Medical and Social Aspects
Key Legal Issues
Role and Responses 

Medical and Social Aspects

Medical Aspects

As people age, vision, hearing, and other sensory capacities gradually decline. Although each individual ages at a different rate, older persons typically experience some level of dimming eyesight, fading hearing, loss of memory, decreased comprehension rate, and physical impairment. These impairments can diminish older persons' abilities to perform daily tasks, decrease mobility, and can affect elders' communication with others. Statistics show that the elderly comprise a significant proportion of physiologically impaired Americans:

  • Adults over 65 account for about 30 percent of all visually impaired Americans
  • Adults over 65 account for about 37 percent of all hearing impaired Americans
  • Approximately 10 to 15 percent of adults over 60 have severe memory problems
  • About 88 percent of Americans over 65 years of age have at least one chronic health condition.

The U.S. Census Bureau estimated that almost 50 million Americans were disabled in 2000, or about one of every five Americans. About 42 percent of the population aged 65 and older is considered disabled. This figure is expected to rise as the number of older Americans living longer lives increases. Leading causes of disability include arthritis, back or spine problems, and heart disease.

Mental Health Issues

Some of the more common mental health issues impacting the elderly are depression, dementia, and substance abuse. Clinical depression in the elderly is common, affecting about six million Americans age 65 and older. Depression in the elderly tends to be undertreated, often because symptoms are frequently confused with the effects of multiple illnesses and the medications used to treat them.

Dementia is a decline in mental ability that affects memory, thinking, problem-solving, concentration, perception, and behavior. Some forms of dementia, such as Alzheimer's disease, are degenerative. People with dementia can become confused. Some people also become restless or display repetitive behavior and may also seem irritable, tearful, or agitated. People with dementia often need longer time to make decisions, may need an advocate to speak on their behalf, and are likely to experience varying levels of mental functioning based on the day and time of day.

Substance abuse, including alcohol abuse and addiction to prescription medications, differentially impacts the older population. Benzodiazepine and narcotics are two types of the prescribed drugs most commonly abused by the elderly, while alcohol and over-the-counter sleep remedies are the two most commonly abused non-prescription drugs. Even regular use of some prescribed medication can be the source of mental health problems, including delirium, anxiety, and late-onset schizophrenia.

Key Medical Concepts

Alzheimer's disease (AD) - the most common form of dementia, a neurologic disease characterized by loss of mental ability severe enough to interfere with normal activities of daily living, lasting at least six months, and not present from birth. AD usually occurs in old age, and is marked by a decline in cognitive functions such as remembering, reasoning, and planning.

Chronic Disease – one lasting 3 months or more, by the definition of the U.S. National Center for Health Statistics. Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just disappear.

Clinical Depression – a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Symptoms last two weeks or more and are so severe that they interfere with daily living.

Dementia - a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems such as agitation, delusions, and hallucinations. Dementia is diagnosed if two or more brain functions, such as memory, language skills, perception, or cognitive skills including reasoning and judgment, are significantly impaired without loss of consciousness.

Disability – The Americans with Disabilities Act (ADA) defines disability as "a physical or mental impairment that substantially limits one or more major life activities of such individual, a record of that impairment or being regarded as having such an impairment." Other definitions, such as those espoused by the United Nations, are more social in nature and distinguish between impairments, disabilities, and handicaps.