Thomas Paine's vision of growing old
John Keane
Ladies and gentlemen, young and old and in-betweens,
You may suppose, with good reason, that silver-haired university professors who lead cloistered lives are unsuitable candidates for speaking about the hardships of old age; and for that reason you might be tempted to agree with the conclusion drawn by the 19th-century English writer Anthony Trollope, whose futuristic novel The Fixed Period (1882) contains a sketch of a university-style 'college' where professors and others are compulsorily retired at 67, given a year to contemplate the world, then administered chloroform and peacefully extinguished from the ways of this world. I trust you will be more generous as I tackle a subject in which all of us, young, old and in-betweens, whether we like it or not, have an unbreakable investment.
We live in an age marked by a great change of our age. I am not speaking in riddles. I refer instead to an astonishing development: the long-term, quiet revolution in ageing that has been triggered by the addition of a whole generation to the average person's life span during the past century in countries otherwise as different as Japan, France, the United States and the United Kingdom. From the rudimentary statistics that we have, we know that population fluctuates like a barometer, in response to the changing pressure of living conditions. For most of human history, life expectancy has been short - perhaps 25 years for our hunter-gatherer ancestors and only 37 years for residents of England in 1700.
Dramatic changes began during Tom Paine's eighteenth century, when improved nutrition, economic growth and emerging public health measures (such as the first vaccination against smallpox in 1796) bumped up life expectancy in England to 41 years by 1820. During the 19th century, the delivery of clean water, removal of waste, and advice about personal health habits all led to lower mortality rates, though urbanization had the opposite effect, due to high mortality rates in cities; life expectancy nevertheless reached 50 years by the early 20th century. Especially since the 1930s, average life expectancy has risen dramatically, thanks initially to vaccinations and antibiotics and later to expensive and intensive medical interventions that characterize modern medicine, but also by a combination of good diet, reduction of backbreaking physical labour, physical exercise and (critically important) strong will and altered expectations. The consequence: life expectancy has today reached (in England) 77.5 years for males and 81.7 years for females. Notwithstanding an outbreak of childhood obesity, it is expected to rise further, with the gap between men and women closing.
The reinvention of old age
I want to propose in this lecture that these extraordinary shifts in life expectancy are fuelling a revolution of perception of old age. The revolution is gathering pace in our time. The revolution is in part demographic. For instance, the UK Office of National Statistics has recently stated that the population group expected to rise most quickly is that of people aged 85 and older, a group likely to more than double in size over the next 25 years, to 3.3 million by 2033, with 80,000 centenarians among them. The revolution I am about to describe is however more than demographic. It is transforming what it means to be an ageing person. It is effectively abolishing the belief that ageing is straightforwardly a 'natural' process - a process that we can't do much about, and that therefore has little or nothing to do with politics. The consequence: our understanding of 'old' and 'old age' is out of date.
Once upon a time, the idea of old age as a contingent and, hence, alterable phase of life simply didn't exist. Every culture of course held views about people approaching the end of their lives. In some hunting-gathering societies, for instance, powerful gerontocracies ruled, with elderly men dominating tribal and household affairs, with younger men and women relegated to the margins of power. In other societies, the practice of ancestor worship extended to the veneration of the old as mystical repositories of folklore and wisdom; older women, for instance, were seen to possess special knowledge of matters like childbirth and pregnancy. Yet there was always a compulsion to think of old people as naturally doomed to die, or as naturally decrepit, as beings whose fates ultimately depended upon a deity or deities. Hence the commonplace practice of parricide as a means whereby sons obtained access to family land; and the accusations of witchcraft directed at old women suspected of harbouring potent knowledge.
In the European region, the belief in the absolute primacy of nature had the effect of suppressing awareness of the continuities and discontinuities in the transition towards old age. Old people were viewed simply as spent adults. The old naturally lived on death's doorstep. It was their destiny. The old were expected (in the words of Philippe Ariès) to indulge the prevailing 'massive sentiment of familiarity with death, with neither fear nor despair, half-way between passive resignation and mystical trust'. The expectation was reinforced by the male-centred 'ages of man' imagery inherited from classical antiquity (think of famous paintings like Titian's The Three Ages of Man [1512] and Hans Baldung Grien's The Three Ages of Man and Death [1539]). The immutability of old age was nurtured as well by the parallels that were sometimes drawn between the stages of life and the behaviour of the seven planets; or by the parallels that were shaped by the belief in the four humours. Certain strands of Christianity reinforced the sense of ageing as an ineluctably 'natural' process, as did literature, for instance Shakespeare's All's Well, that Ends Well [1601-8], in which the King of France speaks of 'haggish age' stealing life and wearing out action.
