The IDEA Series: Urban Legends

It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.

~Mark Twain

 

Aging in Place The IDEA Series

Guest Post by Harry Rick Moody PhD

Rick Moody is simply the best resource on alternative thinking on gerontology I have. So, having said that here are some of his IDEAS on aging you may have never considered. He wrote this piece years ago and I recently asked to see it again for something I’m working on. I share it here with you (his permission of course) so that your conventional wisdom on aging will be challenged too.

Aging Urban Legends

Urban Legends are believed by many even though they’re not true: e.g., “A Tooth Left in Coke will Dissolve Overnight,” “Marie Antoinette said ‘Let them eat cake!’ ” “The Pyramids were built by Jewish slaves,” or “Betsy Ross designed the American flag.”  None of these Urban Legends is true, yet people don’t stop believing them. (And we won’t even talk about alligators living in the sewers).

We have many Urban Legends of Aging: all plausible, all widely believed, all false.  Here are a few:

“Retirement is bad for your health” or “People often die soon after they retire”

Proven false long ago by longitudinal studies of retirement; see the work of Gordon Streib from the 1950’s and confirmed many times since. But this false belief about retirement never seems to go away; see David Ekerdt, “Why the Notion Persists That Retirement Harms Health” (1987).  There are of course cases where people in ill-health opt to retire and do die soon afterward.  But retirement wasn’t the cause.  Maybe there are other reasons to encourage people to delay retirement but fear of bad health isn’t one of them.

“Ageism is the work of the advertising industry.”

It turns out that ageism was invented by the ancient Greeks, as a glance at their youth-oriented art will show.  It was rediscovered by the Renaissance and then propagated in the 20th century for a variety of reasons.  Advertising and media mainly trade on stereotypes already widely accepted in society.

“Anti-aging medicine today is making rapid progress.”

Actually, no progress all; no intervention has ever been shown to slow the biological process of aging.  Herbal supplements sold in health food stores are totally unregulated; many are dangerous. None, including anti-oxidants, has ever been proven effective in slowing aging.

“Advance Directives would have prevented the case of Terri Schiavo.”

Not at all. Her husband Michael would almost surely have been appointed proxy decision-maker, since a spouse is already presumed as such by the courts.  As for Living Wills, they have been shown to be mostly underutilized and ineffective according to most  serious empirical studies on the subject.  New approaches, such as “Physicians Orders on Life Sustaining Treatment” (POLST)  may change the record in the future, but classic approaches to advance directives have been disappointing.

“People are worse off when they move to a nursing home.”

Not true; many people actually thrive and blossom in the new social environment, as countless cases prove. See, for example, the recent memoir Making an Exit for an inspiring story on this point of a daughter who was astonished by her mother’s flowering after moving into a long-term care facility.  Any nursing home social worker can tell similar stories.

“Cosmetic surgery is a sign of ageism.”

Maybe in society at large but lots of people feel compelled to go for plastic surgery for defensive reasons: to get a face lift for dating or to avoid being discriminated against in the job market.  Hey, give ‘em break.  These folks are not ageist, they’re just trying to survive.

“Home care is cheaper than nursing homes.”

Would only that it were so.  But economic studies for decades have shown just the opposite, whenever all relevant costs, such as rent and unpaid caregiving, are taken fully into account.  Home care may be a good thing, but round-the-clock home care is definitely not cheaper than a nursing home.

“Respect for elders was higher in the past.”

A common myth, debunked by historian Peter Laslett thirty years ago; see his classic The World We Have Lost.  Maybe there’s a reason why the Bible contains the Fifth Commandment, “Honor thy Mother and Thy Father.”  It’s the only Commandment that carries a reward for following it.

“More people today are retiring to move to the Sunbelt.”

Some do and always have.  But 90% of retirees stay right where they’ve always lived and most of the remainder move only within their state of residence.  See Charles Longino’s work on “The Mobility Myth.”

“Only 4 percent of older people live in nursing homes.”

A half-truth propagated by well-intentioned advocates.  What is famously called the “4 percent fallacy” number applies only to a single point in time.  But on a life-span basis, 50%  or more of those who reach age 65 will spend time in a long-term care facility before they die.  One more example of the fallacy of cross-sectional versus longitudinal comparison.

“We need more regulation of nursing homes to prevent elder abuse.”

Actually, long-term care is already more highly regulated than any industry in America, except for nuclear power.  As for elder abuse, it’s more likely to happen—and to remain undetected— in a home care setting, with families as a likely perpetrator.  Citizens groups could certainly contribute by consumer scrutiny and advocacy of nursing homes.  But more regulations may not help since we’re not enforcing the ones we already have.

“Older Americans have declining rates of disability.”

Yes, Kenneth Manton proved this point—but only for the past.  Epidemiologists are now looking at accelerating rates of obesity or diabetes and there is good reason to doubt that declines will hold true in the future.  See Jay Olshansky’s article in JAMA (Spring, 2005), and more recent research warning about projected ill-health of Boomers in retirement. Obesity rates are an ominous sign of things to come.

“Religion is good for your health.”

It’s true that people who attend church tend to live longer, but no one knows why. Some studies suggest that volunteerism, the arts, lifelong learning or even having a pet will give the same result.  It could be that religion has little to do with it; maybe bowling would do the same (but not bowling alone).  Here, as so often, correlation is not causation.

