If medical tests found that you had risk factors that could possibly lead to Alzheimer’s disease when you are in your mid-60s, would you want to know?
What if you were a freshman in college, just starting out on your path to adulthood? Would that change your answer?
That’s one of the questions that students in a new course at Washington University are pondering as they look into what their futures may hold — cue the Beatles music — when they’re 64.
Of course, that lilting tune that you now have running through your head was made popular by the Fab Four when they — and their most devoted followers — were decades away from that magic number.
Now, the surviving members of the band and their baby boomer fans have either passed that age or are fast approaching it. But the Washington University freshmen who signed up for the interdisciplinary “When I’m 64” class — a look at aging from the perspectives of social work, psychology, medicine and more — are learning how to consider the future in a whole new way.
“I never thought about it,” said Kate Shikany of Wheaton, Ill., about aging and what life will like for her more than 40 years down the road. “Now I think about it every week.”
That kind of insight is just what professors Susan Stark, Brian Carpenter and Nancy Morrow-Howell were trying to instill when they put the course together over the summer. They also had another motive: Trying to encourage students to think about geriatrics as a career, once they see the changes and challenges that are coming and how few people are being trained to deal with them.
In any case, the organizers say, if students come out of the class with more understanding and less trepidation about growing older, they will be satisfied.
“No matter where the students go,” said Stark, an assistant professor of occupational therapy at the university’s medical school, “they’re going to be interacting with a really large proportion of our population who are going to be older adults, and they’re going to have a better understanding and appreciation for the challenges and issues and benefits of aging.
“They’ll be able to bring that to bear wherever they land in terms of their career and within their own families.”
Student Cynthia Zhang of College Station, Texas, described the course this way:
“It’s a very eye-opening experience. It’s not necessarily just learning about academia. It’s learning about life.”
Centenarians galore
The course description for “When I’m 64” starts with a simple yet startling fact: Today’s freshmen have a 50 percent chance of living to their 100th birthday.
“This demographic revolution,” it adds, “is going to change the health care you receive, the house you live in, the car you drive, the jobs you do, and the relationships you have with family and friends. In other words, this revolution will shape every aspect of your life.”
That expansive perspective led to a course that discusses different aspects of aging each week, in a two-hour lecture session and one-hour discussion group. From jobs to money to transportation to creativity to health to the mind, each topic looks at how growing older changes everyone — and how students can prepare for the changes ahead.
“It’s designed to be very interactive,” said Carpenter, who is an associate professor of psychology. “We want to expose students to multiple disciplines on campus and to get them to grapple with a big question or a big issue that’s going to be important to their lives, not just on campus but when they graduate as well.”
Morrow-Howell, a professor in the school of social work, summed up the approach this way:
“It’s your future. Transform it.”
The course grew out of an attempt by Washington U. to offer more interdisciplinary courses, funded by grants from the office of the provost. Stark said the topics that the course covers are designed are designed to help students see issues from a lot of different angles.
“For example,” she said, “architecture could be involved when we talk about housing and community space development. Medicine can be involved with nursing and occupational therapists and psychologists when we talk about the biology of aging.”
In addition to the class sessions, students are involved in community-based projects, going to local businesses or organizations — places like the Art Museum or Wells Fargo Advisors or the T-REX business incubator — to find out how they plan to deal with an aging population.
“The students brainstormed a list of questions, like how does an aging population affect your organization,” Morrow-Howell said. “What are the opportunities? What are the challenges? What are you doing or planning to do?”
Carpenter said the meetings also have the goal of getting students better acquainted with their new academic home.
“Many of them are new to St. Louis,” he said. “We want them to get beyond the campus. This was a good way to get them out into the community and see more about what is going on around town.
“We tried to choose locations that were all accessible by public transportation, so the students could use the bus system or MetroLink to get where they need to go.”
At the same time, “When I’m 64” takes a very personal look at aging by asking parents to take an online survey about what kind of care they might want as they grow older, then having their students guess what their parents might have said.
“I think that led to further conversations between students and their parents outside of class,” Carpenter said. “I think some students were surprised at how much they knew about their parents. Some students were surprised about how little they knew about their parents. And some of them were surprised about how little they had thought about these issues and talked about them so far.
“Granted, their parents are relatively young. But it’s never too early to start talking about these kinds of things, or at least become comfortable talking about them.”