From roughly the end of the sixteenth century, when Shakespeare was writing, perceptions of old people and ageing began to change. Why and how perceptions changed, slowly at first, I cannot explain in detail. Elsewhere I have pointed to the decisive importance of the emergence of civil society - that is, the growth in the European region of geographically dense networks of non-governmental institutions, such as free towns, markets, independent churches, publishers, scientific and literary associations, themselves protected by parliaments, written constitutions, periodic elections and other mechanisms of representative government. The new universe of civil society (as it was called from the time of the revolutionary events in the American colonies) profoundly transformed the way many people regarded old age. The mentality of fatalism was challenged. But who exactly were the social carriers, the prime movers of this redefinition of the elderly? The task of pinning down the transformations that now form part of the history of ageing is not easy, if only because there is an obvious problem of sources. In their diaries, letters and autobiographies, members of the literate and educated elites and upwardly mobile groups left behind traces of their thoughts and feelings about old people; by contrast, the ways in which (for instance) the vast majority of the population, peasants and rural and urban labourers, regarded old people have passed into oblivion. The evidence that has survived however suggests that among the first to express sustained interest in older people and their proper place in an emergent civil society were Protestant circles clustered around Luther, the Protestants of the Low Countries and the English Puritans.
The contributions of these rising lower middle class believers to the redefinition of old age sometime during the sixteenth century was initially justified using many different and conflicting labels, including Christian duty, civility, civilization, civil society, the commonwealth, the order of liberty, the republic and education. But the quarantining effects linked to these epithets - the demarcation of 'the old' as a category of people worthy of special enquiry and treatment - were pronounced and, historically speaking, without precedent. Old people were no longer principally seen as slaves of their bodies, frail and devilish creatures tainted by the sin that began at the time of creation, an original weakness that was subsequently passed down from generation to generation (a view that lingered for a long time, often being associated with the theology of St Augustine). Old people were also no longer principally regarded as adults exhausted by nature. Old people instead became objects of adult definition and adult psychological interest and moral solicitude.
Let us take a few examples, beginning with imaginings about the prolongation of life. David Haycock's Mortal Coil: A Short History of Living Longer (2007) shows that roughly four hundred years ago European scientists, philosophers, physicians and writers began to define and explore the quest for the prolongation of human life. It was a project that intrigued Sir Francis Bacon (who wrote on the subject of the advantages and disadvantages of age, and wrote a history of life and death [1638]) and it underpinned various scientific innovations. Ideas of ultimate perfectibility, indefinite progress and worldly rather than heavenly immortality, later fed directly into the spirit of the Enlightenment and the birth of disciplines such as medicine and psychology - featuring figures like René Descartes and Benjamin Franklin - and subsequently into today's world of bio-genetic research, cryonics and other fields that continue to search for the same elusive philosopher's stone.
A second example: by the eighteenth century, the century that was to witness a great leap forward in life expectancy, there was a growing literary preoccupation with the process of ageing, from the inside. Jonathan Swift's Travels into Several Remote Nations of the World by Lemuel Gulliver (1726) tells of the introduction of Captain Gulliver to the Immortals of the Kingdom of Luggnagg. Gulliver grows instantly excited at the thought that immortality might also come his way, but he is quickly disabused by his introduction to certain people in the kingdom called Struldbrugs: 'they commonly acted like Mortals, till about Thirty Years old,' wrote Swift, 'after which by Degrees they grew melancholy and dejected, increasing in both till they came to Four-score.' Struldbrugs 'had not only all the Follies and Infirmities of other old Men, but many more which arose from the dreadful Prospect of never dying. They were not only opinionative, peevish, covetous, morose, vain, talkative; but uncapable of Friendship, and dead to all natural Affection...Envy and impotent Desires, are their prevailing Passions.' Swift added that the Struldbrugs 'find themselves cut off from all Possibility of Pleasure; and whenever they see a Funeral, they lament and repine that others have gone to an Harbour of Rest, to which they themselves never can hope to arrive.' He concluded: 'They have no Remembrance of any thing, but what they learned and observed in their Youth and middle Age, and even that is very imperfect.' Swift himself feared dementia, and three years before he died, in 1745 at the unusual age of 77, he was declared of 'unsound mind and memory'. As if to mock old age, he still managed to retain a sense of self-deprecating humour, declaring in his last will and testament that he had decided to donate money to establishing a mental hospital around Dublin for 'ideots & lunaticks' because Ireland was more in need of such institutions than any other nation.
A final example: the late 18th-century public fascination with the figure of the puer senex, the rare male child prodigy who behaved from the beginning like an old man, serves as another instance of the gestalt switch in the perception of ageing that began to happen in modern times. The fascination with old young people was in effect a preoccupation with freaks that defied the rules of an era in which the young were deemed non-adults and the old were naturally a spent force. Thomas Williams Malkin was a much talked-about example. According to his father's testimony (Benjamin Heath Malkin, A Father's Memoirs of his Child [London 1806)]), he was born in 1795, started his career at the age of three, proved himself to be an expert linguist at four, an outstanding philosopher at five, and then began reading the fathers of the church at six, only to die of old age and excess at seven.
