Kathleen and her husband Carl both had professional careers and had reached retirement age. Kathleen was a medical professional with a practice in eastern Connecticut and Carl operated a construction business which he sold upon retirement.
The couple purchased a home for their "golden years" in Florida while maintaining a home in southern Connecticut awaiting Kathleen's retirement.
They had two children who had married and moved to different areas of the country, so the only thing keeping them in the northeast was Kathleen's medical practice. But things began to unfold when Carl decided to move full-time to Florida because of medical issues exacerbated by the cold winters in Connecticut while Kathleen still wanted to maintain her practice “for a few more years” before heading south.
The weekend trips from Connecticut to Florida began to wear on her and she decided that a marriage where her husband was living a thousand miles away was not how she wanted to spend her final years. Kathleen decided to close up her practice and begin the next chapter in the couple’s lives.
“For Kathleen, this was not an easy transition,” said Certified Elder Law Attorney RJ Connelly III. “Once the practice was closed, I would talk with Kathleen who was clearly struggling on just what her and Carl’s life would look like together without a job to go to, living in a new state, and meeting a whole new group of people. After forty years in the medical field taking care of others, she had forgotten her interests outside of the office. Finding a way to feel fulfilled is something that does not occur as soon as the retirement paperwork has been filed.”
For couples like Kathleen and Carl, facing the discomfort of a new life after decades of being synonymous with their career was not only daunting but left them feeling lost and seeking personal satisfaction that their job once provided.
“For many of our retiring clients, they do ask themselves the existential question, ‘Just why am I here?’”, said Connelly. “All of us need a sense of purpose, and for seniors, this sense of purpose is even more important.”
What is a Sense of Purpose?
The best way to describe it would be the point where we reach a milestone in life, like retirement, and we begin to question what living means to us after we walk away from a career, which for many of us, became our identity. At this time in life, we begin to reevaluate what life means to us now, examining how our values have changed along the way, and just who we are when we are no longer defined by our profession. This can be a dramatic wake-up call for most of us.
"Having a sense of purpose is also far more than just finding something to keep ourselves busy in retirement," said Connelly. "It needs to be something that is rewarding to the individual, a reason to get up in the morning and a feeling of accomplishment at the end of the day."
According to Attorney Connelly, it's important to spend time with the newly retired person or couple and explore themes in their lives when reviewing an estate plan with them upon retirement. "When I spoke with Carl and Kathleen about this, I asked them what satisfied them most about their former profession - not what they did, but why they did it. They both thought long and hard about this question and came to a common answer -- helping people."
"We then discussed ways to continue doing this outside of their work and both decided that mentoring peers about aging and retirement would be a great fit for them. They started a blog and a newsletter that is giving them a new purpose in life while satisfying the common theme that they built their lives around," said Connelly.
However, finding a sense of purpose may be far more important than just satisfying a personal need. It may have health implications as well.
Health and a Sense of Purpose
"Purposeful individuals tend to be less reactive to stressors and more engaged, generally, in their daily lives, which can promote cognitive and physical health," said Patrick Hill, an assistant professor of psychological and brain sciences at Washington University in St. Louis. And seniors with a sense of purpose may be more physically active and take better care of their health, some research suggests. Also, they may be less susceptible to stress, which can fuel dangerous inflammation.
Let's look at some studies of how having a sense of purpose can affect health. Studies show a sense of purpose is linked with the following health issues:
Keeps the Brain Working - Professor Patricia Boyle of Rush University in Chicago stated that a sense of purpose in life may help protect against dementia by building the "cognitive reserve", brain connections that if strong enough is thought to stave off the onset of dementia.
Maintains a Healthy Heart - Researchers at Roosevelt Hospital found that those who feel useful to others have healthier hearts because having purpose results in better management of stress and motivates people to live healthier lifestyles.
Promotes a Longer Life - Professor Andrew Steptoe of the University College of London said that a person with a sense of purpose promotes longer life. “There are several biological mechanisms that may link well-being to improved health, for example, through hormonal changes or reduced blood pressure,” he explained.
Stay Independent Longer - A JAMA Psychiatry study found that having a sense of purpose helped people stay physically fit allowing them to age in place longer.
Good Sleep Hygiene - Experts at Northwestern University found that a purposeful life improves sleep and lowers the risk of sleep disorders. In fact, they state that purpose may even be as effective as sleep medications.
But not everyone is Kathleen and Carl, who had time to sit down and think about their sense of purpose or have the resources to do so. What about these seniors?
"You don't need to lead a group or develop a newsletter to find a sense of purpose," said Attorney Connelly. "People can find a sense of purpose from very simple things in life, like planting a garden, taking care of a pet, or even helping a neighbor who may need a ride or help them with simple household chores."
"When I speak with clients about developing goals for later in life, many tend to look for larger things, but honestly, they have already accomplished many of those 'larger things' like a successful career and raising children, so they must be realistic. Just having a goal, no matter how small it may seem, is enough to motivate someone, that's what is really important," said Connelly.
