“Don’t listen to people like Tom Perls, George Vaillant, Betty Friedan, William Shakespeare, and Simone de Beauvoir. They were all between 40 and 70 when they wrote about aging.”

So says George Vaillant, one of the people he warns about. Instead, he uses a favorite simile to suggest a different approach: “Old age is like a minefield; if you see footprints leading to the other side, step in them.”

In his experience, those footprints will belong to people 85 and over, not to young pedants. “Don’t pay attention to know-it-all professors who try to teach you golf or to fly a plane without ever having been up in it,” he advises.

Dr. Vaillant freely admits having been one of those know-it-alls himself, but his studies of older people have led him to learn humility. A psychiatrist focused on human research, he has a leading role in the famous Harvard University Study of Adult Development, a project that has lasted 50 years.

In a recent talk at the Cambridge for Adult Education, this 68-year-old researcher shared with an audience of mostly older people, from many cities and towns around Boston, some of what he has learned about growing into old age.

Among the possible ways of thinking about the subject, he finds human development by far the most interesting. The only reason why Americans tend to think negatively about later life, he says, is that disease becomes more frequent then.

The same thing happens with automobiles: even a hundred-year-old Rolls Royce will have a bad drive train. “You just accept the fact that the last year of life, whether you die at 7 or 107, is going to be kind of a bummer,” he says. “You pay attention to the other 106.”

The study with which he has been involved has followed three groups of people during almost their entire lives, from teenage through old age. This longest study of aging in the world has taken three separate groups of people – – a total of 824 individuals – – and interviewed them intensively. Building on this work, Vaillant in 2002 published the book “Aging Well.”

In the Study’s web site Vaillant describes the individuals followed by the researchers. The first group is made up of 268 socially advantaged Harvard College grads born around 1920. The second contains 456 socially disadvantaged men from Boston’s “Inner City.” Finally, the third comprises 90 socially middle-class, intellectually talented women from California’s Bay area, born about 1910.

On that same web site, Vaillant lists, in his own personal and characteristic language (including parentheses), some of what he considers the most significant findings thus far:

• It is not the bad things that happen to us that doom us; it is the good people who happen to us at any age that facilitate enjoyable old age;
• Healing relationships are facilitated by a capacity for gratitude, for forgiveness, and for taking people inside. (By this metaphor I mean becoming eternally enriched by loving a particular person.)
• A good marriage at age 50 predicted positive aging at 80. But, surprisingly, low cholesterol levels at age 50 did not.
• Alcohol abuse – – unrelated to unhappy childhood – – consistently predicted unsuccessful aging, in part because alcoholism damaged future social supports.
• Learning to play and create after retirement and learning to gain younger friends as we lose older ones add more to life’s enjoyment than retirement income.
• Objective good physical health was less important to successful aging than subjective good health. By this I mean it is all right to be ill as long as you do not feel sick.

Young people, Vaillant believes, have to be self-centered. “You will never have a self to give away,” he says, “if you don’t start out life by being selfish.” A woman who studied biographies and autobiographies calculated that, when subjects were 25, a whopping 92 percent of their wishes were directed toward the self. But by the time they got to be 60, only 29 percent of their wishes were self oriented.

Adult development occurs very slowly and there is no surefire way of speeding it up. But, when it comes, this inner growth moves us toward empathy for other people and altruism. What Vaillant calls the “emotional brain” gets increasingly well connected to the forebrain and we learn to control our passions.

This student of human change considers retirement as one of the great gifts of modern times. In 1900, only one percent of Harvard grads were retired; now 15 percent are. “We have the opportunity, not to live forever, but to retire and do something different.” Vaillant considers longevity as offering the chance to experiment and to use play to discover  ourselves in new ways.

About the awful things that happen in old age, he reminds listeners that they happen in adolescence too. He quotes the Russian writer Solzhenitsyn: “Aging is in no sense a punishment from on high but brings its own blessing and a warmth of color all its own.”

Richard Griffin

It was appropriate for Ruth Abrams to open her latest art exhibit close to Memorial Day. This 79-year-old Brookline resident has made memory the central focus of this display of collages, assemblages, and video. The 20 different pieces of her art recall some of the people and events most important in her life.

One of the collages memorializes Phil Ross, a fellow college student at Ohio University in Athens, who became her boyfriend. After he had given her his fraternity pin, he went off to the Army and was killed in the Battle of the Bulge.

Ruth remembers vividly how she learned of his death. Her roommate met her after class and walked back to their dormitory. There her sorority housemates gathered around her and broke the awful news to her, what she calls “hollow, blank history.”

Soon after, she went off by train to Wilkes-Barre to visit Phil’s family whom she had never met before. They were in mourning and she joined them in their Jewish ritual. One of her preoccupations was wondering whether to give back Phil’s fraternity pin.

In a collage entitled “Trains and Memories,” Ruth uses photos of Phil in uniform, recently sent her by his half brother. In the words written on the display she poignantly asks: “Was it 58 years ago? Why do I still have tears?”

