Understanding Aging and The Elderly

The following can be said about people during their old age.

Some people put up a “fight” against old age through subjecting themselves to cosmetic surgery, use of supplements, aggressive weight-loss programs or through overzealous physical training programs.

Society tends to view the elderly as not as capable as younger people. It is not common for older people to be seen or treated as decisive, strong or as leaders – except in the traditional setting. This same attitude is adopted by many large corporations and government institutions.

Succinctly, aging is characterized by the following features:
o changes in appearance, such as a gradual reduction in height; also, weight loss due to loss of muscle and bone mass;
o a lower metabolic rate;
o longer reaction times;
o declines in certain memory functions;
o declines in sexual activity;
o a functional decline in audition (hearing), olfaction (smell), and vision (sight);
o declines in kidney, pulmonary (lung), and immune (protection) functions;
o declines in exercise performance; and
o multiple endocrine changes (Craik and Salthouse, 1992; Hayflick, 1994, pp. 137–186; Spence, 1995).

The incidence of pathologies (diseases) increases with age. These include type-2 diabetes, heart disease, cancer, arthritis, and kidney disease. With age, humans become more susceptible to certain diseases, and become more likely to die, frailer, and endure several physiological changes, not all of which lead to disease conditions.

People who take care of the aged, including doctors, must consider the following facts about the elderly:
o Aged people’s goals could be different from yours.
o They are not going to be cured.
o You must focus on their quality of life.
o They want to be in their homes.
o They don’t want to fall.
o They don’t want to be in pain.
o They don’t want to be a burden.
o They don’t want to be alone.
o They don’t expect miracles
o They want to be treated with respect.

Furthermore, they generally don’t fear dying. They fear losing their autonomy and their dignity. They don’t care about your metrics, or your age-adjusted mortality rates, or your fancy new genomic tests. They want to be listened to and heard (André Picard).

What causes aging? Aging is due to the interaction of many lifelong influences. These influences include:
o Heredity
o Environment
o Work
o Culture
o Diet
o Exercise
o Leisure
o Past illnesses
o and many other factors.

Understanding the aged person when they are ill is especially important because illness behavior changes in the aged. An elderly patient is less likely to complain about the onset of illness.

Denial is quite common with the onset of new symptoms and can have severe negative consequences in cases such as a heart attack. The attending doctor must be constantly aware of the fact that the elderly patient tolerates pain better than younger patients. They have the feeling that they are disturbing those close to them and the health care provider. The tendency is, therefore, to bear the problem; this leads to late complaint or presentation in the hospital.

The incidence of disease conditions like type-2 diabetes mellitus, heart disease, cancer, arthritis, and kidney disease increases with age. The incidence of some conditions, like sinusitis, varies little with age. The incidence of others, like asthma, tends to decline. Therefore, it is important to stress that aging is not merely a collection of diseases.

It is important to understand the general needs of the elderly. All human beings have the need for affection, belonging, achievement, recognition, independence, hope, and particularly self-esteem. Although such needs do not disappear with age, disability, and hospitalization, opportunities for their gratification do diminish considerably. The elderly person frequently has inadequate financial and social resources to cope with their medical and other needs.

Unknown to, ignored or downplayed by certain practitioners, the elderly patient can pick subtle signs of rejection by medical, nursing, and other hospital staff. Many elderly persons are isolated from family members and friends and tend to look for signs of regard, concern and even affection from hospital staff. Some elderly people have difficulty in describing their symptoms in words, especially if the disease is causing confusion, or if they have impairment in normal reasoning.

Elderly persons, especially those who have substantial amnesia (memory loss) or other types of reasoning impairment, may not adequately monitor and stick to their scheduled drugs.

Do elderly persons get abused? The answer is in the affirmative, though many close (and not-so-close) perpetrators may not want to admit it. Elder abuse (abuse of an older dependent person) may take the following:
o Physical
o Financial
o Emotional
o Sexual
o and other types.
Adequate healthcare staff training and giving proper attention can readily identify elder abuse.

What can you and I do regarding the welfare of the elderly? We should do the following, at the least:
o Help the society and the elderly themselves to change their attitude towards aging
o Encourage the elderly to maintain their independence especially in making certain positive decisions
o Engage the services of a caregiver but if a caregiver is not available, plan to enroll the loved one in an adult day-care center or a proper home for the elderly
o Provide regular financial assistance
o Children, and in particular grandchildren in the African and other societal settings, should pay parents and grandparents visits from-time-to-time
o Resist the temptation to treat the elderly as your children especially when/if they stay under your roof
o Take them out to exciting places (of their choice preferably) and not limit them to indoors or places of worship
o Design or arrange an reasonable exercise program and produce a way to encourage the older person to follow it
o Appreciate the nutrition needs of an elderly relative, especially the need for vitamins and minerals including iron – and provide same
o Take them (or arrange for them to go) for regular medical checkups and for their drug refills
o Help them take their medication regularly and on schedule; they tend to forget that they have taken the medication dose already or are yet to take the dose
o Watch for slight changes in their physical or psychological features, discuss with them, and arrange for them to get the necessary assistance, care, or medical attention
o Ensure that the elderly person gets out in public and tries dining out or going to a pleasurable public event of their choice
o Ensure that the aged look good and have nice clothing in and outside the home. This should apply to even the blind.

Can one plan for old age? The answer is both “Yes” and “No.” Many people plan for old age but none know for how long they will live or what impairments aging will foist on them. Even elderly people with medical problems may not know how many more they will be or how severe the existing medical problems will become. Prevention is still better than cure. There is no absolute prevention for aging but some known features or accompaniments of old age can be prevented.

Conclusion
The elderly are an important group of people in any society. What happens to elderly people in a family, village, city, state, or country reflects the level of the sense of “humanity” of the people in question. Even if the current elderly people did not plan for their old age, the younger leaders and relatives in the society should make reasonable provision for their elderly. Whatever happens to older people in our time reflects what would happen to those who have no real thought about old age now, unless there is a quick and positive change; this is because although most people desire to live long, they have no inkling about how far into old age they will go, should they attain old age.

*This article is an excerpt from In Tune With Him Daily: Guidance for Youths, Focus for the Middle-aged, and All-round Depth for the Elderly, by Inyang Ukot. The book is available on Amazon.