10/20/2026
I recently spent time with someone I love who is getting older and navigating the healthcare system.
I came away thinking about how easily an older adult can fall through the cracks. Not because their doctor isn’t seeing them. There are appointments. Lots of appointments. So much that one can experience doctor fatigue.
Each appointment may focus on what they are supposed to look at, and yet, somehow, nobody seems to be looking at the whole person.
We are very good at identifying what might go wrong as people age. We screen for disease, assess fall risk, monitor medications. We tell people what to avoid, what to watch for, and when to call the doctor. And all of that is important.
But I kept thinking about a different question: Who is helping this person keep living their life? Who is asking what they want to be able to do six months from now? A year from now? Five years from now?
Who notices when they are gradually walking less, getting weaker, becoming less confident, or quietly giving up things they used to do?
And who steps in before those changes become a diagnosis, a fall, or loss of independence?
This is one place where I think our approach to aging gets it wrong. We focus heavily on reducing risk. But reducing risk and preserving a person’s capacity to live are not necessarily the same thing.
Maybe we need to start asking a different set of questions.
Not only: What is this person’s fall risk?
But: What do they want to keep doing that requires strength, balance, endurance, or confidence?
Not only: Are their numbers within an acceptable range?
But: Can they still walk to the places they want to go? Carry their groceries? Get up from the floor? Travel? Garden? Play with their grandchildren? Live independently?
Not only: What disease are we managing?
But: What life are we trying to preserve?
That distinction matters because functional decline rarely happens all at once.
A person walks a little less because walking has become uncomfortable. They stop taking the stairs. They turn down an outing because they aren’t sure they can keep up. After a near fall, they become more cautious. Their world gets a little smaller.
None of these changes necessarily triggers a medical crisis. But collectively, they can change the trajectory of someone’s life.
By the time the healthcare system recognizes the problem, we may be responding to the consequence rather than the gradual loss of capacity that came before it.
This is where I believe adaptive, active aging belongs in healthcare.
Adaptive, active aging shouldn’t simply mean telling older adults to exercise more. It means deliberately helping people preserve and adapt the physical, cognitive, emotional, and social capacities they need to continue participating in their own lives.
That requires knowing what matters to the person in front of us. For one person, success might mean continuing to ski. For someone else, it might mean having enough stamina to care for a loved one.
The destination is different, but the question is the same: What do you want to keep being able to do, and what can we do now to help you keep doing it?
(Liz Schenk)
Contact Melanie 403.315-5898 or [email protected] to Book a consult
