What Young People Should Know About Growing Old: Gerontology Professor's Reality Check

Brian Carpenter [00:00:00] Well, first of all, we kind of wanna acknowledge for folks that, yeah, these are difficult conversations, but it's a good thing for you to be having them now because the, it's gonna be much more challenging if you have to have these decisions in an emergency or in a crisis where you have to make decisions really quickly and everybody's super emotional.

Vance Crowe [00:00:22] I'm Danica Klu, a grad student living in Fort Collins, Colorado, and you are listening to the Vance Grow Podcast. Welcome back to the podcast. I'm glad you're here. Today we do part two of the Memento Maury series, which roughly translates to remember, you will Die. Today, I invited Dr. Brian Carpenter of Washington University to come in and talk about a very unique class that he delivers to students. It is, what will your life be like when you are 64? Now, Dr. Carpenter will get into why they chose 64 and the impact that it has on young people, but really the takeaway from this entire conversation is, can you imagine what your life will be like decades into the future? This is a fascinating and really twisty turny conversation where Dr. Carpenter explains things about the aging process that you might not ordinarily think of. We're gonna get to that in just a moment, but you know that we record Legacy Interviews right here in the studio. And if you were interested and live in the St. Louis area, we have just two slots open for me to record. Over the Thanksgiving weekend, we knew that there were a lot of people in town with family members, and so we opened up that weekend to be a time when you could come in and record their family stories, their wisdom and their values. And there's just two slots open. So if you're interested in having me interview them over the Thanksgiving holiday, go to Legacy Interviews dot com. Alright, without further ado, let's head to the interview with Dr. Brian Carpenter.

Vance Crowe [00:01:56] Dr. Brian Carpenter. Welcome. Good

Brian Carpenter [00:01:58] Morning

Vance Crowe [00:01:58] To the podcast. Glad

Brian Carpenter [00:01:59] To be here. Vance.

Vance Crowe [00:02:01] Is youth wasted on the young?

Brian Carpenter [00:02:04] Some yes, some no. Any age is probably wasted on people in that age. Probably depends more on the people than the age, to be honest with you. I think there are certain things that young people would benefit from knowing that they probably can't know until they're older, just because you live your life and you gain experience and perspective that you're not gonna have when you're 15, 25, 35. But that's not to say that young people can't be wise, and sometimes young people can be more wise than old people. So old people don't have any lock on wisdom, in my opinion.

Vance Crowe [00:02:42] Yeah, I think the biggest thing for me that I didn't realize was that your body is going to age, right? Like you feel young. Every experience that you've had throughout all of your youth is I just keep getting stronger, faster, more vibrant. And then one day you wake up and you're like, oh, it took me longer to recover from that illness or that hangover or that whatever.

Brian Carpenter [00:03:04] Yeah, those aches and pains, they start sneaking in and your body just doesn't do the things that it used to do as you get older. And that's one of the first things that I think strikes people about aging is that they notice that their body, which has been their friend for so many years, done everything they wanted it to do for so many years, just isn't quite the same any longer. And that starts at a pretty young age. Your body starts growing older, you know, well, from the mom moment you're born of course, but it doesn't work as well as it used to, starting from a pretty young age. And that can be really shocking for people.

Vance Crowe [00:03:39] Yeah, I mean, I remember I was working as a deckhand on a ship by, at the beginning of the year when I was working there. I had just finished college, and by the time I was done working, I realized like, there are things about this job that are a lot harder. And I was really, 'cause I was aging, right? I, I was getting better at my job. But like the fatigue of being up all night, those kind of things eventually wear down on you.

Brian Carpenter [00:03:59] Exactly right. Exactly right. And I think people aren't always ready for that change because when you've had the good fortune to be in a body that does everything that you want it to for a long time, when it doesn't, it can be a little bit jarring. It can kind of take you aback to think, wait a minute, this, this thing is supposed to be doing everything I wanted to, and it's not doing it any longer. That's a real surprise for some people.

Vance Crowe [00:04:22] So you teach a class at Wash U about when? I'm 64. Right? Why 64?

Brian Carpenter [00:04:29] Oh, I know, I know. We go back and forth on the title of that course all the time. You know, we started teaching this class eight years ago now, this will be our eighth year teaching at this, this academic year. And at the time we, we wanted a catchy course title that would attract people's curiosity and and wonder. And we were ly referencing the Beatles tune, which turned out not to be really useful because most of the cops, they

Vance Crowe [00:04:57] Don't get it. I don't get it,

Brian Carpenter [00:04:59] Get the reference. But it's also been true that 64, which, you know, people traditionally think of old age or have thought of old age at starting at 65 because that's when people become eligible for Medicare. And when people used to be able to start taking their full social security. So there were administrative logistical reasons why 65 was the benchmark for the beginning of old age, but that was a long time ago when that was the case. And now 65 is not old anymore. So when we're thinking about a course title that is going to communicate that, that you're gonna be signing up for a course about old people and older adults, and aging when I'm 64, just doesn't make sense any longer. But we're reluctant to kind of give it up because it's got such resonance with so many people. So if you've got other ideas for a course title, we'd be all ears because we need to think of, of something that's going to be catchy, but also communicate to an 18-year-old. Oh, this is of course about growing older.

Vance Crowe [00:06:05] It strikes me when you say that 65 isn't old anymore, why not? Why? Why has that changed?

Brian Carpenter [00:06:13] For several different reasons. I think number one, probably the biggest one is that life expectancy has increased dramatically over the last even 50. But definitely a hundred years to 50 years ago, average life expectancy was in the seventies. Now the average life expectancy in the United States is around 82 years old. And when we're standing in front of a group of college first year students, the, based on the demographer's research, we can tell them that half of them will live to see their hundredth birthday. Half of the 18 year olds will live to see their hundredth birthday. So part of the reason why 65 isn't old anymore is that you've got so many more people who are living to be 80, 90, a hundred. We used to talk about centenarians as being the oldest people, and you're two young to remember this, but there was a, a, a, a segment on the Today Show many years ago where the Weather guy,

Vance Crowe [00:07:18] Oh, I remember, yeah, Millard

Brian Carpenter [00:07:19] Scott,

Vance Crowe [00:07:20] Yeah.

Brian Carpenter [00:07:20] Used to highlight people around the United States who turn a hundred. You can't do that anymore because so many people are turning a hundred that it's not a big deal anymore. And now the scientists have, they're still studying the centenarians because they're unusual people in lots of ways. But now the scientists are studying the super centenarians, the people who are living to be 115 and 116. So 65, when you think about old age, if you're gonna live to a hundred and twelve, sixty five is barely middle aged. So 65 isn't really that old any longer.

Vance Crowe [00:07:57] So let's talk about this class then. You're, you're bringing college freshmen in and you're getting them to sign up for a class that is in effect. Like, remember, you're gonna get old, maybe even you're gonna die, right? Yep. Do kids wanna sign up for this class?

Brian Carpenter [00:08:11] We are over-enrolled every semester, which still is surprising to us. We usually have 75 to 81st year students in the class, and usually a wait list of more people who were interested in getting in the class. And they take it for a variety of reasons. You know, some of them have grandparents who are still alive. Many of them have grandparents who are still alive and had good experience with their grandparents, or they did volunteer work at a nursing home when they were in a high school. So they've already got some interest in, in aging. But we also hope that what's, what draws people is the fact that there are three professors teaching the course. So they're really getting three profs for the price of one. I teach it along with a colleague of mine named Nancy Morrow Howell. And she's a social worker by training and she teaches in our social work school. And our other co-instructor is Susie Stark. She's an occupational therapist and she teaches over at the medical campus at Wash U. So there are three of us in the class who are approaching this topic from different perspectives. And I think the students find that appealing that they're gonna be talking about this big topic, this big issue of global aging, but they're gonna hear about it from several different people throughout the semester. The other kind of cool thing I think about the course is that there are older adults from St. Louis in the classroom every week with the students as well. So we're standing in front of the room kind of leading a discussion about a certain topic, but then we open it up for questions and conversation.

Brian Carpenter [00:09:47] And the older adults who are there, tell us about what it's like. Really, I'm talking about what the academic research tells us about growing older, but the older adults then raise their hand and say, well, let me tell you what it's really like to retire, or let me tell you what it's really like to have a spouse with Alzheimer's disease. Or, let me tell you what it's really like to think about giving up your driver's license. And we can talk about those things as professors, but hearing it from an older adult themselves is completely different for the students.