Another collage allows the artist to express her philosophy of later life. It bears the title “Lobster, Take a Risk,” and quotes author Eda Le Shan who sees in the lobster–which needs to shed its shell in order to grow–a model for growth through the courage to change.

“Aging can be a time of change,” says Ruth Abrams, “and a time for growing. The secret of successful aging is to go on to explore life, learning, shedding the old for new challenges.”

Asked if this indeed expresses her philosophy, Ruth agrees. Disarmingly, however, she laughs and lightheartedly refers to herself as “this crazy lady.”

The exhibit “When I Grow Up” features a box enclosing the doll Ruth received when she was six years old. Her family was poor; the doll was given her by a family friend. On the outside of the box, she lists all the things she wanted then. Among them was a bicycle, something she finally acquired at 14. However, she parked the bike on her back porch and it was stolen. Never again would she have another one.

I enjoyed seeing again “Father’s ‘Golden Hands’,” a small display of some tools that Ruth’s father used for various repairs. The term is a tradition Jewish expression for suggesting a person skilled with his hands. Ruth’s father, who owned a gas station, would respond to neighbors hinting at their need to have something fixed. This he would do much to the disapproval of his wife.

A more complicated display  requires lifting a veil to discover words used as stereotypes of old people. “Old” suggests “lonely” or “self-centered,” for example. The artist here delivers the message that old things as well as people are valuable and should not be tossed aside.

Commenting on the value she finds in creating the parts that go into a show like this one, Ruth says: “There’s so much learning that goes on when you’re working physically with a piece.”

She feels the creativity in herself but also complains about some loss. “the trouble is I’m also forgetting,” she regrets. However, she does see this process as a kind of balance.

When she turns toward a collage that centers on outrageous older women, she refuses to include herself in this number. “I’m not outrageous; I’m pretty conservative,” she claims. Of course, she is correct literally in so far as the material in her show comes from what she has conserved or saved, rather than thrown away. Whether this artist is conservative in her world view, however, seems much less certain.

Before this show ends, Ruth plans to reach out to the multicultural community of area residents. She has prepared voice-overs of her “Fabric of Life” video in four languages – – English, Chinese, Japanese, and Russian (and soon, Spanish) for use with the various linguistic groups.

She will invite them to come to the exhibit and give their reactions to her work. Presumably, these reactions will show differences in mentality that may reveal a variety of responses to aging. Ruth hopes to interest gerontologists in analyzing these differences.

The show is on display through June 18th at Newbury College. The college gallery is located at 150 Fisher Avenue, Brookline. My reason for taking notice of this event is the inspiration I derive from seeing one of my age peers display to the public her continued creativity. Ruth Abrams offers just one more proof of the spirit shown by so many people as they sift their later years for value.

Richard Griffin

Most Americans over 50, in need of help because of their disabilities, would prefer to receive money and manage their home care workers rather than to receive services from an agency that keeps control over them.  This is one of the findings from a new study commissioned by AARP on people in the second half of life.

Entitled “Beyond 50.03: A Report to the Nation on Independent Living and Disability,” this new research provides detailed information about those with disabilities and the help they receive.

Not surprisingly, their biggest fear is the loss of independence and mobility. Another non-surprise is the desire of most to continue living in their own homes. One of their largest problems, this research reveals, is the extent of their unmet needs.

Among these latter is the need for help with such routine activities as bathing, cooking, and shopping. The chief obstacle to getting more help is cost. Similarly, many feel the need for  physical changes in their house to make it easier to cope with their disabilities, but they cannot afford to install such improvements as grab bars, ramps, and wider doors.

Those with disabilities give rather low marks to the publoic accommodations in their home communities. More than half assign poor ratings to the accessibility and reliability of public transportation. Only 10 percent of people with severe disabilities use special transportation services.

Again, it comes as no surprise that most care is given by family members. What does upset expectation is the extent of this care: 88 percent of help regularly received at home is given by these family members.

An indication of the overall emphasis in this report comes in the authors’ adoption of a new expression: they do not speak of “long-term care” but rather “long-term support.” Though the difference may appear subtle, Robert Hudson, professor at Boston University and a widely respected gerontologist, calls it a “giant change.”

Its effect is to get away from language that suggests dependence and move toward words that support the ideal of consumer control over services. People over 50 who have disabilities want more say over the way they get help and the word “support” rather than “care’ is supposed to convey a new emphasis on autonomy.

At the risk of appearing a Luddite or other person opposed to innovation, let me here register some misgivings about abandoning the word “care.” Yes, it can be patronizing at times, but I feel attached to a word and concept that often brings out the best in people.  Is there not something fastidious about substituting “support” for “care?” Has political correctness made yet another incursion into the land of service?

In this instance, as before, AARP shows itself a master of euphemism. This is the organization that has eliminated the word “retired” from its name. If anyone were to apply the word “old” to any of its members, the organization might suffer a collective heart attack.

I also remain suspicious of the effort to downplay ideas suggested by the word “dependence.” Of course, I am in favor of retaining a measure of independence for as long as possible for both myself and others. But almost everyone eventually has to rely on others for help with the ordinary activities of daily living.

