Medical and social aspects play into our society's treatment of aging individuals.
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:
- Approximately 22 percent of Americans over 65 reported trouble seeing (even when wearing glasses)
- Roughly 31 percent of Americans over 65 indicated difficulty hearing (even when wearing hearing aids)
- Approximately 27 percent of adults over 60 have severe memory problems
- About 48 percent of Americans over 65 years of age have at least one chronic health condition.
The U.S. Census Bureau estimated that almost 85.3 million Americans were disabled in 2014, or about one of every four Americans. However, this rate may be skewed when considering the rates present in nursing facilities or other assisted living facilities (96.7 percent). This figure is expected to rise as the number of older Americans living longer lives increases. Most common forms of disability included difficulties crouching, standing, pushing/pulling, and walking.
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 a 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 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.
"Ageism" is a term used to describe stereotyping of and discrimination against persons based on their age. In American society, the term refers most commonly to negative attitudes about aging and the elderly. Media and marketing have been criticized for their promotion of a culture of youth and their unfavorable depiction of aging and the elderly. Studies have shown that widespread exposure to negative images of the elderly and media messages that marginalize elders can have harmful effects on the mental and physical health of older people. On the other hand, a recent study of happiness in the United States shows that aging tends to be associated with increased levels of happiness.
The potential for social isolation is another significant concern related to aging. Life course events such as retirement and the death of a spouse can reduce social connections, while physical impairments and reduced mobility can present barriers to social interaction as well as access to information and resources. These conditions can increase the vulnerability of older persons to abuse, neglect, and financial exploitation. Social integration and support networks therefore are considered to be critical to the health and well-being of older persons.
Past theories held that social isolation is an inevitable aspect of aging, which painted a bleak view of older age. This concept was challenged by newer theories and research indicating that older adults tend to maintain their accustomed social roles and activities as they age and that they can be resilient to the impact of later life transitions such as retirement and bereavement. A recent study examined social integration from the perspective of social networks (Social Connectedness: What Matters to Older People?, originally published in Aging and Society, 2019; 41(5), 1126-1144). The researchers found that, although the size and closeness of social networks may decline with age, the frequency of higher quality social contacts may increase as older adults have more time for community involvement (e.g., religious participation and volunteering).
Several demographic trends point to the potential for diminished family support networks for older persons. Increases in the divorce rate, a decline in the birth rate, and geographic mobility may lead to lower social connection and higher levels of social isolation. As fewer family members are available or capable of caring for elderly relatives, additional pressures are likely to be placed on social service agencies to provide some level of assistance. Bringing social, religious and civic institutions into a coordinated community response to elder abuse may help prevent social isolation of older adults, mitigate the negative impact of media portrayals of elders, and reduce their vulnerability to abuse, neglect and exploitation.