A Physician's Honest Guide to Aging

“Aging— it’s better than the alternative.” 

It’s a familiar quip that’s not often said with a lot of enthusiasm, and it’s hardly a rousing recommendation for what may be up to a third of one’s life. 

Yes, there will be inevitable physical declines and losses that can transform your life. But as long as you’re alive, there will be new options for improving your wellbeing, happiness, and sense of purpose. 

Being resilient, facing challenges, and establishing a new normal can allow you to have a positive outlook about the future, to think outside the box you may find yourself in, and to appreciate the possibilities, humor, and joy that can be part of your life.

Here are a few of the practices I recommend in my new book, Honest Aging.

Resist Ageism
Older adults are commonly portrayed in the media as unattractive, childlike, confused, grumpy, and selfish. Has this been your experience? I find it so strange that we disparage and are prejudiced against our future selves, since most of us (the lucky ones) will eventually be members of this group. No wonder we’re in denial. Become a role model for aging. You can do this simply by being yourself and telling people your age—you’ll love the look of surprise on their faces. I see it often when medical students meet my patients.

Right-Size Your Expectations
Age doesn’t need to change your passions. You can still be a daily walker or a competitive runner. But if you expect that by working out you will reclaim the speed and strength that you had when you were 40, you’re wrong. Even those in the best shape will walk or run slower as they age. After all, there are Boston Marathon winners of all ages, but the winning time for 20- and 30-year-olds is about two hours, while it’s twice that for 70- to 80- year-olds. Run a marathon, walk daily, and work out to slow your age-related loss of speed and strength; just remember to adjust your goals and expectations.

Be Resilient, Adaptable, and Flexible
With aging, we lose people, roles, and abilities that have been central to our lives. How we react and respond influences our happiness, contentment, and sense of wellbeing. Being grateful for what you’ve had—and what you still have—can help your mood and bring your focus more to the present. Compassion, humor, and finding new meaning and purpose can help reestablish a positive outlook. How do you spend your days? Are you doing things that you find meaningful? Getting out daily? Helping other people? Consider volunteering. It’s associated with longer life, better moods, and improved health, and it’s a good way to meet new people and become more engaged in your community. Be proactive and explore what you might do to reinvigorate your life.

Redefine the Term “Independent”
Independence is an important word to teenagers. It means they can do what they want, on their own. As we age, independence continues to mean being able to do what you want, but you may not be able to do this by yourself, and it can be difficult to accept help. Yet what’s most important to many older adults is to be able to continue meaningful social and spiritual connections, important activities, and living arrangements. Needing assistance in these areas may feel like a threat to your independence, but accepting help can actually allow you to be more independent and do what you want to do. Help can come from a person, a device, by learning new skills, or by adjusting your perspective and doing things differently.

Never Say Never
It’s easy to dig in your heels and proclaim you’ll never use a hearing aid, move out of your home, have an aide, or take an antidepressant. What you’re really saying is that change is scary, and the alternatives have downsides. Which is true. But they also have upsides. Any time you face a new change, make a list of the pros and the cons. If possible, do a trial to see what happens. For example, commit to using a walker for three months. Track your activities, your mood, how often you go outside and socialize, and whether you fall. Don’t decide whether you’ll keep using it until the end of the trial. Remember, making a change can be the key to having a more fulfilling and independent life.

Advocate for Yourself, and Allow Others to Advocate for You
Pain, shortness of breath, nausea, insomnia, sadness, and other symptoms affect your daily life. It’s important to identify and treat the underlying cause of these symptoms, but some symptoms may persist. These symptoms are not benign (without consequences). They can start a spiral where you become less active, get deconditioned and weaker, more tired, depressed… the list goes on. Do not accept decline as a part of normal aging. Use my book, Honest Aging, as a guide—and get help to figure out what’s causing the symptoms and what can be done to become as symptom free as possible. Commit to trying the treatments, including therapy (physical, occupational, psychotherapy), medication trials, and behavioral modifications. Let others help you when you need it.

Laugh More
Cultivate your sense of humor, especially about those things that scare you or you can’t control. We all take ourselves seriously, sometimes a bit too seriously. Have you ever noticed how many comedians live and continue performing well into old age, and that they are often the butts of their own jokes? Think about George Burns, Bob Hope, Moms Mabley, and Lily Tomlin. Having a sense of humor can help you face the unknown.

At some point, aging will be a new stage of life for all of us. The best approach is to take control of your aging. Have a sense of what to expect, and maintain an open and flexible attitude, actively embracing change. Work on enhancing your positive perceptions of aging, and don’t let old stereotypes define you. If a symptom or physical condition concerns you or interferes with your daily routine, find out if it’s normal or not, and in either case be willing to accept and adapt to your new normal. How you react to challenges is a choice— it is not preordained. 

Use Honest Aging to inform your decisions and to empower you and your loved ones to be advocates for an active and meaningful old age.

Adapted from Honest Aging: An Insider's Guide to the Second Half of Life by Rosanne M. Leipzig. Copyright 2023. Published with permission of Johns Hopkins University Press.

Rosanne M. Leipzig, MD, PhD, is the Gerald and May Ellen Ritter Professor and Vice Chair Emerita for the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. She is the editor-in-chief of the monthly newsletter Focus on Healthy Aging.