Vance Crowe [00:10:17] What if they said that surprises even you,

Brian Carpenter [00:10:20] The students or the older adults? The

Vance Crowe [00:10:22] Older adults, yeah. First

Brian Carpenter [00:10:23] They're surprised at how interested these 18 year are 19 year olds are in their experience. So they're always remarking about how curious the students are, how genuinely interested they are in learning about them. The older adults also tell us that they feel energized by being part of the class. You know, they feel like they're making a contribution by helping us teach young people about the realities of aging. So we think that the older adults get something out of it, just as powerful as the students do, and as powerful as we do, because every year we're learning more from the students and from the older adults as well. That's

Vance Crowe [00:11:03] Actually how I found out about you. I was riding in the elevator in this building and there was an older gentleman that, I mean, he, he must have told me about the class within the first, I don't know, three or four minutes of our conversation. And he talked about how it makes him feel a part of the community. And I think, you know, if, if you recognize college towns, St. Louis is in a college town, but where Wash U is, it's definitely a big presence in that area. University City. The idea that you could stitch together the older people that are living there with the college students is a huge win. Because I think most of the time college kids seem scary to older adults and, and I don't know that that older adults particularly care for college students. You know, they're making noise and getting into problems. Yeah,

Brian Carpenter [00:11:48] It works in both directions. You know, they're, one of the themes of our course is ageism. I don't know if you've heard that term ageism before, but it's, you know, like sexism or homophobia or racism, there is a pattern of discrimination and prejudice and bias against people based on their age. We typically think of that as people being biased against old people, but in reality it works in both directions. And that when we talk to young people, they have stereotypes about old people and they can describe experiences where they may have witnessed ageism towards old people. But when we talk to old people, they tell us that they have stereotypes about younger people as well. So bias is, you know, is open for everybody, unfortunately.

Vance Crowe [00:12:39] So the students, as they're taking this class, what revelations are they having as they go through the semester?

Brian Carpenter [00:12:46] We're, we are intentional about trying to cover a lot of ground. So it's, we don't go deep, but we go broad to expose the students to lots of different issues around aging throughout the semester. So we talk about your body, obviously, and changes that you can expect with your body. We talk about your mind and how people's psychology changes and their cognition changes as they grow older. We spent some time talking about social policies, Medicare, Medicaid, social security. We spent a whole day talking about death and preparing for the end of life. And I think what we hear from students at the end of the semester is that they are, they are intrigued by several ideas that they hadn't thought about before. Ageism is one of them. And noticing all the ways in which our society sends messages about how bad it is to grow older, I think they're also surprised about the conversations we have about death. We ask them to think about the aging of their parents or other older people in their life. And if they were ever in a position where they needed to make some decisions or help coordinate care for somebody, would they know what to do? Would they know what their loved one's preferences are? And they're surprised at how little they've thought about that. We also have a whole day where we talk about sexuality and sex, and that freaks people out a little bit. It wis them out a little bit. That that, that we're gonna have a conversation about sex and it freaks them out because we're talking about this forbidden topic, but we're also asking them to think about the sex lives of their parents and their grandparents.

Vance Crowe [00:14:30] Yeah.

Brian Carpenter [00:14:32] And this is where, this is where those older adults in the classroom become very important, because they're often willing to talk about intimacy over their lifespan and how it's changed. And, and 18 year olds find that a little bit shocking to hear about. They don't like to think about their parents or their grandparents having sex. But I think it's important for them to understand that intimacy evolves over your entire life and that you're a sexual being when you're 18, and you're gonna continue to be a sexual being when you're 85. It might look different, it might not look different, but you shouldn't assume 'cause it would be ageist that just because you're 85 that you don't have an interest in sex or intimacy.

Vance Crowe [00:15:15] Let's explore that. I mean, I, I certainly know virtually nothing about it. And I even, you know, as you're describing this, I'm thinking about just my own self being intimate, you know, at an older age. And it's an uncomfortable thought to, to think like, oh, I could be frail. I could have trouble rolling over, I could have trouble holding myself up. I could, you know, all of the, not, not to mention all of the psychological, you know, fears that men have. So what are the changes that happen to older adults?

Brian Carpenter [00:15:43] You are, you are one step ahead of the game. 'cause you just listed a bunch of things that are on people's eyes only

Vance Crowe [00:15:49] Because you prompted me to think about it. Right. It's not something I thought about naturally.

Brian Carpenter [00:15:52] But this is exactly the kinds of things that most people don't consider is that if you think about arthritis, for example, arthritis is very common, chronic illness that people develop as they grow older. It's gonna affect your ability to move, it's gonna affect your flexibility, it's gonna affect your stamina and your strength and your endurance. And so therefore it's gonna have an effect on your ability to be intimate with yourself or with other people. So that's an example of the kind of thing that, that when you're 18 and your body is doing everything that you want it to do, you don't imagine that the sexual aspect of your life is going to change in terms of what you can do in addition to maybe what you want to do.

Vance Crowe [00:16:35] I, it strikes me, I remember people making jokes about how rampant STDs got in retirement communities. And largely because when those people were growing up, they didn't have a large number of sexual partners. There wasn't all this talk around safe sex or how to protect yourself. And so it was like, it skipped over them and now you've gotta circle back. Is this a real thing? It's

Brian Carpenter [00:16:58] A real thing. It's a real thing. Yeah. The rates of HIV infections, for example, are very, very high among older adults. And if you think about it, that kind of makes sense. When you're past menopause, you don't have to worry about getting pregnant. So people may assume that they don't need to be thinking about using condoms or protecting themselves in any sort of way. And so you've kind of left the door open for STDs because people aren't necessarily thinking that they need to be worried about engaging in safer kind of sex practices.

Vance Crowe [00:17:30] Women, they keep up this a level of sexual desire as, as they get older. It's

Brian Carpenter [00:17:35] No different from men or women. There's huge individual variability. You know, people who probably the best predictor of people's interest and activity in sex later in life is their interest in activity in sex younger when they were younger. So some people will be just as interested in having a sex life when they're in their later years as they were in their younger years. And they'll wanna do the same things with the same kinds of people. Other people may evolve, they may change what kind of intimacy they wanna have, what kind of how they wanna be sexually active and who they wanna be sexually active with. So like everything else in human experience, the nature of your sexuality may change as you grow older for some people, more so than for other people. But it's a re it's a facet of life that isn't gonna go away as people get older and people would be benefited if they thought about it a little bit more.

Vance Crowe [00:18:32] Yeah, I mean I, it strikes me because I get the sense that, you know, one of the thi you know, when you're a young person, you're 18, you are driven by sex. Or at least, you know, largely a lot of what I thought about a lot of what I wanted to talk about and and pursue. And so I think I'd always imagined like, oh, well one of the best things about getting older is that that goes down. And as a 40-year-old with two kids, it does just 'cause you don't have time to think about it. Yeah. But I think like you're kind of taking away something from me that I was like maybe hopeful about. Like, like, 'cause if the desire itself went down right, then you, then you're not pursuing it. It's not, it doesn't consume, you

Brian Carpenter [00:19:13] Can be true for some people, but you might think about it in terms of this is an overgeneralization, but when you're younger, many people will think about the frequency of sex as being the most important thing that they wanna have a lot of sex less attention to paid to the nature of the sexual experience, the quality of the sexual experience. Sure. And I think there's an overemphasis on a certain kind of sexual experience that sex means intercourse when you're 18 or when you're a younger person for a lot of people, not everybody, but that's, you know, there's a lot of other, you can define sexual activity in a really, really broad way. And I think as some people grow older, their view and their perspective and their desires broaden as well. And they have hopefully a more eclectic sense of what being sexually active can look like.

Vance Crowe [00:20:06] Yeah. I think intimacy as you get older, like really does change, right? It's, it's like your ability to appreciate anything, whether you know what you drink and what you eat and the art you look at because you're, it's not just that immediacy.

Brian Carpenter [00:20:20] Yeah.

Vance Crowe [00:20:22] So when you explore these subjects that are deep in their nature, are the kids giggling? Are they like, how, how do people react to this? You

Brian Carpenter [00:20:31] See some giggling, some discomfort when we're talking about difficult topics, whether it's sex or death, for example, less giggling with death, more serious kind of, but discomfort when you're talking about it.

Vance Crowe [00:20:44] Yeah. Anything to separate you from the, from whatever's going on.

Brian Carpenter [00:20:47] Exactly. Exactly. But we also see just a lot of awe, you know, a lot of, a lot of, you know, head slapping like, wow, I didn't, I didn't even really know that or think about that. We have a whole day where we talk about money, for example, and the students are shocked to learn about how much money they will probably need to save if they're ever going to retire at some point in their life. So that's a kind of, they have a negative reaction to that when they think about, oh my gosh, I'm gonna have to work so long and I'm gonna have to make so much money. But on the other hand, you know, the positive is that we teach them about, and some of them have very, very minimal financial knowledge, even as 18 year olds, we teach them about compound interest. Now that's a pretty basic kind of banking principle, right? But when we show them, you know, what your money can do for you if you start saving at a young age rather than later in your life, that just blows their minds as well because they're like, you mean if I put this little amount of money away now when I'm in my twenties, it'll be this huge pot of money when I'm in my eighties. So from all of these topics, I think there are things that shock the students and are discouraging to them about aging. But we also are very intentional about trying to also emphasize the positives about growing older. That there are a lot of things that you could look forward to. And most importantly, there are decisions that you can make at every age, even when you're 18, that will have long-term benefits to what your old age looks like in terms of lifestyle behaviors, savings for retirement.

