APHA 2012: ‘We All Need a Circle of Care’ — A Q&A with Gail Sheehy

Oct 29, 2012, 8:41 AM

Gail Sheehy Gail Sheehy

Sunday’s start to the American Public Health Association annual meeting included keynote speakers superbly equipped to address the meeting’s theme of "Prevention and Wellness Across the Lifespan." Author, journalist and lecturer Gail Sheehy, spoke about the lessons learned from her book, “Passages in Caregiving: Turning Chaos into Confidence.”

NewPublicHealth spoke with Sheehy a few days before the meeting.

NewPublicHealth: How well do you think people have learned that in order to avoid some of the disability of aging, that prevention and wellness at earlier ages are so critical?

Gail Sheehy: I think the message of prevention of disease and cultivation of wellness has become widespread in our society. And the more we see people in our everyday life, running and walking and looking fit, the more the message comes through: “Hey, I would like to look like that when I am 65 and older.” So I think it is spreading, but still usually men are reactive rather than proactive about cultivating better health as they get older.

I did a survey for the American Bar Association a few years ago and we found that men 45 to 55 had a much higher degree of anxiety and poorer health than the men 55 to 65. Why? Because some of the men had a body alert in their forties—a minor heart attack, a very high cholesterol count, prostate cancer—and once they had the physical evidence that their body needed help and protection, they had begun being very proactive in taking care of their health and so they were healthier.

But it would be better if better health was not dependent on a body alert.

NPH: And what works for the women?

NPH: What other key points are pivotal in your APHA address?

Gail Sheehy: We have 30 extra years to work with, over what we had in the last century. We gained three extra decades in the twentieth century and so we have longevity now that nobody planned on.

Why do we save them all for the end when opportunities diminish? Why not distribute those 30 extra years throughout our life cycles and educate adults from their earliest to their latest years about how to use them? For instance, mothers educating daughters and sons in their teens about how to build their health so their vastly extended longevity will be productive and meaningful. And they must also discuss education. The Stanford Longevity Center has conducted research that everyone should have an opportunity to spend as much of their twenties as possible in school, apprenticeships or internships because the more years of schooling one has, the longer one lives. Even one extra year makes a difference and living at home or boomeranging to home allows a young person to take an unpaid internship or a low paid apprenticeship and have lower earnings in the short run, but a much better opportunity for higher income and better networking opportunities later on.

Other changes: Adults and children in their twenties and thirties who may be [living home with their parents] from time to time—as they change jobs, lose jobs, have to take another direction—may have an advantage. If they are living at home, they are likely to get some good advice and some good direction and support from parents. I really see this generation connecting more with previous generations, which is a positive development. 

The loosening of gender roles and more hands-on participation by dads is becoming more common in the thirties. And from the mid-forties to mid-sixties many adults begin or renew a search for meaning, and how that impacts health in making that passage takes us beyond the preoccupation of self and initiates the search for greater involvement with the community or the world. The passage from 45 to 55, according to recent surveys, finds that women today are less happy and more stressed and have poorer health than previous generations of women in the same stage of midlife. It used to be that women in that decade were at the happiest stage of their lives, but now that’s changed and its partly the impact of economic conditions, the downsizing or crushing of middle class income and the great stress that produces in the sandwich generation situation where they still have children at home and mom or dad or in-laws requiring caregiving.

NPH: And what is some optimistic news about older age?

Gail Sheehy: Most of us will make a passage from putting instrumental goals first and put more attention on the emotionally important parts of our life and emotional life typically improves in older people. I have my own personal example I’d like to share.

When my husband and I were both doing very well—I was in my mid-fifties, he was in his mid-sixties, we were happily married after many years of a turbulent relationship and had an adoptive child —suddenly out of the blue he is diagnosed with cancer, very serious throat cancer. And we went into overdrive, we found all the right doctors, he had radical surgery and everything was put right and we had a three-year respite. Then he was diagnosed with lymphoma and we were really down. We went to see a very humanistic, holistic practitioner of lymphoma and he did all the tests and said your lymphoma is indolent and your prognosis is probably about ten years. And any medication, any treatment I give you is not really going to really prolong that lifespan so I’m just going leave you alone. So we sat in the office thinking, "oh my God you aren’t going to do anything?" And he said, "no, my prescription for you is for you to do something wonderful that you wouldn’t have done without this health alert and do it together, change your life." And that is exactly what we did. It took us a year to figure out what it was he really loved, which was being an editor and making magazines. Friends helped him find an opportunity at the University of California-Berkeley teaching students and all we had to do was tear up the lives we had spent decades building in New York and move across the country and we did. And you know we landed in the last of the faculty housing and we were back to fighting over one bath. But we also found a running track overlooking San Francisco Bay and we began doing that in the mornings together and walking down the hill to have breakfast outside and readingThe New York Times and walking back up the hill. We were young again, we were like graduate students. We fell in love again, we were healthier and after three or four years of his teaching and being inspired by inspiring younger people to do what he always loved to do, that lymphoma was gone and it never came back. So there is a whole mind body way of thinking about cultivating good health and wellness as we get older and part of it is just not getting stuck in a rut.

Most importantly, we all need a circle of care when we make major a passage. And you know it’s friends, it’s colleagues, it’s neighbors, it’s people you might run with and they are your resources to think of new opportunities and to help you pursue them. And certainly we need a circle of care later to help us as caregivers to take care of our elders, because you can’t do that alone.

This commentary originally appeared on the RWJF New Public Health blog.