As a clinical year PA student in my mid-20s, there are many privileges associated with youth that I take for granted. It was during this rotation at Metropolitan Hospital where I really learned these privileges. I spent hours talking to older patients mostly in clinic, in patient, or on a televisit. We spoke at length about their medical problems, which were often complex and debilitating, but also about their lives. What is it like to grow old? I asked them. Here is what I learned.

As a general consensus, most of the patients have mixed feelings about aging. Aging is essentially loss – loss of function, independence, health, cognition. Aging is also lonely.  it is accompanied with loss of loved ones and lack of visitation from family. Aging is costly. As we become more dependent and less resourceful than before, it takes money to bridge the gap. For example, medication, transportation, home health assistance, and sensory aids (hearing, visual, mobility), are expensive but a necessity. Although aging is often associated with deficits, I have come to learn that it’s natural process that comes with a lot of benefits. Growing old provides a sense of broader perspective, and it often makes people inclined to focus much of their efforts and energy towards living a blissful life. I learned that elderly patients are  more thoughtful with their decisions regarding their health. For example, when it came to advanced directives almost always would the patient choose DNR/DNI because they would prefer a graceful way to leave the world on their terms. They didn’t want to have the chance to wake up in a hospital bed with a broken sternum or intubated.

To care for an aging patient means to treat the patient from an interdisciplinary perspective, to understand the patient’s history, living situation, support network, available resources, values and goals. It also means to care for their family, understanding that they, too, might be frustrated, fearful, and tired. I saw an 80 year old who was independent in ADLS and lived alone. The daughter of the patient was worried because her mother had suffered from a few recent falls and wanted a home attendant even though their insurance did not cover it. We told the daughter than family members could apply to be the caregiver and get paid for their services. This news gave the patient and the daughter hope and peace of mind.

Geriatric medicine taught me what its like to adopt a mindset of humility and to view each patient as a beacon of lived experience and wisdom. It means to acknowledge that just as a clinician may possess medical expertise, a patient, especially a geriatric patient, is an expert at life itself. Each has something to teach the other.