Life expectancy is no longer increasing in the U.S., even for us, the MEA demographic – educated, curious, and health-conscious.

Chronic illness and the weaknesses of old age plague the lives of the vast majority of us who are lucky enough to exceed the average life expectancy (at best about 80 for men and 86 for women).

If you reach age 65 in reasonably good health and without one of the six chronic illnesses that cause ninety percent of deaths in old age (congestive heart failure, cancer, chronic obstructive lung disease, stroke, diabetes, and dementia), you are likely to live nineteen more years. Ten and a half of those years are likely to be comparatively vigorous. Eight and a half of those years will be marked by progressive problems and ultimately disability, if we define disability as the inability to take care of ourselves. These numbers have not changed since the 1990s and are not changing now.

Don’t bury your head in the sand like Woody Allen. Talking about death won’t kill you.

As we focus on the second chapter of our lives, let us not forget that most of us hope to enjoy a third chapter. To enjoy it we must approach it rooted in reality.

Study and embrace aging and chronic illness. Take control of your final chapter. Be there when it happens.

Sam Harrington, MD, is the author of At Peace: Choosing a Good Death After a Long Life and attended MEA in July 2019.