As a healthcare professional, I have seen the focus and attention our healthcare system places on treating illness rather than preventing it. As Peter Attia calls it in his recent book called Outlive, this is Medicine 2.0. Its primary focus is on extending our lifespan and having us live longer lives. Technology has made significant strides to prolong life, but it has disregarded the quality of life we live - especially in the final years. Medicine 3.0 focuses on preventing the four significant causes of slow death. They are heart disease, cancer, neurodegenerative disease, and type 2 diabetes.[1] Many of us would rather live a good life than a long life of suffering. This requires attention to our holistic well-being.
Mobility
Mobility is often taken for granted, but it is essential to aging well. A decline in mobility can lead to an array of physical issues, including muscle atrophy, pressure ulcers, and increased susceptibility to infections. This physical deterioration causes discomfort and pain and has an impact on mental health. Reduced mobility often leads to feelings of helplessness and loss of independence, which contributes to depression and anxiety. Conversely, poor mental health can exacerbate physical limitations. Muscle mass decreases approximately 3–8% per decade after the age of 30 and this rate of decline is even higher after the age of 60 [2]. This involuntary loss of muscle mass, strength, and function is a fundamental cause of and contributor to disability in older people. It could take a year of going to the gym and eating right to build lean muscle - and this could all be gone during a few weeks of illness requiring bed rest later in life. If you are ‘middle aged’, you are in the 4th inning of a 9-inning baseball game. If we don’t start exercising and eating better now, there is little chance we will be in contention to win at the end of the game. The more muscle mass and mobility we can develop now, the more likely we will be able to have enough left during the last decade of our life we can do the things we want to - and stay mentally fit at the same time.
The End of Life Mindset
One of the most important aspects of end-of-life care is fostering acceptance of the situation and preserving self-dignity. This requires open and honest communication with patients and their families.
I recently had a conversation with someone who was supporting a loved one through a chronic illness. Doctors said nothing else could be done to keep them alive. What the doctors were talking about was making her live longer. But that doesn’t mean nothing can be done. By bringing her home from the hospital and surrounding her with love, they were able to regain some independence and do some things on their own. During this process, they were able to realize the final stage of the Grief Model - Acceptance. The loved one had accepted death was coming. They had conversations with their children to express their wishes, regrets, and how they wanted their children to honor their legacy. Though sad to see their loved one suffer during the past years, my friend expressed a sense of peace about it. This peace came from feeling that their loved one was also living in peace through their acceptance of what was to come. Ironically, death comes for everyone. It seems far away, like the finish line of an ultramarathon race. The truth is that it could very well arrive tomorrow. If it did, would you feel you had lived a good life?
ACTION STEPS
Confront your own fear of death. Answer this question honestly - Do I fear death? If the answer is yes, consider what specifically you fear and if there is something you can do, at this moment, to begin to address this fear.
Everyone knows the many benefits of exercising. What would drive you to exercise more? Your kids? Your energy level? Your mental well-being?
References
1. Attia P. Gifford B. Outlive. New York: Harmony, 2023.
2. Holloszy JO. The biology of aging. Mayo Clin Proc. 2000;75 (Suppl):S3–S8.