As someone who writes a lot about the medical and social issues of aging, I am constantly faced with a problem: What am I supposed to call old people these days?
I know. Some of you are mad at me already, but it gets really tiresome to have to alternate among the hazy euphemisms that are supposed to stand in for the hated word “old.” Older, as in older adults or older people, seems to be the most acceptable term, but it offends the part of me that prefers words with some precision. Older than what? Everybody’s older than somebody. Senior citizen has fallen out of fashion, but “seniors” is OK in some quarters. (Definitely not all.) Some writers use “mature.” Do we really have to wait till we’re 65 to be mature? I rather like “elders,” but when does that start?
I am old enough to remember when it was OK to call people not much older than I am now (62) old. I get that ageism is a serious problem, especially if you feel good and want to — or have to — keep working after 65 in a setting that prizes youth. In some quarters, 30 is over the hill. So, I see why advocates dislike the word old and all its pejorative implications. We live in an era when both our recent presidential candidates were past traditional retirement age, when rock stars tour in their 70s, when Tony Bennett is beloved and charismatic at 90, when doctors, lawyers and professors routinely work well into what used to be old age. We need to rethink what old means.
But I personally think that some of my baby boomer peers — the oldest are now 71 — are ridiculously sensitive about words that imply they’ve lived a while. I also think it’s crazy to use the same word to describe me that you’d use for my frail, almost 88-year-old mother. I asked her how she thinks people should describe her and she said “ancient.” She wasn’t joking. I am clearly beyond middle-aged, from a math perspective, unless I got every possible good gene in my family. It would make my life as a writer who sometimes has to write about age groups easier if we had more than one word for the huge swath of the population over that arbitrary line: age 65.
I asked some experts for help with my terminology problem and found that they’ve been struggling with it too. For years.
“We need a word or words to describe this period, and we just don’t have them yet,” said Tracey Gendron, a gerontologist at Virginia Commonwealth University. She prefers not to categorize people, but says referring to older adults and the aging population is acceptable.
As she and others pointed out, one source of the problem is that we’re dealing with something new. “I think we’re in an unprecedented time, this longevity revolution,” she said.
Aging experts, she said, have tried calling people young old (65 to 74), old old (75-84) and oldest old (85+). Age-based categories at this stage of life often aren’t helpful, she said, because there is so much variability in how people age.
“The variation in aging is vast,” said Christine Arenson, a geriatrician at Thomas Jefferson University Hospital. Most geriatricians think of their target patient group as starting around 70, she said, but a 40-year-old who has had diabetes for 20 years might have much in common with older patients. “Most 65-year-olds in America are quite healthy still,” she said.
John Shoven, a Stanford University economics professor, said you could define the end of middle age as the point at which people have a one percent chance of dying in the next year. The age at which men and women have reached that milestone has climbed impressively since 1930.
Shoven looked at three groups: those who had a 1 percent, 2 percent and 4 percent chance of dying in the next year. Shoven thinks achieving 1 percent risk roughly corresponds with the end of what most of us think of as middle age. Shoven himself — he’s 70 — likes to think of middle age as the middle of our adult years, not the middle of our whole life. He thinks if your chances of dying are less than 1 in 100, you’re still young. He doesn’t think we’re old until our risk climbs to 4 percent. The striking thing is that the age at which people reached those milestones has climbed impressively. In 1930, an average man reached the 1 percent threshold at 44. Men now hit that mark around 60, women at 65. The age at which men have a 4 percent risk of dying in a year rose from 65 in 1930 to 76. Women now get there around 80.
That jibes with Jerry Johnson’s experience. He is chief of geriatric medicine at Penn Medicine and is himself 69. He says that many 70-year-olds have more in common medically with 50-year-olds than with 80-year-olds. “Between 70 and 80, a lot happens in terms of endurance and energy conservation and exposure to new diseases and co-morbidities,” he said. Between 80 and 85, many people begin to think and act differently.
He hasn’t found a word that pleases everybody. Some patients don’t want any word for the older age group. He thinks a label helps with “succinct communication” but added that “labeling is always flawed. There’s no way to get around it.”
There seems to be general agreement among experts that “elderly” and “senior citizen” and “aged” are on the outs. “Elders” has fans because it connotes respect, but, apparently, some critics think it’s too much like “elderly.”
The FrameWorks Institute, which helps advocates and scientists communicate more effectively about their social issues, recently studied attitudes and messages around aging and concluded this year that aging has a major image problem. People almost always see it as negative. The way we talk about aging is littered with “othering” language that sees older people as “them” and not “us.” As Allen Glicksman, 63, director of research and evaluation for Philadelphia Corporation for Aging, joked, “Old is 10 years older than you are.”