Implications of age related changes
By now you have understood some of the salient changes at the biological and psycho social levels that come in old age.Many of the age-related changes can have serious implications for psycho social performance of older individuals.However,majority of old persons have ample capacity to deal with the age-related changes and altering requirements of every day life –whether they do or not, however, is another matter.Let us now look at the implications of these changes.
Implications of health related changes:
The most obvious manifestation of health related changes in old age is increased dependence in Activities of Daily Living (ADL). Many research studies have shown that in old age with advancing age, people require help in activities of daily living like eating, getting up and sitting,walking,making tea/ coffee, taking medicines,managing money and so on. It may be noted that there would be high variability among the elderly interms of independence inactivities of daily living that rests on factors like heredity, nutritional status, activity level, attitude towards life, acceptance of age-related changes, health seeking behavior, etc.
You may recall that old age brings deteriorative changes in sensory capacities. This significantly brings changes in the social interactions of the elderly.Visual handicap makes the aged dependent on others for their daily living, especially with regard to taking medicines, going out alone and the like.Also, deteriorating vision may hamper aged females’ creative utilization of their leisure time through, say, embroidery and, thus, they may feel lonely and unattended. Likewise, elderly people with hearing disabilities usually adopt a strategy of submission and silence rather than being ridiculed by insensitive normally hearing individuals.Similarly, locomotion problem, say, arthritis, may restrict the outside movement and interactions of older persons with neighbours and friends.This may,consequently,result in loneliness,frustration,alienation,withdrawal and even severe psychosomatic disorders including dementia like symptoms.
Added to this,mental health problems are rampant too.Gerontologists assert that mental health problems among the aged are both organic and functional in nature.Catabolic process attacks on the nervous system and brain tissues there by increasing chances for mental health problems. Personality mal adjustments coupled with stresses and strains give rise to functional disorders. In old-age,many people suffer from anxiety over finances and health,feeling of being unwanted,isolated and lonely,feeling of guilt,irritation, and inability to adjust to changed condition and decreased social contacts and participation. Psychiatrists dealing with the clinical problem of the aged often find that neurosis makes their appearances with astonishing frequency in later life.Alzheimer’s disease, also called ‘primary degenerative dementia’ and dementia, a marked decline in an individual’s previously high level of intellectual performance are among the common mental disorders in old age.Also, depression often accompanies ageing.
Further, loneliness is considered to be a major emotional problem experienced by aged people.Though a subjective experience, it is rampant among older people.Loneliness can be situational – due to certain environmental factors or it can be a trait where ‘loneliness’ is a stable and persistent pattern of feeling, despite significant others being around.Trait lonely aged persons may have low opinion about them selves,dislike sharing their feelings and are low in intimate relations (Rubenstein and Shaver, 1980).Often, they may report high social anxiety, be prone to depression and feel that they are being judged or ridiculed by other persons (Perlman and Peplau 1982). Such elderly people lack effective coping strategies. Next, anxiety and tension have become obvious characteristic of modern day living, having serious repercussion on the physical,mental and social well-being of a person. In addition, death fear is also a peculiar mental health characteristic of old age.
Another implication of modern-day living is faulty life-style.“Most of us die of unhealthy life-style”, asserts Rogers (1983).Now-a-days, increasing numbers of people are dying of life-style related diseases like asthama, ulcers, heart-attack, cancer, etc., and not due to previously considered killer diseases like cholera, plague, diarrhoea and malaria.
The present life-style, characterized by imbalanced nutrition, lack of exercise,more or less constant stress, tension and no time for relaxation and enjoyment, is one of the major factors of non-communicable diseases.The World Health Organization, (2007) maintains that aged people are prone to non-communicable diseases such as hypertension, heart diseases, stroke, diabetes, cancer, respiratory diseases, arthritis and mental problems. Presently, such non-communicable diseases account for about 56 percent of all deaths worldwide and this proportion is expected to jump to 73 percent by the year 2020. So, healthy body and healthy mind are crucial factors for well-proportioned life.
It is quite unfortunate that still in the contemporary society, many myths and misconceptions, stereotypes and discrimination associated with mental health ailments arewidely prevalent.More often than not,mental disorders among elderly go unnoticed and unidentified due to lack of awareness among caregivers and consequently they do not receive timely treatment.Aged with mental ailment, thus, face scorn, are made fun of, stigmatized and at times, abused verbally and physically.
Implications of economic changes:
old age brings deterioration in earning capacities. Compulsory retirement adds fuel to economic vulnerability among elderly.Further,nearly 93 percent of the Indian population works in the unorganized sector where there are hardly any retirement related social security options. Thus, people in informal sector work till their physical capacitieswane and then they are thrown out of the job market.
Social safety net for the vulnerable aged is not effective in India.The National Policy on Older Persons (1999)bring out that one-third of elderly in India are living below poverty line and another one-third of it are just above it.Thus, two-thirds of the aged population in the country is economically vulnerable and need social assistance which it is provided to merely six percent of the population in terms of Old Age Pension and Annapurna (where 19Kg of food grains are given to destitute elderly per month).Need less to say, In addition, in middle and lower middle class, scarce economic resources are first diverted to education and development of children than the aged are the last in the priority list.However,medical expenses increase considerably in old age and they start pinching in the family budget.At times, elderly face abuse and exploitation by denial of basic and timely medical treatment.
Preventive healthcare is not a common practice in Indian society. Same is the case with elderly.More peculiarly, elderly women, driven by patriarchal socialization norms tend to postpone, delay and deny access to treatment for their ailments unless ailment becomes acute.
Covey (1992) observes that elderly females have higher rates of morbidity, though it has been observed that ‘women are sicker but men die sooner’. Epidemiologically, apart from age-related ailments like diabetes, hypertension, deterioration in sensory capabilities, etc., females suffer from two broad health disorders, gynæcological and post meno pausal morbidities.Certain socio-cultural factors also add to the morbidity among females.All through the life-cycle, females are subject to various kinds of discrimination,oppression and exploitation.