Agrarian Justice
These examples reveal a bigger trend that touched the life of Thomas Paine. By the end of the eighteenth century, popular interest in the compression and blurring of 'the three ages of man' implied not only a deepening consciousness of the possible contingency of ageing. It also implied a deep desire to do something about the wretchedness of ageing. Exactly that spirit was expressed at length in Paine's remarkable tract Agrarian Justice, opposed to Agrarian Law, and to Agrarian Monopoly (first printed in Paris and reprinted in London in 1797). Written after a bout of jail fever (typhus) and pinched by fears of imminent death during the winter of 1795/6 - I remind you that this was the year in which the first smallpox vaccination was carried out in Britain - the pamphlet was a reply to a sermon by the Bishop of Llandaff, the good Richard Watson, former Regius Professor of Divinity, Cambridge and Archdeacon of Ely. Paine was upset by the way the bishop had praised the division between rich and poor as a sign of God's wisdom. The pamphlet was also Paine's commentary, six years into the French Revolution, on a troubling development: the rapid growth in post-Jacobin France of a class of nouveaux riches. In contrast to the Jacobin dictatorship, which had preached austerity, the new Thermidoreans (said Paine) were discovering private freedoms, mixed with market pleasures. Civil society was reborn, but the return to laissez-faire split it into classes of rich and poor people.
The widening inequality Paine considered unnatural. Poverty was not ordained by God. It was thoroughly historical, the work of human hands. 'To understand what the state of society ought to be,' wrote Paine, 'it is necessary to have some idea of the natural and primitive state of man; such as it is at this day among the Indians of North America. There is not, in this state, any of those spectacles of human misery which poverty and want present to our eyes in all the towns and streets of Europe. Poverty, therefore, is a thing created by that which is called civilized life. It exists not in the natural stateÂ…The life of an Indian is a continual holiday, compared with the poor of Europe; and, on the other hand, it appears to be abject when compared to the rich. Civilization, therefore, or that which is so called, has operated two ways, to make one part of society more affluent, and the other part more wretched, than would have been the lot of either in a natural state.'
Paine considered poverty as not only historically specific (loud echoes of his view were later to reverberate through the Make Poverty History campaigns of our time). Poverty was shameful. He likened the division between poor and rich to 'dead and living bodies chained together'. But against the apologists of poverty, he insisted that the problem was remediable. Poverty is not God's will. The tactic of governing by 'breaking the spirit of the people by poverty' was neither inevitable nor practicable. Poverty is an artificial, humanly produced, humanly curable blight. 'It is wrong to say that God made Rich and Poor', wrote Paine, 'he made only Male and Female; and he gave them the earth for their inheritance.' Paine poured scorn on the suggestion that God favoured private property, as if 'the Creator of the earth' had once upon a time opened 'a land-office, from whence the first title-deeds should issue'. He instead embraced the principle that the earth is 'the common property of the human race', which implied (Paine said) that amidst all the productivity benefits of private property the propertied rich had an obligation to help the poor - the old, the blind, the lame - not by charity alone, but by acknowledging that the trend whereby 'the working hand perishes in old age, and the employer abounds in affluence' was incompatible with the new system of representative government.
The propertied rich would therefore have to accept a government-sponsored inheritance tax system designed to redistribute and equalise income, to eliminate what Paine called the 'extraordinary violence' of poverty. Paine did not say what would be done with recalcitrant property owners and their families who refused to acknowledge the common property right, let alone pay their share of death duties. He supposed that they would come to their senses, or at least comply with the plan for fear of the French revolutionary events spreading everywhere; the problem of strikes by the wealthy against redistributive policies had to be faced by later social reformers. Paine instead sketched a plan for setting up a National Fund out of which every man and woman reaching twenty-one years of age would be eligible, as 'a right, and not a charity', for a compensatory one-off payment of fifteen pounds sterling, enough perhaps to 'buy a cow, and implements to cultivate a few acres of land'. At the same time, every person 'rich or poorÂ…to prevent invidious distinctions' reaching fifty years of age would receive an annual citizen's pension of ten pounds. Those who chose to refuse their annual payment would find their share paid directly in the common fund, from which they could later draw retroactively, if they so chose: 'as we often see instances of rich people falling into sudden poverty, even at the age of sixty, they would always have the right of drawing all the arrears due to them'.
Ageing & politics
Paine was no demographer, and it is true that he lived in an age not only without reliable statistics, but in times when most people did not even know or remember their dates of birth. He guessed that the population of England was around 'seven millions and a half' and that the number of people who had reached the age of fifty was 'about four hundred thousand' (less than 20 per cent of the total population). He also estimated that on average men and women would live 'about thirty years' after the age of twenty-one: 'though many persons will live forty, fifty, or sixty years, after the age of twenty-one years, others will die much sooner, and some in every year of that time'. Paine's guesswork need not detain us. What is surely impressive is his image of old age as a contingent phase of life, as a period that contained within it different and potentially better options. Simply put, Agrarian Justice, opposed to Agrarian Law, and to Agrarian Monopoly was a pioneering effort at thinking in practical utopian ways about a new politics of ageing whose ultimate aim was the eradication of the misery produced by old age poverty.
