Chapter 13. Aging and the Elderly
Aging comes with many challenges. The loss of independence is one potential part of the process, as are diminished physical ability and age discrimination. The term senescence refers to the aging process, including biological, emotional, intellectual, social, and spiritual changes. This section discusses some of the challenges people encounter during this process.
As already observed, many older adults remain highly self-sufficient. Others require more care. Because the elderly typically no longer hold jobs, finances can be a challenge. Due to cultural misconceptions, older people can be targets of ridicule and stereotypes. The elderly face many challenges in later life, but they do not have to enter old age without dignity.
Driving to the grocery store, Peter, 23, got stuck behind a car on a four-lane main artery through his city’s business district. The speed limit was 50 kilometres per hour, and while most drivers sped along at 60 to 70 kilometres per hour, the driver in front of him was going the speed limit. Peter tapped on his horn. He tailgated the driver. Finally, Peter had a chance to pass the car. He glanced over. Sure enough, Peter thought, a grey-haired old man guilty of “DWE,” driving while elderly.
At the grocery store, Peter waited in the checkout line behind an older woman. She paid for her groceries, lifted her bags of food into her cart, and toddled toward the exit. Peter, guessing her to be about 80, was reminded of his grandmother. He paid for his groceries and caught up with her.
“Can I help you with your cart?” he asked.
“No, thank you. I can get it myself,” she said and marched off toward her car.
Peter’s responses to both older people, the driver, and the shopper, were prejudiced. In both cases, he made unfair assumptions. He assumed the driver drove cautiously simply because the man was a senior citizen, and he assumed the shopper needed help carrying her groceries just because she was an older woman.
Responses like Peter’s toward older people are fairly common. He did not intend to treat people differently based on personal or cultural biases, but he did. Ageism is discrimination based on age. Dr. Robert Butler coined the term in 1968, noting that ageism exists in all cultures (Brownell, 2010). Ageist attitudes and biases based on stereotypes reduce elderly people to inferior or limited positions.
Ageism can vary in severity. Peter’s attitudes are probably seen as mild, but relating to the elderly in ways that are patronizing can be offensive. When ageism is reflected in the workplace, in health care, and in assisted-living facilities, the effects of discrimination can be more severe. Ageism can make older people fear losing a job, feel dismissed by a doctor, or feel a lack of power and control in their daily living situations.
In early societies, the elderly were respected and revered. Many preindustrial societies observed gerontocracy, a type of social structure wherein the power is held by a society’s oldest members. In some countries today, the elderly still have influence and power and their vast knowledge is respected.
In many modern nations, however, industrialization contributed to the diminished social standing of the elderly. Today wealth, power, and prestige are also held by those in younger age brackets. The average age of corporate executives was 59 in 1980. In 2008, the average age had lowered to 54 (Stuart, 2008). Some older members of the workforce felt threatened by this trend and grew concerned that younger employees in higher-level positions would push them out of the job market. Rapid advancements in technology and media have required new skill sets that older members of the workforce are less likely to have.
Changes happened not only in the workplace but also at home. In agrarian societies, a married couple cared for their aging parents. The oldest members of the family contributed to the household by doing chores, cooking, and helping with child care. As economies shifted from agrarian to industrial, younger generations moved to cities to work in factories. The elderly began to be seen as an expensive burden. They did not have the strength and stamina to work outside the home. What began during industrialization, a trend toward older people living apart from their grown children, has become commonplace.
Mistreatment and Abuse
Mistreatment and abuse of the elderly is a major social problem. As expected, with the biology of aging, the elderly sometimes become physically frail. This frailty renders them dependent on others for care — sometimes for small needs like household tasks, and sometimes for assistance with basic functions like eating and toileting. Unlike a child, who also is dependent on another for care, an elder is an adult with a lifetime of experience, knowledge, and opinions — a more fully developed person. This makes the care providing situation more complex.