Brian Carpenter [00:22:31] That there are things that you can be doing that you have control over that can influence the quality of your life when you make it to 80, 90 or a hundred.

Vance Crowe [00:22:40] I think when we talk about retirement, one of the things that strikes me is like there's, it's this very western idea in that, you know, you're kind of marketed to by all these institutions saying, you know, put money away, put money away so that that way you can retire. But it's really just a slot of time in your retirement when you get to be in that kind of happy, you know, we're jumping off the dock into the water, we're, you know, doing something fun that they do in the commercials because a substantial portion of that amount of wealth that you save in retirement is for you to have end of life care and, and nursing homes and things like this. But it's like sold to us as retirement is the goal. It's the, it's the, you know, when you get to walk up to the top of the mountain and you're in heaven.

Brian Carpenter [00:23:27] Yeah. And what does that tell you about how you're supposed to be thinking about the rest of your life? That you know, your life, you can only really start living until you stop working. But what is, if that's the message, what does that tell you about how you're supposed to feel about your work life before you retire? I mean, when you think about it, why is our life divided up the way it is now? We front load it with years and years and years of school where we don't have to, our responsibility isn't really to work for most people full-time. It's to learn to get educated. And then that stops. You graduate and then you're supposed to enter this second phase where you're working, working, working. And you do that for a while and then you stop that. And then there's this nebulous thing called retirement where you're neither learning nor working. You're doing this, you have this extended vacation of some kind. Why does it have to be structured that way in these discreet buckets? I mean, why can't, I mean, we created it, you know, we decided that's how we were going to live. But why does it need to be that way? Why couldn't we have a different model where we go to school for a little bit and then maybe work for a little bit and then maybe not work for a couple of years and then maybe go back to school again, and then work for a little while and then go back to school and then do nothing for a while? Why does it have to be set out in these three big chunks that way? And that's kind of as much of a philosophical question, a sociological question as it is a practical one.

Brian Carpenter [00:25:02] I think.

Vance Crowe [00:25:02] Yeah. As, as I'm cycling through your argument, I, I start thinking like, well one of the reasons is if you put a 12-year-old to work, you get in a lot of trouble for that, right? Sure. Like we, we don't, our policy doesn't allow that. But you know, you think about, you know, I've had a chance to live a little bit in Latin America and in in Kenya, and one of the things that you notice is they're, they don't have these hard seasons in the same way that we, that you're describing, right? You, when you become a grandmother yna, like you're doing what you did before, you're just allowed to do it at a slower pace. And people kind of run around you and ask you like, how should it get done? But there it's all white to gray to black as opposed to Yeah. Hard stops, right?

Brian Carpenter [00:25:47] I think there are, there, you could imagine many advantages to that, you know, psychological advantages, maybe even social advantages if, if people have more opportunities and more flexibility in how they spend their time and what they do with that time. And it wouldn't create this sense of expectation and burden that your retirement has to be this certain kind of thing that, I mean, retirement is as a construct, as an idea has been changing dramatically over the last couple of decades as well. And this idea that you're supposed to work and work and work and work and then you stop and then you just have this leisure time until you're dead. You know, that's not satisfying to a lot of people. Nor are certain groups of people able to do that, you know, for financial reasons or health reasons. You know, that expecting this big chunk of time where you're just gonna be, you know, dump jumping off of a dock into a lake. That's not the reality that a lot of people in our society are even gonna be able to have.

Vance Crowe [00:26:50] Yeah, I mean, you said a statistic that, you know, kind of makes you clinch your fist 'cause it's scary, which is that 18% of baby boomers have less than $50,000 in their retirement savings. I mean, $50,000 if you have a leaky roof, you know, could be, could be cut in half, is it's, the principle is not going to earn enough interest. You would have to put it in such risky things to be able to even eke out an additional year of savings on that.

Brian Carpenter [00:27:20] Exactly. And people think about social security sometimes wrongly as the source of income that's gonna support them in their later life. And social security was never intended to be a full replacement for somebody's income after they stopped working. It was supposed to be a supplement to people's savings. But when you don't have a a when your society is not structured in a way that allows people to save or people aren't able to save because they have to their living paycheck to paycheck and they just don't have the extra cash to put into savings, then you're creating a situation where they're gonna get to later life and they're gonna rely on this pot of money and social security that's not gonna be sufficient to support them.

Vance Crowe [00:28:07] Yeah. So I watched some of your lectures the other day and I, I will say that I think you are literally the best Zoom lecturer I've ever seen. You're, you're an excellent in person, but with Zoom I found myself having to like stop what I was doing 'cause I was just trying to play it and do other work. And I would be like, wait, wait, I've gotta go and watch this. So I would highly recommend go going and watch it. But one of the things that you brought up about I've social security and these other programs was when they were created, the actuaries said, look, half of everybody will be dead by the time they're, was it 62 And so or so they're at 61.8, half of the people are going to be dead. So why don't we just set the retirement age here and we know it'll pay off, right?

Brian Carpenter [00:28:52] So many of our social policies were created for a demography that that doesn't exist anymore. You know, these were social policies that, policies that were created 50, 60, 70 years ago based on what our population looked like then in terms of the age demographics and the age breakdown. Now we have a world that looks completely different and yet we haven't changed our social policies to keep up with those demographic changes. So something's gonna need to change 'cause those policies aren't working the way that they did for us decades ago. Yeah.

Vance Crowe [00:29:24] The other part of this was not only are people living longer, but so many more of them are living longer. Right. And when you show your graphs that are, you know, like look at how the baby boomers, not only were they a big generation, but they also are living 20 years longer than their family. The implications on this are so hard to grapple with because I think ageism becomes a real situation when, when you're a young person sitting there saying, look at how much money we're funneling to the older people to keep them alive, to keep them in healthcare, whatever that is. And yet that's going to be by far the larger voting group than, than most younger groups. So there's gonna be a crazy tension here.

Brian Carpenter [00:30:13] Yeah. Yeah. And I think that's, it's un it's unfortunate that it gets framed as a attention that it often gets framed as an us versus them. That, that it has to be a zero sum game. That, you know, if we take care of old people, we, we have to lose something else. And I think, I don't think that's the right way to think about it for, for a couple of reasons. One is that I think there are alternatives that, that we could think about from a policy point of view and a financial point of view that wouldn't nec necessarily mean that we have to sacrifice something for a younger generation in order to support the older generation. I think the second more important thing is that old age, be an old, being an older person is the thing that we all, we all aspire to. We all want to be old someday. I mean, we, you know what I mean? Right. We wanna

Vance Crowe [00:31:03] Be, well, I mean this goes, I, so when people have a birthday, I, and they like complain about getting older, I'm always like, well, it beats the alternative. Right, exactly.

Brian Carpenter [00:31:10] And

Vance Crowe [00:31:10] That is, it's either death or you get old. Those you the only two options you have.

Brian Carpenter [00:31:15] Exactly. And so if we all want to get old rather than die, we create this contradiction in people's heads. If we construct a society in which people feel negative about older adults in aging, because if you are 20 or 30 or 40, and the idea you have about growing older is mostly about decline, disability dependence, oh it's gonna be terrible, then you just set yourself a trap because one day you are gonna be there. So if your expectation is for only negative, terrible things in old age, then eventually you're gonna be part of that group that you are biased against when you're younger. This is the only human characteristic that we will all grow into. I am not going to become a different race or ethnicity as I grow older. I'm not gonna become, for me a different gender as I grow older. So I'm not gonna experience something different in those kinds of identities or characteristics. But I will be an old person someday. Knock on wood. I hope to be an old person someday. So if I have negative ideas about what it's like to be an old person now, what's, what's that gonna mean for me when I do become an old person if I've spent my whole life worrying about, yeah,

Vance Crowe [00:32:38] Dreading it

Brian Carpenter [00:32:38] Has.

Vance Crowe [00:32:39] Yeah,

Brian Carpenter [00:32:39] Exactly.