The pamphlet undoubtedly radiated the hard lessons he had already learned personally about the wretchedness of ageing and death. During the annual Thetford Assizes, as a young boy, he had witnessed hangings, watched by wide-eyed crowds, on Gallows Hill, not far from his rented family cottage on Bridgegate. His first and only wife (Mary Lambert) and child tragically died during childbirth in Margate. He narrowly survived an ice storm when crossing the Atlantic on a passenger sailboat. He had witnessed suffering, wounding and death during the American colonies' resistance to the redcoats of the British Empire, beginning with the Battle of Lexington. Thanks to a remarkable cock-up by jailers, his neck escaped the guillotine of the Luxembourg prison during the period of Jacobin terror in France. It could also be said that Agrarian Justice foreshadowed the wretchedness that plagued Paine's later life - and his attempt to live meaningfully and to the full, without relying on bogus beliefs in the supposed 'truth of the Christian system' (as he wrote in the first part of The Age of Reason).
He lived until 72, twice the average of his day (was it the Norfolk air of early childhood?), but he also found himself surrounded by nagging men of God, parsimonious parsons and self-righteous preachers who tried to scare others into believing the deist (who wrote that his religion was to do good) was in fact a filthy atheist. We know he physically suffered terrible pain from fits of gout, and in general from the aches and pains of an ageing body for which, in times without cheap painkillers except gin and brandy, he suffered the extra humiliation of hyperbole and verbal insults. We know as well that he handled himself with remarkable dexterity, and that despite fears of pauperisation writing with quill and ink was for him an act of public affirmation, an intellectual and emotional flight from a body with declining powers; and that he kept his sharp sense of humour until the end. In the extraordinary 1804 series of pieces published in Elihu Palmer's deist journal Prospect; or, View of the Moral World, Paine was at his best when satirising contemporary Christian customs and beliefs. He spoofed the fanaticism of Sunday laws of rest, which 'oblige a person to sit still from sun-rise to sun-set on a Sabbath day, which is hard Work'. He paid special attention as well to the fable of Noah, which according to Paine contained many anachronisms. 'My opinion of this story', he wrote, 'is the same as what a man once said to another, who asked him in a drawling tone of voice, 'Do you believe the account of No-ah?' The other replied in the same tone of voice, ah-no'.
Paine's emphasis on the need to civilise civil society, to use government intervention to put a stop to malnutrition and the fear of starvation and uselessness that still gripped the bulk of the elderly among Europe's peasantry, craftspeople and urban workers and vagrants, was radical, and compelling. 'It is not charity but a right - not bounty but justice, that I am pleading for', he wrote. His insistence that philanthropy was not enough, and that a public solution was now necessary - 'a system of pullies, that the whole weight of misery can be removed' - was to gain ground, for instance in the nineteenth-century campaigns by friendly societies and the labour movement to win support for retirement policies and state pensions designed to improve the living conditions of growing numbers of older people pushed from gainful employment into retirement, simply because there were no jobs for them.
Paine may have been idealistic for his times. 'An army of principles will penetrate where an army of soldiers cannot', he wrote. But his vision of the universal right to age in dignity, to do something collectively to put an end to wretchedness in old age, was gradually to change minds. Political successes were eventually to come, for instance in the pioneering pension schemes ratified by law in Bismarck's Germany in 1889 - the world's first government-run old-age security plan - Denmark in 1891, New Zealand in 1898; and in Britain in the 1908 Old Age Pensions Act, backed by the Liberal government of David Lloyd-George, which introduced the first general old age pension paying a non-contributory amount of between 10p and 25p a week, from age 70, on a means-tested basis from January 1 1909 - 'Pensions Day'. The public demands by Paine and others to improve the status of older people had many, various and interesting effects, ranging from the early twentieth-century invention of gerontology as a field of study of ageing from the biological, psychological and socio-economic perspective to a breathtaking trend that is today by no means spent: the emergence of a politics of old age.
If Paine were alive today, he would find himself astonished by the changes that are taking place. In the United Kingdom and many other countries, average life expectancy has been rising some 2½ years each decade for the past 4 decades, one consequence of which is to break down the lock-step life course - youth followed by middle age followed by old age. Silver societies - let's call them - emerge in which a brand new generation of people between roughly the age of 50 and 70 years are living healthier, more vigorous and 'youthful' lives for the first time. No longer biologically and socially immutable, old age has become a building site, a phase of life that is up for grabs in every sense. The repertoire of images and interpretations of what it means to grow older is widening. The emerging kaleidoscope of views about old age means that the grip of the metronome on older people's lives is weakening; the linear compulsion to carve up their lives into equal days, days into equal hours, hours into equal minutes and seconds, is beginning to be counter-balanced by the introduction of novelty and the corresponding multiplication of different time frames (to speak in the language of Michael Young's The Metronomic Society [1988]).
