Interview by Martha McCully
When we think about life and work, the “balance” may feel like a sliding scale as we age. Why does this happen and how can we maximize our happiness as it does? We asked Mark S. Lachs, MD, MPH, a physician, scientist and Co-Chief of the Division of Geriatrics and Palliative Medicine at Weill Cornell Medicine and New York-Presbyterian/Weill Cornell Medical Center to define work/life balance with the idea of finding the most meaning possible as we age.
This is our third installment of our series with Dr. Lachs. Follow these links, if you would like to read the previous Q&As about Age and Ambition or the first interview about Healthspan.
What do you mean by work/life balance later in life?
Well, it’s subjective. Balance does not mean a 50/50 split between work and leisure. Time is implicit in this conversation. I define balance this way: aligning the time you spend with how much you enjoy that activity. So, if you love your job—unlike most people—that percentage might be higher for work. If you hate your job and only want to work 10% of the time, you are buying time to spend with your family and hobbies. The allocation differs and changes based on life cycle, your spouse, or maybe you have grandchildren coming. But it’s synchronizing your aspirations with the actual time allocation. And it’s going to be different for each person.
What are the important elements to consider in a work/life balance, other than work and life?
There’s pleasure, economics, security, socializing, and of course health. Also, caregiving responsibilities. The economics are important here as you can work less hard if you have money to sustain that.
Your health is obviously a factor if you have a chronic illness that someday will limit you. That’s important in the calculus, not only in terms of what the balance is, but also what you will do. I had a patient with early Parkinson’s. He was a factory worker and transitioned to a position that required more brain work and less mobility. He also took time off to anticipate his future disability–the hiking trips were earlier and museum trips came later.
Calculating your leisure time involves other people, not for everybody, but for most. If you have a spouse with a chronic medical illness, that might affect your timing of slowing down a bit.
Also consider the nature of the bucket list. Certain things on your list may require more agility and cognitive function than others. All of these factors have an influence.
Doesn’t work provide meaning that can enhance your life too?
Work is important. It can give you identity. You go to a cocktail party and the first question is ‘What do you do?’ If you’re retired and you do nothing, you’re a loser. There’s also the legacy you create, what you want to leave behind. Legacy depends on the kind of work you are in. In my case, I’m very proud of the practice I’ve built and the research I’ve done, but you don’t have to be a Nobel laureate to have legacy and meaning in your work. If you have a job in an auto factory you could take pride in your craftsmanship. Look at the space program in the ‘70s–the people who worked as maintenance engineers on Saturn V take a lot of pride in that.
What other aspects of work are important as we age?
Even if you’re not as productive at work as you once were, work is still an important place to feel needed. People want to feel needed, be a part of something. There are lunchtimes, birthday celebrations, happy hours, retreats, team-building exercises–really cool things that millennials have brought to the workplace. If you spend a third of your life at work, particularly in person, that’s where your social interactions are coming from. So, work provides community, and older workers can benefit from a lot of this.
Do both younger and older workers benefit from socializing at work?
There’s really interesting literature on intergenerational socialization at work. There was a study conducted at BMW plants, where three teams competed to make cars–older workers, younger workers, and intergenerational teams. The older workers made great cars, meticulously crafted because of their experience, but they made fewer cars, maybe because of physical limitations and lack of speed. The younger group made tons of cars but there were quality errors, something wasn’t perfect, like the fender, the paint job. The most productive was the intergenerational group, the older workers were the brains, and the younger workers were the brawn. At work there’s an opportunity for older people to interact with younger people, and that doesn’t happen as much in the social world…particularly in America. But you get it in the workplace. As people age, we lose personal friends and loved ones, but we can maintain a social life in a work environment.
Why are intergenerational relationships so important?
Intergenerational workplaces are an incredibly important concept because of the knowledge older people can impart to younger people. We want to pass our skills and knowledge on to younger people because it provides extraordinary meaning to both parties. And older people need to mentor younger workers, as mentorship is another way that work gives us meaning and combats loneliness.
In my own career, I view it as the most important thing I do. You want to create legacy– that could be giving a building to a college if you’re wealthy, but it can also take the form of bringing your knowledge to younger people who appreciate your stewardship. I’ve gotten so many life lessons from senior physicians, not just about medicine, but also the politics. It has also taught me about work/life balance.
What are the effects of loneliness and social isolation on our health and longevity?
Social isolation can contribute to premature death, let’s start with that. We’ve known that since the ’70s. There’s a famous Alameda County Study by Harvard social epidemiologist Lisa Berkman PhD. It was the first study that showed bereavement conveyed a risk of death in the year following that death, independent of health issues. Since then, isolation and lack of emotional support have really proven to affect recovery from illness too. For example, after a heart attack people have differential recovery with emotional support. You can build support and improve your recovery, that’s not a drug, that’s you going out. Everyone has the college friend who organizes the alumni get-togethers, and I was always like, “Let them do that.” Now I say, “Thank God for those people.”
Loneliness is also associated with depression, and multiple studies show that depression can lead to nonadherence to medication regimens. If you’re lonely and sad and don’t take your meds, you don’t have to be a doctor to see how that’s going to end up.
In England there is a Ministry of Loneliness, in addition to a Ministry of Housing and a Ministry of Education. That’s how important that is.
Why is loneliness so tied to our health?
We desire connection, it’s so basic to human beings. We saw this during Covid-19–that’s why people started drinking, relapsing with opioid addiction, and getting divorced. Covid-19 was an amazing natural experiment. Kids were delayed because of school, not just educationally but in their socialization. Suicide rates among young people were higher than ever–yes social media is a factor, but also working virtually and not having the happy hours at work. It kind of makes the point: Aging really starts in utero, not at 65. These are trends over the course of a lifetime.
So back to balance, should we be thinking of pleasure first even if that pleasure comes from work?
There are four quadrants of work and life: Things you like doing that the job requires–that’s the best quadrant, you want to maximize that. Things you hate that the job requires–you want to minimize that quadrant. The other two quadrants are not ideal. So, how do you find work that optimizes what you like and what they need? That could mean reorganizing your work. If you don’t like your boss, you can ask to be transferred.
How do we know what we truly enjoy and care about, at work and in the rest of life?
If you know yourself, you can determine what gives you pleasure. We need to reflect on what really turns our gears and why. People don’t take inventory of that enough. It really has to do with mindfulness. I’m a big fan of mindfulness. Nothing happens without mindfulness. People don’t stop enough to reflect on what makes them tick.
Being mindful and knowing yourself is a lot about self-care. People think about medicine and health care, but there’s more to it. The way the body, mind, and social world are connected is really quite remarkable. We instinctively thought so, but it’s turning out to be true as science is bearing that out.
Is there an ideal number of hobbies and pleasures to pursue?
What I often tell people about the life side of the work /life balance is, “Not too many things.” There’s perfection in three. Most of my patients have three things they care about. Maybe it’s grandchildren, their charity, and travel. If the list is too long, it can create an ADD experience and become overwhelming. It’s like a diner menu; if there are 900 things on the menu, you can get decision paralysis.
Martha McCully is a writer and brand consultant. She was formerly the Executive Editor of InStyle and founding Beauty Director of Allure. Her writing has appeared in Elle, Harper’s Bazaar, Los Angeles Times, and KatieCouric.com.