Vance Crowe [00:32:40] I, I, when I was a kid, so, you know, I went to this preschool that was connected with a, you know, a nursing home and that had good benefits to it because I didn't have a grandmother that was growing older, you know, so I got to see older people. But it was also terrifying, right? You're a little kid, you're, you know, you're brought in to sing nursery rhymes or Christmas carols or something to the older people. And I vividly remember the people that are so infirmed that all they're doing is making, you know, low bellowing noises or, you know, they're, they're just kind of staring off in a corner. And that to me was what growing older was. It wasn't until I got out into the world that I saw something different. How should you prepare little kids to see what old ages, if you don't have grandparents around? Yeah,

Brian Carpenter [00:33:30] That's, I, that's a fascinating experience. What do you, what do you think the people were thinking who built that? Who wanted you to spend time with these old people?

Vance Crowe [00:33:41] I think that it was the nature of a small town, you know, a little nursery school and a retirement. And I think that, you know, for many of the kids that attended that school, particularly when it started, they were going to see their grandparents. Their

Brian Carpenter [00:33:54] Grandparents.

Vance Crowe [00:33:55] And so I think there was some sort of like thought about like, hey, we're connecting older to younger. It just that as it played out in my mind and the, you know, I can remember the parakeets, we would go in there, they would always have these little birds around. I always thought that was neat. But it, it was, I don't think until I moved to Africa that I ever spent time with older people, maybe over the age of 70 ever

Brian Carpenter [00:34:21] Did. Do you remember anybody in that school experience ever talking with you about the people you were visiting and who they were and what kind of experiences you were having? Or were they you they just kind of threw you in there and said, okay, like have fun, be supportive?

Vance Crowe [00:34:37] I think that my memories just aren't that clear about it. You know, we clearly did it multiple times and so it was carol's and things

Brian Carpenter [00:34:44] And I

Vance Crowe [00:34:45] Just remember hitting a point where I would like dread it. It'd be like, oh

Brian Carpenter [00:34:49] Yeah,

Vance Crowe [00:34:49] We're going over there

Brian Carpenter [00:34:50] With those scary smelly people.

Vance Crowe [00:34:51] With those scary smelly people. That's exactly right. And I think that my sense about a nursing home, I have about as much desire to go to one as I have to go to a prison

Brian Carpenter [00:35:01] That's so bad. This is an example of an a maybe well intended intergenerational program, trying to bring two generations together, but without the right kind of context and explanation and support. So it's just gonna reinforce a lot of bad stereotypes. Unfortunately. I'm sorry.

Vance Crowe [00:35:22] It's entirely possible that there are people that ran Noah's Ark that'll watch this episode. So my experience at Noah's Ark daycare was very good. I agree with you. Like I think that for my own daughters, I want them to have experience of older people that I had later. So my mentor is 103 years old. I met him when he was in his nineties and he was one of the sharpest people I'd ever met. So getting old like Pete would be the, you know, the great gift of a lifetime. In fact, I think everyone wants to be like Pete because he has what they call Pete's orphans, right? These are young people that maybe didn't have an older person, he takes 'em into their life. He taught me how to, you know, eat properly and to have good manners and to do all the kinds of things that I wasn't gonna pick up from my parents. And so, you know, how do you get to the place of being like Pete, right?

Brian Carpenter [00:36:11] You have Greek, you have latched onto, I think such an important idea that we need to foster opportunities for people across generations to interact with each other. And it shouldn't be focused just on taking preschoolers to nursing homes. 'cause those are, that's fine. But those are very, very narrow homogeneous groups that you're introducing to each other. So what you missed was having the opportunity to see the diversity of older adults and the many different ways that people do grow older. You saw one kind of old experience, you saw people who were more dependent and maybe even had some dementia or cognitive problems, but you didn't get to see meet people like Pete or other people who were experiencing aging in a different way. The other thing that I think is revealing about that your story is that why didn't you have opportunities to meet people in their sixties or forties or thirties? You know, we, we, when we talk about intergenerational activities or programs, we tend to think about very young people brought together with very old people. But our society is multi-generational. And really the more beneficial thing I think would be to make sure that people are exposed to people across the entire lifespan.

Brian Carpenter [00:37:43] Preschoolers should be talking to 40 year olds. So 30 to 60 year olds. That's the nature of our society. But we have your example is a great one of how we put people into these boxes, these generational boxes, but we don't really encourage ways for them to interact. You interacted with your parents of course and maybe other in your school teachers, but when was the last time at your age now you said you were in your forties. Do you have any friends who were in their twenties?

Vance Crowe [00:38:14] Well, yeah, my executive producer over there. Like you, this is a good point that I think that most 40 year olds don't have 20-year-old friends or 18 or you know, the, these, this age group. I have found there is tremendous value in trying to get yourself around young people because things that used to be intuitive to me, how to run a computer program, how to, you know, what's going on, the things that come natural to them, just by virtue of the plasticity of their brain has been very, very valuable. But almost nobody does that. Nobody

Brian Carpenter [00:38:47] Does it. Well. There aren't a lot of opportunities to do it in our society. Like think about how hard, it's really hard to meet new friends, even in your same age group. How would you even go about meeting a friend who was in their twenties? Or how would you even go about meeting a person who were in their sixties or their seventies? Our society just doesn't create opportunities for that as much as it, as it could. Yeah.

Vance Crowe [00:39:07] And probably in large part because of the thing you were saying before about, you know, we have these very defined blocks. College kids don't hang out with, you know, people in their middle ages. And, and the fact I, and you mentioned this in your lecture about the age that people are having children does these weird things to our culture, right? So if I didn't have children until I'm 30, then if I have kids and I'm hanging out with a 20-year-old, our lives are so completely different. Not just because I have kids, but I'm also 10 years older than this person. You know, your financial positions are different. Your what you're interested in is different, what your priorities are. And so even when you do bring those things together, they're very disjointed.

Brian Carpenter [00:39:50] Right? Exactly. This is another one of the points that we make to the students in our class is that you're gonna make some choices when you're younger about, you know, when to find a spouse or a partner if you're gonna find a spouse or partner, when you're gonna create your own family. If you're gonna create, create your own family, what kind of work you're going to start and how long you're gonna stay in it. Those decisions that you make when you're in your twenties, they have repercussions far beyond your twenties and people don't really think about that. What, what the long-term consequences of those choices are.

Vance Crowe [00:40:28] I had a guest named Chad Fleck on my podcast and I thought I was having him on because he was doing some farming and kinda some homestead stuff. And about partway through the interview I realized, no, actually the value of this is that this guy got married when he is 19. He has kids already. He, he has grandparents, they have parents, his grandparents are likely going to be great grandparents. And I realized I don't actually know anyone that has children that are going to have great grandparents. And that would've been much more common before, not because people age longer, but because they had children so much earlier.

Brian Carpenter [00:41:05] Exactly, exactly right. And I think you're gonna see that, see more of that again, that you're gonna have multi, multi, multi-generational families that we experienced in the United States a hundred years ago and now they're gonna come back. But for exactly a different reason. The one that you pointed out, part

Vance Crowe [00:41:19] Of your work is teaching, but another part of your work, you do counseling where you work with people that are saying, Hey, mom and dad are getting older. How am I going to handle this? How does somebody find you and what, what do they find when they're looking for you?

Brian Carpenter [00:41:34] It's usually word of mouth. You know, people just hear about the work that I do in my clinical practice and say that, you know, they talked with me or knew about me and had a conversation with me. And people just call when they, when they're experiencing some sort of transition in their life. I will say that it's as likely to be the middle aged people who contact me as their parents because sometimes it's the parents who are understanding that they're entering a new phase of life and that there are some challenges that they hadn't anticipated before and they wanna be more prepared and they wanna talk about how do they have those conversations with their middle aged kids. You know, parents whose older parents who say, I wanna make sure that I get my will in order, my advanced directive in place and I wanna sit down with my kids and tell them about what's important to me so that if I'm ever in a medical situation where I can't express my own wishes, I want them to know what I want because they're the ones who are gonna probably make decisions for me. And I've tried to talk to my kids about that and they shut it down. They just don't wanna hear me talking about myself getting

Vance Crowe [00:42:46] Sick. Oh the kids shut it down,

Brian Carpenter [00:42:47] The kids shut it down. It works both ways. 'cause sometimes it's the parents who shut it down, but it's, in my experience, it's just as likely that it'll be the middle aged generation who shuts down the conversation too.

Vance Crowe [00:42:57] So I travel around, I speak with a lot of ag audiences, I'm invited to talk about succession and a lot of that to be, you know, how do you negotiate that we're gonna hand something down? How much of it needs to remain the same? And how much can can change when I'm there? Most of the time it's younger people saying, I can't get dad or mom to turn the reins over to me or I can't get them to have this conversation 'cause they think I'm trying to kill them then them. So to what you're saying is surprising to me that there are older adults that are saying no, it's, it's the o other way around.

Brian Carpenter [00:43:31] Yep. Yeah, no hard and fast rule. I think, you know, it's another one of those situations where it really just depends on the family and you know, families are very different from each other in terms of the, the history, the power dynamics, how people talk about things, what's an okay thing to talk about? What's a not okay thing to talk about? Families are super different from each other about all of those rules. So I think it can work in either direction for people.