It might even be said that old age is becoming so pluralized that 'old age' is no more. New spaces are opening for different definitions of seniority; some people, for the first time, are able to find a voice in the public square, even to win political and legal protection for their claims. Some elderly people become active senior citizens. The once-reigning assumption that 'old people' or 'the elderly' have common interests - because they are ill, frail, demented - is breaking down. The term 'ageism' (coined in 1968) has been let loose on the world. There is much talk of productive ageing; of older people as important custodians of memory; and evidence is growing in some countries that older people are acting as material supporters of younger people, so defying the traditional view that old people are a burden on the young. There are calls for new ways of breaking down the image of 'the elderly' as 'old codgers' and 'old women', as interested only in knitting, gardening, fireside chats and reading. There are demands for new policies to widen the structures of opportunity available to older people; and loud calls for new ways of supporting frail old people in acknowledgement of their basic rights as citizens to enjoy their old age in meaningful and socially interesting ways, wrapped in dignity and respect from others.
Incivilities
That older people should be liberated from humiliation so that they can live in dignity and respect, as citizens, was of course Thomas Paine's point. But he was also among the first to say publicly that reality cheated the elderly. His warning reminds us that for many older people life in contemporary civil societies is no paradise on earth. They see no golden age of senescence, either in the past or the present; and they do not think the improvement of their lives is just around the corner. They rather feel a major curse of older age, bad luck. Luck can be cruelly undemocratic. Through simple twists of fate, frailty and/or disablement can suddenly hit us while our peers are meanwhile still behaving like adolescents. The dense networks of solidarity and self-help available through a well-functioning civil society - patterns of friendship, domestic care, institutions of further education, the café, bingo hall, the pub - cannot magically reverse rotten luck, although they can to some extent cheer people up.
The feeling of many older people that though they are lucky still to be alive, being old resembles either an unlucky dip or a life sentence in prison after luckily escaping hanging, easily breeds feelings of disappointment and bitterness, along with the dysphoria of loneliness - the broken hearts, the inactivity and consequent physical deterioration of their bodies. Other ailments drag older people into wretchedness. The first-ever WHO global report on violence, published in 2002, estimates that at least 6 per cent of older people (aged 65+) have been the victims of violence. The estimate is probably too low; and that is why new remedies are urgently needed, like the Mexico City municipal government's current campaigns to publicise the problem of violence directed at older people by encouraging kiss-ins, such as that held earlier this year on Valentine's Day at 3pm in Mexico City, when 40,000 old, young and in-between people gathered as part of the city's fair called "El amor es sin violencia... besame mucho" promoting non-violence in relationships. The people - or the lips - of Mexico City now hold the world record for public kissing; the previous record holder, sadly for England, was Weston-super-Mare.
Then there is the growing problem of poverty. It is important to remember that the contemporary revolution in longevity is not just a rich country affair, but a world-wide phenomenon; more than 60 per cent of people over sixty reside in poorer countries, a percentage that will soon rise to around 80 per cent, while one-fifth of the world's older people now live in China, where life expectancy nudges global standards. Closer to home, there is rising awareness that in the richest countries people - women, disproportionately - do not arrive at the gates of the autumn of their lives with equal resources in hand. Among both the 50-70 year-olds and the over 70s, inequalities of wealth and income are widening, and deepening. The spectre of old age destitution is looming for growing numbers of ageing people. In the UK, according to a 2006 Joseph Rowntree Trust report, 2.2 million or 30 per cent of older people of pensionable age are now living in poverty (poverty defined as less than 60 per cent of median income); the figure is three to four times higher than in Austria, Netherlands, Sweden, Italy and Luxembourg.
The trend raises questions about what kind of democracy we have on these islands. Poverty is generally made worse by mounting anxieties about unemployment (half a million workers aged 65 and over cannot today find a job in the USA), the viability of health and domestic care arrangements and pension systems. Take the case of pensions: the current drive by companies and government to reduce or dismantle pensions (the tactics range from shifting from defined benefits to defined contributions schemes all the way to abandoning pension schemes altogether) is worrying. This is especially true for women, who generally are disadvantaged compared with men. Discrimination against women in the field of pensions was evident even before the onset of the great recession, in that (in 2001 in the United Kingdom) fewer older women than older men receive a private pension (35 per cent versus 67 per cent). Fewer women than men receive an occupational pension (57 per cent versus 71 per cent). Consequently, the decline in value of the full basic state pension since 1980 - it is now £95.25 a week - has hit older women especially hard. Things will not be made easier by the raising of the state pension age for women (those born between 6 April 1950 and 6 April 1955) from 60 to 65, which is what shall happen between next year and 2020.
Then (as if to compound the wretchedness of old age) there is the embarrassing problem of rising unhealthy life expectancy. We feel cheered up by statistics, such as those that reliably predict that a British man who hits his 65th birthday will, on average, live to a few months shy of his 90th year. Yet realities are more wretched. For older people are more and more faced with the challenge of personally coping with one of the darkest and least-discussed trends: the growing mismatch between rising total life expectancy and healthy life expectancy. In the richest parts of the world, the average lifespan is nearing 80 years. If present trends persist, as has happened for over a century now, most people born today will live to the age of 100 years. But what will these additional years in fact mean for many older people?
