On Aging: B. Philosophical & Historical Aspects of Aging

This section deals with the features of, and attitudes toward, the aging sector, aging and ageism. It touches on the approach of different cultures; female vs male roles; cultural issues; what aging brings both positively and the challenges; and issues around death.

1. Attitudes towards old people have evolved significantly over time: In the 17th and 18th centuries there weren’t enough old people for anyone to view them as a major social burden. In the 1790 first US census, 2% were over 65. So those that did survive enjoyed high status (particularly in the Puritan moral universe where God conferred the “crown” of old age and one of superiority). (BTW: in 1900, 4% of Americans were over 65; 1965, over 10%.)

Even the philosophers of the era weren’t enthused. Thoreau expressed open contempt for the idea that the elderly possess special wisdom. In Walden (written in 1854 when he was 30) his basic credo was that no customs or beliefs can be justified without proof – and he thought that the young were best qualified to seek out proof and truth. “I have lived some 30 years on this planet, and I have yet to hear the first syllable of valuable or even earnest advice from my seniors.” Even Thoreau regarded old age more as a necessary evil than a desirable state of being. “Nature abhors the old, and old age seems the only disease; all others run into this one.”

A notorious example of ageism was Sr. William Osler’s valedictory address upon his departure from John Hopkins University in 1905 when he left for Oxford. He talked first about the “comparative uselessness of men over 40…The effective, moving, vitalizing work of the world is done between the ages of 25 and 40.” Secondly, he referred to “the uselessness of men above 60, and the incalculable benefit it would be in commercial, political and in professional life, if … men stopped work at this age.” He got quite a reaction, with mentions of those old folk who prove him wrong (Beethoven, Tolstoy, etc.). Even an Anti-Age Limit League was formed! 

By the late 1960s there are two reasons attitudes changed. The first was that in the US the over sixty-fivers were influenced by the dissident spirit of the times; many grandparents, for example, marched against the Vietnam War. Also, older voters played a role in the passage of Medicare in 1965. Secondly, there was increased longevity due to a better standard of living (better fed, housed; sanitation, etc.) along with medical advances (immunizations, antibiotics, insulin, etc.).

A majority of first world children now have four living grandparents. There was a myth which harks back to a time that never was, in which most Americans supposedly grew up in a three-generation household. But actually this lamented family of the past had many children and was largely two-generational, with many brothers and sisters, uncles and aunts. It was also affected by the deaths of its younger members, as many mothers died in childbirth and young children did not live to adulthood. Nearly 25% of 19th century children had lost at least one parent. In the early decades of the 20th century, children had less than a 40% chance of having two living grandparents. 

2. Some cultures revere their elders: Elders are very important and respected members of many cultures, in particular, for example, First Nation, Métis, and Inuit communities. The term Elder refers to someone who has attained a high degree of understanding of their history, traditional teachings, ceremonies, and healing practices.  Elders have earned the right to pass this knowledge on to others and to give advice and guidance on personal issues, as well as on issues affecting their communities and nations. 

Margaret Atwood writing in the 2009 issue of AARP The Magazine said, while visiting in the Arctic, that she had been told a number of things about Inuit Elders. “First, you can’t become an Elder just by getting old; it’s a title bestowed by others. You never push your advice, but you offer it if asked. ‘You can tell who the Elders are,’ said my informant. ‘Just watch a group. When an Elder speaks, people listen. But Elders don’t speak often. An Elder knows what to do in times of difficulty. Elders acquired that knowledge by having endured hard times before. As one of our old sayings puts it, ‘Good judgment comes from experience. Experience comes from bad judgment.’”

3. Old age is a critical women’s issue; females are the survivors: There are aging differences between men and women, physically and culturally. First of all, almost everywhere in the world, women live longer than men (in the US the average female life expectancy is 81.1 years, five more than men). In the US two-thirds of people over 85 (and 85% of centenarians) are women. Secondly, a much higher percentage of men are married, e.g. for the ages 75 to 84, 74% of men are married but only 38% of the women. Over age 85, 60% of men, are married, but only 15% of women. 

