People of 80 or 90 plus who are eking out their lives in nursing homes with very poor quality of life are, according to New York geriatrician Mark Lachs, an indictment of society’s priorities. ‘I would argue,’ he writes, ‘that the “life extension” these people have experienced – a good deal of it the result of technology – is as big a failure of medicine as any 40 year-old dying of breast cancer or 50 year-old perishing of a heart attack.’
Dr Lachs is the author of Treat Me Not My Age which, despite its title, isn’t mainly a book about ageism in medicine, but about how to avoid becoming one of those people with half-lives, detached from the world, fading away even while being kept alive by the ‘miracle’ of modern science. Some of Lachs’ prescriptions are familiar – he emphasizes the crucial role exercise plays in delaying immobility – but he also draws on fascinating work being done at Cornell University’s Weill Medical College, where he is professor of medicine, on the ways in which design can allow people to remain at home and connected to the world.
Architects typically base their designs on the body measurements and movements of people aged between 20 and 50 with no visual impairments. In an ageing population, this is a serious problem for housing, not to say discriminatory. Sometimes the modifications that would, for example, prevent falls – using contrasting colours for seating and carpets, or ensuring that there is good lighting in hallways, especially between bedroom and bathroom – are inexpensive and, once you have been alerted to them, glaringly simple.
Mark Lachs’ book led me to the Environmental Geriatrics website of his department at Cornell and to its offshoot This Caring Home, both of which are full of tips for intelligent design for homes. It’s worth looking at the multimedia course, which is aimed at medical students but is fascinating for anyone, to see what it’s like to go downstairs with perfect vision, then again with glaucoma or macular degeneration.