Aging with Purpose

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Near the end of my clinical career as a psychiatrist, I, like so many other psychiatrists, was required to do more in less time. In order to use that precious time as best as possible, I wondered if there was anything else I could do to offset that limitation. Soon, I recalled the landmark book by the psychiatrist Viktor Frankl – Man’s Search For Meaning – which describes how even those in concentration camps were better able to cope if they had a sense of meaning in their lives there.

I then decided to ask each of my patients what gave them the most meaning in their lives. That way, I hoped, I might quickly know what was most important to them, then also be able to connect how the treatment could help them achieve those goals.

Usually, the answers were quite helpful. Often, the most meaning resided in important relationships, religious quests, or work success. Of course, almost all felt that getting better mentally would help them to fulfill their goals or, if not, they at least wanted to find some meaning in their suffering. Occasionally, an answer needed much more discussion, such as “to get high”.

Once in a while, my patient could not come up with an answer. That required a suicide assessment. If that seemed negative, we spent time trying to find a purpose in their life.

While I found this focus to be invaluable clinically, what I didn’t realize at the time is that it might also add years and health to their lives. Recently, new research that I have been reading pointed out that likelihood.

The most recent research by Hill and Turiano from the University of Rochester Medical Center reported in a 2014 articlePurpose in Life as a Predictor of Mortality Across Adulthood – suggests that you can live longer the longer you have a purpose in life. The longer and more sustained that purpose, or purposes, is, the better.

Earlier in 2012, as part of ongoing studies of healthy aging by Boyle and others at Rush University Medical Center in Chicago, retirement-age women and men were given questionnaires to rate their sense of purpose in life. The results were published in May 2012 in the articleEffect of Purpose in Life on the Relation between Alzheimer Disease Pathologic Changes on Cognitive Function in Advance Age. Those with the highest sense of purpose were half as likely to develop Alzheimer Disease after 7 years.

Remarkably enough, those who scored high were just as likely to have plaques and tangles in their autopsied brains. However, despite the similar physical findings, those with a strong sense of purpose in life tended to score higher on testing of memory and thinking.

Unfortunately, earlier research by Boyle and colleagues indicated that adults tend to feel less and less purpose in life as they age. Especially in Western society, the elderly tend to feel less valued as they retire from work and children leave home.

Given all the costs – psychological, social, and economic – of Alzheimer Disease and other illness, continuing to find a purpose in life after the age 65 can have multiple benefits. Working on the goals of this website is, of course, one example. That can include writing a blog, commenting on the blog, and working on the challenges the posts discuss. Other more general protective factors seem to be continued employment in a valued job, a sound marriage, frequent contact with family, learning new things, and in particular, volunteering.

Not helpful in this regard are hedonistic activities just done for one’s pleasure, sort of like the answer “to get high” that an adolescent patient of mine answered to what gave him meaning in life. That meant that my own earlier fantasy of just lying around listening to my beloved jazz records in retirement would not serve as good a purpose as doing whatever I could for my more beloved wife.

Asking about purpose in life is something we can all do, including geriatric physicians with their patients in an outpatient setting or hospice. No wonder the book by the pastor Rick Warren – The Purpose Driven Life – is so popular. Given this new research, perhaps the purpose of aging is to age with a purpose!

H. Steve Moffic, M.D., 67, retired from clinical practice at 66. He was fondly deemed a “psychiatric gadfly” by the Chair of the Department of Psychiatry where he first trained. His book The Ethical Way: Challenges and Solutions for Managed Behavioral Healthcare, published in 1997, was the first extended discussion of the ethics of managed mental health care.

20 Responses to “Aging with Purpose”

  1. Herb

    Thanks for another thought provoking article. Seems like your purpose is helping others find a purpose.

    • Steve Moffic

      Herb, what a cogent analysis of my purpose! I’ve long thought that finding one’s purpose in life was our ultimate challenge and whatever I could do to help that was worthwhile, including for my children.

      I often thought that having mental illness was an obstacle to finding that purpose, so that if we helped someone recover, we also helped them find their purpose in life. Of course, maybe their is a hidden purpose in struggling with mental illness itself, even with all the pain and suffering.

      -Steve

    • Artie

      If my problem was a Death Star, this article is a photon todpore.

