【Abstract】Nowadays， the tendency of aging is getting more and more prominent all over the world. Experts do research and evaluate the physical and mental changes of the elderly. Atul Gawande， an American surgeon， shows his concern towards the elderly in his book Being Mortal： Medicine and What Matters in the End. He proposed a question： Medicine and what matters in the end？ He attempts to appeal to the readers for the attention to psychological changes of the elderly. In this essay， I aim to give readers a brief review of the book and analyze the psychological shift of the older people.

【Key words】physical declines； families； nursing homes； independence

【作者簡介】黃靜雯，北京師范大學(xué)珠海分校外國語學(xué)院。

Content：

Atul Gawande raised a question in the title to arouse the attention of the readers： What matters in the end？ In the past， people who can live to the old age were rare. Hence， they were always associated with power， authority and status. According to Atul Gawande， people in the past often overstate their age to the census takers （18）. To the older people， the sense of being valued is what matters to them.

In Being Mortal： Medicine and What Matters in the End， Bill Thomas uses 100 parrots， 2 dogs， 4 cats， a group of rabbits， and a flock of chickens to enliven what may otherwise be a dull place for the elderly （106）. Thomas let the older people own the value of life and ability to live. In addition， the elderly should have the right to stop their natural and internal processes independently， obeying their own egos and personalities， in spite of how rapidly medical technology develops. To them， dignity， independence and freedom are of great importance to their aging process. As a result， shaping and protecting their personality should be paid much attention.

Now due to the growth of medical technology， people believe that their lives can be prolonged. Nevertheless， aging is our fates and must come someday. Geriatrician try to convince us that the prevailing idea of being ageless are wrong （42）. Why will people get old？ As Gawande says， “the story of aging is the story of our parts （28）.” Internally， the elderly experience the most dramatic physical changes. Their auditory， vision， tactility， sensation， memory， cognition and motion all decay. The decline of the elderlys physical functions leads to a decrease in the absorption of carbohydrates， starch， protein， and fat. As they realize that the youth has left them and time has changed them from vigorous youths into ailing old men， an enormous psychological gap is shaped. The decrease of physiological energy causes negative changes in psychic energy and the elderly tend to a low state of mind.

Families and nursing houses play significant roles in the aging process of the elderly. The personalities of the elderly are mentally vulnerable and easily influenced by the external world. in their old age. The over care of the family to the elderly will lead to the frustration of their dignity and ego for loses of independence and freedom. Later when the children are engaged in work and cannot take care of their parents frequently， the elderly will feel like being neglected without proper respect and concern. But as Atul Gawande proposed in his book Being Mortal： Medicine and What Matters in the End that “all privacy and control were gone in nursing homes（67）.” The elderly who live in the nursing homes do not have absolute control over their own bodies and lives. Their confidence， dignity and humanity are fiercely slashed. They may have to adapt to the shift from their homes to nursing houses.

Personality is unique whose activities are purpose-directed. It is easily influenced by the outside world. As I mentioned before， older people are easily frustrated by their physical declines and nursing homes disrespect the personalities of the elderly. To shape and protect their personality and ego， we encourage enhancing the communication with them and understanding of aging process. The proper concern and care from families is the external support of their aging process which is essential to the protection. Besides， the older people should fill their spare time with various activities to fulfill their lives.

So far， what we reflect on aging in order to live better. Aging is ones fate and death will come one day. At the end of ones life， what finally matters？ I have mentioned several changes towards the aging process， among which their mental changes should be paid most attention. We should be pretty cautious and careful to take care of the elderly since ensuring and protecting their ego and personality is of great importance.