A woman’s body responds to aging dramatically with menopause (with changes in estrogen levels taking place) while a man’s body responds more gradually (with testosterone level changes being the dominant hormonal component of aging). According to Dr. Paula Rochon, a geriatrician and founding director of the Women’s Age Lab at Women’s College Hospital, “Women have specific and unique health needs that are often unacknowledged by our health system and its care providers. Certain medical conditions such as osteoporosis, thyroid problems and headaches, for example, present more often in women, and other conditions, like heart disease, present differently and are not always recognized by clinicians.” Brain aging appears to be different, with women more likely to suffer from cognitive impairment.

Women are much more likely than men to experience all of the most severe quality-of-life problems associated with longevity. In old age it becomes an issue of how women are to survive alone (whether economically, physically or emotionally). 

An anecdote to illustrate cultural challenges comes from an interview with Marie Henein (the well known and somewhat controversial criminal defence lawyer, who became a household name while defending former CBC radio host Jian Ghomeshi during his sexual assault trial). She feels women who are profoundly accomplished in their professional lives, who are now turning 50 are struggling with “becoming invisible” And she looks at her male colleagues and “they are in the prime of their lives. I mean, they’re at the pinnacle of everything, attractiveness, professional accomplishment.” She was wondering why “we were in such a different category and why these women who really had everything were feeling pretty crummy about themselves.” A rhetorical question to ponder.

4. Reasons for aging: it helps survival, brings wisdom, positivity and purpose: Dr. Agronin,  in his book The End of Old Age: Living a Longer, More Purposeful Life offers the following reasons for aging:

1. Aging helps us survive: our primeval ancestors lived short, precarious lives among the dinosaurs with natural selection driving their continuous existence only through rapid reproductive success. Old age didn’t exist in an environment that had no use for individuals beyond the stage of reproduction and basic rearing. Fast forward to modern humankind. Age brought greater accumulation of knowledge and experience, so elders become critical contributors to survival.
2. Aging brings wisdom: it allows the ability to solve problems based on experience and the integration of information. (Not every expert agrees with this, by the way, and part of the problem is that wisdom is unquantifiable and undefinable.) 
3. Aging brings positivity and purpose: people with positive self-perceptions about aging demonstrate median survival rates 7.5 years longer then do those with negative self-perceptions. Aging itself becomes the motivation to improve both the quality and quantity of life.

5. Seniors make a significant contribution to the richness of Canadian life and to the economy: Older people provide a wealth of experience, knowledge, continuity, support and love to younger generations. The unpaid work of seniors makes a major contribution to their families and communities. Some 69% of older Canadians provide one or more types of assistance to spouses, children, grandchildren, friends and neighbours. Many grandparents care for their grandchildren on a part- or full-time basis; and increasing numbers of Canadian grandparents are raising their grandchildren on their own. 

As caregivers to spouses, family, friends and neighbours, seniors can be a force in reducing health care and social service costs. Civil society programs benefit from the voluntary contributions of a large and growing number of retired seniors with valuable knowledge and skills. In addition, seniors are the largest per capita donors to charity.

Older Canadians also make an important contribution to the paid economy. More than 300,000 Canadians 65 or older were in the labour force in 2001 (they are 4.5% of workforce). As demographic shifts reduce the ratio between the proportion of employed and unemployed Canadians (i.e., children and retired people), governments and some employers are encouraging individuals to work longer. Remaining in the workforce and actively participating in civic affairs depends, in large part, on staying in good health.