  2. Diane Kane

    Hi Steve,

    I found the ideas that you raised very thought provoking. I was pleased that you referred to Viktor Frankl. I think that he would agree that humor helps to give meaning to life, even in a concentration camp. “To discover that there was any semblance of art in a concentration camp must be surprise enough for an outsider, but he may be even more astonished to hear that one could find a sense of humor there as well; of course, only the faint trace of one, and then only for a few seconds or minutes. Humor was another of the soul’s weapons in the fight for self-preservation. It is well known that humor, more than anything else in the human make-up, can afford an aloofness and an ability to rise above any situation, even if only for a few seconds.”

    A woman once told me that she thought those who kept their senses of humor were the ones who survived the camps. She said that she and others were out in the cold shoveling manure. They were hungry and tired but they looked forward to the opportunities to make fun of the guard behind his back.

    I look forward to reading more of your blogs!
    Diane

    • Steve Moffic

      Diane,

      Thanks so much for your comment, including the quote about how humor helped in the concentration camps. Humor probably did keep hope alive and thereby helped survival.

      I think, like you, that humor and laughter are essential to dealing with the obstacles in life that might otherwise prevent us from achieving our purposes in life. Teaching others how to laugh and laugh, as you do, is then such a meaningful therapeutic purpose in itself.

      -Steve

  3. Peter Norlin

    As usual, Steve, I found your thoughts persuasive and valuable, especially since I have a small paperweight on our mantelpiece that reads: “The purpose of life is a life of purpose.”

    It seems to me that clarity of purpose is first, key step in the success of any human endeavor–a plan, a project, . . . or a life.

    Thanks for reinforcing this wisdom!

    Peter

    • Steve Moffic

      Thank you as always for your response, Peter, and for those over 65, we just have to remind ourselves that our purpose(s) in life is not over and, perhaps for some, our most important purpose has just begun!

      Steve

  4. Barbara ("Archie") Burkel

    Dear Psychiatric Gadfly (I like that)!

    When I lived in Atlanta, I worked for President Carter as Volunteer Coordinator. I believe I discoverd the secret to life during that time; it complements your discovery of finding purpose in life.

    The volunteers ranged in age from 14 – 90. They came from around the country and the world. They brought with them a cross section of the ills that can befall people: Sickness, divorce, death of loved ones, loss of jobs. I learned what kept them going was having five simple words,”Something to look forward to.”

    It could be something major like a grandchild’s wedding or it could simply be a movie date with a friend next Thursday. As long as they found “something,” they were alright enough.

    Of course, volunteering, in and of itself, is something you mention in terms of having/finding a purpose. Ironically I wound up creating my own “volunteer brigade of stylish Ladies who are making a difference” when I created The Hat Ladies. While we have impacted our City of Charleston, SC, the biggest impact has been on our own lives.

    Just like Diane Kane, now I have yet another thing “to look forward to” in the form our more blogs from the Psychiatric Gadfly.

  5. Steve Moffic

    “to look forward to” is worth repeating again and again, Barbara. When someone is looking forward, it is implicit that they feel some sense of purpose, some important reason to be or stay alive. So many ill people stay alive longer than predicted, including my own mother, because there was just something so important to them and their loved ones that they just had to beat the odds to stay alive.

    As I buzz around your hat, what I also notice is the creativity that can come into play in finding a purpose. Such creativity can add something very special to society and inspire others to feel they are part of something new and worthwhile.

    Hats off to you!

    Steve

  6. Miriam Camitta

    Timely article with excellent advice. it reminded me of something I came across recently. As Daniel Deronda told the desperate heroine Gwendolyn in George Eliot’s novel of the same name: “What makes life dreary is the want of motive.”

    • Steve Moffic

      Thank you so much, Miriam, for your feedback and for mentioning the novel that the readership may want to look into, if they haven’ already. And the quote certainly fits. Mentioning “dreary” got me wondering if the lack of purpose or motive leaves a kind of mild depression, one that could have a negative effect on the immune system and susceptibility to some illnesses. Hence, this could be a connection to dying earlier without a purpose in life.

      Steve

      • Miriam Camitta

        Eliot was concerned with spiritual sickness, but we (and I think she as well) understand the mind/body connection. She saw was speaking here of living with “motive” not only as an antidote to depression, but a form of salvation.

