Planning your exit strategy

The only certainties in life, said Benjamin Franklin, are death and taxes. As GPs we see the infirmities and indignities of old age, but we probably suppress the knowledge that in time we will be similarly afflicted. Yet we may well live a quarter century or more after retirement. Old age encroaches slowly but it always comes as a surprise. And no-one can look back on old age. So we don’t have a guidebook to help us through it. Planning your exit strategy is even less fun than planning your pension, but it’s just as important.

Here are some thoughts we could be putting to our patients, and to ourselves as we move into middle age.

  • However bad your health, remember that living to old age is a privilege. And better than the alternative. Find one thing a day to treasure, however small, whether it’s a walk among the bluebells, or just a bird on the windowsill.
  • At retirement, most people still have plenty of energy. Maintain your old interests and friendships, but invest in new activities which you can continue as you age. Whether you go in for learning Chinese or china-mending or growing prize dahlias, you will keep your mind alive, and you will meet people. Something that attracts a wide age group allows you to develop relationships with younger people, especially valuable when your peers start dropping away. Your contemporaries can sympathise with your painful feet; younger people can help you forget them.
  • Build up social credit while you can. There are plenty of opportunities to be useful after retirement. If you have helped others, if you have been a life-enhancer, if you have been a good friend, you will have people who are happy to offer help when you need it.
  • Use it or lose it. Regular exercise maintains muscle strength and balance and mental well-being. And if your press-up days are well behind you, you can still walk, shuffle or even Zimmer down to the post-box on the corner. No matter that you don’t have a letter to post; the fresh air and exercise will invigorate your muscles, your bowels and your mind.
  • If you can’t get out, do what you can to avoid becoming chair-shaped. Even just standing up for a few minutes once an hour will help.
  • Keep things clean. If you live alone it is easy to let things go, especially if you are depressed or tired or have limited mobility or can’t see the mould on the bread. But it’s dispiriting to visit someone who hasn’t washed or cleaned their teeth for a week, who is sitting in grubby clothes on a stained chair surrounded by biscuit crumbs and dusty piles of old magazines. Even if you can’t afford home help, be determined to keep up standards.
  • De-clutter your life and your home. Don’t leave decisions about what happens to your mementoes and tea-spoon collection to your executors. As eastern religions recognise, getting rid of possessions is liberating.
  • Beware the chains of routine. Be as flexible as you can in habit as well as body. If someone offers to take you out for tea, don’t decline because you always have your hair done on Tuesday afternoons.
  •  When someone phones, never, ever, say “It‘s so nice to hear a human voice.” It puts such a responsibility on your caller. If you haven’t spoken to anyone for a week, ring someone you know. Check that it’s convenient for them to chat, and if it isn’t arrange a time.
  •  It’s tempting to rely on your children to meet all your physical and emotional needs, but it isn’t fair. Try not to leave anyone with the awful burden of feeling that you are totally dependent on them.
  • Keep up with the latest information technology for as long as you can. Today’s elderly who can use email are able maintain contacts and manage their lives even though their hearing makes phone-calls tricky and their Parkinson’s makes writing difficult and verbal arrangements fall through gaps in their memory. Who knows how people will communicate in the future, but it is important that when we are elderly, we know how.
  •  Have things to talk about. You don’t need to go to a football match, or to a Tracey Emin exhibition, to have an opinion. Again, being IT-savvy is important. If you can find your way round the web, your TV or tomorrow’s gadget, you can keep up with the outside world and contribute to discussions. Don’t leave learning new ways till it’s too late; get into audio books, DVDs by post, music downloads while it’s easy to learn.
  • There are lots of books about how to be young, but Diana Athill ‘s ‘Somewhere towards the End’ is one of the few about how to be old. At 94, she has had time to think about it. Two pieces of her advice: it’s useless to fret over regrets; and ordinary things become precious when you know you won’t be able to enjoy them much more. So make the most of every day.

Diana Athill Somewhere Towards the End Granta 2008 ISBN-10: 1847080693 

Judith Harvey

Judith Harvey was a research scientist, ran the VSO programme in Papua New Guinea and taught in a Liverpool comprehensive school before going to medical school. She has been a partner, a salaried GP and a locum, an LMC chair and a long-time supporter NASGP. Her charity, Cuba Medical Link, enables medical students to go to Cuba for their electives.

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