Dear Brudenell,
I?m most grateful for the opportunity of answering this question.
Since I began as a Google Answers Researcher, I?ve always wished to
work on a question that, like this one, dealt with a significant
issue, involving not just searching abilities, but also challenging in
a sensible and intellectual meaning. I hope to have been at its level.
First point: the word ?elder?. I?ve chosen to leave aside any
consideration about connotations of the word in the present culture?it
seems appropriate enough to differentiate the group of people over 85
from the other ?seniors? within the frame of the present research.
However, when addressing to them, other options such as those
suggested by Hummer-ga might be a better choice.
Since you?ve introduced this question as the third of a suite I began
by carefully reading my fellow researchers previous works, and taking
them as inputs for further development.
Before getting to the point, I ask you please forgive some apparent
digressions that I considered necessary for a better understanding of
the suggestions regarding government?s role in improving elders?
quality of life.
After the excellent job done by Hummer-ga and my own research, I?ve
divided the subject in these two main aspects to focus in:
1-Cultural preconceptions; capability of choice and decision.
2- Physical, psychological and economic vulnerability; dependence on
the younger people and institutions.
Next, I?ll develop each item in two parts: first a description and
then a series of suggestions, some of which may already be part of
programs being held by different governments.
1-Cultural preconceptions.
Description:
The mythical wish of eternal youth is as old as human?s conscience of
aging and death, but in our present times this desire seems empowered
by medical technology and social expectations. While the strength,
capacity and health of the young body has always been appreciated,
seniors have been traditionally considered holders of knowledge,
experience and wisdom, and there place and role in the communities was
an important and cherished one. As an example, lets remember that the
words ?senior? and ?senator? have the same Latin root: ?senex?, that
means ?old person?. In the early Roman political system ?as well as in
Athena?s- the group of governmental high decision makers was
integrated by the old ones. In ancient societies ?as well as in
surviving non ?modern? ones- the age itself was an attribute to be
respected.
What happened in the way? The current overestimation of youth and its
concomitant underestimation of the older people is a process that
slowly began in the Renaissance, along with the decay of the medieval
guilds?while invention and incipient industrialization was turning
obsolete the ancestral methods of production. The eighteenth century?s
philosophical movement known as The Enlightenment?that questioned the
traditional religious vision of the world to the prevail of
Reason?enhanced that change, and it started to take speed in the
latter nineteenth century, as the Second Industrial Revolution took
place. The traditional respect for senior?s wisdom corresponds to an
era when the knowledge that the young needed was the same that the old
had gained more experience in. But as technology innovation begun to
be increasingly present in the every day life and?moreover-in labor
abilities, senior people begun to remain ?outdated?. The knowledge
acquired by the old generation was no longer useful for the new. The
youth?s attribute to learn faster became more important than the
experience.
The twentieth century did nothing but increasing the phenomenon. While
in the 1950?s the pattern still was that managerial positions in a
company were hold by ?senior? employees who had entered the company in
their first youth and were trained by their work experience in it, at
the end of the century the trend?exceptions left aside?had completely
changed. Young MBA nerds displacing older managers, middle-age workers
thrown to unemployment by new technologies, the relative disadvantage
of the older ones to learn or accept new organizational models and
processes, all that reinforced the misconception of the old as useless
and the young as powerful.
Along with these trends of economics, there were the changes in
lifestyles, values and customs. The twentieth century brought the
sexual liberation, the women?s liberation, the relaxation of religious
observance, the generational gap. Again, the older ones became those
who ?don?t understand?, whose ideas were ?outdated?, the
?narrow-minded?, the ?prejudiced?. This aspect is one that
differentiates the current elders from the other seniors: a person who
was 25 in 1960?69 today?probably perceived that decade of major
cultural changes in a different manner than another one who was 45?89
today.
Of course, the above stated are rough generalizations that do not fit
every individual case, but yet this is essentially how the respect
that used to accompany aging, was turned into indifference or even
disrespect. Old people became not to be listened, their opinions are
not to be considered, very often even on decisions about themselves,
such as health treatments, care, housing, both in the family and
community level.
As a consequence, many ?still young? people, approaching to their
senior ages?sometimes even earlier?as well as seniors themselves do
whatever they can afford to prolong youth beyond what?s possible.
Aging is not respectable, is not productive, is not sexy, so let?s
remain young at any cost, that?s the grieving aspiration of many.
At the same time, medical technology successfully prolongs peoples
lifetime, what doesn?t mean that youth is really prolonged. There
are?and there will be?more living old people. Thus, the challenge
seems to be how to accept the elders as a part of our community,
beginning by accepting aging?our own?as a part of our lives: we all
expect to reach elder ages, and we certainly aspire to be respected
when we get there.
