Our local newspaper carries a Sunday comic strip called For Better or For Worse.  Two of the main characters are a couple in their 50’s.  After visiting the man’s father who has had a stroke the woman says to her husband, "I wonder which one of us will become dependent first".   They end the strip with a nice sentiment determining that if one of them becomes so memory impaired that they don’t remember each other they would have to fall in love over and over.   

This strip clearly illustrates internalized ageism.  Instead of asking, "I wonder what we will do IF one of us becomes dependent", she makes the assumption that they will become dependent and it is just a question of which one first.  Internalized ageism can have a powerful influence on an individuals aging experience.  For example, a person who starts to lose the ability to perform basic daily activities determines it is "normal" to be frail as they get older and fails to take action to improve strength, balance, coordination, mobility.  Family members watching an older adult become increasingly frail fail to respond, the doctor fails to respond, all because internalized ageism paints a picture where age = decline until dependence and death.

What if we all believed that aging with vitality and purpose was a probability rather than just a possibility?  Wouldn’t we then start responding to decline in an entirely new way?   Viewing symptoms of physical decline as a condition that needs to be diagnosed and treated would result in an entirely different outcome than just watching and waiting for the "inevitable" dependence to pull us under. 

What messages do your personal beliefs play over and over in your mind about the probabilities and possibilities of aging well?  If they are negative what are you doing to change your perceptions?  What actions do you personally take each day to ensure aging well?   When we consciously confront internalized ageism then we can start writing our own story about aging well in body, mind and spirit.   

I just returned from Chicago where I presented at the joint conference of the National Council on Aging and the American Society on Aging.  I’m glad to report the big buzz of the conference is that the Administration on Aging and the Centers for Medicare/Medicaid are FINALLY making a move towards prevention.   For close to 20 years evidence has continued to prove that we can prevent chronic health conditions through healthy nutrition and regular physical activity.  However, it has taken this long to get the federal government to make a committment to prevention.  They are finally earmarking small percentages of funding for preventive services and making rules more flexible to allow agencies to use general funding for prevention. It doesn’t sound like much but trust me is a huge shift from their standard approach of paying for illness rather than paying for wellness.

Granted it is still "disease focused", i.e. diabetes prevention, heart disease prevention, etc. but it is a start!!  I’m optomistic this is just the beginning.  As programs across the country prove money can be saved through prevention, funding agencies will be eager to use it as as a cost saving tool.  I hope  eventually the momentum will move towards a more wellness-based approach acknowledging the importance of addressing health in body, mind and spirit. 

Someday I hope individuals released from the hospital and rehab after a major health incident will be referred to wellness centers.  These centers would specialize in helping people examine how to live their best life  physically, emotionally, socially, spiritually, intellectually and vocationally.  So instead of a disease focused approach (doctors appointments, medicine, responding to the illness) which often results in life revolving around the disease/condition, people would be in a wellness environment gaining the strategies necessary to thrive for their full lifespan regardless of circumstances.  Let’s all start asking for that from our health insurance companies!!