In an effort to make sense of the trend, the University of Cambridge researcher Guy Brown (The Living End: The Future of Death, Aging and Immortality [2008]) has recently noted that death is being transformed from a 'digital' event - a sudden switching off of a light, due to infectious disease, heart attack or accident - into an 'analogue' process that rather resembles the slow elimination of light using a dimmer switch. What this means is that many people are now faced with the prospect of spending their final years on a miserable slow-motion journey towards degradation and darkness. There is of course nothing inevitable about either the degradation or the darkness. The economics of the pharmaceutical industry play a part, if only because its profits are enhanced by manufacturing drugs that turn acute sources of physical death into chronic diseases, thus turning people into patients for life. Government health policies reinforce the trend by investing disproportionately in campaigns to prevent heart attacks and infectious diseases.
The upshot is that growing numbers of ageing people are left to tackle the effects of ageing on their own. They experience, as no previous generation has experienced, the painful subdivision of dying and death into its component parts. They learn first hand what it means to fall apart, to slide towards death, out of sequence, bit by bit. They are forced to cope with the death of reproduction, the death of erotic desire, the death of the ability to run and jump, the death of memory, the death of laughter, the death of playfulness, the death of the will to live. The growing disjunction between their biological lives and their autobiographical lives - their felt ability to tell themselves and others coherent stories featuring their selves as central characters with unique and meaningful qualities - is unlikely to be solved by technological breakthroughs. The opposite is much more probable. The pain and misery brought by analogue death is likely to be exacerbated by the common experience of confinement in hospitals, unfriendly places where withered and worn out bodies are kept alive by virile machines, switches, wires and tubes.
A new politics?
Ageism, insults, violence, fears of falling into poverty traps, worn out bodies, slow death on life support machines: none of this is pretty, which is why the new forms of suffering raise political questions. What should be done about this wretchedness of old age in the early years of the 21st-century? Can anything be done?
Tom Paine, the commoner with a Norfolk accent, the great writer who supposed that the vast majority of people would not live much beyond 50 years, and that most would succumb to infection, or accident, lived in times fundamentally different from ours. It should therefore not be surprising, especially because of the radical stretching of life expectancy that is going on, that people on the road to old age - and younger people as well - are slowly but surely being confronted with political questions unknown to their parents, grandparents and great grandparents, let alone to Paine's generation. I hope you will see that in this lecture I have therefore drawn on the spirit rather than the letter of his writings, to pose the basic question that he also posed: what does it mean to live old age freed from wretchedness?
Replies to this question are not easy. But our times they are a changing. Were he suddenly to re-join us, Tom Paine would be pleased to observe that a politics of ageing is beginning to happen. It is true that 'age warfare' is not on the political agenda. It is just possible that countries such as Britain are set to experience the permanent sub-division of older people into a large underclass of politically marginal and physically and mentally individuals incarcerated in homes for the aged, hospitals and other institutions, and a small 'gerontocracy' of relatively well to do retired and semi-retired people who, in some countries, act as a sizeable group of voters capable of wielding considerable political clout, mostly to keep things as they are. This long-term scenario is certainly possible, and if it came to pass it would definitely be bad for our democracies and their avowed commitment to equality.
On the other hand, it is equally true that technological battles against the plagues of ageing will never succeed. Those who think that so-called SENS - strategies for engineered negligible senescence - make sense are bound to be disappointed. Engineered wellness, the dramatic extension of lives lived in an unending summer of health and vigour, is not on the horizon. For that reason alone, it seems likely that growing numbers of older people will themselves decide to confront the growing problems we face. In an era (in the United States) when more than 50 per cent of people over 85 are still mobile and independent, it is most improbable that silver citizens feeling the wintry chill of ageing will suddenly or somehow go quiet, roll over and die.
It is significant that a public literature on senescence (and a market for it) is burgeoning; for the first time on any scale, older people are writing about ageing from the inside, from behind enemy lines, as it were. That's a good and helpful sign. José Saramago's wonderfully imaginative Death at Intervals (2008) is something of an anthem for this changing sensibility. Framed by a wickedly Swift-like sense of humour and irony, even by the willingness to poke our tongue at the inevitably of our dying and eventual death, Saramago's novel can be seen as a reply to the desperate advice once dispensed by the poet, Dylan Thomas: 'Do not go gentle into that good night. Rage, rage against the dying of the light.' By contrast, Saramago's fable invites us to imagine a society where one day, without warning, people stop dying. The break with the inevitable has dramatic effects. The government is paralysed, but the undertaking industry adapts by going into the business of arranging funerals for animals. Insurance companies spend their time wriggling out of guaranteed coverage of the permanently undying. Those old people who try to act as if they were sitting by the fireside telling stories to their grandchildren are ridiculed. Some people euthanise the living dead by transporting them across borders, to places where death remains active. The priests are petrified by death's obsolescence. So are the terminally ill. People begin to ask themselves soul-searching questions: how can we exist without mortality? If we cannot imagine death, let alone what comes after death, then what point is there in religion? Do we have the right to take our own lives? Do we have an obligation to help others who wish to, but cannot?
