"In the last half-century, we have been the beneficiaries of a boom in medical science that has doubled the average life expectancy. However, many of the wear-and-tear diseases of later life, especially mental impairment, have not been conquered. This means that we will have an ever-increasing population of people who live past their productive years. Unless we understand that we all have value in self-fulfillment, a large segment of the population will suffer from Spiritual Deficiency Syndrome of chronic discontent.

"In a workshop for health professionals who provide home care, a nurse complained about her frustration with one elderly client who was always critical of whatever anyone did for her. 'Why have you come so late? I've been waiting for you for almost an hour,' she would accuse the nurse. Or, 'The blood pressure cuff is too tight. You're hurting me.' Or, 'You've confused me about taking my medication. Now I don't know what to do.' Or, 'The bath water is too cool (or too hot).'

" 'She is critical about everything I do,' the nurse bemoaned.

" 'Forget about saying, "Thank you"!'

"This reminded me of an incident when I was an intern and was called to administer an intravenous antibiotic to a patient. This patient happened to be an octogenarian who had been a member of my father's congregation. She had known me from my infancy and had frequently visited our home. Now she was a bilateral-leg amputee and was hospitalized because of pneumonia.

"As I was about to give her the injection, I said, 'This is only going to be a tiny pinch, Grandma. It won't hurt much.'

" 'Foolish child,' she said. 'Let it hurt. Do you think anyone wants to leave a world that is pleasant?'

"This helped me understand why some elderly people may be cantankerous. I think about it like this: if the last two days of my vacation are bright and sunny, going back to the office may be an ordeal. If the last two days are cold and rainy, it is much easier to return home.

"Elderly people know, consciously or subconsciously, that their time is running out. It is much easier to accept life coming to an end if living is unpleasant. That, in turn, is why they may make life appear to be miserable.

"I said to the nurse, 'I'm sure that your patient really does appreciate what you do for her, but she has to complain about everything. By making the world appear inhospitable, it is easier for her to accept the inevitable.'

" 'By the way,' I added, 'what is the very last thing this woman says to you when you are about to leave?'

" 'She asks, "When are you coming back?" ' the nurse said.

" 'See?' I said. 'She does appreciate you. She just can't admit it.'

"Self-fulfillment for the elderly may look very different from self-fulfillment for younger people. Yet the concept of being the best we can be, in whatever condition or circumstances we are in, applies universally. It is not enough for just the ill or elderly to accept this. Acceptance is a spiritual concept and is a key component of self-fulfillment and happiness."