The need to be in control

Do you want to grow old happily and healthily? Make sure you don’t lose control over your life and will be able to keep on making your own choices. In healthcare, focus is on taking care of people. In doing so, responsibility and control is taken away from them. For the elderly, this is a sure road to decline.

It won’t take long before more people of over 65 will populate the earth than children younger than five years old, according to the World Health Organisation. This is caused by the fact that people live far longer than they used to. Life expectancy has rissen explosively in the past decennia due to big steps forward in healthcare and thanks to better living conditions.

But to be able to live longer isn’t always a positive thing. The older we get the greater our chances of something going wrong in our bodies and of becoming ill. That’s why recently attention has shifted somewhat from lengthening life to raising the quality of the final years of life. It may be nice to reach 95 years of age, but if you are terribly demented the last five years of your life and don’t even know who you are there’s not much fun in it anymore.

The cost of long term care will rise considerably in the coming years. In 2010, long term care cost in the European Union took 1.8% of the gross domestic product (GDP). In 2060, it is expected to increase to up to 5%. Expenditure for long term care for elderly in the United States will more or less have doubled in 2020 compared to the year 2000.

Elderly people stay healthy far longer nowadays. (© Yuri Arcurs -

Elderly people stay healthy a lot longer nowadays. (© Yuri Arcurs –

This fact and many more negative facts appear in publications frequently. Emphasis is put on how expensive senior citizens are and on the huge problem of the sharp rise in the ageing population. In these messages, you hardly find mention of the fact that the cost of healthcare for the ageing population is increasing less than expected because elderly people stay healthy far longer nowadays.

The number of elderly who need long term care is growing, sure, but the costs of long term care are rising much more rapidly. This is mainly due to rising labour costs. Rather superfluous ‘care managers’ rake in ample incomes. But this fact isn’t mentioned either. The negative focus is on the difficult and costly elderly.

Negative image
The image of elderly in the western world has deteriorated ever more in the past years. Societies where young people honour the elderly because of their wisdom, still exist. But in many parts of the western world you have been written off if you’ve reached the age of fifty and you will be called a dinosaur, a mammoth, or a fossil. The constant negative publicity has produced its effect. It is easy to portray elderly as slow and difficult and make fun of them.

Among young people, it is in to complain about all the money they have to cough up for the care of all those older people. For the sake of convenience, they pass over the contribution all those elderly have made creating the present society in times when they were still the young people. In the same way, they prefer to forget that the young person who is sneering about elderly now, will be the older person of tomorrow.

It is true: elderly swallow far too many pills. Research in the Netherlands – a fairly conservative country where medicines are concerned – showed that half of people between 55 and 65 years of age take medication prescribed by the doctor. In people over 75, this has risen to 75%. Many people over 70 take five or more medicines every day. I am sure a lot of these medications are counterproductive or superfluous. One doctor doesn’t know what the other doctor is prescribing. Besides, lifestyle changes could take away the need for many of the medicines.

Especially since medicines sometimes are just bad for your health. People who use sleeping pills have a four times bigger chance to die than people who don’t use these pills, according to research in the United States. And their chance of getting cancer is increasing considerably as well.

Elderly take far too many pills. (© JanMiko -

Elderly take far too many pills. (© JanMiko –

Recently, the Dutch government even had to send out a request to all general practitioners in the country asking them to prescribe less pills for depression. Everybody who is a bit down and visits their doctor, is leaving the consulting room with a prescription for an antidepressant. No wonder the number of Dutch taking Prozac or comparable products is not far from reaching ten percent of the total population. A horrible idea since by now it has been proven without a doubt working out in the gym regularly has the same positive effect on a mild depression and may even be effective in more severe cases. And physical exercise doesn’t show the nasty side effects of antidepressants.

Taking over
In healthcare, the care part is being emphasised. It is all about taking care of other people. There’s no such thing as one’s own responsibility. The people who work in healthcare take over the responsibility for someone’s health, often with the best intentions of course. Even when people still are perfectly capable of making their own choices and taking their own decisions.

This is especially true for elderly people. In general, the elderly won’t be taken seriously in healthcare facilities. And when you treat someone like a child, that person will often start to act like a child. In psychology, this is called learned helplessness. If you lose control over your life you become apathetic, you feel desperate, and you will get depressed. After all, nobody is listening to what you would want. In spite of good intentions, the result is all wrong and decline will continu in a faster pace.

During an experiment in a nursing home in the US, residents were given more responsibility and control over their situation. This resulted in the residents becoming more alert, more active, happier and healthier than fellow residents who were being treated in the normal nursing home way. In the group who had control, significantly less people died than in the traditional group.

This shows it is very important to accept elderly as they are. Let them keep their independence and the control over their lives as long as possible, even in nursing and care homes. This works both ways. On the one hand, elderly people will continu to function better physically and mentally which of course is very pleasant for them. On the other hand, it will generate significant reductions in costs of long term care which is interesting for the complaining younger generations.


Hands © Tatyana Gladskih –

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