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Irish Doctor’s Wisdom on the Art of Aging

Photo: In “Mr. Turner” actor Timothy Spall plays the aging British artist J.M.W. Turner, whose late style, while ridiculed by critics, would inspire Claude Monet. Turner left funds to  found a home for impoverished artists. (Sony Pictures Classics)

WASHINGTON, D.C.–Late Matisse. Late Turner. [] Late Rembrandt.
Their artworks were the themes of the big exhibitions in London galleries this past year. So pointed out Dublin geriatrician Desmond O’Neill, MD, one of the world’s leading researchers in his field.

He recently became the first European honored by the Gerontological Society of America (GSA) with its Samuel T. Freeman Award, given to a “prominent physician in the field of aging–both in research and practice.”

O’Neill is the first European recipient in the award’s 37-year history. The GSA cited, in particular, his more than 300 peer-reviewed scientific papers and chapters.

“Arts people are smart and they can see the trends,” he said. “There’s this schlocky phrase that ‘artists are the storm troopers of consciousness.’”

Seismic Shift in Attitudes on Aging

And in this instance, he believes, they’ve detected the seismic shift in attitudes in his profession about aging and increasingly in society at large.

“The narrative has been a simplistic one of loss and decline,” said O’Neill, professor of Medical Gerontology at Trinity College and consultant physician in geriatric and stroke medicine at the Tallaght Hospital campus. “There’s a huge swing back against that.”

He continued, “We’ve got to recognize growth in later life. And also not only recognize growth, but also the extraordinary abilities of people in later life to cope with the existential problems they have.”

O’Neill noted, “Older drivers have the highest levels of illnesses that might affect driving, yet they’re the safest group of drivers on the road. So, their adaptive abilities, their mastery of how they engage with their environment, is brilliant.”

There is now a fascinating body of literature on the older worker, according to the Dublin physician.
“If you have come down in the Hudson and survive, do you want an almost 60-year-old with all his life experience or do you want a 25-year-old?” O’Neill said, alluding to Chesley “Sully” Sullenberger’s successful navigation of Flight 1549 on Jan. 15, 2009.

O’Neill, a frequent writer for the Irish Times and British Medical Journal, reported that research has shown older workers take less time off and are more productive than younger colleagues in many jobs.

“Older roofers, for example, seem to spend a little bit more time per tile, but actually get the job done faster because they know the shape of it,” he said.

Older hotel receptionists, he said, “take a bit long longer on the phone call, but they get more second reservations.”

Creating ‘Age-Attuned’ Societies

Still, said O’Neill, author of Ageing and Caring, he doesn’t believe the “Pollyannaish” approach suggested in popular books like the Younger Next Year [] book series is helpful.

“People used to talk about ‘successful aging.’ It means that if you didn’t reach the criteria of successful aging, you’d failed,” said O’Neill.

Henri Matisse did not successfully age in a physical sense. After decades painting standing up, he was forced to adjust his style radically sitting down. “Through his disability, he grew and changed and produced something new,” O’Neill said.

“So what we’re actually talking about is ‘optimal aging’ that understands the existential hits that we’re going to take in terms of disability and creates a system that frees you from unnecessary constriction by that disability,” O’Neill said.

That means building more “age-attuned” and livable societies–for us all. A key issue in the U.S., he emphasized, is the relative scarcity of geriatric health professionals like him.

That this country has so few geriatricians here compared to other industrialized nations is a serious flaw in the system, he believes.

O’Neill used the hypothetical of example of an emergency room with two options for the older patient: behind Door A is a geriatrician and behind Door B, the general medical service.

“You reduce the chances of death or going into a nursing home by 25 percent by going into the geriatrician,” O’Neill said, adding, It can happen and it can change [in the U.S.]. The Canadians have changed direction.”

International Progress

Australia, with a public-private health care system similar to the U.S., pays physicians well for the hour needed for a comprehensive geriatric assessment–with a higher fee for evaluations done by telemedicine, O’Neill said.

In the U.S. however, pay and conditions for geriatricians simply don’t match up with the specialist in more high-tech areas.

Asked where Ireland ranks internationally league table on care for seniors, O’Neill replied: “Somewhere in the middle, possibly slightly above the middle. The Nordic countries are at the top.”
In Ireland, O’Neill said, the position of geriatrics has improved since the early 1990s.

“You had to be tough. There was much greater amount of ageism in the system.” What’s more, he remembered, “You had to be bloody-minded and ignore it. Now it’s really changed. It’s respected.”

But progress is qualified. Although today all the public hospitals in Ireland have geriatricians, none of the private hospitals has.

Overall, though, O’Neill said of official attitudes, “The will is there. There’s no doubt. We now have geriatricians in acute medical units. There’s a national clinical program for older people. Only Austria, Belgium and Ireland have done this.”

However, O’Neill said his country’s National Aging Strategy “a bit bland and lacks teeth I must say, though we’ve a good minister for older people in Kathleen Lynch from Cork. She is the best one there has been yet. She really has her heart in the right place.”

He credited the U.S.-based Atlantic Philanthropies for supporting geriatric and gerontological projects in every university.

Inspired by Physician Parents

O’Neill, attributes his productivity to his parents, both physicians. He watched them deal with dementia in his grandparents with a mix of “care and distress.”

Considering himself fortunate to have positive memories of his four grandparents, O’Neill is glad also that his own children have had time with their grandmothers.

An early career influence was his year in Marseilles with the nonprofit Les petit frères des Pauvres (the Little Brothers of the Poor), which aims to relieve isolation and loneliness among seniors.

“Their motto was ‘Flowers Before Bread,’” O’Neill said. “The state will take care of the basics, but who makes you feel special, remembers your birthday, takes you on holidays? I remember thinking: ‘That’s trimmings on the cake,’” he said. “But I began to realize that’s what it’s about.”

At the GSA conference, O’Neill said his research has led him to advise gerontology professionals, “Instead of going in with a music group to a bunch of people in a nursing home or doing painting activities with them, find out what it is they feel they no longer have that they used to have and how can we help with it.”

Seniors can suffer from not just esthetic deprivation but also esthetic injury, he said, “because often in a nursing-home or hospital environment there’s a lot of noise and horrible things on the walls.”
In his view, a “very vibrant arts program” can lift the morale of patients and staff.

O’Neill, who directs the National Centre for Arts and Health at Dublin’s Tallaght Hospital, recalled, “We had a composer in residence in our stroke unit and our Parkinson’s unit.”

Similar programs in the U.S. have been documented by the National Center for Creative Aging.

Peter McDermott wrote this article for The Irish Echo with support from the Journalists in Aging Fellows Program, a project of the Gerontological Society of America and New America Media, sponsored by AARP.

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