HJAR Mar/Apr 2020

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2020 35 As we think about aging, many of us have financial investments or savings that we count on for retirement. We regularly check to see how our funds are doing. But how many of us are thinking about what quality of life we will have in our retirement years?We need to consider whether our ac- tions today will help minimize the portion of our lives that we will live with morbid- ity, and optimize the quality of life we will enjoy before meeting our mortality. There are things we should be paying attention to every day. I will divide them into four cat- egories: behaviors, social outlets, emotional health, and health care. BEHAVIORS If we have behaviors that are likely to erode our physical stamina or health, we need to address them. The most common and damaging are tobacco use, unhealthy diet, lack of exercise, and substance abuse. We should pay attention to how physi- cally active we are. The human body is an incredibly capable piece of machinery that, if taken care of and exercised, can last for a long lifetime. But lack of physical activity, frequently combined with excessive weight gain, can reduce that machinery’s ability to function properly. Why do we gain excess weight? The hu- man body evolved through periods of time when food was often scarce, and physical activity was a necessary part of life. We now live in a time when physical activity is rarely essential for short-term survival, and high-calorie intake is not only readily available, but also pushed from every di- rection (think supersized drinks). Without Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement actively considering what types of food we consume, and how physically active we are every day, our machinery will become less effective, and disability will set in earlier in the form of obesity, hypertension, joint problems, mobility and balance issues, and often, falls and injury-related disability that could have been avoided. SOCIAL OUTLETS Many older adults are isolated. Their spouses have died and they have not main- tained circles of friends. Multiple studies have shown that having a social network has a beneficial effect on an older person’s health and length of life. We need to make sure that before we enter our later years, we have a network of friends with whomwe enjoy in- teracting and engaging in shared activities. That means turning off the television, getting up from the couch, and getting out ― whether it is to church, a bowling league, a bridge club, or some other social outlet. EMOTIONAL HEALTH Hobbies and other activities we enjoy can help us get value from life in our later years. Solving puzzles is a good way to keep the brain healthy and stimulated. Studies have shown that caring for a pet can have a posi- tive impact on emotional health. There are countless other examples. But if you think you or a family member may have clinical depression, seek professional help. Depres- sion is common among older people, but is not a normal part of the aging process. HEALTH CARE It is important to establish a relationship with a healthcare provider who can be trust- ed for honest assessments that include not only possibilities for medical treatment, but also the likelihood of positive or negative outcomes. When health conditions arise, we want them diagnosed as early as pos- sible, and we want to have all the options in front of us so we can make informed deci- sions, supported by our families and social networks. We are all going to die, but I think the goal for ourselves, and for our parents or other loved ones, is death with dignity, oc- curring when all options for maintaining an acceptable quality of life have been ex- hausted. Unfortunately, our medical care system is not good at recognizing when it is time to stop. According to a recent study published in the New England Journal of Medicine, for the first time since the early 1900s, more Americans are dying at home than in hospitals. I believe this reflects a recognition that at some point, when the quality of life we want is no longer achievable, dying peacefully at home, surrounded by friends and family, is preferable to dying in an intensive care unit or nursing facility. I think of the ideal as this: Live well, die fast. We want to extract as much as we can from life, and when the time comes, we want to meet our mortality as quickly and peace- fully as possible. That requires intentionally investing every day in our physical health, our social network, and our emotional health, as well as checking in periodically with our healthcare provider. Money is not the most important thing we need to invest for our future. n