“The U.S. spends a lot on health care, but it also gets results.”

Haven’t we heard that “We have the best health care system in the world!”  Yes, we’ve heard it but it isn’t true.  According to UN data, US life expectancy is lower than Costa Rica.  Recent studies suggest that, in state-by-state comparisons, higher spending is often associated with worse health outcomes, as suggested by the fact that up to 100,000 Americans die each year as a result of medical errors.

“Prevention and health promotion is the way to save money in health care.”

Sounds good, but it’s probably not true.  That’s what Prof. Louise Russell concluded more than two decades ago in her massive economic study, Is Prevention Better Than Cure?  The nonpartisan Congressional Budget Office in 2009 agreed, finding that health promotion measures would in fact not save money in healthcare reform.  Prevention might be a good idea, but it won’t necessarily save money.

“Geriatric medicine today is becoming more widely accepted.”

Quite the opposite.  There are more M.D.’s who are members of the American Academy of Anti-Aging Medicine—a bogus field– than there are Board-certified geriatricians.  The number of geriatricians is actually lower today than a decade ago and it continues to decline.

“Older people are more likely to be victims of crime.”

According to Justice Department data and the FBI, older people are less likely to be crime victims than any other age group in the population.  However, they’re more afraid of crime, perhaps because they watch more television than other age-groups. Older people should probably be more afraid of falling, since falls injure more seniors than crime does. See “Hidden Dangers: Falls Injure More Seniors Than Violent Crime”

(New America Media, Apr. 4, 2011).

“Stem cell research will help us find a cure for Alzheimer’s.”

Few neurologists believe this one.  We don’t even know the cause of Alzheimer’s and most favored hypotheses (e.g., plaques and tangles) have not been supported.  Stem cells may help for other conditions, but probably not Alzheimer’s.  However, California voters probably believed it would when they passed their Stem Cell Initiative.  Parkinson’s maybe; Alzheimer’s, very unlikely.

” Computer Exercises Can Prevent Alzheimer’s.”

The brain fitness industry is now big business, but the scientific basis for its claims are shaky.  In 2014 an international consensus group convened by Stanford University found no basis to believe the claims of the brain fitness industry.  As for Alzheimer’s, no one knows its cause, or cure.  The landmark “Nun Study” demonstrated that susceptibility to dementia can be predicted by measuring cognitive strength among teenagers.  Probably the best thing to do to promote brain health is physical exercise.

“Crossword Puzzles Will Prevent Cognitive Decline.”

You may enjoy doing crossword puzzles or engaging in other mental exercise, but it won’t prevent cognitive decline, including dementia.  The “use it or lose it” philosophy has much to recommend it and people do get better at anything with more practice, whether crossword puzzles or computer games.  But experts, like Timothy Salthouse, point out that the pattern here is strictly correlational and “Correlation is not causation.”  People who are drawn to mental exercise probably have greater cognitive reserves to start out with.

See
Aging: Concepts and Controversies 9th Edition

Harry (Rick) Moody, PhD.

Recently retired as Vice President and Director of Academic Affairs for AARP in Washington, DC. He is currently Visiting Professor at Tohoku University in Japan, and Distinguished Visiting Professor at Fielding Graduate University. Dr. Moody previously served as Executive Director of the Brookdale Center on Aging at Hunter College and Chairman of the Board of Elderhostel (now Road Scholar). Dr. Moody is the author of over 100 scholarly articles, as well as a number of books including: Abundance of Life: Human Development Policies for an Aging Society, Ethics in an Aging Society and Aging: Concepts and Controversies, a gerontology textbook now in its 7th edition. His most recent book, The Five Stages of the Soul, was published by Doubleday Anchor Books and has been translated into seven languages worldwide.

Dr. Moody has been instrumental in the development and update of the Certified Senior Advisor course and curriculum. He has worked with the Society of Certified Senior Advisors since its inception to create the CSA Textbook, Working with Seniors: Health, Financial and Social Issues and has been a long standing consultant and advocate for SCSA.

A graduate of Yale (1967) and a Ph.D. in philosophy from Columbia University (1973), Dr. Moody taught philosophy at Columbia, Hunter College, New York University, and the University of California at Santa Cruz. From 1999 to 2001 he served as National Program Director of the Robert Wood Johnson Foundation’s Faith in Action and, from 1992 to 1999, was Executive Director of the Brookdale Center at Hunter College. Before coming to Hunter, he served as Administrator of Continuing Education Programs for the Citicorp Foundation and later as Co-Director of the National Aging Policy Center of the National Council on Aging in Washington, DC.

Harry Moody is known nationally for his work in older adult education and recently stepped down as Chairman of the Board of Elderhostel. He has also been active in the field of biomedical ethics and holds appointment as an Adjunct Associate of the Hastings Center.

In recent years he has been an invited speaker at Yale, Stanford, Notre Dame, Brown, the University of Yokohama, and the Chattauqua Institution. He has frequently been interviewed on TV and radio about Elderhostel and personal growth in the second half of life.

Contact: hrmoody@yahoo.com

Thank you, Dr. Moody for your contribution to Aging in Place: The IDEA Series

-Patrick

 

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