6. We should fear ageism, not aging; seniors need to be seen as active and valuable societal contributors; aging needs to be redefined and venerated: Ageism is ingrained in our society. The World Health Organization’s Global Report on Ageism estimates that one-in-two people hold ageists attitudes. According to Margaret Morganroth Gullette, an American scholar in age studies, for the most part ageism continues to be a socially acceptable prejudice to the point of being murderous. “As we age, we are seen as less human.” In an interview on CBCs Ideas titled The Value of Old Age, Gullette says that a profound lesson to emerge from the COVID pandemic is how older members of our society are treated. She calls the high number of deaths from the virus in long term care “eldercide”. “The problem is we don’t value old age. COVID made ageism far worse as we saw people in nursing homes dying because their lives did not matter enough. Many people think that was incompetence, true – but ageism explains it better.”

Fear of aging stems from entering what British sociologist Paul Higgs calls: “The Fourth Age” – a stage that embodies the more feared and marginalized aspects of old age. It’s the period of life where a person is advanced in years and frail, or cognitively impaired and dependent on others. People in the fourth age are often sent to the edges of society where they become invisible – ‘the other’ – with little agency, according to Higgs. “What happens to those people being positioned by the ‘fourth age’ is that they move into a third person narrative. ‘He needs. He is. We will decide. He’ll like that.’” To summarize, in our first world society, we don’t value old age.

Dr. Agronin presents a different paradigm of aging than suggested by some (that living too long can be a loss) that “identifies and engages the myriad pieces of our own aging self that can dispel negative stereotypes of being ‘old’…We can actively live a creative age… age should become a powerful, life-changing tool that enable us to elevate, celebrate, and transcend being old. He offers an alternative view of aging: “As we age, we gain wisdom as a form of mental currency that we store away as a critical reserve. Our age-enhanced resilience gets us through adversity and enables us to discover our true purpose in life.” 

He redefines aging as “an experience-dependent series of cumulative, progressive, intrinsic, and positive psychological changes that usually begin to manifest themselves at midlife and eventually culminate in increased well-being.” To age is the most profound thing we accomplish in life. We can begin again to venerate aging and the aged because of their essential roles in our family, community, and society.

Dr John Muscedere, CEO of the Canadian Frailty Network, has said: “Treating individuals differently because of their age, influences our societal values, priorities, policy decisions and financial allocations. Ageism also influences the systems that guide the aging process. If we undervalue older Canadians, will we prioritize initiatives that directly benefit them?” He suggests that a re-envisioning of the aging process is needed. “Rather than viewing older adults as individuals to be taken care of, Canada must see its older population as the active and valuable contributors that they are.” 

7. Growing old is an art that can bring rewards: The onset of aging can be so gradual that we are often surprised to find that one day it is fully upon us. The changes to the senses, appearance, reflexes, physical endurance, and sexual appetites are undeniable and rarely welcome. Yet, as Dr. Sherwin Nuland (in his book The Art of Aging) shows, “getting older has its surprising blessings. Age concentrates not only the mind, but the body’s energies, leading many to new sources of creativity, perception, and spiritual intensity.” “Growing old”, Nuland teaches us, “is not a disease but an art – and for those who practice it well, it can bring extraordinary rewards.” He states that “Faith and inner strength, the deepening of personal relationships, the realization that career does not define identity, the acceptance that some goals will remain unaccomplished – these are among the secrets of those who age well.” We are all old people in training.

A recent study published in the New England Journal of Medicine, found that at age 60 you reach the top your potential, and this continues into your 80s. It declares that if you are between 60 and 70 you are in the “best level of your life.” If you are between 70 and 80, it’s the second best level. (The third best is from 50 to 60.)

In her 70s Betty Friedman wrote in The Fountain of Age, “We have barely even considered the possibilities in age for new kinds of loving intimacy, purposeful work and activity, learning and knowing, community and care…For to see age as continued human development involves a revolutionary paradigm shift.”

8. Sharing the aging journey unites those on the same path: Aging and sharing of the aging journey brings a unique closeness and understanding with a spouse and close friends who are making the journey with you in real time. Previously these boundaries knew far fewer confines. Everything within those boundaries becomes more precious than it was before: love, learning, family, work, health, and even the lessened time itself. Garrison Keillor stated it thus, “My classmates are united by our mortality.”

