I want an improved health span, not life span

I probably won’t die of “old age.” More likely, I’ll die of some disease associated with growing older.

For too many of us, health span is reduced by disease, not old age. Many those diseases are preventable, or could be made less deadly through research, but little money is put into cures because old people get them. It’s ageism, pure and simple.

image: Die at your peak

We are living longer but not necessarily better. While the average lifespan of Canadians is 82 years, the health span is only 72 years. That means a lot of seniors live their last 10 years in poor health. In some cases, it’s a life not worth living.

By “health span,” I mean living healthy, independent and strong lives. Health span can be measured of the quality of life that includes: Mind & cognition (processing speed, short term memory); Body (maintenance of muscle mass, functional movement, freedom from pain).

Andrew Steele, biologist and the author of Ageless: The new science of getting older without getting old, told CBC Radio’s Spark:

“Until now, we’ve been treating medicine in this very unsystematic way. So what we could do by understanding these hallmarks is to potentially come up with treatments to intervene in them directly. And that means preventative treatments; treatments can go in earlier and stop people getting ill in the first place (April 29, 2022).”

Researchers who want to improve the quality of life by reducing the diseases of aging are often met with pushback. Critics say that dying of disease is natural and keeping seniors healthy as they age will result in them living longer. The illogical thinking doesn’t escape Andrew Steele:

“Let’s say I had written a book on cancer research and how I think we’re going to cure leukemia in the next 20 years. Nobody would write me an email saying, ‘Hi, Andrew, you know, this cancer research, aren’t you really worried about all these extra people who are going to be surviving cancer and cluttering up the planet’?”

If we want to improve the health of children by reducing disease, why wouldn’t we want to improve the health of everyone?

The answer is ageism. Another guest on the radio show has done research on how positive attitudes on aging can actually improve the health of seniors.

Becca Levy, a psychologist and epidemiologist at Yale University, found that ageism results in more than hurt feelings or discriminatory behavior. It affects physical and cognitive health and well-being in measurable ways and can take years off one’s health span.

So rather than treating aging as a single, inevitable change in our bodies, it’s more like a series of processes brought about by disease. If those processes can be prevented, or even reversed, then the health span of people could dramatically increase, along with being able to live considerably longer.

Life span has increased by improving health span. Better public health measures such as clean water, antibiotics, and vaccines mean we live longer and healthier.

But diseases that develop with aging remain a barrier to improved health span.

To maximize longevity, we need to delay the onset of the three largest killers of humans: cerebrovascular and cardiovascular, cancer, and neurodegenerative. These three causes of death will kill 75% of us.

For me, the ideal would be a health span equal to my life span.

Ageism contributes to poor care in long-term facilities

The COVID-19 pandemic has made it clear the disparity of care for residents in long-term care compared to that in hospitals. An indicator of that disparity is the fact that 80 per cent of COVID-19 deaths have been in long-term care homes so far.

image: mybetternursinghome.com

I’m avoiding the label of “the elderly” for these residents for reasons I’ll explain later.

The reduced long-term care is not for lack of dedication by workers but for political reasons. Barb Nederpel, President of Hospital Employees’ Union, told me:

“The pandemic has brought the problems in how we treat seniors and those who care for them into sharp focus. Twenty years ago, workers in long-term care earned the same wages and benefits regardless of their employer. Through privatization and contracting out, the BC Liberals forced thousands of these workers into lower paid jobs. Many took second or third jobs to make ends meet. To keep seniors and workers safe during the pandemic, public health officials are limiting workers to single sites and we’ve secured agreement from government to increase those wages back to the industry standard.”

For ideological motives, the BC Liberals argued that private care facilities could operate more efficiently. Privatization created a multi-tiered system where those who could pay more got better treatment.

The trouble with this model is that in this market where there is a labour shortage, workers will go to where they are paid more -leaving places that pay less short-staffed. The residents who call those places home suffer.

Ageism is at the heart of deaths in long-term care homes. The reduction in worker wages reflects the degree that we care about the residents of those facilities. The death of “the elderly” is seen as no big deal. People get old and die. The meme “Boomer Remover” that has been circulating reflects the dark humour of ageism.

To dismiss residents as “the elderly” robs them of their dignity as fathers and mothers, grandfathers and grandmothers, brothers and sisters. Let’s call them persons; persons who love and are loved, who laugh and cry, and make a difference in the world. Age should be just one aspect of anyone’s life, not a defining attribute.

Hospitals are relatively well-prepared for the pandemic in contrast to long-term care homes says Rona Ambrose, former Conservative minister of health and minister during the Ebola crisis in 2014:

“Our hospitals are ready. Doctors and nurses have been properly trained and are waiting to be called in for COVID-19 duty. Personal protective equipment is available, and, if not, it’s on its way.

“Meanwhile, caregivers in many long-term care homes are underpaid, lack training and don’t have PPE. How could this have happened when we knew from day one that long-term care homes would be centres of COVID-19 infection? How could we have failed our care-home residents so badly? There are hundreds of these facilities dealing with outbreaks across Canada (Globe and Mail, April 13, 2020).”

Post-pandemic, we will need to reset our values so that workers’ wages coincide with the value that we place on them. It’s too bad that it takes a pandemic for that disconnect to sink in. There has been an outpouring of appreciation for workers who have put their lives on the line to serve us. Let’s back up that appreciation for long-term care workers with a living wage.