The truth is that we have created a new stage of life but have not yet envisioned its purpose, meaning, and opportunities, and the space is being filled with our fears. Like a drunk searching for a lost wallet under the wrong lamppost “because that’s where the light is,” we are not looking for answers in the right places.

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When I was a young geriatrician practicing in Baltimore, I operated under the light provided by my medical training, which prepared me to prevent or treat the health concerns affecting my patients. My training was invaluable, and geriatric medicine is a specialty highly tuned to the needs of older adults. Yet, as they shared their lives with me, my patients taught me that many of the ills associated with aging were worsened—or even created—by the lack of meaning and purpose in people’s lives. Too many of my patients suffered from pain, far deeper than the physical, caused by not having a reason to get up in the morning. Many of my patients wanted to make a difference in the world but, finding no role for themselves, were treated as socially useless and even invisible.

We are a species wired to feel needed, respected, and purposeful. The absence of those qualities is actually harmful to our health, as public health and social scientists have demonstrated. In one pivotal study conducted in the late 1970s, psychologists Ellen Langer and Judith Rodin (now president of the Rockefeller Foundation) examined the significance of autonomy and personal responsibility for the health of nursing home residents. One group of residents was told that they could arrange their room furnishings however they wanted, decide for themselves which nights to attend a movie, and choose house plants to keep and nurture. A second group of residents, advised that the staff “want to do all we can to help you,” had their furniture arranged for them, were informed which movie nights to attend, and were given a house plant cared for by a nurse. After three weeks, almost all residents in the first group experienced significant improvement in physical and mental well-being, whereas most participants in the second group declined or stayed the same.

A follow-up study conducted 18 months later found, remarkably, that members of the disempowered group (which mirrored how we usually treat older adults) were twice as likely to die, compared to their empowered peers (30 percent mortality compared to 15 percent). Further, there is science to suggest that beyond just feeling useful, a key need for successful aging is to feel that you have contributed to leaving the world better than you found it.

So I began to write prescriptions for my patients: “Find something meaningful to do and report back.” Time after time, I would hear back from highly capable older adults that they couldn’t find jobs. If they tried volunteering, they were frequently assigned to roles that didn’t use their capabilities, like licking stamps for someone else’s mail. What a waste of people with a lifetime of experience!