Miles to Go Before I Sleep: Robert Frost and the Common Good
Executive Director, Vizient Research Institute
At noon on January 20, 1961, John F. Kennedy delivered his iconic inaugural address. The temperature was 22 degrees, but a 19-mph northwest wind made it feel like it was only seven degrees above zero. Telltale wisps of condensation escaped as warm breath hit the frigid air. The speech delivered on that blustery day 60 years ago left us with the indelible challenge: “Ask not what your country can do for you, ask what you can do for your country”.
Fourteen weeks earlier, at 2 a.m. on October 14, 1960, presidential candidate John F. Kennedy arrived at the University of Michigan for a scheduled campaign stop the next day. On the steps of the Michigan Union, he introduced the idea of young people living and working as volunteers in the developing world. On March 1, 1961, his 41st day in office, Kennedy signed an executive order establishing the Peace Corps.
Since 1900, the percentage of Americans aged 65 or older has increased 17-fold, growing from 3.1 million then to 54.1 million today. This population cohort will surpass 80 million by 2040 and will hit 94.7 million by 2060. This explosive growth brings with it an enormous burden of chronic illness, shouldered by a group of people who are increasingly disabled, socially isolated and severely limited in their ability to cope with their illnesses and the complexity of the health care system.
At the same time that we see exponential growth in the chronically ill population, we have an unprecedented increase in the number of healthy seniors — folks whose professional careers are coming to a close, but whose physical and mental capabilities are far from exhausted. With their working lives winding down, many of these healthy seniors express feelings of diminished usefulness. A survey of over 15,000 retirees found roughly 40% of respondents between the ages of 65 and 79 reporting a low to moderate sense of purpose in life, which the researchers conceptualized as having goals, a sense of direction and a feeling that there is meaning to present and past life. Even more telling, one in five of those retirees were characterized as having low purpose in life. After age 80, that proportion jumped to nearly one in three.
It’s this fortuitous confluence of relatively healthy seniors and their less fortunate generational peers that make the echoes of volunteerism that Kennedy spoke of in 1961 relevant today. Imagine healthy seniors, nearly half of whom struggle with feelings of diminished purpose, volunteering to assist less fortunate folks with whom they have so much else in common. Imagine helping someone who grew up listening to the same music, who raised their family at the same time, who laughs at the same jokes…imagine healthy seniors helping others deal with the challenges of chronic illness or social isolation, and in so doing experiencing a renewed sense of purpose themselves.
Imagine the ‘elder corps’
In an atmosphere of political polarization, it is sometimes easy to forget that people tend to come together when facing tough times. Communities closing ranks in the wake of a natural disaster. Volunteers building houses as part of Habitat for Humanity. Or traditional competitors collaborating to save lives during a global pandemic. Selflessness never goes out of style. As the wave of aging baby boomers washes ashore with all of the medical and socioeconomic challenges that accompany it, it will take new and even unconventional ideas to manage the storm surge. Part of the answer may be coming ashore in the wave itself in the form of healthy senior volunteers.
Many of the earliest Peace Corps volunteers are now in their seventies. They are the generation who answered the call in their youth. Why wouldn’t we think that they would answer it again if asked? When you’re 25 years old, you don’t know where you’re going and most of life is ahead of you. When you’re 75 years old, most of life is behind you but you know where you’ve been. At both times, volunteerism can give you a heightened sense of purpose.
When asked what health care providers could do to make their lives better, chronically ill patients and their family members answered in a resounding voice: assist with navigation. The stress associated with making their way through a labyrinth of processes and care pathways was far and away the most common source of dissatisfaction among our most vulnerable patients.
In addition to the country at large reaching out to healthy seniors to serve, health systems can look within for a ready source of talent — our own retirees. Who better to assist the socially isolated or the struggling chronic patient in navigating the system than those who spent their careers doing so? It’s safe to assume that at least some of our own retirees are among the 40% of seniors who express feelings of reduced purpose in life. America in general, and health systems in particular, should look to our burgeoning senior population for help in battling the effects of social isolation and shouldering the burden of chronic illness.
In his poem Stopping by Woods on a Snowy Evening, Robert Frost, one of President Kennedy’s favorite poets, eloquently referred to important contributions still to be made before one’s own passing as “miles to go before I sleep”. John Kennedy closed his speech on the steps of the student union that early October morning by saying “I do not apologize for asking for your support…I come here tonight asking your support for this country over the next decade.” At a time when we have unprecedented numbers of aging Americans, many of them healthy and many of those feeling a diminished sense of usefulness, we shouldn’t apologize for asking for their support.
We need them now as much as ever.