When it comes to ageing, we live in a cultural paradox: youth is increasingly fetishised and worshipped in our media, even as our life expectancy and our chances of living to a ripe old age rises. For Dr Shane O’Hanlon, the evidence of this phenomenon is all around us. “We’re constantly hearing adverts for anti-aging treatments and serums and things, as though aging is something you need to spend your life trying to avoid,” O’Hanlon, a consultant in geriatric medicine at Dublin’s St Vincent’s Hospital, says.
In his work O’Hanlon is frequently reminded of the realities of aging. But many of these are not in line with the negative perceptions our culture seems to reflect.
“As an intern, fresh from medical school, I was brought onto a geriatric medicine ward and it was absolutely amazing,” O’Hanlon says. “You go in with the idea that older people are in nursing homes or hospitals and that you can’t fix the problems that they have. It was a revelation to see that a lot of the things people come in with are fixable, that a lot of things that seem to be due to old age are actually due to disease.
“Old age isn’t just about being unhappy, getting diseases and going into a nursing home. It’s actually about blossoming. As you mature you get a new lease of life, some of the things that tied you down, like job and mortgage, aren’t a heavy weight anymore. A lot of people go into a period of new experiences; they go into fifth gear.”
Of course, 2020 has shone a light on the challenges of aging like no other year, and O’Hanlon has himself lost patients with Covid-19.
More societal paradoxes: younger generations changed their behaviour to protect vulnerable groups including the elderly, but more than half of all deaths with Covid-19 in Ireland have been in nursing homes. Sixty-four per cent of all deaths with Covid-19 have been in the over-80s, according to the CSO.
The elderly have been urged to cocoon for their safety, even while it’s recognised that the conditions of cocooning, such as isolation and mobility loss, themselves pose a huge risk.
“When cocooning was proposed as a blunt solution when the pandemic hit, myself and colleagues had a lot of concerns about the impacts,” O’Hanlon says. “Clinics switched to online or by phone and often we couldn’t see patients, but what became clear down the phone was that a lot of patients became really very isolated.
“There was a feeling people expressed of being a burden; a lot of people said, ‘I don’t want my grandkids to have to miss out on life, I want them out and about; you can leave me and I’ll be fine.’”
For O’Hanlon, the desire to celebrate positive aging, and the cherished hope that 2021 will see elderly people emerging from cocooning into a society ready to examine the challenges aging brings, has led to a project rooted in the arts rather than the sciences.
Emergence, an anthology compiled by O’Hanlon and his colleague Professor Paul Finucane, is a collection of poetry and prose on the theme of aging, chosen by geriatricians from all over the island of Ireland.
“There’s a vast collection of literature out there that can help us deal with the effects of Covid as a medical profession,” O’Hanlon says. “I was speaking to Paul, and we both found we were taking a lot of solace from literature so we decided to do something focused on positive aging.” O’Hanlon used to teach a module called Humanities in Medicine in the University of Limerick and took up writing poetry himself during lockdown. He believes the therapeutic benefits of the arts can and should transcend the patient/doctor divide, giving room for everyone – doctors, families, elderly people – to explore and express the events of 2020.
“As doctors, not enough of us write,” he says. “We’ve had difficult experiences this year and I’m encouraging all my colleagues to take up a pen and write about it. We’ve all felt a great weight this year and it hasn’t lifted yet. We all think about our patients that have died and the difficult circumstances of how people have died this year: dying in a room without their family in many circumstances.
“Some people having been in hospital for months without seeing their families and then having died after that. It’s been a really difficult year for family members and care-givers and that’s something that’s not recognised by society too.” From the ancient to the modern, and from an array of authors including Walt Whitman, Liam Ó Muirthile, George Eliot and even president Michael D Higgins, who donated a poem for inclusion, Emergence celebrates a diverse collection of viewpoints on age and aging.
The diversity of voices in Emergence is of course a reflection of the diversity of aging experiences, O’Hanlon points out. “As geriatricians, we say there’s no such thing as ‘The’ elderly person. It’s a very diverse group you’re talking about, a small word for a massive group of people.”
“We were delighted when the President offered us a poem for our anthology. He is a great supporter of rights for older people and carers. For me, this poem is a reminder that life is more about the journey than the destination. As a patient in her 90s advised me recently, ‘Live for today. You can’t do anything about yesterday and tomorrow might never come.’”
“After Seamus Heaney had a stroke, he published this poem in the Human Chain collection. It acknowledges help he received from family, friends and others involved in his care, whom Heaney felt were part of a human chain of helpers contributing to the miracle of his recovery.”
“This piece by Corkman Liam Ó Muirthile speaks to the influence of the lives and values of our parents and older generations on us as individuals. We must acknowledge the values and journey of those older than us to both appreciate our own journey and values and of those who come after. This must be particularly difficult for anyone who was bereaved this year.”
“This is a beautiful short story about Sinéad Gleeson’s aunt, and the tender relationship they shared over many years. It is interspersed with poignant observations about her aunt's journey into dementia and how it affected both their lives. Gleeson's writing is vital for health professionals as it gives a valuable insight into how our care can be truly patient-centred.”
“Waterford-based Lani O'Hanlon describes how her mother is a passionate woman but finds herself ‘rehearsing to be an old lady hobbling on arthritic feet.’ She abandons this persona when a lover from years before reappears, leading to the memorable final lines, ‘The invalid toilet seat vanished. She made my sister go shopping for new underwear.’”