Americans have gained at least 25 years of life expectancy over the past century. People born in 1915 lived an average of 54 years. Those born in 2015 can expect to live on average to about 79, meaning that many will become centenarians.
Nonetheless, expectations about the life journey — retirement at 65 with ensuing leisure and decline — have hardly changed since Social Security was enacted in 1935, or even since Otto von Bismarck set the retirement age at 70 in 1889.
A Stanford University program that brings older adults to campus for a year of study and reflection is a test case for shaking up those assumptions, according to its founder.
Former Stanford Medical School dean Philip Pizzo, who in 2015 launched Stanford's Distinguished Careers Institute, wonders: Can higher education — by helping older students renew their interests, connections and wellness — play a measurable role in boosting well-being and reducing dependency as Americans routinely live through their 80s and even 90s?
"With life expectancy increasing as it has, the longstanding social narrative that you retire in your 60s is hardly relevant today," Pizzo, 72, said in a recent interview in his office at Stanford Medical School.
Since 2015, Stanford's Distinguished Careers Institute has brought nearly 75 tuition-paying "fellows" (plus, in many cases, spouses and partners) to campus for a year or more to study anything they choose.
Pizzo said he's interested in knowing if you provide vehicles for people to renew their purpose, communities and health and wellness, will that compress their personal morbidity?
"So that rather than having sloping curves where in your 30s, 40s and 50s you're losing things, you can attenuate that decline and live better," Pizzo said.
Pizzo is systematically assessing the experiences of the Stanford fellows with an ambitious eye to the future. Though Stanford's program has attracted former high-ranking professionals who can pay the more than $60,000 in costs, he wonders whether similar initiatives for older adults could work elsewhere — including community colleges — on a larger and more affordable scale.
Stanford fellows, so far, have given thumbs up to the experience.
"Who could resist the opportunity to explore and learn at Stanford University while you re-imagine your next stage in life," said 2015 fellow Jere Brooks King. The Palo Alto resident said that year helped her transition from a high-tech business career to the nonprofit sector.
"I've been a lifelong learner, but it has been over 40 years since I first set foot on a college campus as a freshman student," King said. "The Stanford DCI program was a chance to "re-boot" at a premier university that I didn't want to miss."
Los Altos resident Jeff Byron said his 2015 fellowship year was an "extraordinary" one.
"Early on during my fellowship at Stanford, I realized there wasn't going to be a magical outcome at the end of just one year," said Byron, an engineer, investor and former member of the California Energy Commission.
"Nevertheless, (the program) was rejuvenating and a wonderful reset that got me thinking differently about myself, taking care of my health, and what I wanted to do. For that, and the new friendships, I was grateful for the opportunity and really glad I did it."
Stanford's program is built around three themes that Pizzo believes are critical to well-being in older adults: a sense of purpose or renewed purpose; a sense of community and social engagement; and physical, emotional and spiritual wellness.
"People often get to a certain point where they either become no longer motivated by the work they're doing or get moved from the work they're doing," he said. "And then they potentially stand at a void where opportunity is no longer immediately accessible, and there's this loss of a sense of purpose."
Stanford participants are asked to commit to a "purpose pathway," such as arts and the humanities, energy and the environment or international studies, to guide their experiences and create opportunities for "intergenerational teaching and learning."
Another great risk for older adults is loss of social engagement, Pizzo said. The Stanford fellows gather for social events and weekly sessions on academic topics or discussions of larger social questions. And in a particularly challenging storytelling project, "fellows share aspects of their life journeys that have been meaningful to them — that's a great way of bonding," he said.
Though trained as a pediatric specialist, Pizzo had occasion early in his career to ponder the hazards of aging. He observed several older physicians — once renowned in their specialties — forced out after making excessive errors or failing to keep pace with medical advances. As a young doctor he resolved never to let that happen to him — even planning a specific exit strategy to be executed well before he lost his edge in medicine.
Four decades later, nearing his 68th birthday, Pizzo stepped down after 12 years as medical school dean. But as carefully as he'd plotted the move — even announcing his planned departure two years in advance — he couldn't escape the feelings of irrelevancy that come for so many after an active career.
"I still experienced surprising questions about personal identity and self-worth," he wrote in an April essay for the Journal of the American Medical Association (JAMA).
"It is ... easy to ignore the multitude of ways our workplace provides structure, purpose and social connectedness. And when we transition from the workplace, questions about one's purpose and even social isolation can erupt quickly. ...Regardless of our life journey, we all share these transitions — and how we face or address them can have an impact on our health and well-being."
Though determined to stay active, Pizzo set aside his long-planned retirement idea of pursuing a Ph.D in history and instead decided to explore the longevity boom.
"I realized that from 1970 to 2010, with life-expectancy increasing as it has, the world had really changed," he said. "It led me to the question, 'What's the role of the university in the future? Could it be a place for people in their 50s and 60s to come back and kind of renew themselves for new directions and opportunities? Could it allow the university to change to create intergenerational learning and teaching?'"
In the spring of 2013, Pizzo approached Stanford administrators with his idea of bringing older adults to campus, and the program was announced a year later.
"We weren't sure whether people were going to apply," he said. "But we found we had way more than we could ever accommodate. (Pizzo declined to state the number of applicants.) There's a huge demand and interest in this."
Through regular interviews of participants and follow-up with former fellows, Stanford is "assessing impact on how (the program) alters perceptions and realities around purpose, community and wellness," Pizzo said.
"We're less focused on the immediacy of 'What's your next role?' but rather, 'How does this change your life journey?' We'll evaluate this over the next decades. It may take one to two decades to fully appreciate and validate."
Pizzo has been in touch with other similar programs for older adults at Harvard University and the University of Minnesota, as well as new or prospective programs at the University of Notre Dame and the University of Texas.
"What I'm hoping is that over the course of the next five or 10 years, colleges small and large — including community colleges — will develop programs that meet their needs and ideally have some of the components of purpose, community and wellness so they could share their outcomes in a common database," he said.
"We'll be able to see not only how this affects individuals but, on a larger social scale, if people will do better and reduce the need for medical and social services. By engaging people and reconnecting them, can we create communities that will be more self-sufficient and capable?"
In a Stanford Continuing Studies course this past summer, Pizzo shared some of his learning to date. The course, "Health and Wellness Through the Life Journey," consisted of lectures from various faculty members related to "rethinking longevity and how to prepare for a healthier life journey that benefits our family as well as our community and ourselves."