Vance Crowe [00:43:56] What advice can you give someone about how to get their kids to be willing to think about death?

Brian Carpenter [00:44:01] Yeah, so we have a couple you, well first of all, we try to reinforce the idea that the conversations are important. We don't wanna minimize how difficult they're gonna be for some people. 'cause these are hard important things to talk about. I mean, money is a difficult, touchy subject for a lot of people. Just like sex is for Yeah,

Vance Crowe [00:44:22] For

Brian Carpenter [00:44:22] Younger people. So first of all, we kind of wanna acknowledge for folks that, yeah, these are difficult conversations, but it's a good thing for you to be having them now because that it's gonna be much more challenging if you have to have these decisions in an emergency or in a crisis where you have to make decisions really quickly and everybody's super emotional. So first of all, we tell people, great, it's so good that you're thinking about having these conversations now. Now how do you get them started? And we've got, you know, tips for people about how to introduce the topic. How do you raise the issue, how do you frame it in a way that communicates to the person, whether they're a older parent or a middle aged person, that you're bringing this up because you care about them and you care about your relationship with them and you're trying to be thoughtful about them by having the conversation early so that it's not gonna be more challenging if you have the conversa if you wait and have the conversation later. So we try to help them see the benefits of having these kinds of conversations sooner rather than later. And then we give them some practical tips about how to do it. Like you don't wanna, for example, you don't wanna have like a sit down with everybody in the family on Thanksgiving for five hours where you think you're gonna hash out every last thing. That's just not a good strategy. So we give them some practical tips about how to bite off little pieces of this a little bit at a time.

Vance Crowe [00:45:51] So what are, like, where, where are the first pieces to bite off?

Brian Carpenter [00:45:54] That's a question that we might ask the family as well is like, is there, is there one particular topic where you're feeling some urgency right now? Maybe it's related to driving safety for, for instance, or maybe it's related to inheritance or property, or maybe it's related to healthcare decisions. You know, they, they had a friend who went into the hospital and had a bad experience with some medical care that they, that was, that didn't work out well and that scared them and thought, oh, maybe I should talk to my kids about this. 'cause I wouldn't want that same thing to happen to me. So different people come to this to want to have this conversation for different reasons. And that's usually the place to start is, you know, what, what has happened recently to you or in your family that got you thinking about having this conversation and that's where we should start.

Vance Crowe [00:46:46] Oh, that's fascinating. Right. I, you know, I think about, I'm very capable of having conversations with just about anyone except for my parents, right? When it, when it comes to your parents all of a sudden saying something has a meaning that could last forever. Like the the, I can't take that back. Or if they interpret this the wrong way, the implications could be, you know, life altering or in, in some way, right?

Brian Carpenter [00:47:13] This

Vance Crowe [00:47:13] Must be the stress that other people feel. Yes.

Brian Carpenter [00:47:15] That and I think that, that they understand that these conversations come with a lot of backstory. There's a lot of history and people have been in their family for decades and decades and decades. And that's a long time for patterns to emerge, roles to, yeah,

Vance Crowe [00:47:35] Who's the responsible child, exactly. Who's the not responsible child.

Brian Carpenter [00:47:38] And all that stuff plays out in these conversations. So yeah, they can feel a little bit like a time bomb for folks 'cause of all of those possibilities.

Vance Crowe [00:47:47] When you think about aging for yourself, are you frightened of it?

Brian Carpenter [00:47:50] Not frightened? I have to be honest, mixed feelings about it. And I think my work in this area has, has helped me to have mixed feelings. And I think that's a good thing to have mixed feelings. You know, our, to go back to our course for a minute. When we first started teaching the course, our goal was to make 18 year olds excited about growing older. And that really didn't happen. And we were a little bit naive to think that that was gonna happen. Now we have a more realistic and measured goal, which is to help 18 year olds understand that aging is gonna bring some challenges, but it can also bring some joys. And there are things that you can do to prepare for it. And if you don't like what aging looks like right now, you can change it. You know, it can be up, it can be up to you and your generation to make aging different. And so if, if that's what I want my students to believe, I need to believe that too. And I think I do, I think I understand that there are, that there are going to be some inevitable challenges about growing old. You're not gonna have the same body that you had when you're 90, that you had when you're 20. And you're gonna need to accept the reality of that and still appreciate all the things your body can do, but maybe try to be more flexible about what you're asking of that body and accommodate the changes in your body. And that's true of every facet of yourself as you're growing older.

Brian Carpenter [00:49:25] So I'm not afraid of growing older, I think I hope I'm more knowledgeable about what might be ahead and have started to plan for that and approach every birthday with the open, open-minded, a more open-minded attitude about the things that are changing and, and being willing to shift how I think about life and myself in life, in my relationships and my living situation. Everything about my life. Just trying to be more flexible in the face of some very real challenges that, that people are going to experience as they grow older. That's just the reality of it.

Vance Crowe [00:50:05] What changes over the last 10 years have you made as a result of learning what you learned?

Brian Carpenter [00:50:09] I'm trying to be friend ha have friends of all different ages. That's one thing that I've tried to work on, not very successfully. 'cause it's hard, I'm still trying to figure out how to make that happen. But I've talked to enough older adults who had very narrow social networks where they got to be 85, 90 and their friends are all dying. And so they, what they have is this shrinking pool of friends who are all the same age and the same thing is gonna start happening to all of them. They didn't have friends in their sixties, they didn't have friends in their forties. And so I wanna make sure I, to the extent that I can, that as I grow older, I'm not relying on a cohort a, a social network that's all in the exact same place in the lifespan that I am. That's one thing that I've changed,

Vance Crowe [00:51:02] Strikes me because that's precisely what Pete did. He figured out everyone in his life, everyone he knew is dead. You know, starting with his wife all the way up to all of his other friends. Yeah, all of the friends that he lived in the apartment building with everybody. Yeah.

Brian Carpenter [00:51:18] But

Vance Crowe [00:51:19] Somehow he managed to keep a lifeline to younger people and then those young people brought more young people, brought more young people. But if he hadn't set that up 30, 40 years ahead of time, he wouldn't have had it when he turned a hundred. Exactly.

Brian Carpenter [00:51:34] Yeah. He's, this is a smart guy, this Pete. Oh,

Vance Crowe [00:51:36] Brilliant, brilliant. Absolutely completely one of a kind, amazing, brilliant person.

Brian Carpenter [00:51:40] He should write a book.

Vance Crowe [00:51:43] Oh, we've pushed him. He's been on the podcast a couple times and now he is like done with it. He is, he is like, ah, I've, I've, I've said everything I need to say. I've told all my stories. So

Brian Carpenter [00:51:51] Yeah, he sounds like he's approaching things the right way.

Vance Crowe [00:51:53] Other changes you made?

Brian Carpenter [00:51:55] I'm trying to be more adaptable about how I take care of my body. So I used to be a runner, not so good. You know, if you do that for a long time. So now I do other forms of exercise that are more, they're less stressful for my body. So I'm making change. I'm, I'm, I think I'm trying to be realistic about what my body can do as I grow older and take care of it and still stay active in a way that feels meaningful and fun to me, but do it in a way that respects the limits of my body.

Vance Crowe [00:52:28] I, so when we had our, our first daughter, we took 'em over to a family friend's house and, and the couple is maybe in their maybe mid sixties, and I noticed that the dad, the, that he could get up and down off the ground so easily, it was like just getting up and down and picking up the baby. And I came home and told my wife about this, you know, we were talking about it and she was like, yeah, that, you know, it's one of those transitions, she's a physical therapist where she says, you know, you go from realizing that the muscles that you're trying to put on or the these people trying to take testosterone and things to keep their bodies as big as they can ultimately becomes an impedance. And the way that you stay younger, longer is like, flexibility is the ability to get up and down and move around, but nobody tells you this. Right. It is not a part of popular culture to say, you know, oh, the, the thing you really want when you're in your forties is the ability to reach down and touch your toes and get outta bed without hurting yourself.

Brian Carpenter [00:53:24] Exactly. I, I mean like, I'm already worried about like, who, who's gonna cut my toenails?

Vance Crowe [00:53:29] You know, they seem, they're starting to

Brian Carpenter [00:53:30] Seem farther and farther away from me every year. But you're right, it's that flexibility, the stretching, the strength, the balance, that's the stuff that's gonna be more important for you. One

Vance Crowe [00:53:40] Of the things that I've been concerned about, because a, a long time ago I heard that, you know, your creativity goes away as you age. In fact, I have some friends that are doing really high end mathematics and they basically burned everything down in their twenties because they said after I'm 20,

Brian Carpenter [00:53:59] The

Vance Crowe [00:54:00] Odds are that I'll get some new idea is virtually zero. Is that true?