9. There are poignant aging markers entering life’s wrap-up chapter; the actuarial stats become a reality: When you are in your 40s to 70s there are few indicators or reminders of the finiteness of one’s life span. Conversations are more about family, careers, hobbies, travel. But something begins to happen as one pushes beyond. Body related markers are all too obvious: difficulty with light glare when night driving or reading fine print on labels; opening bottles and tying shoelaces with arthritic fingers; missing important parts of a conversation; more frequent peeing; punching another hole in the belt buckle; bending and balance, etc. etc.

As we age the obits become harder to shrug off. Death becomes a more conscious presence in everyday life. Members of your high school or university class, or of your book club or social club aren’t just having troubles; they are dying. Funerals are disturbing for 40 or 50 year olds because they are unusual; not so past say 75; they happen with troubling frequency. When my mother died at age 97, she had one remaining friend from her age cohort.

Walter Angell, in a 2014 issue of The New Yorker, captured it: “We geezers carry about a bulging directory of dead husbands or wives, children, parents, lovers, brothers and sisters, dentists and shrinks, office sidekicks, summer neighbors, classmates, and bosses, all once entirely familiar to us and seen as part of the safe landscape of the day. It’s no wonder we’re a bit bent…Death will get it on with me eventually, and stay much too long, and though I’m in no hurry about the meeting, I feel I know him almost too well by now…We have become tireless voyeurs of death: he is on the morning news and the evening news and on the breaking, middle-of–the-day news as well.” 

The Bible doesn’t help either; it says (Psalm 90:10) “The days of our years are threescore years and ten and if by reason of strength they be fourscore years, yet is there strength, labour and sorrow; for it is soon cut off, and we fly away.” I interpret this as meaning that living to the age of 80 entails much difficulty and pain. Also, a reminder of the reality was that, while yes people did live into their 70s, 2,000 years ago the average lifespan was in the 30s.

10. Older societies will be less likely to wage war: An American political scientist, Mark Haas, believes that older societies will be less so inclined because there are fewer young people available to fight, and governments must divert funding away from the military to provide social programs for older citizens. He calls this rather long-term phenomenon the “geriatric peace”. He says that “statistical evidence shows that when countries reach a median age of 30 and a fertility level of 2.0, the likelihood of war is significantly reduced.”

11. The talk of “vanquishing” old age has to be countered with realism: Anyone over 85 has a 50-50 chance of winding up in a nursing home. If you are 65 you have a 50% chance of spending time in a nursing home before you die. Around 10% of the stays will be short-term, for recuperation after hospitalization. The remainder will be for the long haul, with discharge to a funeral parlour. 

The optimistic psychobabble comes from different places: the downplaying of real disabilities (particularly the explosion of Alzheimer’s and drug companies with “cures” such as Aricept a drug that does nothing to inhibit progression of the disease); marketers of anti-aging products as mentioned; keeping mentally active through the purchase of brain-challenging computer programs, etc. There has been an exaggeration of the capacity of science to find solutions. The “hucksters of longevity” make this dangerous; there is a proliferating business in Web sites, catering to boomers who want to increase their odds of living longer (see The Methuselah Foundation or Strategies for Engineered Negligible Senescence).

The question is often asked whether just remaining alive, as long as expensive medical procedures make it possible, is a worthy goal. Should aggressive steps be made to extend life at any cost (both financial but also psychic) in a pro-longevity posture?

Living longer is great; dying longer is not so good. It’s akin to the mythical prophetess – the Sybil (of Cumae) – who asks the god Apollo to grant her eternal life. In the canny way of gods who demonstrate the folly of mortals by giving us exactly what we want, Apollo grants Sybil her wish of eternal life. But he withholds the additional gift she leaves unspoken: eternal youth. Sybil lives on and on, becoming increasingly decrepit, shrinking and decaying until the townspeople hoist her aloft in a cage in the town square to be scorned by passerbys. After a thousand years, Sybil has wasted away completely; only her pitiful voice remains. She is asked what she wants and answers the obvious: ”I want to die.”

