on getting old

Old age psychiatry - why bother? Audible gasps in the audience. An hour and a half of discussion ensued with no clear answer to the question in spite of congregation of supposed advocates for old age mental health professionals that are psychogeriatricians. Indeed, why do we bother. When most of my day is spent visiting nursing homes with old people misbehaving because they got old. No matter what pills I throw at them, they will and will not get better. The misbehaviour will not instantly resolve, which is what the facilities/ carers want. But with time, months and possibly years down the track, we know the person will no longer be cognisant enough to cause problems. Our job is to prescribe to the carer and facility. To a lesser extent, prescribing for ourselves, to satisfy our narcisstic needs to be "doing something to help". To me, the answer to "why bother" with old age psychiatry can only be answered if we look at the value, if any, of old people. Is the life of an old person, who doesn't work, who require significant society resources, of value. It may sound like a proposterous question to ask but is it? Every one laments at the ageing body declining capacity, every product is marketed to "keep you looking young" and the world seeing "ageing" as a "problem". The elderly used to be valued because it reflected wisdom and intelligence, being able to survive to your 70th or 80th decade. So while you can't join in the hunt or gather food to provide, you offer the group knowledge about where the food might be, or where to find shelter. Such function seems obselete in modern society. So people look after the elderly out of obligation - filial or altruistic, or pity. Somewhere along the way of development in society, "life" got lost. At some point, "life" ceased to be of value in itself, but needed to be qualified by productivity, work and how much you have to offer to society. (One could argue that being wise and offer the young with knowledge is a "use" exploited too). But death is part of life. So is getting old, so is getting frail, so is getting sick. Just because it is unpleasant, does not mean it is unacceptable, does not make "getting old" a "problem". People aren't meant to live forever nor are we meant to be young forever. It is part of life, just like kids grow up, milk teeth have to fall out, It's neither good nor bad. It is just change, progress to a different stage of life. When your value is based on income, based on "works", it will nearly be impossibly to achieve such major paradigm shift. To me, unless we value "life" for "life" itself, we will never see old age as the "golden age" it's reputed to be. Unless we see getting old, sick and death as an unashamed part of life that is to be, if not embraced, but at least accepted, just as the birth of a child, marriage of couple, the answer to the question "why bother" with old age psychiatry, will indeed by unequivocally "no, don't bother".