Brian Carpenter [00:54:06] It's complicated. First of all, it's complicated because creativity is kind of a mushy concept to begin with, right. You know, is it, we typically think of creativity as, you know, our artists, the painters, the authors, the musicians, and that's one way of thinking about creativity. But is it any less, less creative for you to go home today and open up your refrigerator and figure out, Hmm, I need to make dinner out of what's in there. Let's see if I can throw something together. Is that necessarily being creative? You know, and if you can do that when you're 85, does that mean you're still creative? You

Vance Crowe [00:54:46] Know, fascinating.

Brian Carpenter [00:54:46] So I think that one of the complications around your question is how, what we're talking about, you know, what are, what exactly is the skill or the competency that we are worried about losing as we grow older? 'cause the reality is that your brain, like any other organ in your body, is gonna change as you grow older. Just like your liver's not gonna be the same liver and your lungs aren't gonna be the same lungs, and your skin isn't gonna be the same skin. So as your brain is changing, as you grow older, it's, we know that it's gonna be less able to do certain things with the same speed and efficiency as it did when you were in your twenties. And that's a reality. But that doesn't mean that you're destined to be infirm, cognitively impaired individual as you enter your later life. Number one, you can do things to take good care of your brain, just like you do things to take care of your body. And it's important to start taking the care of your brain when you're in your twenties.

Vance Crowe [00:55:52] What does it mean to take care of your brain?

Brian Carpenter [00:55:53] I'm not gonna tell you anything you don't already know. You need to be eating well, getting plenty of rest, exercising. You know, the, the basics that we've known are important for a long time. What's good for your heart is good for your brain. So if you take care of your heart, you'll be doing your brain a favor as well. So nothing magical there. It's the public health. People have told us all those things for decades that you, you're not gonna tell anybody on the street that, that they should be exercising more. And that's gonna be a surprise to them. The challenge is getting people to do it, you know, to eat better, to sleep well, to get plenty of exercise and to stay socially connected and purposefully engaged. So if you're taking care of your brain, you know, that's, that's a good thing. But there are also ways that you can, that we know that older adults accommodate changes in their brain as they grow older and their cognition as they grow older. So some people, you know, for example, will, will say to me, you know, I, I don't know what's going on with my, I I, I'm afraid I'm getting Alzheimer's disease. I I misplaced my cell phone, or I walk into a room and I'm can't remember exactly what I was looking for. Or I meet somebody new and I can't remember their name. And I'm like, yeah, that happens to everybody as they grow older and even happens to people when they're younger too. It doesn't necessarily mean that your brain is, they

Vance Crowe [00:57:19] Just don't attribute it to getting older.

Brian Carpenter [00:57:20] Exactly.

Vance Crowe [00:57:20] Yeah,

Brian Carpenter [00:57:21] Exactly. So that's one of those stereotypes that people have that you know, you are destined to have problems with your memory and your thinking as you grow older. And for some people that does happen. And it is normal to experience some mild changes and your memory and your thinking as you grow older because your brain's different than the brain you had when you were younger. But that doesn't necessarily happen to everybody. It happens really pretty late in life for most people. And it isn't necessarily a, a sign that people have a kind of dementia, like Alzheimer's disease. Alzheimer's disease is a disease. It's not a normal part of aging. And not everybody who reaches old age will develop Alzheimer's disease. We think that about maybe around a third of the people who are at age 85 may have some kind of dementia, like Alzheimer's disease. But the other, the flip side of that statistic is that two thirds of the people at 85 don't have Alzheimer's disease. So Alzheimer's is a disease like arthritis, like cardiovascular disease. It is not a normal part of aging.

Vance Crowe [00:58:33] Do you think Alzheimer's will be cured someday?

Brian Carpenter [00:58:35] We all hope, you know, we've been working on that, or I haven't been working on that. There are other people a lot smarter than me who have been working on that for a long time. Are we closer?

Vance Crowe [00:58:46] Hmm. Depends

Brian Carpenter [00:58:47] Who you ask. I mean, we haven't had a treatment breakthrough in decades. I mean, there was a new medication that was just approved last year by the FDA, but that got scaled back. Now it's only available under very limited circumstances for a very narrow group of people. It's not even clear whether it's beneficial or how beneficial it is. So there's still a lot of unanswered questions around Alzheimer's disease at this point. We're making gradual steps in how we understand it. But no magic bullet at this point.

Vance Crowe [00:59:20] It's an interesting part of life because if you've ever watched somebody with Alzheimer's, you, you notice like they don't really know what's going on. Like in the beginning they do, but once they've hit a certain point, it's almost like going back to being a child all the way to an infant. And, and for the people on the outside of it, it seems to me horrifying, right? This is not just going to prison. It's going to prison where you lose all of your faculties and you're not safe for yourself. But for the person inside of it, it doesn't seem, well, I mean, I'm sure it can seem scary, but they, they seem to be drifting off in a way.

Brian Carpenter [00:59:59] Yes, for some people, you know, it's, this is a terrible disease and it's terrible for the people who are experiencing it and the people around them for a lot of the reasons that you just mentioned. You know, I think for, for some people, the, the very beginnings phases can be terrifying because you, once you have a diagnosis, you know that this is a Alzheimer, in the case of Alzheimer's disease, it's a progressive form of dementia. So it, it will get worse. And we know that, we don't know how quickly it will get worse for any one person or what they will start to lose in what sequence. That's hard to predict for any individual. But we know a little bit about what's gonna be coming down the road. And the specter of that can be extremely di di discouraging for people and depressing for people. How

Vance Crowe [01:00:52] Does somebody get a diagnosis of Alzheimer's?

Brian Carpenter [01:00:54] Our diagnosis of Alzheimer's disease is a provisional diagnosis, so it's a tentative diagnosis. 'cause the only way we can diagnose it definitively now is with a biopsy by looking at brain tissue under a microscope. That's the only way for to know for sure that a person had Alzheimer's disease. So now we're, we use a variety of biomarkers, so things that we can see in the brain and the body that tell us something about the accumulation of substances in the brain and the body that are indicators of Alzheimer's disease. And we can combine that with other clinical tests of people's memory, cognition, other functions that, and we can kind of predict that with about 95% accuracy right now. And there's several tests that are under development right now that might increase the accuracy of that. So they typically, people will go to an evaluation center where they're, they'll have these biomarkers evaluated, have an interview with a physician who asks questions about changes they've been experiencing, often involves bringing a family member in, or somebody who knows that person well, to ask them about changes that they've noticed as well. Maybe sometimes some paper and pencil testing to help understand where the person's cognitive strengths and weaknesses are at the moment. And that after that, all that information is gathered and synthesized, then the physicians can usually offer a diagnosis. And again, we think that we can do that with about 95% accuracy

Vance Crowe [01:02:27] When somebody is having an older parent. And the parent, you know, in your lecture you had talked about one of the highest priorities people have is to stay in their home. What keeps somebody from being able to stay in their home?

Brian Carpenter [01:02:39] Often it's safety issues. It's an ability to, to navigate around your home in a way that allows you to take care of yourself in the way that we all have to take care of ourselves every day. It's the ability to continue to do dressing, bathing, grooming. Those are pretty basic things that people don't usually lose the ability to do until later. But it's also being able to, you know, prepare a meal, get your groceries, pay your bills, stay in touch with other people. And when individuals start to have difficulties doing those things, whether because of a cognitive reason or a physical reason, that can often send out some red flags about whether the person is safe to stay in their home. We, we want people to be able to stay in their homes as long as they, they can, if that's what they wish. And there are many, many more programs that are emerging to help people do that because we know that it's cheaper and often more satisfying people to stay, for people to stay in their homes rather than moving into a residence. Oh,

Vance Crowe [01:03:48] I guess I had thought about it as being the opposite, but I guess you now interesting. Say more about that.

Brian Carpenter [01:03:54] So, well, first of all, the, the most important thing is that when people wanna stay in their home, that's a place where they would rather be. And we should make that possible for people when we can. But if you think about the transition from home to an assisted living facility, for example, or a nursing home, those are communities where there are a lot of services that are brought together to help support the person to be able to do the thing that they couldn't do on their own, in their own how home. So those places are great because they bring all of those services together for individuals. Well, when you bring all those services together, there's a cost associated with that.