Saramago's satire hits below the belt. It touches sensitive spots. It asks us to imagine a society populated by living dead or 'over-aged' people who are haunted by tough basic questions about what they want out of life. Surely Saramago is right: the contemporary postponement of death prompts us to search or souls and to wrestle with the practical task of cultivating life, freed from the wretchedness of old age. Much the same concern is evident in the emerging politics of dignified death. It is highly significant that public and professional interest in assisted suicide is rising. In this country, intense media interest in the recent assisted suicide of the renowned conductor Sir Edward Downes (aged 85) and his partner Lady Joan Downes (aged 74), at the Dignitas facility in Switzerland, serves as a weathervane of things to come. Groups like Christian Nurses and Midwives and the Royal College of GPs remain firmly opposed to the principle of choosing to die in dignity. But we know things are changing when the Royal College of Nursing, which has 400,000 members, shifts its stance from opposition to neutral, as it did this past summer, despite the fact that health staff caught providing patients with drugs needed to take their lives currently face up to 14 years behind bars.
Signs of new forms of collective action are also multiplying. In New Zealand there is even a Grey Power movement, founded 20 years ago by elderly citizens angry about government attacks on their pensions. The Kiwi initiative now concentrates on tackling such problems as the 'phantom waiting lists' that shuffle elderly citizens between their GPs and specialists, in effect giving them the run around within the health service. Such campaigns remind us that some of the antidotes to wretchedness must necessarily be 'public', in the sense that governments, parliaments and elected representatives must be pushed by citizens to recognise their duty to find practical ways of making life better for the elderly. I have mentioned (at random) the New Zealand and Mexico City initiatives, but many others are thinkable, and desirable, even necessary.
A reformed and improved pension system that expands choice, guarantees an adequate minimum of support for the elderly, as of right, as Paine first proposed, is essential. Taking seriously what the great English demographer Peter Laslett once called 'processional justice' requires other public solutions. Tackling ageism in the labour market, for instance using methods inspired by the pioneering 1967 Age Discrimination in Employment Act in the United States, is vital. Equally imperative is renewed public support for shrinking the scope of medically aggressive treatment, its replacement by pleasant places of comfort in which terminally ill older people are offered pain relief, comfort and company, with a smile. It so happens that we are living in times of rising public interest in new ways of handling the new wretchedness of life's endgame. A ground-breaking 2005 report from the Alzheimer's Association in the United States points out that the poor public understanding of advanced dementia in effect sanctions all sorts of unpleasant medical treatments - colonoscopies, dialysis, drugs for osteoporosis and cholesterol - that add to the agony and woes of older people. The report questions the prevailing view that dementia is a disease of the mind, an illness that erases treasured memories but leaves the body intact. It emphasises that dementia is in fact a physical illness, a progressive terminal disease that shuts down the body as it attacks the brain; and the report therefore goes on to challenge the prevailing fetish of medical intervention in hospitals and nursing homes by asking (for instance) why only 11 per cent of older people suffering advanced dementia are referred to hospice care.
The hospice movement that began in the late 1960s deserves a renaissance. Institutions like St Christopher's, founded in London by Cicely Saunders in 1967, stood for comfort as an alternative to aggressive medical intervention. It aimed to care for dying patients by emphasising the value of social and psychological support, plus pain relief. Helped by such works as Elizabeth Kübler-Ross's On Death and Dying (1969), hospices sought to confront head on the fact that many people do not react to the awareness of their own death and dying by heroic leaps of personal growth and self-enhancement. They suffer hell on earth. Delusions, depression and anxiety disorders and severe pain and disability are their lot. That is why, if given a choice, most people (70 per cent in the United States) prefer to die at home, as they mostly did a century ago, and in Tom Paine's time. Sadly, only 25 per cent now do; only 1 per cent of people pass away in hospices, which have been starved of funding, integrated into hospitals, diversified into day care and home care centres and (as Julia Lawton's The Dying Process [2000] points out) increasingly reserved for patients with such terrible medical symptoms that they cannot easily benefit from social and psychological help. So the vast majority of people (75 per cent in the United States) now end their lives in either a nursing home (25 per cent) or in hospitals (50 per cent) that might better be described as 21st-century technological prisons.
The personal as political
Tom Paine's exemplary personal battles with ageing remind us that choices and changes in everyday life can and do have wider effects, that when things seem hopelessly inevitable personal decisions can change the course of events by having wider political consequences. The principle that the personal is political - that supposedly powerless individuals have within themselves the power to change things, for the better - is today being applied by growing numbers of older people. Some efforts to deal with the wretchedness of ageing are arguably questionable, or less than effective. In search of a crutch, some ageing people are reading a lot (perhaps too much) of Philip Roth, especially his Everyman, to confirm their view that old age is not a battle, but a massacre. Others spend their time quietly cursing that they are lucky still to be alive, rather in the way a lifer in prison is lucky to have escaped hanging; or they seek solace in the bottle, or in God's covenant with the children of Israel, or in Moses or Christ's or Mohammad's victory over sin and death. Still others find solitude in gardening and nature and the moments of inexplicable joy and intensification of the senses they can and do often yield.