Morrow-Howell added:
“I want people to be less afraid of age, to be less ageist. We don’t talk about age. We don’t plan for it. We try to avoid it at all costs. We hoped they could just be more comfortable with age, with aging, with talking to their parents, talking with their grandparents and doing a better job of not avoiding it for their whole lives but instead dealing with issues.”
The professors emphasized that they aren’t futurists and their course is not designed to predict how society is going to be 50 years from now — no visions of jetpacks and vacations on Mars. What they want students to do is take what may be their first hard look at developments in a variety of fields that will determine what their lives will be like.
“I’d like them to have a more open mind about older adults and aging and to see it as an opportunity rather than solely a negative thing in their life ahead,” Carpenter said. “And I’d like to them to think about additional classes and coursework while they’re here that is related to aging. I’d like to see them again in one of our classes at some point.”
The specter of Alzheimer’s
In a recent Tuesday morning discussion session in the campus’s South 40 residential area, 14 students talked about the previous week’s lecture on personality and the mind. Graduate student Jon Gooblar asked about their experience with Alzheimer’s and got responses like how it’s scary, it’s tragic, it’s so hard understand. It’s different from diseases like cancer, the students said, because it eats at the essence of who you are.
Gooblar said he is doing research on people before they get Alzheimer’s and asked the question that took up most of the hour: If biomarkers should uncover a likelihood that you would contract the disease, would you want to know? How far in advance?
Discussing the prospects of treatment or even a vaccine that could prevent Alzheimer’s in the first place, he noted that even a 30-40 percent chance means a 60-70 chance of not getting it. So would they want to have such advance knowledge? What would they do differently if they had it?
Some students asked practical questions, like who else might have access to such data, and how could it affect things like their job prospects or their insurance. Others wondered whether they would live their lives differently – not get married or raise a family that would suffer loss later on, or learn to savor experiences and memories more deeply than they would otherwise.
Freshman Shikany, who claimed the class is her favorite, said she was looking forward to discussing such dilemmas on her visit home for Thanksgiving. She still wasn’t sure what her own answer would be.
“I think that if there was a specific way I could reduce the chance of getting Alzheimer’s, or eliminate the chance altogether, I would definitely want to know,” she said. “However, if I was told that there were a 50 or 60 percent chance that I was going to get Alzheimer’s, I don’t think that I would want to know because I think that it would just be looming in the future.
“I’m 19 right now. Would I want to be anticipating that for decades?”
Her classmate Zhang considered the ways that such advance knowledge might alter how she lived in the intervening years.
“If I start a family,” she said, “I’ll be like, if I know that at some point I might not remember them, then I would live with the intent that I have as much fun with them as I can when I can still remember, so I can form really good experiences with my family in the present.
“Because I’d know that in the future, I might not have the chance. So I think that as difficult as it would be emotionally, it might improve the way I approach life.”
Zhang said her situation may be different from those of other students in the class because her parents are already in their 60s, so the topics she learns about every week have more immediate importance.
“This is particularly relevant to me,” she said, “because I’ll probably be experiencing these kinds of issues very soon with my parents. That’s very close to me. So I felt this class would be a very good way to start thinking about the issues of aging or just give me resources for things that I know are going to be relevant with the aging population.”
Discussions with her mother, and filling out the parent survey, have already touched on sensitive topics, Zhang said.
“It was a learning experience for both of us,” she said, “just in terms of this is something we should think about. My mom had really given it that much thought, so on a personal level, it’s helped my relationship with my parents. It’s also making me feel like I’m a little more well prepared to handle what might come pretty soon for my family.
“She’s told me, oh, it’s totally fine if you put me in a nursing home — don’t worry about me. But from my experiences of working in one, I was like, Mom, I will take care of you. If you can’t take care of yourself, you can come and live with me. I will do that for you.”
So while they may not be 100 percent sure of their answer to the Alzheimer’s conundrum, the students are at least asking the right questions, and even starting to apply them to their own lives.
“This class has really changed the way I live my life right now,” Shikany said. “I try to eat healthier and I try to exercise more than twice a week, even though that’s hard as a college student. But making the change now is the best way to have the best life when you’re older.”
That kind of sentiment is just what Stark and her faculty colleagues wanted to hear.
“We were nervous about encouraging 18-year-olds to take a class on aging,” Stark said. “They’re just getting used to their grown-up selves. Asking them to project a few decades ahead seemed like a stretch.
“So this is a very mature, really neat group of students that signed up to take our class I’ve been very pleased.”
And yes, most of them were familiar with the Beatles.