The 8th stage is where the older adult reflects upon their life and either becomes satisfied or develops a sense that it was not a life worth living, hence Despair. Erikson is quoted as saying: “Despair expresses the feeling that time is now short, too short for the attempt to start another life and to try out alternate roads…” He also states that we do have one firm foothold in this stage to fall back on and that is “Basic trust”, and “life without it is simply unthinkable.” He states that Wisdom is the healthy product of the 8th stage where we can develop “an informed and detached concern with life in the face of death itself”. We must also note that those in their later years, long past their “Generative years”, still need a purpose and involvement in society. How can they still be useful and give back? That is the question many older adults have and probably why so many volunteer to form a labor force of unpaid caregivers and doers for others in need, truly purposeful living. However, there is another stage, the 9th.

Erikson also points out that “I am persuaded that if elders can come to terms with the dystonic elements in their life experiences in the 9th stage, they may successfully make headway on the path leading to gerotranscendence.” What is gerotranscendence? Principles regarding gerotranscendence from the Erikson’s book “The Life Cycle Completed” are: Letting go of the material things; gaining the wisdom of humility; defining ourselves by what we give back; to rise above, outdo, go beyond, independent of the universe and time; to leave behind those things we can not carry any longer as they are  too heavy a burden; gaining new spiritual gifts. It’s as if the the older adult in the 9th stage transcends to be a playful child once again, not caring about the material things nor the false pretense of power and stature. Sounds like a nice place to be!

So what’s my point in bringing all this up? My perspective is that the last stage gives us the opportunity to find peace with ourselves and transcend into a different person who is at peace with the world. A loving, caring human being truly of value to the world. That would be by my definition of “successful aging”.

Falls, for example, can be caused by a number of risk factors such as medications, leg weakness, protein malnutrition, vitamin D deficiency and urinary incontinence, all of which can be altered with a little knowledge and effort. If we are protein malnourished we can always eat more protein, and that combined with the proper exercise regimen can improve our leg strength. We can also do balance exercises that help reduce our risk of falling, along with altering some of those medications known to cause falls, such as blood pressure medications, medications for insomnia among many others. Incontinence can be managed with behavioral modifications thereby avoiding medications that can affect our memory and cause falls. Vitamin D deficiency, known to be associated with poor balance, falls, and memory loss in some, can be corrected with the right replenishment of vitamin D. All of these are easy to identify when screened for and easily altered to improve function and quality of life. We all know our body’s organ systems decline with aging but we can slow down that decline and alter the trajectory with these interventions.

What I recommend is to go to the National Institute of Aging web site at: www.nihseniorhealth.gov or www.nia.nih.gov, and go to the Publications section, Age Pages, and search for the condition that affects you or your loved one. The brochures can be printed in PDF format or can be read on line with altering text size for those with low vision. It’s a great way to continue your life-long learning and age well. One other point is that medications themselves can cause geriatric syndromes which are assumed to be a normal part of aging. A medication review with an experienced pharmacist can help identify medications associated with geriatric syndromes and help you age in place. Don’t subscribe to the stereotype that falls, urinary incontinence and memory loss are always a normal part of aging. They may not be in your case!