Ageing musicians

Dustin Hoffman is 75 years old. The famous actor (Rain Man, Kramer vs Kramer) recently directed his first movie "Quartet". I saw it this week in Geneva. This great film is about a home for retired musicians where a new resident arrives. Reggie, Wilfred and Cecily get a special shock when the new arrival turns out to be their former singing partner, Jean. Her subsequent career as a star soloist, and the ego that accompanied it, split up their quartet and ended her marriage to Reggie. The movie is then mainly about whether the famous four will be able to patch up their differences in time for Beecham House's gala concert. And whether the former star is able to cope with her functional decline, not being able to perform on the same very high level (high standard and high notes). Can she be convinced to start singing again?

Apart from being a must see movie, there are also two lessons from this film for ageing policies.

The first lesson is that it is good to create environments where old people can prosper and use their talents. The home for retired musicians is a great example. There are many activities organised that appeal to them, like dancing classes and music rehearses. But they are also still productive and active. A great scene is where Reggie gives a lecture to young students who come to the home every so often. He compares the opera to present day rap and a young rapper answers by rapping about the opera. Both rap and opera is about the expression of intense emotion through song. And of course there is the gala where they are all performing, raising funds for the financing of Beecham House.

The home is located in the English countryside and has all kinds of adjustments to make life easier for the old artists. That is is of course a good thing. But creating age friendly environments should not be restricted to old peoples homes. On the website agefriendlyworld.org there are many examples of how to make the whole world a better place for older fellow citizens. Examples are reserving hours at swimming pools, extending walk signal times at pedestrian crossings and making sure that people know each other. In the WHO global network - also on this website - a growing number of cities and communities worldwide are striving to better meet the needs of their older residents.

In fact I find the term age friendly a bit degrading and implying that the rest of us must adjust to older people. Some things get worse when you age (biking in the mountains is a good example as I noticed on Thursday), but some things may also get better, like wine. Wisdom, patience, less ego and openness to other people to name just a few things. Age friendly is also about using the special gifts and skills of older people.

The second lesson for policy is about convincing old people. However wise and patient, they can also be very obstinate and conservative like everyone else. It is never too late to stop unhealthy life styles (although this is a bit ridiculed in the film when two 80+ are caught on smoking and reprimanded by the main nurse. Another old guy replies, how much longer will they live, a week?). And convincing them to become more active also requires an active attitude of people. In the film the three musicians try to convince Jean that she should take part in the show. Inviting her for a nice diner does not help, but telling her that her former competitor would then get the final act is the trigger that does the job. 
 

There is an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. The popular word is “nudging”. How to nudge people toward particular decisions or behaviors related to health or health care? We live in a world that’s fueled by immediate gratification with little regard for future consequences. Many people are short-sighted: why forgo the instant ecstasy of that second or third serving of chocolate cake when the rewards of restraint are so distant? Simply telling people that certain lifestyle choices have a negative or positive effect on the quality or longevity of their life simply falls on deaf ears. It is better to try influencing decisions in a subtle and indirect manner. The picture below is a funny example of nudging. I am sure it is possible to find many examples of nudging that can - for example - make older people more active.

And finally, although the film wants us to believe that musical skills decline with age, there is in fact ample evidence that you can perform on a high level till a very high age. Just look at the Rolling Stones. Yes, Keith Richard has arthritis. Fortunately, there’s no evidence that playing any instrument wears joints out quickly. Musicians get arthritis, just like the rest of us. He may be comforted by the adage that says that life is short but art is long.