What is it like to be old? It’s an important question, because old age is the one place where every one of us is headed. If we could imagine our own lives in the future, we might be able to envision a better future for all old people and take action. This is something worth thinking about, and we can’t start too soon.
One Old Man
Lately, I’ve been contemplating old age, having just finished The Secret Diary of Hendrik Groen, 83 ¼ Years Old.
The book has become an international bestseller, translated from the original Dutch into 20 languages since its publication in 2014. It is the day-by-day account of a man living in a care home in Amsterdam. For some time, it was unclear whether the book was fact or fiction. Was it the real diary of an old person in the Netherlands? The author was unknown to anyone but the publisher. Then in 2016, it was revealed that Hendrik Groen was the pen name of Peter de Smet, a 62-year-old Dutch librarian.
Although much younger than his protagonist, de Smet knows exactly what it’s like to be old. The Secret Diary is an honest and direct account of the trials and tribulations of old age. It is also a thoughtful, poignant, and funny portrayal of a man trying to adapt to the changes that come with advanced age, while exercising a healthy dose of resistance. The book is good-hearted and life-affirming — just what we need when contemplating old age.
As a reviewer for the Minneapolis Star Tribune (2017) notes, “The author understands what it means. . . to lose dignity and independence, to lose friends to dementia and death. The author also understands friendship and how crucial human contact is – especially when life is contracting.” The reviewer concludes that, while the book may not appeal to readers who are advanced in age themselves, it is a must read for “someone headed there, or whose parents are headed there.”
A young reviewer for the literary website Seven Circumstances (2017) recommends The Secret Diary to readers of any age who want a glimpse into their own future: “You want to know what awaits most of us? Read this.”
Well, yes and no. The kind of life we lead in old age depends a great deal on where we grow old.
The Case for Elder Care
Hendrik Groen is a charming character, and his fictional diary is fun to read, but it also raises many social issues. Although Groen complains about the food, the petty bureaucracy in the care home, and the lack of meaningful activity, his life is actually pretty good, compared to the lives of old people in other parts of the world.
In reality, old people in the Netherlands have far more support, culturally and economically, than old people in most other countries, including America. The Netherlands is a social-welfare state with the most advanced elder-care system in the world. In 1968, it was the first country in Europe to initiate a mandatory long-term care system. Every resident pays approximately 10% of their yearly income, including employer contributions, to fund this system throughout their working lives. In return, they are guaranteed good housing and quality care when they get old.
The Dutch population pays very high taxes for this kind of social insurance, but they hold their elders in high regard, and there is strong support for the system. They use the word solidariteit, solidarity or social responsibility, to describe their commitment to older residents. Most of the nursing homes are non-profits, and a core of volunteers from the community assist the staff. The workforce in care homes, about 400,000, is joined by approximately 200,000 volunteer relatives and neighbors in caring for residents (“The Netherlands Makes Aging and Long-Term Care a Priority,” Boston Globe, 2022).
The Netherlands was also the first country to legalize euthanasia (when a physician administers a lethal dose of an appropriate drug to a suffering patient) and physician-assisted suicide (when a physician provides a lethal dose for suffering patients to administer to themselves). Since 2002, the Termination of Life on Request and Assisted Suicide Act has made it possible for people enduring “unbearable suffering with no prospect of improvement” to request that their life be terminated humanely.
Hendrik Groen’s fictional life is an accurate representation of the care Dutch system: he has lived rent free in a good-quality nursing home for the past two years, and he doesn’t worry about money, although he has very little; he enjoys three nutritious meals a day plus coffee hours; and he has free access to health care, including a room in the dementia ward, should he need it. He has many age-related conditions and often thinks about euthanasia, which he discusses with his doctor. He is comforted to know that he won’t suffer at the end and may even have a choice in the time and manner of his death.
In America, which lacks a national long-term care system, most older people worry about running out of money, becoming a burden to their family, and dying in pain. Medicare, the national health insurance program for all citizens over the age of 65, does not pay for long-term residence in a nursing home.
Currently, a private room in a home like Groen’s would cost approximately $106,000 a year. The average length of stay among nursing home residents in America is approximately a year and a half, but about 20% of the population will need to stay for five years or more, according to LongTermCare.gov. Less than seven percent of Americans have private long-term care insurance, which means that everyone else will have to pay out-of-pocket to live in a nursing home.
Very few Americans have enough savings or assets to afford to live in a nursing home for any length of time, which means that elder care falls primarily on the family. This is a great burden to younger generations. Because we haven’t planned for our old age, individually or collectively, most Americans are woefully unprepared, financially and emotionally, for the future.
There is Hope
In her book The Coming of Age (1972), French philosopher Simone de Beauvoir advised, presciently, that we all must overcome our denial of aging and death. At every age, we must learn to look at old people with kindness and contemplate our own lives in old age: “If we do not know what we are going to be, we cannot know what we are; let us recognize ourselves in this old man or that old woman. . . it is harder to adopt than falsehood, but, once reached, it cannot but bring happiness.”
This is why The Secret Diary of Hendrik Groen is an even better book than most people realize. In creating such a relatable character, Peter de Smet has made it easy — even pleasurable — for us to see ourselves in this old man. And the fact that there are so many people around the world reading this book is an encouraging sign that we may be open to change.
Beauvoir was talking about the need to raise awareness at the individual level, but she also knew that social change often starts with change from within. When we are able to imagine ourselves as old, we will be better able to understand the needs of all old people, now and in the future. With that awareness, we will be more likely to advocate for much-needed reforms in national health policy and long-term care, including more options for compassionate choices at the end of life.
My greatest hope for all old people in the future is that their lives are at least as good as Hendrik Groen’s.
Written by: Ruth Ray Karpen
Ruth Ray Karpen is a retired English professor who now works as a freelance researcher and writer. She has published many books and articles on aging and old age, life story writing, and retirement. She also volunteers for a local animal shelter. In our series on Heart and Soul, she explores how later life, including the end of life, offers unique opportunities for emotional and spiritual growth.
On behalf of Smart Strategies for Successful Living, our sincerest appreciation goes to Ruth Ray Karpen for her contribution to the heart and soul of living and aging.