Lessons from the Vertical Limit: Valuing Older Adults

What is the value of a life? Many older adults see it as diminishing in a world where new is better and old is disposable. The cultural rhetoric can be discouraging as the news of threatening Social Security and Medicare long term solvency crisis suggests that older adults, specifically Baby Boomers, are an economic liability. The potential for too fewer contributors to the program to sustain benefits has led to political rhetoric and increasingly challenging proposed solutions [1-3]. Increased life expectancy has become a buzzword for the burden of boomers on a younger workforce? When we can no longer "do" the things we used to do, the challenge offered us by Viktor Frankl is to remember and be the model of a life well lived [4].


Short Communication
What is the value of a life? Many older adults see it as diminishing in a world where new is better and old is disposable. The cultural rhetoric can be discouraging as the news of threatening Social Security and Medicare long term solvency crisis suggests that older adults, specifically Baby Boomers, are an economic liability. The potential for too fewer contributors to the program to sustain benefits has led to political rhetoric and increasingly challenging proposed solutions [1][2][3]. Increased life expectancy has become a buzzword for the burden of boomers on a younger workforce? When we can no longer "do" the things we used to do, the challenge offered us by Viktor Frankl is to remember and be the model of a life well lived [4].
In Carl Jung's understanding of the life cycle, life is defined by dependence at both the first and last of life. The joy of the child is found in the expectation of life; the joy for the senior is in the example of a life fulfilled. There is always meaning to be discovered in life, if we take the time to grasp it. Frankl in his famous statement once noted that the world can take anything away, except for our right to perceive the world [4]. Even in our dying, we can be an example for the world.
These are tangible, concrete benefits to society from the group of retirees who continue to engage in service without pay. However, all that older adults offer the younger generations does not come in the services of grandparent grandchildren or volunteering in agencies or at elections [5]. The wisdom, love of life, and opportunity to learn from suffering are gifts of value impossible to quantify.
The following is a journal entry from a social worker's observations of lessons learned from an older adult dying with ALS (Lou Gerig's disease). A farmer who could no longer farm; a story teller who could no longer tell the stories of the land; a hero who could not move but moved me.

Life Lesson Without Words
I had known him for several months; watched the strength drain from his arms and legs Watched him begin to struggle for air and lose the ability to swallow without choking. He was unable to walk or laugh; He could not cry without choking on his own secretions Understanding him grew increasingly difficult. ALS was robbing him of every communication except blinking his eyes. I did not know how to help. I did not know. His eyes met mine, and then cut to the window that looked out over his land. He blinked twice, a silent "yes. " I asked if he wanted to be outside…an almost impossible task …. he blinked "no. " His eyes cut to the window again. So, I went outside and walked his land and took good notes, listening carefully, smelling the good earth. When I returned, I opened the window, described to him all I had seen and heard and smelled. Peace returned to his face. One single tear slipped down his cheek. I got the spelling board …. with blinks, he spelled out "thank you. " He gave me the gift of mindfulness …. the gift of his land …. the sharing of his experience. And he thanked me. From the depths of his weak body, his strong spirit spoke in to mine. What is the measure of quality of life? I know that day, my quality of life changed …. and he thanked me.

Vertical limit
There is a concept in mountain climbing called vertical limit. It seems a germane concept for the discussion of life and contribution for older adults.
The "vertical limit" is defined as the highest altitude at which humans can survive… If humans spend time above this altitude, their health gradually declines due to a lack of oxygen and lower barometric pressure. Altitudes above approximately 25,000 feet are called the death zone …. greater chance of frostbite, hypothermia and potentially fatal swelling of blood vessels, especially in the brain [5].
Perhaps older adulthood is the vertical limit of this physical life, i.e. the point at which our health gradually declines with greater risk for a variety of conditions that can be fatal. The vertical limit is also a point higher than any individual has traveled before. It is the heights to which many of us aspire; the heights of unconditional positive regard; the heights of service and wisdom and care. The challenge of caregiving includes the realization that we know more, can do more, and have more capacity than we ever realized. The challenge of "being" cared for returns us to the ultimate human experience of "being" loved for who we are rather than what we do. The vertical limit is, perhaps, the opportunity to find again our true worth and share it with others [6][7][8].
There are many instances of heroism, courage, and truth of older adults who, at the vertical limits of their lives, inspire us with their wisdom and self-sacrifice. Even in his dying this is a story of a man who, immobilized and silenced by ALS, taught a young social worker to dig deeper, think critically, live in the moment, and focus on strengths for answers.
Journaling the care of older adults does not just capture their stories. It allows us to discover our own meaning in life. It grasps the capacity of their wisdom to transform us. It embraces the essence of strengths applied in difficult circumstances. Perhaps most of all, we find in ourselves love and strength that we might never have discovered otherwise. May we engage anew in finding and telling the stories of older adults who, while they need us, also give to us gifts of wisdom and strength and growth not otherwise achievable.