But what about an individual or couples who appear to have nothing to motivate them in life? Is there something their loved ones or friends can do to help light the fuse, so to speak?
"The first thing I would recommend is to encourage them to socialize," stressed Connelly. "Isolation leads to loneliness and loneliness leads to a sense of doom, and goodness knows what the pandemic and lockdown did to extinguish the spark of motivation. But as things get back to normal, encourage them to get out of the house, go to senior centers, take trips with other seniors. Go for walks in parks, museums. There is so much to do and getting them out will open up a new world for them. Socializing and engaging in meaningful conversation will often help seniors regain that sense of purpose."
Could a pet be an answer? "I think pets are helpful for many seniors and of course gives them a sense of purpose. After all, a pet depends on us for food, taking them for walks, and love. But what about a senior who may have physical or cognitive limitations where pet ownership may not be a recommendation?" said Connelly. "In those cases for seniors who love pets, there are options. We have a client who cannot take care of animals in her home for varying reasons but she does volunteer at a shelter with a mentor which gives her a reason to get up in the morning and the interaction with others that she needs to thrive."
Failure to Thrive
"Another issue that can arise in seniors who lack socialization and other forms of stimulation is failure to thrive, a term most of us associate with infants but is being seen more and more frequently with our senior population," stated Connelly. "Adult failure to thrive manifests itself by a gradual decline in the senior's health without an apparent medical explanation."
Failure to thrive symptoms in adults include an unexplained weight loss, decreased appetite, poor nutrition, and inactivity. There are usually signs of depression, dehydration, and impaired physical or cognitive function that may lead to a misdiagnosis. Failure to thrive in adults, like in children, can lead to death. If adult failure to thrive is suspected, medical intervention needs to occur immediately.
Depression in Seniors
Although lacking a sense of purpose can lead to more immediate issues like depression in seniors, chronic depression in that age group can lead to the appearance of being unmotivated. This is an issue that must be addressed by medical professionals.
"Imagine a senior who spent his or her entire life as a provider for a family, the cornerstone for the kids, and has found out that he or she is in the early stage of Alzheimer's," said Connelly. "Now, they know what the outcome of this disease is, and to feel dependent on others can be incredibly difficult, if not demeaning, to them. In such cases, it's even more important to help them keep that sense of purpose, the feeling of being needed by others, in place. If not, you may not only be dealing with Alzheimer's but a depression that could make things exponentially worse for all concerned."
And Attorney Connelly is right to be concerned. Late-life depression affects about 6 million Americans over the age of 65 and yet, only about 10% will get treatment. The reasons for this vary but the most oft-cited one is that seniors do not display similar symptoms as younger people. Some of this is due to the fact that older people have more illnesses and the medications they take have side effects that may be similar to those of depression, allowing the symptoms to be explained away. Another reason is the belief among many that older people "slow down" so the symptoms are often dismissed as a function of aging.
"Depression in seniors is more than just a mood disorder," Connelly points out. "Clinical depression can lead to serious physical illnesses and for some, an inability to heal appropriately following a surgery or an illness."
As Attorney Connelly stated, depression reduces an older person's ability to rehabilitate. Studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increases the likelihood of death from illnesses like heart disease, stroke, and cancer. For that reason, it’s important to make sure that an older adult you are concerned about is evaluated and treated, even if the depression is mild.
Some of the symptoms of depression that older adults may exhibit include:
Have trouble sleeping
Be grumpy or irritable
Struggle to pay attention
Not enjoy activities they used to
Move more slowly
Have a change in weight or appetite
Feel hopeless, worthless, or guilty
Endure aches and pains
Have suicidal thoughts
The Suicide Problem
The connection between depression and suicide in older adults cannot be ignored. Among this group, depression raises the risk of suicide, especially in older white men. The suicide rate in people ages 80 to 84 is more than twice that of the general population. The National Institute of Mental Health considers depression in people 65 and older to be a major public health problem.
Attorney Connelly also points out that the lack of a sense of purpose is compounded by the other issues that arise as a result of aging. "As we age, we begin to lose those around us who provided emotional and social supports. These losses may be because of retirement, moving away, entering institutional care, or even death. This begins to limit the number of people who may see the change in behavior, the onset of depression, and suicidal ideation. As a result, treatment is delayed and outcomes may be less than optimal," said Connelly.
Keep it Simple
Remember the importance of having a sense of purpose and the takeaway is that it doesn't have to be deep or difficult. It can be something as simple as collecting items or working in a garden. It can be a pet or a person (a senior living alone who needs help cooking). But as long as you have something that keeps you waking up in the morning and going to bed at night looking forward to the coming day, you have found your sense of purpose.
"Here's my mantra," said Attorney Connelly, "it doesn't matter how or when you decide to live a purposeful life, it only matters that you do!"