Today, people are living much longer than ever before, leading us into uncharted waters. From 1946 through 1960, the United States experienced the Baby Boom years. Today, the earlier Baby Boomers are entering into retirement age. As a result, there will be an increase in the aging population, which will not only bring more job opportunities in the Gerontology field, but will also require massive changes to the Health Care Industry. With professional experience as a medical social worker and geriatric care manager, I am interested in learning more about the various needs of the elderly population, particularly the baby boom generation. My work experiences and observational study of senior citizens have sensitized me to several issues and challenges the elderly population faces; such as declining physical and mental health, financial vulnerability, housing, loneliness, and abuse.

Physical and mental health decline are major concerns that seniors have to contend with as they age. The human body is a system that wears out with long and repetitive use and the capacity to think, act, relate, and learn starts to falter and deteriorate.  Aging breeds illnesses such as memory loss, immobility, and organ failure, hearing loss and poor vision. Susan Levy, M.D. (2010) says “The Most widespread condition affecting those 65 and older is coronary heart disease, followed by stroke, cancer, pneumonia and the flu.  Accidents, especially falls that result in hip fractures, are also common in the elderly” (p. 1).

In my observational study of elders at an assisted living facility, there was a general tendency for the elders to be impatient, irritable and non-communicative.  This was most likely the result of physical pain or neurological and psychiatric problems, ranging from depression and anxiety disorders to Alzheimer’s disease and other debilitating forms of dementia. Shekhar Saxena, (2010) head of the mental health department at the World Health Organization reports that “Within the next 18 years, the number of people, worldwide, suffering from dementia will likely double to 65.7 million and triple by 2050, due to people living longer.  The organization has determined that there are around 35.6 million sufferers today, costing over $600 billion a year for care and treatment” (p. 1).

Another issue facing senior citizens is financial vulnerability and the rising cost of medical care.  The financial dilemma is common among seniors who are no longer able to work.   However, a lack of financial capacity creates a stressful life and invites the entry of problems other than physical and mental health issues. While I will never know the financial status of the elderly people I observed, I do know that they are the lucky few who are able to afford assisted living, which can be quite expensive. It appears that my grandmother’s generation, or the elders I observed, are doing pretty well economically; however, the current health care system will not be able to handle the financial and medical needs of the baby boomer generation.  There will be a rise in health care needs as well as an increase in financial vulnerability with the baby boomer generation.

Housing is a major concern for the elderly. Most seniors would like to stay in their homes for as long as they can.  Reluctance to move is particularly true for those who own their own home. Some have the financial ability to afford caregivers, but others don’t.  Due to failing health and cognitive decline, elders may have to move in with a relative or consider an assisted living facility or nursing home.  However, the housing options don’t look very promising for a growing aging population.

As the overall population ages, the numbers of the most vulnerable will grow as well.  A new report from the Center for Housing Policy, Housing an Aging Population—Are we Prepared? claims that “By 2050 the 65+ population is expected to grow from 40 million today to more than 88 million; put another way, one in every five Americans will be 65+.”  Demand for housing will more than triple over the same period to 19 million” (2012: 3).   The report also found that older adults are more likely than younger adults to have housing affordability challenges.    As a result, the aging of the population is likely to increase the overall proportion of the country with severe housing cost burdens.  The report also finds that many older adults lack access to affordable services that could help them age in place.   Older adults with low and moderate incomes often lack access to various housing choices, such as an assisted living facility.

 Perhaps no other age group feels the sting of loneliness more than the elderly.  I have personally witnessed this in my profession and feel strongly that it leads to depression.  I think it is natural for elders to want to retreat as they age, but they also need encouragement to be socially engaged as much as they are able.  While individuals living alone tend to experience the most isolation, several activity directors have informed me that assisted living facilities have a difficult time getting the residents to be involved in various activities.  There is a natural tendency to isolate as a result of failing health, but there is still a need for one on one interaction with a human.

According to a new study by UCSF researchers (June, 2012), loneliness can cause suffering to people at any age, but it can be especially debilitating to older adults and many predict serious health problems and even death.  One of the more surprising findings of the teams analysis is that loneliness does not necessarily correlate with living alone. The UCSF study also found that people 60-years-old and older who reported feeling lonely saw a 45 percent increase in their risk for death. Isolated elders also had a 59 percent greater risk of mental and physical decline than their more social counterparts.

As the population of older Americans grows, so does the hidden problem of elder abuse, exploitation and neglect.   Elder abuse is the infliction of physical, emotional, or psychological harm on an older adult.  Elder abuse can also take the form of financial exploitation or neglect of an older adult by the caregiver.  In a report by The National Elder Abuse Incidence Study (1998), “Every year an estimated 2.1 million older Americans are victims of physical, psychological, or other forms of abuse and neglect. Those statistics may not tell the whole story.  For every case of elder abuse and neglect that is reported to authorities, experts estimate that there may be as many as five cases that have not been reported” (p. 1).

Some older people are repeatedly abused, but even one incident of abuse can be traumatizing to the elderly person according to authors Carmel Bitondo Dyer, Marie-Therese Connolly, and Patricia McFeeley in Elder Mistreatment: Abuse Neglect and Exploitation in an Aging America.   The author’s say that even one incident of victimization can be potentially harmful and even fatal for an older person:

A single act of victimization can “tip-over” an otherwise productive, self-sufficient older person’s life.  In other words, because older victims usually have fewer support systems and reserves—physical, psychological, and economic—the impact of abuse and neglect is magnified, and a single incident of mistreatment is more likely to trigger a downward spiral leading to loss of independence, serious complicating illness, and even death (p. 339).

 An additional issue is that often older people who have been

abused or neglected do not wish to testify against their family members who have abused them, out of a misguided sense of loyalty, or of love. Fortunately, each state in the United States has an office of adult protective services to investigate the abuse or neglect of adults.  Interventions provided by Adult Protective Services include receiving reports of adult abuse, exploitation or neglect, investigating these reports, case planning, monitoring and evaluation.

References:

 

Susan, Levey, M.D. (JUNE, 2008).  What Are the Most Common

         Issues of Aging? Retrieved from: http://www.agingcare.com/article.

Shekhar, Saxena. (2010).  Latest Dementia Statistics from the World              Health Organization. Retrieved from: http://careforyou.us/latest-dementia-statistics-from-the-world-health-organization/

Barbara Lipman, Jeffrey Lubell, Emily Salomon. (2012).  Housing an Aging Population: Are We Prepared?  Center For Housing Policy, Washington, DC. Retrieved from: http://www.nhc.org/publications/index.html

Leland, Kim. (June, 2012). Loneliness Linked to Serious Health Problems and Death Among Elderly.  University of California, San Francisco.  Retrieved from: http://www.ucsf.edu/news/2012/06/12184/loneliness-linked-serious-health-problems-and-death-among-elderly

The National Elder Abuse Incidence Study. (1998). U.S. Department of Health and Human Services, Administration on Aging.  Retrieved from: http://www.aoa.gov/AoARoot/AoA_Programs/Elder_Rights/Elder_Abuse/Index.aspx.

Carmel Bitondo Dyer, Marie-Therese Connolly, and Patricia McFeeley. (2003).  “The Clinical and Medical Forensics of Elder Abuse and Neglect.” In Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, D.C., National Academies Press, 339.