This is for those among us who scream at the first signs of a wrinkle or budding white hair and for those who wish to remain forever 40. Or 50.

The trouble is, old age is not interesting until one gets there. It is a foreign country with an unknown language to the young and even to the middle-aged.

So when do you know you are getting older?

So you are old when:

Your children begin to look middle-aged.

You look forward to a dull and quiet evening.

Your favorite part of the newspaper is 20 years ago today.

You turn the lights off for economic reasons rather than romantic ones.

You sit in the rocking chair and can’t get it going.

Your knees buckle but your belt won’t.

The little gray old lady you help cross the street is your wife.

You sink your teeth into a steak and they stay there.

You have too much room in the house, and not enough in the medicine cabinet.

Everything hurts, and what doesn’t hurt, doesn’t work. Get the drift?

When are we old? Former President Jimmy Carter, in his book “The Virtues of Aging,” writes: We are old when we think we are, when we embrace an attitude of dormancy and isolation.

There are two models of aging: healthy and unhealthy, graceful and not so graceful.

My late mentor Dr. Emmanuel T. Gatchalian Sr. was 85 when he was chairman emeritus of the Geriatric Center at St. Luke’s Medical Center. In one of our annual geriatrics conventions, I listened to by far one of his best lectures on the pathways to aging and longevity.

After his talk, I congratulated him. At 85, I told him, I still was learning a lot from him. And he retorted, ‘Wait till you hear my lecture when I’m 100.”

Pope Leo 23rd thinks how we age is always a choice: Some people age like fine wine, others turn to vinegar.

Grumpy old women

People who turn to vinegar are perhaps those who gave rise to the appellation “grumpy old men, cranky old women,” people who have not learned to live and let live or let go, forgive and forget, those who frown, are nitpickers, and are always angry.

Lucille Ball said the secret to being young is to eat simply, live honestly and lie about your age.

The world is aging at a pace beyond what has been predicted. It is important to know that in order to add more life to the years that have already been added to life, preventive gerontology is important. Let’s see what sensory losses and aging changes can do.

Vision: Spiritual eyesight improves as physical eyesight declines.

Hearing: You can no longer hear your spouse snore (Yay!).

Weight: Obesity is no longer just an aesthetic problem but a disease that promotes diabetes, hypertension and cholesterol disorders. In fact, some cancers can be traced back to obesity as well.

Lung cancer makes one forever young, as you never grow old because you die young. There was the case of a smoker who was diagnosed with lung cancer. When he asked his doctor how much time he had left, the doctor replied, “10, 9, 8, 7…”

A satisfying sex life in aging is one of the indicators of a good quality of life among older persons. Openness and good communication are key to a satisfying sexual relationship in aging. It is important, however, to recognize that there are certain limitations. And monogamy is, of course, encouraged.

The problem oftentimes lies in the female partner who has a lot of issues that need to be confronted and resolved. There are medical solutions to these problems. Men who have been refused by their wives complain of being called “dirty old men” if they turn their attention elsewhere. There is no truth to the rumor that cavorting with younger women can make you young.

The same can be said of older women with young consorts. As seen in the Old Testament, King David was given a female servant, Abishaq, to minister to his needs and maintain vital “heat.” But this formula does not seem to work, as the next chapter in the Old Testament already talked about King David’s death!

Then there’s the issue of erectile dysfunction among males. I recall a story of an elderly couple who were listening to an evangelist over the radio. At the end of his sermon, the preacher admonished all those who were listening that if they need healing, all they needed to do was to raise their right hand in prayer while the left hand rests on the body part that needs healing. Upon hearing this, the husband promptly raised his right hand, and his left hand was touching his groin. On seeing this, the wife said, “Honey, the preacher said he is going to heal the sick, not resurrect the dead!”

But this of course is a thing of the past. Currently, there are three anti-erectile dysfunction drugs in the market that have shown up to 90-percent efficacy. Let me warn you, however, not to be indiscriminate, as 10 percent of persons with HIV are senior citizens.

The second part of this piece is a recipe for graceful aging—aside, of course, from using lots and lots of sunblock and being nice to your daughter-in-law. I mention this because in my clinical practice, most older women or men are brought into the clinic or office, and making follow-ups and accompanying them for procedures have been their daughters-in-law.

If you can’t afford Botox

Anyway, for graceful aging:

1. Acceptance vs resistance

If we do not die young, then we grow old and die old. There’s no other way. But to those who cannot afford Botox or Obagi, remember what Victor Hugo has to say: When grace is joined by wrinkles, it is adorable.

2. Be prepared for an empty nest.

3. Know where to land by planning your retirement.

I have seen people who were powerful and in control, but upon retirement realized their “insignificance.” These are people who are depressed and have diminished self-worth. But come to think of it, now that you are retired, you will never get fired from work. Happy?

On retirement, this is what Winston Churchill has to say: “I feel like an airplane at the end of a long flight—in the dusk, in search of a safe landing.”

4. Do not be afraid to assume new roles.

With the diaspora of OFWs and the emergence of the so-called “invisible” families— grandparents assume dual roles as parents and grandparents. Or caregivers. Often unpaid.

Do interesting things. The dictum you cannot teach old dogs new tricks applies only to dogs and not to people. To most people, learning should stop only in the grave.

People who have dared to do something new even in late life include people like:

Col. Saunders—60, founder of Kentucky Fried Chicken

George Bush—72 when he learned to skydive, and celebrated his 80th by skydiving

Ronald Reagan—73 when reelected to his second term

Nelson Mandela—75 when he became the first black president of South Africa

Grandma Moses—76 when arthritis made it impossible to embroider, so she shifted to painting

Winston Churchill—77 when he became Prime Minister of the UK

Growing old is about passing off bits of common sense and having them mistaken for wisdom.

Growing old is about being still and silent, and having it mistaken for deep contemplation.

Growing old is understanding that the best things in life come in at both ends, and not in between.

Growing old is about ceasing to look like Emilio Estevez or Charlie Sheen, and looking more like their father.

Growing old is about white hair becoming a trophy and not just an annoying speck to be covered by cheap hair dyes. (The pricier ones really work! Wink wink!)

Growing old is about not knowing the difference between worry lines and wrinkles, and not caring at all.

Growing old is about talking in riddles, and letting others find the truth for themselves.

Growing old is when “company” means friends and not a “place of work” or a “place to make money.”

Growing old is about crying when people are laughing, laughing when people are crying, keeping still when people are frantic and because of this, being taken as a pillar of strength and not an antisocial lunatic.

We all need to grow old to experience life to the fullest.