What to do:
In first place, governments should lead?or at least promote?a major
cultural change, through the means at their hand:
--Surveys: Hard data on what are the elders? needs regarding care,
health or other matters that require mainly material solutions are far
more available than information about their feelings, desires and
aspirations. Governments could run periodical researches so that the
elder?s needs in those aspects?which will certainly change as people
of different generations reach those ages?will be widely known and
updated. On the other side, periodical surveys on how the people of
different ages see elders and their needs would complete the picture.
This actions will provide the inputs to design and correct the
cultural change planning.
--Education: Beginning in primary school, the curricula should include
information on how the paradigms, lifestyles, technologies, methods of
production, etc., that guided the active life of our elders, even
though no longer valid for the current times, they were once, and they
contributed as a step to what now is already achieved and taken for
granted. Initiatives for experiences of intergenerational encounters
are to be promoted, as well as visits to the school by elder family or
community members to ?tell their story?. The capacity to listen to
their points of view, without prejudging them as ?old fashioned? or
so, is to be trained as an exercise of tolerance, and the possibility
that ?I might be the wrong one?. Discovering that wisdom and truth may
come from the elder people?s word is an experience that no person in
the community should miss.
--Information: The continuous surveying would provide the governments
data on actual needs of the elders, how they perceive the social view
about them, and how the rest of society really see them. This
information should be organized and made public through
communicational campaigns conceived to better the mutual perception
and understanding of the elders? issue, from both sides.
--Participation: There are dozens of organizations of senior people,
who hold their programs, and have valuable information of the needs of
the oldest ones. Governments should summon them as protagonists to
this cultural change initiative. Even though the active members of
these organizations are mostly seniors under 85, a few are older, and
in any case they?re all familiar with the elders? needs.
--Coordination: Besides the senior people?s organizations, there are a
big deal of programs addressed to the elders by institutions of
different kind, such as universities, community services, etc.
Governments should restrain from imposing policies to these
organizations. Instead, they should be aware of such efforts and act
as a coordinator to enhance the results.
Some of the aforementioned suggestions are already being practiced,
but a leading concept that would integrate all the efforts with an
explicit finality of cultural change on the issue is not clearly
visible.
2-Physical and psychological vulnerability; dependence on the younger
people and institutions.
Description:
In hummer-ga?s answer, there are several items?which I quote
below?that I?ve compiled in this category. The word ?dependence? is
used here in a very wide sense, covering from physical to economic
aspects. I?ve grouped them in subcategories, which actually are often
interrelated; thus, I?ll give an interrelated approach in the end.
*Physical / housing:
--Less able to navigate stairs.
--More likely to have a physical disability, the severity increases with age.
--?Over half of seniors aged 74-84 have difficulty with one or more of
the activities of daily living, as do three-quarters of the over 85
age group?.
http://www.cmhc-schl.gc.ca/publications/en/rh-pr/socio/socio056.pdf
--"Living in health care institutions is most common for the oldest
seniors, those aged 85 and over. However, for this group of seniors,
the proportion of men in these facilities dropped from 29% in 1981 to
23% in 2001, and the decline for women was from 41% in 1981 to 35% in
2001."
http://www12.statcan.ca/english/census01/products/analytic/companion/fam/canada.cfm#seniors
*Psychological:
--More dependence on others for social activities.
--More start dropping out of view on the streets of their communities.
*Economic:
--Lower income.
--Less able to take care of own financial affairs.
Physical difficulties are closely related to housing. Buildings are
typically designed for the standard abilities of individuals. Persons
who had no disabilities before growing old and then became frail
seniors will probably not have the house adapted to the new
condition?specially if being a low-income person. For people living
alone, physical barriers may complicate them to go for food, affecting
negatively their nutrition. Also their social life gets difficult,
making deeper a feeling of loneliness and isolation that is very often
felt by a person who has seen friends and other beloved ones pass
away. What leads to the psychological aspect: Apart from consequences
of medical conditions such as Alzheimer and senile dementia, even when
neurologically healthy, elders may tend to melancholia due to their
lack of social life, solitude, the conscience of vulnerability and
loss of physical capacities, and the proximity of death. Low incomes?a
problem itself?reinforces the above described ones. Some elders need
additional economic help from their younger relatives or?when not
available?from charity organizations of both governmental or private
sector. For those who have savings but, given their physical,
psychological or neurological limitations can?t take care of their own
economy, an existent possibility of a better quality of life is
dismissed.
What to do:
Basically, initiatives to face these problems already exist. The
challenge consists in making them suffice.
