Cullen Hayashida
Special to The Hawai‘i Herald

There is news about older adults just about every day in the media — among the topics are the exploding demographics of seniors; the increasing number of dementia cases; reports on episodes of falling; commercials on pharmaceuticals, nutraceuticals and cosmeceuticals; the high cost of long-term care; family caregiver stress and more. It feels like an inescapable vortex of concerns that overhang our hopes and plans for our golden years.

For the past four decades, I have been in the thick of eldercare service development, focusing primarily on the creation of long-term-care related services for the frail and disabled. During these years, I have observed two divergent approaches related to aging. On the one hand, there has been a longstanding tendency to address aging as sick care and its need for chronic care management. Because of the high cost anticipated with nursing home care, there is an ongoing need to find more cost-effective solutions with home- and community-based care and aging-in-place policies. This “aging as sick care” perspective addresses health challenges, adjustments to losses, long-term caring and, eventually, death and dying. As important as it is for these issues to be understood and planned and prepared for, the emphasis on this perspective has not attracted many into the field of gerontology.

The second countervailing approach is an antiaging perspective that purports the theoretical possibility of extending life far beyond a century. Skin-tightening creams, hair regrowth products, cosmetic surgeries, hormone therapy, regenerative medicine, genome therapies, organ transplantations, nutritional supplements, among numerous other products and services, continue to experience hyper-growth. Is it any wonder that there are more practitioners associated with the American Academy of Anti-Aging Medicine — a field not recognized by any legitimate medical certifying body — than there are board-certified geriatricians? Could this be why there are fewer geriatricians today than there were a decade ago — and why their numbers continue to decline?!

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