The old is new.

When I was editor of the medical publication Geriatrics back in the 1980s, we had a saying: "The old is new." It meant that medical management of the elderly involved clinical challenges and complexities that had seldom been considered before in physicians' practices. To take seriously the diseases of aging patients and their treatments required a paradigm shift. It also required from physicians a mastery and balancing of complex factors that had been traditionally overlooked when decline was accepted as "part of aging." In short, geriatrics was medicine's new thing.

It's too bad that more physicians haven't latched onto this idea as yet, but that's a subject for another column (and in fact has been). The point here is that "the old is new" still holds true, in fact it is spreading far beyond the confines of the doctor's office. It is knocking on the doors of long-term care administrators, financial and real estate investors, business operators, politicians, and civic planners. As the famous (and occasionally infamous) baby-boom generation sweeps on into its senior years, new schools of thought are developing every day revolving around the question, "What are we to do with these people?"

The most imminent manifestation of that is a Baltimore-based conference called "Environments for Aging," occurring this September 7-8. In the interest of full disclosure, I work for the company--Vendome Group, LLC--that is helping organize this conference, and I have written up an interview for this issue with one of the conference leaders, John P. Stewart, executive director of the Baltimore Commission on Aging and Retirement Education ("Peering Into the Future of Aging," p.22). All that aside, what is emerging from events like the conference is a vision of senior living that we've never seen before in this country.

Interestingly, I think that many if not all of us have known someone who lived an active and vital life on into their advanced senior years. My great-grandfather, for example, worked his farm until he was 93. ("He died with his boots on," goes the family legend.) Examples like this of "successful aging" are far from unheard of.

What is new, though, is that seems to be becoming a societal expectation. President Bush's moans about turning 60 aside, more people are following his physical example--staying active and engaged in life with no signs of slowing down. This is a far cry from that "going gentle into that good night" that was our traditional thinking about people in their 60s and 70s and beyond.

You will see other articles on this theme in this issue; e.g., "Staying Alive: Three Takes on Today's Senior Living," p. 14. Modern evolutions of senior housing and of wellness programs have also been addressed in these pages through several issues in recent years, and will be again. The message coming through loud and clear for the readers of Nursing Homes/Long Term Care Management is to open your eyes, be receptive to the change going on around you, and figure out how your organization and profession can best adapt to and work with this change.

As you do, you just might start developing a feeling of excitement and anticipation--you know, the kind of feeling someone gets when venturing into something new.

To send your comments on this editorial to the author and editors, e-mail [e-mail].

BY RICHARD L. PECK, EDITOR-IN-CHIEF