12. All of us are like a story, but for the elderly you only see the last two pages: There is a reality that as people get old (and even that is a relative stage, depending on the age of the observer), those significantly younger who encounter them, have no concept of what they once were. 

In Michael Lewis’ book The Premonition, he talks about Carter Mecher, and his training as a critical care doctor. What caught my attention was Carter’s humanity and his ability to see beyond age and frailties, which he reveals in a passage describing his work in a VA hospital. Most of the patients were blue-collar guys who had fought in the Second World War. Melcher then says, “All you saw as a doctor, or medical student, were these dying old men. But if you got them talking, you’d hear the most amazing stories – how they once flew their fighter plane under the Golden Gate Bridge, how they had taken Iwo Jima. “All of us are like a story,” he’d tell his students. “You’re seeing the last two pages of the book. You know so little about him. He was once a little kid. He was your age once.”

Dr. Marc Agronin talks about the concept of the individual person as a congress of many. “We see a single face and hear a simple story, but that is only a view of the surface. Behind each exterior and within each person is a vast repository of knowledge, skills, experiences, eyewitness accounts, thoughts, feelings, and passions”. There is an imperative to view ourselves in our totality. Put together, the accumulating products of our aging self represent a rich tapestry of abilities, interests, experiences, relationships, and commitments that can be described as our age culture.

13. Different age cohorts have unique strategies for communicating, with generational differences speeding up: My parents wrote letters, and often during the war used telegrams (with short, clipped messages, all one typeface, no punctuation, and delivered by “telegram boys” dressed in special uniforms). Telephone was used sparingly and long distance was expensive. I remember pre-booking the Christmas call with dad’s family in London. My age cohort uses the phone a lot and have comfortably moved to mobile phones. We have gone through letter writing (notes back from boarding school, camp or holidays) and now are comfortable with email. 

Our children don’t write letters; they of course are computer and mobile phone oriented using email and more and more texts, also FaceTime and its alternatives. Our grandchildren are oriented to the mobile phone, but for texting, not speaking. One of my grandkids can type twice as fast with two thumbs than I can write using cursive (we had a contest; he won decisively!) Speed apparently is essential thus the move away from email (which has a number of steps that slow one down) to such alternatives as SnapChat which is faster (plus it has no history trail). (Anecdote: the girlfriend of this same grandchild over the past 8 years has used SnapChat 1.4 million times, and rarely the phone for speaking.) 

This says nothing about cohort differences in how information is received and the level of information coming from screens vs newspapers, magazines or even radio. It’s my hearing aid buds vs their music buds! Significant generational differences exist in technology; my grandkids are “digital natives” (My 12 year old grandson Ayden jumps around his computer with abandon, composing music.) The generational differences have sped up: our children to Penny and me; but their children to them. The divide between my parents and me was at a different pace; it was just radio to TV.

14. Choosing activities to pursue in the final chapter of one’s life can bring focus and meaning to this stage: This sounds a tad maudlin but is practical. As one reaches a certain stage, the reality is that seniors give thought to activities and priorities they would like to accomplish before they become incapable of taking action. The obvious ones might include:

• Plan on how one’s assets should be distributed. A wealthy connection of mine has three stages and they are, 1. How much money does he and his wife need for living, travel, health care and other pleasures; 2. Ensure one’s children (and in a selective way, the grandchildren) have a reasonable amount of the estate, but not so much that “they never have to have a job”; then 3. give the rest away, in a controlled and involved manner. Obviously this calls for updating one’s will (or produce one, if not done already)
• Downsize those items that one will never use, and family or friends will not use either
• Remaining actively in touch with family and in groups and clubs that provide comfort and external social and intellectual stimulation
• Complete projects that you want done for posterity. Some like to contemplate a future “to do” list (travel, experiences, charitable work).

