying because no-one will take them to the lavatory, to see them being ridiculed, abused and hit, was deplorable. As an historian, my guess is that in a few hundred years time, the treatment of the frail old in 21st Century Britain will be seen as much of a blot on our culture as Bedlam and the madhouses were on the culture of the 18th Century. There will be many books and PhD theses written on how, and why, we got it so wrong.

"Bedlam", an engraving by the English artist William Hogarth (1697-1764), depicting patients on a ward at the Bethlehem Hospital, London An engraving from The Rake's Progress by the English artist William Hogarth depicting inpatients at Bedlam

But the spotlight will not just be on the carers (some brilliant, some inadequate, some - frankly - cruel). It will also be on us, on the readers and the television audience, who looked at these programmes and deplored.

Of course, from the safety of our own living rooms, we like to think that, if we were the carers, we would be more or less consistently kind to the frail elderly - we would not abuse or hit. But can we be quite so sure? Dementia is a case in point. The popular, sanitised view of this has made it a rather gentle condition - sufferers are "confused", a bit dopey, living in the past, with the fairies or on another planet. Some indeed are like that, and I hope that that is how comes to me, if and when it does. But this disease has a cruel side. Others, we know, become truculent, aggressive and more difficult to care for than the euphemistic adjective "challenging" can possibly capture.

Most parents know the experience of "losing it" with their own young children. Love them as you do, cute as they are, there are occasions when they wind you up so much that you shout at them too angrily or give them a slap (even though you know you shouldn't). It's wishful thinking, I suspect, for most mothers and fathers to claim anything else. Of course, we shouldn't compare the care of the elderly with that of the very young. Despite Shakespeare's "seven ages of man", which precisely squares that circle, it's misleading (and insulting) in all kinds of ways to conflate the two. But I still wonder how many of us who don't always remain calm with our own beloved offspring could work in a care home and not occasionally say, or do, something we regret to the sometimes very difficult residents.

An elderly patient with carer

It is extremely instructive to look at the reports on relatively decent care homes produced by the Care Quality Commission and available online. Here you start to see below the lurid headlines to the day-to-day reality, and conflicts, of the care-home world. One old lady, I read, had not had a bath or a shower for over three weeks - or so one partly critical report noted. Why hadn't she? Well, it took three people to get the lady to the shower, and she didn't want to have one anyway. Maybe they had got the care-plan wrong, maybe they were too busy to coax her in the right way. Or maybe when you're over 90 you should just be allowed not to bother.

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A number of major employers are offering "eldercare" - help with looking after older relatives. Will this soon be as common as providing help with childcare, asks Andrew Bomford.

Try too looking at the job descriptions for care-home assistants. We are seeking, they say, someone with a couple of NVQ's who will "enable service users", another coy euphemism, "to achieve independence as far as possible in all areas of their life", "help [them] to identify and choose their support needs", someone who will "understand how to treat the patient/client with respect and dignity", and "understand the rights of the individual to have their wishes respected". And so on.

That sounds to me as if they are looking for a saint for £6.31 per hour (maybe saints come cheap).

So is there a better future in sight? When all those books and theses are written in a few hundred years time, will the solution seem obvious, the problem solved? We can only hope so. It would be nice to think that when the so-called "elderly" make up a third of the population, sheer people power might make a difference. The fact is, though, that when most of us get to the frail stage, we're past speaking out, as that long non-death of Tithonus reminds us.

His should be a warning tale for all of us in the savvy senior set, still striding out in our Doc Martens.

A Point of View is broadcast on Friday on Radio 4 at 20:50 BST and repeated on Sunday at 08:50 BST. Catch up on BBC iPlayer

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Here is a selection of readers' comments.

I am a retired GP and now care home company director. Within our care homes we have very caring people working on behalf of the residents. They recognise that it is their own councils who do not value them enough to pay a weekly fee which allows us to pay a higher wage. And the councils are constrained by their stretched finances. The problem is that our society encourages a caring attitude to others and at the same time sanctions a system which rewards the those in the financial sector who produce nothing of real value. We all have allowed this excessively unequal distribution of wealth by our passive and disempowered behaviour. Instead of a growth economy we need a sharing economy which values human dignity and protection of our world resources. We need a whole new story of what is valuable in life. Then we may see better caring relationships throughout our society.

Dr. David Mead, Forres, UK

A thoughtful piece which captures my own thinking at just a few years older than Mary, and after a mild heart attack which certainly prompted reflections on mortality. There is no doubt in my mind that as we age the quality of life becomes more important than its length. I have no wish to shuffle off this mortal coil, but would prefer that to a lifetime shuffling round in bedroom slippers not recognising my children or being able to engage in discussions like this!