Vance Crowe [01:04:33] And so if you're living there and not using it, you're amortizing all of the

Brian Carpenter [01:04:37] Costs. But if you're staying in your own home, you know, the, the biggest expense is that property. It's easy enough. Well, I shouldn't say it's easy enough. Ideally you would, we would have a society that en enables it to be easy for you to bring in a housekeeper, somebody to help you with grocery shopping, somebody to do some laundry and housekeeping for you, maybe even somebody to help you use the bathroom or take a shower. That's much less expensive than having these communities where all of those services are brought together. Yeah,

Vance Crowe [01:05:09] One of the ladies in my neighborhood has an in-home care thing, and then her sister got old at the same time she did. So after the husband died, the sister moved in and then they shared

Brian Carpenter [01:05:19] In-home

Vance Crowe [01:05:19] Care and it, it was a brilliant idea. Then when one of the daughters would come, they'd take care of both of them. It was, but I had always thought about staying in your home as being a luxury. It actually hadn't crossed my mind that moving into a facility would be more expensive,

Brian Carpenter [01:05:36] Almost always more expensive. Not always, because it depends on how much help you need brought into your home to be able to stay healthy and stay safe there.

Vance Crowe [01:05:47] You mentioned a statistic and you were bringing up like why aging changed so much in the United States in one of your lectures. Clearly I loved your lectures, they really stuck with me, but they, one of the things that you brought up was on average people are gonna live seven years without a driver's license in the us and you think about how your life would be if you are not allowed to go get into that car because our entire worlds are situated around that this is only going to get larger.

Brian Carpenter [01:06:14] Oh yeah. Although, I mean, don't be pessimistic. Don't, you don't have to be entirely pessimistic about it because regardless of how you feel about driverless cars, autonomous vehicles, you know, that is the kind of technology that could be a real game changer for older adults who can't drive themselves any longer. If we are able to have this technology that allows people to get around, particularly in communities that aren't well serviced by public transportation or don't have other transportation services for older adults. I mean, that's one of the things that I like about some of the ride sharing companies that are out there now, is that I know a lot of older adults who are using them to get around town because they may be driving themselves, but maybe they'll just go to a few places during the day where they feel safe with their driving. But if they wanna go to the symphony at night or they wanna go visit some friends who live further away, then they'll pick up the phone and call a rideshare. And then they don't have to worry about feeling nervous about being on the road at, you know, nine o'clock at night when maybe their vision isn't as good as it used to be. So I think there are some services and programs and technologies on the horizon that might help us deal with that transportation issue. But here again, we created a, a society here in the US that isn't well serviced in terms of trans dealing with transportation challenges that people have. I mean, if you live in a rural area or a suburban area, even often your options are pretty limited in terms of alternative transportation.

Brian Carpenter [01:07:49] So you're right, if you have to give up your car, you're in big trouble.

Vance Crowe [01:07:52] Earlier you had talked about you are gonna make choices when you're in your twenties. That's gonna impact you when you're in your sixties. Eighties. You know, beyond, one of the thoughts that you brought up during your lecture was stepparents, right? If you have children, presumably you build a good relationship with them. Oftentimes they might be willing to step in and take care of you, but if you married in later and those children aren't yours, that's going to be a different existence. Talk about that. That was surprising, but seemed very real for a lot of people.

Brian Carpenter [01:08:26] Yeah, I think your example is of one kind of family where there's an original family, but that family dissolves and maybe gets reconstituted in another structure. And that's one example of the kind of family that's gonna need to rethink its expectations and rules about who's responsible for doing what kinds of things. What are your obligations as a child to a stepparent that maybe you haven't known for very long in terms of practical support or financial support or emotional support. And those kinds of rules and expectations are being rewritten all the time now because families in the United States just look a lot different than they did 50, 60 years ago. We've got single parent families, you have families with no children, you have families that were reformed after dissolving. You have maybe multi, multi, multi-generational families that have all these complications in them. So it was a lot more straightforward when families had two parents, two kids, and maybe some grandparents. You know, the rules were pretty straightforward then. But now you've got all these different variations in families that are making things more complicated. So I, people are now renegotiating or having to have conversations about all of those things that we didn't have to have conversations before when the rules were more clear.

Brian Carpenter [01:09:59] It's only gonna get more complicated in the years ahead because family structures are gonna continue to evolve and continue to look really different.

Vance Crowe [01:10:07] Do you think the United States is a good place to grow old?

Brian Carpenter [01:10:09] Ooh, that's a really good question. It depends where you are, I think in the United States, and it depends what steps you have taken to prepare yourself. I don't think any place is going, you shouldn't rely on any one place to solve all your problems for you as you grow older. But there are certainly some places that have more resources and opportunities that will help you live a certain kind of old age that you might have in mind for yourself. Here in St. Louis, we have what's called a naturally occurring retirement community. The acronym is a norc. And there are NORCs that have sprung up spontaneously all over the United States, and they are communities or neighborhoods that have gradually accumulated a large percentage of older adults. And the Newark here in St. Louis is out in Creve Corps off, well out in Creve Corps. And it's a neighborhood where over time more and more old people moved when they saw that there were more and more services catering to old people in that neighborhood. And where people aged in their own homes, they found ways to stay in their homes longer. And so what's grown, sprung up is this neighborhood of a large proportion of old people and services have moved in to support those old people healthcare services, but also businesses. And in fact, there is a, you can buy a membership to the Newark now that gets you discounts at restaurants that offers community activities, social activities.

Brian Carpenter [01:11:53] And so it's brought together this set of supports that help those older people live successfully and independently in that neighborhood. Now it looks really different in New York City here we have a suburban Newark, but in New York City there are NORCs in apartment buildings. They're vertical NORCs where the same thing happened. People moved into these apartment buildings when they were younger and they've just stayed there for decades. And eventually the apartment building is almost all old people. And so businesses come into that Newark to be able to support the old people to stay there. Yeah.

Vance Crowe [01:12:26] One of the very first clients I ever had when I started working for myself was an adult daycare. And this was when I, even when the person approached me, I actually thought it was a joke because I didn't realize this is a real thing. It's a real thing where you might have one older adult that is getting to the point where they can't take care of themselves and you can't leave them for the day. And you have the other adult that still has a vibrant, active life. It just had never dawned on me. Yeah, that you could have a service like this.

Brian Carpenter [01:12:56] Exactly. Right. Yeah. And those kinds of services are gonna be more and more important I think, as the population ages, and you're gonna see more options. This is one of the exciting things about working in the aging field right now, is that there's a great entrepreneurial spirit, you know, for people who are seeing a need and opening things like adult daycares or other kinds of residential options for older adults or services to help them live independently longer in their own homes, products and other kinds of services that are, you know, just coming on the market as people now have realized, wow, there's a big, there's a big marketplace out there. So there's a business opportunity, but there's also a kind of social imperative that if we want, if we want to take care of these people, we need to structure our society in a different way than we have before.

Vance Crowe [01:13:45] So if you think about aging, you know, the other thing that goes along with it is death. What do you think happens when you die?

Brian Carpenter [01:13:52] Personally, I think that this is it, but after I'm gone, I'm gone. I don't think my anything is gonna happen to my body and I don't think my spirit, whatever my spirit is, is gonna take another form. But that's a very personal belief. And I've talked to other people, many other people who have very, very different beliefs about what will happen to them after they die. None of us can know with certainty who's right.

Vance Crowe [01:14:20] Does how somebody thinks about what will happen when they die change how they age.

Brian Carpenter [01:14:26] It can, it can, for some people, certain kinds of beliefs about what will happen to them may, may motivate them to live a certain kind of life up until the point that they die. And if they, if they believe in something like karma, for example, they may devote themselves to good acts in order to make it more likely that their next life will look a certain way. But I've also seen people who have beliefs about what will happen to them that are more scary, more frightening, more negative, that can be really frightening for them as they approach their own end of life. If, for example, they imagine that what's waiting for them on the other side is not particularly pleasant, then of course they'd want to delay dying as long as possible. If they imagine that what's waiting for them is eternal damnation or something that's equally scary to them. So I think people's beliefs about what will happen to them after they die can influence their experience of life and their experience at the very end of life too.

Vance Crowe [01:15:30] I'm sure you get asked by students a lot the the question, you know, what do you know about what older people regret? And so I do these Legacy Interviews, and when I first started, I thought asking about regrets would provide some insight. When you ask people that they really think back about some change or some thing, what I've ultimately discovered is the best question to ask, and I'd be interested to hear your answer on this and what, what kind of you, where it takes you. But is the, is the question, what was the most difficult lesson to learn that was the most valuable to know?

Brian Carpenter [01:16:06] Right.

Vance Crowe [01:16:06] Which is close to regret, but it's not the same thing because that, that's like, Hey, if you learn a lesson, it's, hey, I, it just took me a while to get there. Right. Do you, do you have an answer? Does one come to mind so far in your life? What was the, what was the most difficult lesson to learn that was the most valuable to know?