15. The cycle of acquisition and disposition changes as we age with the emphasis on the latter: All our lives we buy, build or collect material stuff, and much of it for good reason – we crave comfort from our things; they are memories usually of significant events or connections in our lives. As we approach the era of adapting, consolidating and gradually moving down in living arrangements (into condos, eventually into seniors’ residents and to nursing homes), the stuff is sold, given away (to sometimes resistant children) or scrapped, and where ultimately to where no control occurs post death. It becomes a question of nostalgia conflicting with space, with the former usually losing.

16. Most Canadians are not financially prepared to retire: The average Canadian median savings at retirement is only $3,500. Keeping the house maintained and safe (retrofit for manoeuvring stairs, etc.) is more than most can handle. Then there are the home health care costs, which are climbing. (The most the government will pay for home care is $3,500 per month, which amounts to 3 hours/day.)  Alternative approaches can be pursued (see Section C).

17. The search for a decent death is a complex equation; our death-denying culture makes things more challenging: Life has its ultimate bookends: birth and death; any discussion about aging must address the latter. Death is always the same: we all live, then die. By the time we reach the age when our contemporaries start dying in significant numbers, we are still reluctant to acknowledge what the obits have been telling us. In the US today only 20% die at home, although 90% want to. More than half die in hospitals and 20% in ICUs probably hooked up. 25% die in nursing homes. A small number die in hospices. One third of the costs of death are spent in the final year of life, and one third of that in the final month! As Susan Jacoby said in her book Never Say Die, “If a decent death is defined by the absence of extended suffering, an American who lives into advanced old age in the 21st century probably has less chance of receiving that mercy than the poorest peasant did in the 14th century.”

There is a gap between the way people die and the way they say they want to die. We have a death-denying culture that makes it difficult to discuss issues openly. This tends to discourage people from doing advanced care planning. (By the way, only half of the population have any written will and 70% of people don’t have a living will, which probably indicates an aversion to thinking about or planning for the end of life.) 

The approaches for mentally competent people to take when contemplating the manner in which they would prefer to live out whatever time is left, range from “do everything medicine can do”; to do everything possible only if there is a realistic hope that I can emerge as a functioning, mentally competent human being, then stop and “let me die”; to the most common non-approach position where people hope that when the time comes, either they will be able to make a last-minute decision about continuing or discontinuing treatment themselves or that their closest relatives will do the right thing; and then there is MAID in Canada. 

Part of the equation is, as Jacoby so eloquently put it, “the recognition that human intelligence itself is a part of and not the master of nature. Acceptance of the point at which intelligence and its inventions can no longer battle the ultimate natural master, death, is a true affirmation of what it means to be human.”

18. One central focus of religion is dealing in and with death: This is a tricky area as we are generally careful in our society in protecting ones belief system. Fear of aging is more than fear of decrepitude. Ultimately it is the fear of death. (As well, Homo sapiens are the only animals with awareness that they will one day die.) So I cautiously say that the fear of death, and the thought of life being without some possibility of post-death “presence”, are fundamental to most religions. 

Traditionally churches have also been where, upon death, we say good bye to our family and friends, and they say good-bye to us. Solace is provided. The rituals are comforting and allow some sort of closure. Some suggest that religion developed in order to provide reassurance that death is not final, that something of us goes on. As Dr. Nuland says, “Belief in God is belief in the supernatural, and if there is a supernatural – especially a benevolent and caring one – there is hope for some form of living beyond the mortal shape of it that we know. Seen this way, religion becomes the paradoxical product of an inherent biological drive. Neither we or God need ever die.”

Ernest Becker, in his book The Denial of Death, suggests that man’s paradox is that he feels agonizingly unique and yet he knows that this doesn’t make any difference as far as ultimates are concerned. He has to go the way of the grasshopper, even though it takes longer. Becker came to believe that individual character is essentially formed around the process of denying one’s own mortality, that this denial is a necessary component of functioning in the world, and that this character-armour masks and obscures genuine self-knowledge. Much of the evil in the world, he believed, was a consequence of this need to deny death.