As to controlling the services, this also can be a false ideal. Many of us older people, by reason of our disabilities, lack of know-how, or other reasons could never manage employees on our own. In practice, it would more often be our adult sons and daughters who would have to take charge of paying our caregivers and responding to the inevitable problems employees have. That would mean becoming dependent on our adult children, not something bad but something natural and unavoidable in the long run.

However, despite these reservations, I do welcome the AARP report, the third in a series offering new information about Americans over 50. And I support the development of more technology to assist those of us who have disabilities. I am cheered to discover that two-thirds of people in mid-life and beyond who have  disabilities are accustomed to using computers. This is an encouraging sign for the future.

As AARP points out, serious problems cry out for action. The majority surveyed here are convinced that better health insurance would improve their quality of life. This holds true of those over age 65 who have Medicare protection: the fact that Medicare does not cover the cost of prescription drugs would by itself suggest as much.

It is also increasingly difficult to find skilled and reliable people to provide services for people at home. Nursing assistants and home health aides are in short supply and turnover is a constant problem.

Finally, many older Americans with disabilities cannot afford the services they need. Even those with annual incomes between $35, 000 and $50,000 worry about paying for long-term supportive services. And those who must beggar themselves to qualify for Medicaid have a truly unenviable lot.

Richard Griffin

“My sons and daughters had a meeting without me and decided they wanted me to stop driving, but they’re making a big deal out of nothing. I’m very comfortable on the road. I’ve driven longer than they’ve been alive.”

This quotation from a person recently diagnosed with dementia appears in “At the Crossroads,” an excellent  guide developed by The Hartford Financial Services Group, the MIT Age Lab, and Connecticut Community Care. Already, 150,000 copies have been distributed free of charge; I recommend it to elders and their families who may face difficult decisions about driving.

At a daylong conference last week hosted by MIT, researchers reported their findings on the complicated and often agonizing driving decisions confronting older Americans and their families.

Joseph Coughlin, director of the Age Lab, summarized some of what has been discovered thus far about the habits of drivers over age 50. In his words, “the data sheds new light on how older people define the driving decision; choose to self-regulate their driving behavior; weigh personal risk and safety as a function of health and age; and, what role families, physicians and other unwilling participants have on the driving decision.”

The quotation at the top of this column shows there are wrong ways of dealing with the situation. For the adult children of the gentleman in question to have made a unilateral decision to stop him from driving was clearly wrongheaded and a surefire method for getting their father’s back up.

No self-respecting parent could be expected to accept a prefabricated plan like that one without feeling threatened and even outraged. There may be an excellent case for their father to give up driving, but his adult children clearly do not know how to make it.

Taking away the keys from the elder driver, selling the car, taking away his or her license, or disabling the car are also ineffective. More than that, of course, these actions violate the rights of the person and ignore his need for sympathetic understanding and treatment.

We may also infer from the father’s words quoted above that he may be fooling himself. Yes, he may possibly feel comfortable on the road (though one can doubt it) but this feeling does not mean that he remains a competent driver.

The clear fact of his having driven for more years than his children have been alive is, of course, irrelevant. It helps the man to rationalize his determination to stay on the road but will not reassure anyone else that he should continue driving.

Two presenters at the MIT conference recommended advance planning before a decision is made to stop driving. Early discussion that includes the person with dementia might reduce hard feelings. However, they admitted that such an approach has its limitations and may not work.

Another help can be to involve an authority outside the family. A physician can be such a person, but that role can be tricky. Dr. Michael Cantor, a Veterans Administration geriatrician, finds it a difficult balance to respect the rights of patients to make their own decisions and protect their confidentiality while, at the same time, feeling responsible to the public for the patient’s inability to drive safely.

One of the central findings of the researchers was to discover how the driving decision is more complicated than simply continuing to drive or giving up driving altogether. Rather, something between the two, namely self-regulation, is the choice of many people over 50. And the factor that influences people most to self-regulate is their health status. Those in poor health are much more likely to modify their driving habits, for example, by not venturing forth at night or by giving up driving in bad weather.

Conference keynoters emphasized the psychological as well as the practical meaning of operating an automobile. Maureen Mohyde of The Hartford went so far as to call driving “the key to life” and to assert “driving is everything.”

Her terminology strikes me as bordering on the absurd, even though I recognize the driving mystique that maintains its hold on so many Americans. Yes, driving enhances life by putting us in touch with other people and the great outdoors, for instance. But, in itself, it is only a means to an end and not always indispensable.

I also recognize that for many elders a car makes the difference between access to favorite activities and isolation from them. Those who live in places where public transportation does not reach may be cut off from what has been important to them. Happily, however, there are numerous elders – – including many of my friends and neighbors – – who lead active lives without depending on an automobile of their own.

Back to the brochure I recommended. It can be ordered free of charge in either English or Spanish at http:www.thehartford.com/alzheimers or by writing The Hartford, Dementia and Driving Booklet, 200 Executive Blvd., Southington, CT 06489.

Richard Griffin