Valerie Adams, Abergavenny, Wales

The attitude towards sickness and death needs to change. Use the Power of the Mind. Never even consider the downside of life. When I ran my Financial Services business, I was constantly shocked at how many people were intending to become incapacitated in the future quoting 'it's only to be expected'. No, it isn't, don't expect it! It's not so much a case of denying it as not even considering it. It works for me. I notice even Mary says that in the unlikely event of her reaching 100 - well, there you go. Mary, of course, might have inside medical knowledge as to this - but for the majority who don't, why even think about it. Forget the statistics. Embrace the unpredictability of Life. Happy Living!!

Iris Spencer, Worthing, England

The difficulties in caring for us in old age make the pressure to euthanize us even greater and raises the question who has the right to decide ,relatives seeing their inheritance go in care fees may well think that person has no future even though they may have lucid intervals & enjoy life in a restricted way .The search for dementia cure has hardly begun and since it is not a sexy subject has little support.

Mrs A Farrelly, Wallington, England

I have worked in Care Services for many years, creating, developing and managing services. We only get it right when we are overtly vigilant. Setting, implementing and maintaining standards is the key and it is not easy. Let's understand too that 'the elderly' are those from 60-100 years. We don't have a name for 0-40 years do we?

Susan McLean, Paisley, Renfrewshire

So you are only 59 then professor? I'm 71 and enjoying every minute. I perform in pantomime and have written one, am a steward at my church, enjoy overseas travel and am often out chatting with friends. Have just redecorated the kitchen. Each day is a gift. That's why it's called The Present.

Martin Letts, Southampton, UK

Mary Beard's point that we expect sainthood on the minimum wage absolutely hits the nail on the head. As long as care homes for the elderly are seen as a great way to make money this can only continue. Having seen both my parents sink into forms of dementia and one of them in particular suffer what seemed like terrible neglect, I do (sadly) feel perfectly qualified to comment.

Ian Fordham,

As a person who looked after those less well of than myself in my younger days, I found that with all the good intentions in the world, things do not turn out as 'rosey'. Unlike our own homes, care establishments have a time table that has to be kept, this means less 'free' time to deal with everything at a pace of the person being dealt with wants. Frayed tempers by either the person receiving the care or the carer (due to inadequate staffing) leads to confrontation and none acceptable actions by either party, 99% of the time this is none intentional but leaves a bitter taste in the mouth for a long time to come, the other 1% are just people who are on a power trip and due to their own inadequacies take it out on those less able to fulfil their own egos, these are the ones that need ousting not the carer who has 'lost it' for a short and much regretted period.

Robert Strudwick, Northamton

Many of the problems in elderly care are caused by our own fear of old age. We allow age to throw a cloak of anonymity over people, so they are just perceived as 'old', white haired, frail and possibly demented. I think that for every elderly person in care there should be a small folder in their rooms containing their life stories, achievements, attitudes and photos of them at various stages in their life. There should be more visioning processes in the training of care workers so that they start to consider themselves as one day being old and that they will essentially still be the 'them' that they are today. Large institutions, homes and hospitals should slowly be closed and the care should be done in smaller places so that a more personal relationship is allowed to develop. And yes, pay care workers more. We are worth it!

Jane Buttigieg, Bristol

I am 61 and have a frail father demanding more and more, is very insular with no friends. I am heading into the future with his situation on my mind and I think about behaviour. His has been difficult so I find it difficult to be as helpful as I would be if I truly loved him which I don't. I only see a bully. I believe if you are lucky enough to have people around you who truly love you you will always get loving help as you grow old and enter the terminal stage. However you MUST not take it or them for granted. My uncle dropped dead while tending his cabbages, so no long lingering stress. I have recently obtained an allotment!

Richard Jones, Church Crookham Hants UK

In the 1990s My mother was in a lovely care home. She had breakfast in her room and read the papers, then got up and dressed slowly through the morning ready for lunch and dinner and socialising during the afternoon and evening. A bit like a country hotel. They sorted out her problems and she was relatively happy. The cares had time through the morning to help the residents when they needed it through out the morning. Unfortunately along came an enthusiastic inspector who instructed the home that the residents should all be up and dressed for breakfast in the dining room. This meant that the staff were rushed the residents harassed and unhappy. Fortunately we were after a short time able to care for Mum until she needed nursing care three years later. I think my point is that outside pressures can be put on care homes and care workers which make it hard for good thoughtful care to be given.

Jennifer Smith, Aberystwyth

Yesterday I was called out to deal with two medical emergencies (I am a First Responder). One was to a 93 year old who was full of life and having a good "old age" in an independent living flat. The other was to an 83 year old in a Care Home who should have been allowed to die peacefully but because there was no DNR in place, she had to be treated. Medicine was "forcing" her to stay alive. We do need to consider the issue of "staying alive in old age" from the point of the person as well as society.

Paul Harvey, York, Yorkshire

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