19. The presence or absence of either spirituality or religious adherence has little association with successful aging: In the famous landmark Harvard Study of Adult Development (the longest prospective study of physical and mental health in the world), participants were asked at age 75 if their spiritual life had deepened. The majority answered, “No.” As Dr. George Vaillant, current director of the study, said in his book Aging Well, “Yes there are more old people than young people in church but that does not prove that people go to church more as they grow older. It may simply reflect that as the younger generation gets more science, anthropology, and history in school than their grandparents – and less religious instruction – they may also attend church and temple less than their grandparents ever did. In old age they may continue to do so.”

20. The scriptures are full of promises of advice and blessings in old age: It’s important to remember that the definition of old age back in Biblical times was radically different, when the average life span was in the 30s (and interestingly, lower for females because of childbirth difficulties). In the time of Jesus a person of 33 years old (his estimated age at death) was a senior.

In a paid advertisement from the Victory Baptist Church in Peterborough one message was that “growing old should be a time for rejoicing and a deepened commitment to whatever the Lord enables us to do.” They point out that the Bible says that sooner than we think all will become old. It provides some advice on aging and (through Paul) it is “Aged men (are to) be sober, grave, temperate, sound in faith, in charity, in patience.” (Titus 2:2-3) They also suggest that “the time of old age can be a time of happy harvest if we have sowed the seeds of good fruit.” (I get one out of two – although “They still bear fruit in old age; they are ever full of sap and green”, Psalm 92:14, does give hope.)

21. In Canada, through MAID, Canadians have a legally acknowledged right to die: This comes close to home, as in the past three years I have had five people I know take the MAID (medical assistance in dying) program. In March 2021, Bill C-7 passed making a number of changes to Canada’s MAID law, originally passed in 2016 – the most notable being the repeal of the stipulation that an individual’s death has to be “reasonably foreseeable” (terminal) to qualify for medical assistance. Some want to see MAID expanded (right now, the law does not allow for advance directives – which would permit an individual to legally arrange a medically assisted death before being diagnosed with a condition that might someday inhibit their ability to give consent); others are concerned about the amendment allowing MAID for mental illness. There were over 7,500 MAID cases in 2020.

22. How we view death varies across cultures: There are nearly 200 countries around the world. Within each, and crossing borders with all, are hundreds of religions, races, original peoples. How different cultures view (and handle) death is quite diverse. A few examples: most Africans believe in ancestors – the dead who continue living and guiding their family in the afterlife. Without a proper funeral and burial, the ancestor will become a wandering ghost. Asian views on death have roots back to Hindu, Islamic, Confucianist, and Buddhist religions. In India, the practice (now banned) of female self-immolation after the death of her husband (sati) was a historic Hindu custom. Chinese funerals are rich in superstition and rituals, which include removing mirrors and hanging cloth on the doorway of their homes. Not following proper rituals means death and misfortune for the grieving family. In Central and South America with 40% of the world’s Catholic population, there is a mixture with local folk spiritual traditions, resulting in a unique outlook on and practices to do with death.

Western Europeans trend towards secularism, thus funerals are more human-centred and celebrate the life of the deceased, not their death. Eastern Europeans are more likely to be highly religious and follow Orthodox or Christian traditions. Many Eastern Europeans mix folk religions in their death customs. The majority of people living in the Middle East believe in Islam. Muslim funerals are simple and focus on the deceased’s actions in the earthly realm. Death isn’t an easy process; it’s bitter and painful for Muslims (especially the soul separating from the body). In North America conversations about death don’t usually occur between families. Instead, it often has an associated morbid quality. 

Click here for Section C, Political & Public Policy Considerations Regarding Aging https://powellponderings.com/on-aging-section-c-political-public-policy-considerations-regarding-aging/