        • Steve Moffic

          And, Miriam, wouldn’t you sadly know it, but as far as depression goes, I just noted that a new study in the journal Neurology indicates that depression seems to contribute to faster cognitive loss in the elderly who are already cognitively compromised to some degree.

          As to salvation, perhaps another general purpose of those over 65 is to find spiritual satisfaction before we die, maybe a subject for a future blog!

          Steve

  7. Review

    Great article Mr. Moffic. It’s been documented that seniors with a purpose live longer than those who don’t. Take a look at Andy Rooney,Charles Schulz, Joe Paterno, Bear Bryant and many others who die shortly after they retire. Whether its having a job to go to everyday or “having a purpose” it’s important to have something meaningful in one’s life. Humans are goal seeking creatures and having a purpose keeps us going. Don’t you think? http://toplifeinsurancereviews.com/best-life-insurance-companies-for-seniors-over-65/

    • Steve Moffic

      Yes, indeed, having a purpose keeps us going, but there are always exceptions to the rules, like having a dangerous purpose or a drug-abuse seeking purpose. Then we get into the question of values, don’t we?

      Thanks so much for bringing up this “Review”.

      Dr. Moffic

  8. 腕時計の後に(サファイア展の窓を通して)より完全なビューへの骨格化と装飾を処理します。私の考えでは非常に高級で上品な、ティソの最高の彫刻の線の部分の1つである。それはあな

    腕時計の後に(サファイア展の窓を通して)より完全なビューへの骨格化と装飾を処理します。私の考えでは非常に高級で上品な、ティソの最高の彫刻の線の部分の1つである。それはあなたが気にしない手巻き腕時計なら毎日でも着用者として適している。ルイ・ヴィトンコピー 私に明らかでありません、クロコダイルストラップがどのケースに合った1つのものである。若干のイメージに近い突起の間に座るより伝統的なまっすぐな端は、ケースに触れることはないのですが。他の画像において、それはケースの形状に適合するようにぴったりのストラップを使用しています。私はちょうど知りませんが、実際に使用されています。 http://www.msnbrand.com/goods-copy-4779.html

    • Jodie

      I’m so glad that the ineerntt allows free info like this!

  9. もしあなたは真剣なの人が見たら、君をもっと知りたいのについて運動は必要の裏切らない、きっとそのななじゅう時間の動力の準備、よんしよ週波数の運行速度は、使用シリコン糸遊。

    もしあなたは真剣なの人が見たら、君をもっと知りたいのについて運動は必要の裏切らない、きっとそのななじゅう時間の動力の準備、よんしよ週波数の運行速度は、使用シリコン糸遊。 ロレックスデイトジャストスーパーコピー すべての都铎運動を認証天文台が、都铎傲慢に発表し、試験の平均を上回っ天文台表標準のよんしよろく秒までの平均毎日提供の結果-に+よんしよ秒/日。全体としては、このように1つのかなりの運動は私にとって。しかし、同じ2015都铎北旗の運動は、この運動は見えない内部を都铎王朝をキャップ。もう一度、これはートル防水時計。 http://www.gowatchs.com/brand-200.html

  10. 23分で分のマーカーを1958年ミュンヘン空気災害において彼らの命を失った人々の記念になって、8人のプレーヤーと15の他の魂を主張した。より幸せな時代は、ボールドでマークされ、赤7時

    23分で分のマーカーを1958年ミュンヘン空気災害において彼らの命を失った人々の記念になって、8人のプレーヤーと15の他の魂を主張した。より幸せな時代は、ボールドでマークされ、赤7時アワーマーカー、多くのワールドクラスの数を七つ身がユナイテッドのシャツに対する敬意を払います。再度ナンバー7、9と10に加えて、赤でハイライトされる分のマーカーによって参照:これらの3つのジャージ番号・ユナイテッドの「聖三位一体に装着し、「最高の法とチャールトン。また、20分のマーカーは、クラブは、その歴史でも英語がほとんどによって勝ったチームのリーグ・タイトルの数を祝うために赤で取り出される。 http://www.bagkakaku.com/vuitton_bag/2/N51263.html

  11. Jimbo

    We need a lot more intsihgs like this!