This year’s cold weather hit Taiwan abruptly and fiercely. National Fire Agency statistics showed that within just six days last month, 181 people, most of them older, across the country had “out-of-hospital cardiac arrests.” Behind the cold numbers are loved ones collapsing in bathrooms, living rooms or at doorsteps.
What truly affects older people’s survival is often not their blood sugar or blood pressure, but muscle strength, walking steadiness, cardiopulmonary endurance and ability to regulate body temperature. When a person’s physical function declines, even a 5°C drop could be life-threatening. When older people remain more active, they have the capacity to endure the winter cold. Simply walking to a family gathering might extend their lives to another spring.
It has become the norm to use medication to keep older people calm, giving them wheelchairs for safety instead of making them walk. However, the biggest nightmare of caregivers might not be illnesses, but older people losing the ability to do things on their own. Such functional decline could gradually shrink a person’s world to a single bed.
Therefore, “exercise is medicine” is not just a slogan; its essence is to restore dignity and freedom for older people. The goal is not to get strong, but to enable the body to try again on its own. When a 70-year-old is finally able to stand up again, walk downstairs to buy soy milk or carry a lunchbox by themselves, the joy of regaining control over their life cannot be quantified by any medical data.
In Japan, local governments reduce the dependency on long-term care through community exercise programs, while in northern Europe, exercise is a first-line treatment for chronic disease management. In Taiwan, despite excellent medical treatment and the National Health Insurance system, the disease prevention framework remains only verbal advice, lacking the social structure that could transform exercise into daily companionship.
This requires systematic specialist intervention, such as professionals who can teach, accompany, understand motivational psychology, provide protection and personalized training. This is not only a family responsibility, but also a direction long-term care policies should advance — shifting from “caring for the disabled” to “maintaining mobility,” from patching holes to preventing disability, and from waiting for hospital sickbeds to preserving freedom.
The government and the general public should envision a gentler vision of healthcare: Health should not begin only when one is hospitalized, nor should love be confined to older people’s bedsides. If exercise could be integrated with medication, aging would not be reduced to waiting, pain and silence.
Health should not be just about extending life, it should be about extending the time that one can live freely.
Gerald Kuo is vice director of the Taiwan Home Health Care Charity Association.
Translated by Eddy Chang
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