Brian Carpenter [01:16:25] I can think of one, but I can't say that I have really put the lesson into practice as much as I wish that I had. I, I think I'm aware of the lesson and I know it's important. Have I actually done anything about it? I think so, but I'm still working on it. And it's a, it's a lesson about being less afraid or less concerned about what other people might think about me or what I'm doing. And I think that when I look back on my life, there were moments when I should have just done it. You know, I should have just gone there or I should have just talked to that person, or I should have taken that risk or done that thing. But something held me back. And the lesson that I'm trying to learn is, is to not be held back. You know? 'cause you're, 'cause at least in my belief, I'm only gonna live once and it's, I'm not gonna get back tomorrow back. So why not make today and the next day as rich and as fulfilling as possible? And that means I may need to take some risks and do some things that will feel uncomfortable, but when I look back on those things, it's probably not gonna be a big deal. And in fact, it may actually make my life better in the long run. I

Vance Crowe [01:17:43] Find that actually to be a very common lesson that was really difficult for people. And, and it's striking for me because to a fault, I don't have that right to, to the extent that I really don't care what other people think to the position that it helps. But I've noticed that people, when they hit, I don't know how old you are, but when they hit about 65, that's when that lesson clicks in and they bring that up a lot. Right. That there were so many things in their life that they knew was the right thing to do, or they wanted to do this thing, but they were very worried and and you probe it, you often find they, they weren't trying to avoid any one person's like thoughts about them. Yeah. It was kind of like, what will people think? And it seems real.

Brian Carpenter [01:18:30] Yeah.

Vance Crowe [01:18:31] But when they then reflect on it, it, it isn't.

Brian Carpenter [01:18:33] Yeah.

Vance Crowe [01:18:34] Do you find that people have regrets in their older years? Do they talk about regrets? No.

Brian Carpenter [01:18:39] More so than younger people? I don't think

Vance Crowe [01:18:41] Really.

Brian Carpenter [01:18:41] I don't think so.

Vance Crowe [01:18:43] Fascinating.

Brian Carpenter [01:18:44] I don't think so. Yeah. I mean, maybe you've got more years and more experiences to regret, you know, so maybe just like the pot of possible regrets is bigger by the time you get to be 75 and you have maybe more time, you've had more time to reflect on your life and it's in a different perspective than when you're 25. But I, I mean, I spent a lot of time with college students and they can tell me a lot of regrets that they have in their life, even though they've only lived 25 years or so. Yeah.

Vance Crowe [01:19:17] Or

Brian Carpenter [01:19:17] Less too.

Vance Crowe [01:19:18] Yeah, I would, that's, I probably day to day had more regrets as a young person than I do as an older person. And the older person is just because I'm not as impulsive as, as I once was. Right. Right, right. So you lower the number of regrets you have if impulsivity is the thing driving you right,

Brian Carpenter [01:19:33] Or make, maybe you make different decisions that you have less to, less to regret because of the decisions that you make differently as you grow older.

Vance Crowe [01:19:41] So this concept that we're doing this series on Memento Moori, remember you will die. What does that strike you did? Is this something that plays in your head very often

Brian Carpenter [01:19:51] Without sounding too morbid? I'd say like constantly. Really every day. This is, you know, one of, one of the areas that I've been interested in, in for a long time. And we are doing some work here in St. Louis to, that's focused on end of life and the value of people reflecting on their mortality. And you know, what, what good that can bring to people to do that. To be aware that your days are limited and how to take that as energizing rather than, you know, them inner innovating. That this is an idea that can propel your life forward rather than paralyze you. So yes, I think about it all the time because I do believe that when people are willing to engage with the idea of their mortality, that it can have some psychological and practical benefits to people.

Vance Crowe [01:20:46] How does somebody engage with their mortality?

Brian Carpenter [01:20:49] Slow down. You know, I think that's the first step because if you think about your calendar, you think about your day, you know, do you have time today to pause and reflect? Maybe, maybe, maybe not. But thinking about the end of your life and what your life has meant, it deserves some respect, you know, that kind of reflection. But we have a hard time building that into our day-to-day life. 'cause we're busy and we've got a lot of responsibilities. So the first step is being intentional about the process. You know, committing to time, whether it's to read or to talk with other people or to take a walk with the goal of thinking about life and thinking about death. People need to make that happen and that needs to be an active process. 'cause it's not just gonna happen naturally unless you get thrown into a situation where you're confronted with death face-to-face. And that will happen to everybody eventually. But why not do it on your own time and do it on your own terms. It's likely to be much less scary and much more beneficial.

Vance Crowe [01:22:04] I remember a time when a friend and I were talking about meditation. I had just started doing it, this was several years ago. And he said, well, have you ever done a death meditation? I was like, why in the world would I want to do that? That sounds like, you know, going to, you know, some awful place in your meditation. And then, you know, ideas like that tend to seep into your mind, right? And you then you do start thinking about it, and then you, you prepare. And it, it was an interesting exercise for me because I realized I was avoiding being a, i I wasn't afraid of death, but only because I was avoiding thinking about it. And then once you have the, I'm thinking about it, then you're like, okay, well now I've accepted that I will die. So now what? And so your concept about it propelling you forward, really strikes me because that it really did all a sudden the things that you're, you know, the people you're afraid of upsetting or the tree that you might wait to plant, all of a sudden you have an impetus to it that isn't just your to-do list.

Brian Carpenter [01:23:04] Exactly. Yeah. And I think that's an awareness that can be beneficial for people regardless of their age. Because, you know, we tend to think of that most people who die are old. And that's true from a statistical point of view, but you can die at any age. So why wouldn't it be equally important for an 18-year-old to contemplate their mortality as a 85-year-old?

Vance Crowe [01:23:25] And how do your students react to the, the day of, of death in your

Brian Carpenter [01:23:30] Mixed, you know, some people are a little bit caught off guard by it and a little bit frightened by it because they haven't been shown that you can actually talk about it and think about it without it overwhelming you or getting really depressing or really sad, and that there might actually be something good about it. So we approach it in a very gentle way to encourage people to contemplate this idea in a way that we are asking them to contemplate lots of different ideas. We don't make a big thing about it. It's like thinking about other parts of your life as well. And we hope that it, there's a little bit of that process that is destigmatizing and maybe a little desensitizing to people that, that they can, that they have an experience where they think about death, think about their mortality in a way that doesn't overwhelm them or swamp 'em or make them feel really, really sad and depressed. And having come from that experience, they can say, oh, this is something that I can talk about and it's kind of interesting and maybe there's something valuable in continuing to think about it at different parts of my life.

Vance Crowe [01:24:33] Well, Dr. Brian Carpenter, this has been an amazing conversation. I'm so glad to have met a guy on the elevator that pointed me in your direction. And if people wanted to learn about your work here in St. Louis, where would they go to do that?

Brian Carpenter [01:24:49] We have a, I have a, we run a lab research laboratory at Wash U and if you google my name and Washington University, it'll get you there eventually.

Vance Crowe [01:24:57] Well, I found you in a matter of seconds, so it was not, you're not a difficult man to find. Good. Well, thank you for coming on.

Brian Carpenter [01:25:02] You're very welcome.

Vance Crowe [01:25:23] Thanks for sticking around to the end of the interview. You're in for a special treat because Jim Tobin agreed that we could air a part of his legacy interview. In this clip, you'll hear him describe what it was like when he was a little kid and he decided he wanted to run away from home. We hope you enjoy this, and if you're interested in having me interview one of your loved ones, go to Legacy Interviews dot com to find out more. As a little boy, I, I got frustrated with something going on in the household and told him I was gonna run away. And as I was walking out the door, my dad yelled, don't forget your boots. And they found me several hundred yards away, stuck

Brian Carpenter [01:26:03] In the mud. So I, I, I think that's the last time I ran away.

Vance Crowe [01:26:08] What sorts of chores were you responsible for as a kid?

Brian Carpenter [01:26:12] Well, we, we raised cattle and hogs and so in the winter you'd have to go chop a hole in the ice so that cows could drink. And we were farrowing about a thousand head of pigs a year. So I took care of the faring house when I was probably 12 years old. So you're going out, laying out the sows and feeding them, putting them back in, making sure that all the pigs are in good shape. A lot of responsibility for a young child. I, we, we couldn't begin to give our children the same responsibility at that age, but I don't, I don't regret we learned a lot from that.

Vance Crowe [01:26:55] What do you think's different? Why couldn't you do that?

Brian Carpenter [01:26:58] Well, we weren't on a farm. We didn't have a farm to, to assign things. I did take the boy, our sons, our parish priest when I was talking to him about this responsibility things, bring 'em to the food pantry on Saturday morning. So I would get them up in the morning on Saturday and we'd go help box up or sack up food for the, the food pantry at St. Cronin's and they would grumble about getting out of bed on Saturday morning. But I, I think once we got there, they, they got into it and it, it gave them a perspective on the world that, that they wouldn't have had otherwise. I, I think that was helpful.