Much of our conversation in the opioid prescribing for older adults workgroup has focused on how one’s body is psychologically different with each passing decade – metabolism, risk of side effects, pros and cons of different treatments. Our bodies tend to change in predictable ways. In addition to this body-focused process, the socio-political-cultural world in which we have lived exposes us to different environments that can dictate the quality and length of life as well as contribute to our varied and diverse perspectives. Social norms change, the cultural water in which we swim changes, and yes “an individual’s age is one of the most common predictors of differences in attitudes and behaviors.” This applies to how we approach clinical encounters as much as to anything else – what we expect from our providers, what we expect from our children, what we expect from ourselves.
Some find generational grouping and analysis to be helpful – for me this thinking has felt very limiting and at times wildly inaccurate. Broad generational statements say much more about the person making the statement than they offer any insight. People are much more similar than different and so I am continuously frustrated by clickbait articles and statements from individuals that millennials are running the diamond industry (if this were true, would this be bad?); boomers ruined everything (how could this possibly be true); gen Xers are a mess (this just feels mean). So much of this thinking seems to tend toward the negative – separating the us from the them – and is so very unhelpful.
An individual will be differentially capable of any number of ways of thinking, being, and doing based on their exposures (economic, educational, adverse childhood experiences, trauma) and their capabilities. I share some aspects of my baggage with other people born in the 1980s. I assume my child will share some post-COVID world baggage with these other socially-distant toddlers and I hope that she won’t write similar articles that I and my cohort “ruined everything.”
Mental shortcuts are easy, like these broad statements, but tend to obscure truth. I acknowledge that uncertainty is uncomfortable, and we can teach ourselves to be ok being uncomfortable. My challenge as we approach any number of clinical topics is to keep our minds open about those who are older and those who are younger and to center an individual as an individual. Further, our statements and ways of thinking, our interpersonal interactions, can help or harm a person’s health and wellbeing – we should aspire to have Clear eyes, full heart, [so we won’t] lose sight of people as people.
Ginny Weir, MPH
CEO, Foundation for Health Care Quality
Director, Bree Collaborative