Good luck to them, I say. And good luck as well to those who strive to craft more potent and positive outcomes by talking to wise friends; or by pondering the prudent advice offered by manuals on ageing. Their numbers are growing rapidly, and within their pages gems of wisdom can sometimes be found. For instance: walk in the footsteps of long-living laboratory chimpanzees on a reduced diet by eating better, and eating less. Pick at puddings. Try supplemental calcium, oestrogen replacement and drinking a drop of red wine to ensure a healthy daily diet of resveratrol, a compound supposed to have anti-cancer and anti-inflammatory properties. Get plenty of exercise. Heed the advice of 99-year-old Glaswegian Jerry Morris, the first scientist (60 years ago) to observe that London bus conductors had substantially fewer heart attacks than sedentary drivers, and who daringly drew from this the inference that vigorous physical exercise normalises the workings of the body, as well as the radical policy implication that with the decline of hard manual labour robust exercise, for the first time in human history, is disappearing from daily life and thus becomes an imperative, including for women (not much has changed since the pioneering English National Fitness Survey of 1990, which found that half of women aged 55 to 64 could not comfortably walk a mile).
Avoid the mawkishness of nostalgia. Mind things less, enjoy things more. Remember that facelifts may look stunning at night but a bit weird by day; and that crows feet around eyes are the dried-up beds of old smiles. When friends and relatives die, love those remaining harder and deeper. Grow the capacity for compassion. Suffer fools less gladly. Commit to love and charity. Become a life lover. Forget your birthday. Take comfort in the story that Einstein, getting on a train at Paddington, asked whether Oxford stopped at his train. Keep a pocket full of lists, and check them regularly. Deal with the disabling effects of the creeping sense that as you get older, the past grows ever larger. Do so by stretching and widening your horizons by planning ahead. Don't be panicked by the slackening pace of libido; think of it as a return on a higher level of the freshness and gleam of childhood, minus its multiple insecurities. Face down physical impotence by cultivating the erotic imagination, remembering that in the dictionary the beautiful word sexagenarian comes immediately after sex; and, well, have more sex: bang on rather than sign off.
Avoid self-pity. Listen to plenty of Handel, or U2 or (if you really must) the Beatles, remembering Sir Paul McCartney's confession to the Los Angeles Times (February 2006) that "When I'm 64" should have been titled "When I'm 94". Cultivate and keep a sense of humour. Grow old disgracefully. Think of the comedy writer Jilly Cooper: 'the menopause is nothing more than a pause between men'. Ponder the impertinent advice offered by that well-known, spookily youthful Melbourne housewife, an elderly woman who lists kissing among her hobbies, Dame Edna Everage: 'I stay young because I pick up the Gift of Life and run with it - in heels!' Recite a few lines of Jenny Joseph's 'Warning': 'When I am an old woman I shall wear purple/With a red hat which doesn't go, and doesn't suit me./And I shall spend my pension on brandy and summer gloves/And satin sandals, and say we've no money for butter./I shall sit down on the pavement when I'm tired/And gobble up samples in shops and press alarm bells/And run my stick along the public railings/And make up for the sobriety of my youth./I shall go out in my slippers in the rain/And pick the flowers in other people's gardens And learn to spit.' Or, speaking of disgraceful humour, remember George Melly, the Scouse jazz and blues musician famous for his insistence that pleasure can be gained from deafness, if only because it makes boring conversations more interesting; and renowned for his amusing anecdotes, like the time that he was apprehended by a police constable while urinating against a wall in Shepherd's Bush. Melly explained that it was a medical problem linked to ageing. All right, replied the young bobby, 'but next time try not to choose the wall of a police station'.
Ladies and gentlemen, young and old and in betweens: the age of old age without pain and suffering, humiliation and violence has not yet arrived. But as life expectancy, the political expectations of older people and the tides of economic uncertainty all rise, and as there is ever less life left in the old maxim 'thrifty 'til fifty then spend to the end', we can safely say that the era of condescension of senior citizens, of patronising talk of grumpy old men, kind old ladies and tittle-tattles clutching teacups in rocking chairs, is over. If that is so then future historians looking back on our times are likely to note a strikingly novel trend: while the age of wretchedness in old age has not come to an end, we witness, in the spirit of Thomas Paine, the growth of public and private initiatives to build a different future for older people, led by senior citizens and their representatives unwilling to accept the sordid and unjust reality of things present.
John Keane is Professor of Politics at the University of Westminster and WZB and a Fellow of the Royal Society of Arts. His books include the prize-winning biography Tom Paine: A Political Life. His full-scale history of democracy, The Life and Death of Democracy, was published earlier this year. This public lecture was delivered at the closing event of the year-long bicentenary celebrations, Tom Paine 200 Festival, Carnegie Room, Thetford, 7 November 2008.
Suggested citation Keane, John, ''Old Age Without Wretchedness' ', Evatt Journal, Vol. 9, No. 6, December 2009<https://evatt.org.au/old-age-without-wretchedness>