Elder abuse describes when a caretaker intentionally deprives an older person of care or harms the person in their charge. Caregivers may be family members, relatives, friends, health professionals, or employees of senior housing or nursing care. The elderly may be subject to many different types of abuse.
In a 2009 study on the topic led by Dr. Ron Acierno, the team of researchers identified five major categories of elder abuse: 1) physical abuse, such as hitting or shaking, 2) sexual abuse including rape and coerced nudity, 3) psychological or emotional abuse, such as verbal harassment or humiliation, 4) neglect or failure to provide adequate care, and 5) financial abuse or exploitation (Acierno, 2010).
The National Center on Elder Abuse (NCEA) in the United States also identifies abandonment and self-neglect as types of abuse. Table 13.1 (below) shows some of the signs and symptoms that the NCEA encourages people to notice.
|Type of Abuse
|Signs and Symptoms
|Bruises, untreated wounds, sprains, broken glasses, lab findings of medication overdose
|Bruises around breasts or genitals, torn or bloody underclothing, unexplained venereal disease
|Emotional/ psychological abuse
|Being upset or withdrawn, unusual dementia-like behaviour (rocking, sucking)
|Poor hygiene, untreated bed sores, dehydration, soiled bedding
|Sudden changes in banking practices, inclusion of additional names on bank cards, abrupt changes to will
|Untreated medical conditions, unclean living area, lack of medical items like dentures or glasses
How prevalent is elder abuse? In 2009, Statistics Canada’s General Social Survey reported that 2% of men and 3% of women said that they had been emotionally or financially abused by a child, relative, friend, or caregiver in the five years preceding the survey. Incidents of both self-reported violence and police-reported violence against elders are much lower than for other age groups in the population (Brennan, 2012). Some social researchers believe elder abuse is underreported and that the number may be higher. The risk of abuse also increases in people with health issues such as dementia (Kohn and Verhoek-Oftedahl, 2011). Older women were found to be victims of verbal abuse more often than their male counterparts.
In Acierno’s study, which included a sample of 5,777 respondents aged 60 and older, 5.2% of respondents reported financial abuse, 5.1% said they’d been neglected, and 4.6% endured emotional abuse (Acierno, 2010). The prevalence of physical and sexual abuse was lower at 1.6 and 0.6%, respectively (Acierno, 2010).
Other studies have focused on the caregivers to the elderly in an attempt to discover the causes of elder abuse. Researchers identified factors that increased the likelihood of caregivers perpetrating abuse against those in their care. Those factors include inexperience, having other demands such as jobs (for those who were not professionally employed as caregivers), caring for children, living full time with the dependent elder, and experiencing high stress, isolation, and lack of support (Kohn and Verhoek-Oftedahl, 2011).
A history of depression in the caregiver was also found to increase the likelihood of elder abuse. Neglect was more likely when care was provided by paid caregivers. Many of the caregivers who physically abused elders were themselves abused — in many cases, when they were children. Family members with some sort of dependency on the elder in their care were more likely to physically abuse that elder. For example, an adult child caring for an elderly parent while, at the same time, depending on some form of income from that parent, would be considered more likely to perpetrate physical abuse (Kohn and Verhoek-Oftedahl, 2011).
A survey found that 60.1% of caregivers reported verbal aggression as a style of conflict resolution. Paid caregivers in nursing homes were at a high risk of becoming abusive if they had low job satisfaction, treated the elderly like children, or felt burnt out (Kohn and Verhoek-Oftedahl, 2011). Caregivers who tended to be verbally abusive were found to have had less training, lower education, and higher likelihood of depression or other psychiatric disorders. Based on the results of these studies, many housing facilities for seniors have increased their screening procedures for caregiver applicants.
Figure 13.15 Long Description: Five street signs are lined up on the side of the road. They each say “Senior Center” with an arrow pointing to the left. Underneath each sign is a different reminder. “Don’t forget.” “Remember to TURN!” “Wake up!” “Lunch only 4 dollars.” “TURN NOW!” [Return to Figure 13.15]