By Dr. Adrienne Green
As CEO of the San Francisco Campus for Jewish Living serving over 500 patients and residents on any given day, I take pride in treating older adults with the high-quality care, dignity and respect they deserve.
As a physician, I ground my approach in compassion, data and evidence-based practices. As a Jew, I hold deeply to the values and tradition of honoring our elders. These perspectives inform my work — and fuel my frustration with ageist attitudes that persist in our society, even among older adults.
My 85-year-old father struck a nerve recently when he asked, referring to assisted living, “Where do the normal people live?” His friend who lives in a senior community chimed in, “We don’t eat in the dining room. It’s for people with walkers and wheelchairs.”
Their comments reflect a stigma I encounter too often — fear and judgment of aging itself. My first response was to take a big breath and let the comments pass. But when it came up again, I felt compelled to respond: “Everyone in our community is perfectly normal, as are the people eating in your dining room or needing a walker or experiencing memory loss.”
In the back of my mind, I couldn’t help but think how deeply rooted and offensive this ageist mindset is and wondered, “What will you think when you find yourself needing a walker one day?”
“We need to shift the narrative away from seeing someone as ‘broken’ if they use a walker or hearing aids or have trouble remembering their medications.“
Dr. Adrienne Green, President and CEO
I don’t mean to criticize my wonderful father or his friend, as their sentiments echo those of many older adults. Perhaps this is driven by the fact that adults over 40 feel much younger than their actual age. Our society’s reluctance to fully embrace aging often leads to resistance toward therapeutic interventions, like mobility and hearing aids. This hesitation also delays critical conversations and timely visits to explore senior living communities. If we are to truly honor and respect our elders, we need to shift our thinking.
Understanding some facts about aging helps set the stage. Let’s start with current statistics circulating among geriatric specialists about mobility:
• 80% of people over the age of 85 struggle with mobility, and 40% in this age group use a mobility aid such as a cane, walker or wheelchair.
• 50% of those over 80 experience falls each year.
• There are tactics to improve mobility and prevent falls, such as strength and balance training or tai chi, which has been shown to reduce fall risk by 43%.
It is well-documented that hearing loss can lead to social isolation, depression and cognitive decline:
• Hearing loss affects 40% of those in their 70s — and 80% of people over 85.
• Despite evidence that hearing aids have been shown to improve social and cognitive outcomes, 67% to 86% of those who could benefit aren’t using them.
Memory loss, mild cognitive impairment (MCI) and dementia exist along a spectrum:
• Memory loss is part of the natural progression of aging. MCI occurs in 10% to 15% of those between ages 70 and 79 — and 25% of those between 80 and 84.
• 25% to 45% of people who are 85 and older have dementia.
• Exercise is not only important for balance but also reduces the risk of cognitive decline.
• There are medications and non-pharmacologic therapies (music, for example) to manage symptoms of dementia.
There are other examples of changes that accompany normal aging, but these three — mobility, hearing and cognitive function ― are core and provide much fodder for the stigmas that we observe.
We need to shift the narrative away from seeing someone as “broken” if they use a walker or hearing aids or have trouble remembering their medications. We should promote evidence-based interventions, such as assisted-listening devices, that mitigate the negative impact of hearing loss. Likewise, we should champion advanced medications and care techniques shown to improve function and quality of life for those with MCI and dementia.
Similarly, I hope that senior living facilities, where these interventions are ingrained, can be seen as places where people can thrive with purpose and joy, thanks to high-quality health care, exceptional caregiving and enriching programs.
The realities of aging are not deficiencies. They are opportunities to leverage tools and programs that enhance independence and connection. (There is also a great opportunity for innovation here.) Research shows that senior living communities improve quality of life, health outcomes and daily functioning. I see this every day.
Older adults, sporting both walkers and hearing aids, are connecting over meals, spending time with family, playing cards, studying Torah, creating amazing works of art and engaging in fitness and performing arts activities. They rejoice together and support each other through difficult times. These moments of celebration and collective care reflect our Jewish values of community, compassion and excellence. That isn’t something to fear, but rather to admire and strive for.
I read about a Hasidic master who said, “Jews are forbidden to feel old.” My dad would certainly subscribe to this wisdom. Let’s create a new paradigm where older adults in our community are not defined by age but by their incredible insight. Let’s ensure they feel valued, respected and acknowledged for what they bring to our lives because, as we all know, aging is a gift that not everyone is granted.
Please email us at lwoide@sfcjl.org to receive the recorded version of Dr. Green’s Normalizing Aging event.