Programs for adequate housing, adapted for the frail seniors, such as
the ?supportive housing? concept described in the article ?Supportive
Housing for Seniors? (
http://www.cmhc-schl.gc.ca/publications/en/rh-pr/socio/socio056.pdf
)?being developed in Canada?would be the base of the solution.
According to the cited article:
?Supportive housing helps seniors in their daily living by combining a
physical environment that is specifically designed to be safe, secure,
enabling and home-like with support services such as meals,
housekeeping and social and recreational activities. This allows
residents to maximize their independence, privacy, dignity and
decision-making abilities. Supportive housing can be developed in many
forms depending on the types and level of services to be provided, the
project size desired, the types of accommodation preferred, the types
of tenure wanted and the types of sponsorship available. Services can
be provided through a combination of on-site and off-site arrangements
and can be made available to both residents and other older people
living in the surrounding neighborhood. Highly service-enriched
supportive housing, such as assisted living, can be an alternative to
unnecessarily accommodating people in a nursing home.
?Supportive housing can be developed by the for-profit, the
not-for-profit, or the public sector ? or by partnerships between
these sectors. It can be made available in a range of tenure types,
such as rentals, leaseholds, condominiums and life leases. It is also
possible to combine different tenure types in individual projects.
Several provinces have developed their own definitions of supportive
housing that is eligible for public funding.?
Governments should either lead or actively promote these initiatives,
establishing a state policy with goals and deadlines, and involving
the business and non-profit sectors. An intelligent participation of
governments may result in concurring efforts of already existing
initiatives?such as university volunteer programs for students to
accompany elder people?with, e.g., real estate business opportunities,
with the clear finality of bettering elders? daily life.
Regular and emergency medical assistance should be included in the
services, as well as psychological, complementing in this latter
aspect the favorable design of houses which include socializing and
recreational areas.
Now, very much in the psychological and affective field, the issue of
death in itself is one frequently not appropriately considered. Elders
can be favored by meeting areas where they?ll make new relations, but
some of those friends will eventually pass away as others probably did
before, and they know it. So the elder person is always reminded of
the fact that he or she can be next. Death is probably the most
difficult issue to dial with?yet, there are counselors and other
specialists devoted to accompany people who are about to face it. This
kind of service should also be available for the elders. Many?maybe
most?of them have a religious credence, thus spiritual relief is to be
provided as well. Therefore, religious organizations should be
summoned up to the endeavor too.
The personal finance issue is to be considered too. Well trained?and
well controlled?professionals could act as advisors and assistants for
those who can?t deal by themselves with their own financial matters.
********************
I?m aware that these suggestions do not cover the whole issue and its
implications?I wonder if that?s possible. Instead, I?ve tried to offer
a handful of ideas?some of my own, others already existing ones that I
thought worthy to be included?that I hope could be seen as
interrelated, as if it was a sketch for a program to be developed. The
leading concept embracing all the rest is ?cultural change?: the
eventual implementation of a program including all these ideas needs
the support of an ongoing process of cultural change, which will be?at
its time?enhanced by the implementation of the suggested actions, in a
virtuous circle. Other important factor is that the way I imagine the
solutions should be potentially cost-effective: governments would
induce, stimulate, coordinate most of the actions, but NGOs and the
business sector would be profoundly involved. The ?business
opportunity? approach of many of these actions should have a
distinctive role. Riding on a process of cultural change toward elder
people, charity programs and voluntary service can make their part.
After the implementation of these suggestions, it?s reasonable to
expect a reduction in the number of people accommodated in long term
care facilities, which may help with budget implications.
Most of the material of this work comes from my training and practice
as a Social Psychologist, complemented with some web-based
research?which I detail below?and the aforementioned answers to your
two previous questions on the subject.
I hope this work meets your expectations. Please ask for any
clarification you may find necessary. Thank you for this most
interesting question.
Guillermo
Search strategy:
"governmental policies" "senior" "over 85"
://www.google.com/search?num=100&hl=en&lr=&ie=UTF-8&oe=UTF-8&newwindow=1&safe=off&as_qdr=all&q=%22governmental+policies%22+%22senior%22+%22over+85%22&btnG=Google+Search
Links analyzed (apart from those mentioned in the article):
Solving the Senior Care Crisis?Now
http://www.aphsa.org/issues/seniors.pdf
State Agencies on Aging
http://www.retirementliving.com/RLaging.html
New York State Office for the Aging Web Site
http://aging.state.ny.us/index.htm
Welcome to California - Department of Aging - Services and Programs
http://www.aging.state.ca.us/html/programs/services_menu.html
The Toronto Seniors?Assembly Newsletter
http://www.city.toronto.on.ca/seniors/pdf/seniors_newsletter_winter02.pdf |
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