Aging America

Aging America

by NICOLE PEARSON

This is a story about a little spitfire woman from Western New York. A die-hard quilter and lover of all things yellow, her roots come from a humble and wholesome background on a dairy farm. Her spirit and joie de vivre surpass the most energetic of Millennials—those who have the pleasure to meet her are often surprised she is 81 years old. And with an attitude as bright as her sun-colored curtains, she is someone I proudly call grandmother. But her story isn’t all sun, quilts and smiles. Jean Pearson, like so many older Americans, is affected by our collective blindness to the difficulties faced by our nation's elderly.

The average American life expectancy in 2014 was about 85 years of age. The average life expectancy 50 years ago was about 69. The need to address aging is not caprice, but a necessity.

It began innocently enough: one day she had trouble seeing from her right eye. “New glasses!” she thought, would be the fix, and promptly made an appointment with the ophthalmologist, Dr. Gordon Wuebbolt. Everything seemed to be working out, and the Dr. Wuebbolt agreed. New glasses were his fix and they could even be delivered to her house. She used them for a while, but to her surprise they did not help. Troubled, she called Dr. Wuebbolt again, and she came in for another visit. The troubles apparently were "simply nothing," as Dr. Wuebbolt explained to Jean—she simply had not given her eyes enough time to adjust to the new glasses. With only as much as a pat on the back and a “rub some dirt on it” advice  her concerns were quickly brushed away.

Finally, after some more time of discomfort and blurry vision, she went to Dr. Wuebbolt’s office a third time, but instead of prescribing another panacea, this time he said, “I’m sorry Mrs. Pearson there’s nothing more I can do for you.”

These are words that are all too commonly heard by 60% of older Americans. Yes, sixty percent—effectively the percentage of older individuals who don’t receive proper routine preventative health services, such as an eye-exam. Of course, sometimes, even advanced technologies and medical advancements cannot cure the most stubborn of ailments. However, what did my grandmother have, you ask? A cataract. It wasn’t cancer or something incurable or a terminal disease. No, had her eye doctor been more attentive, even more rigorous, a simple eye exam would have diagnosed her correctly. But he wasn’t attentive, and she didn't get diagnosed. And now she is at risk for permanent blindness.

What should we make of this? We could easily write off the doctor’s negligence as poor practice, but it goes deeper than that: How could a doctor miss such a common eye problem? According to the National Eye Institute, half of all people over 80 have a cataract or have had cataract surgery. Didn’t he know this? How could he miss it in a person so active, so positive, and so full of life?

Could the answer be related to her age?

People are living longer than ever. The average American life expectancy in 2014 was about 85 years of age. The average life expectancy 50 years ago was about 69. The need to address aging is not caprice, but a necessity. It is critical to address our collective social attitude toward the treatment of elderly adults, since often, neglectful attitudes and inactions are exacerbated with the elderly population. And quite unfortunately, these attitudes are exhibited even by the behavior of caregivers or—looking closer to home—by people in your own neighborhood.

American society in general glorifies youth and fears, or even despises, old age.
— Thomas Day

Why are we so opposed to growing older? In a lot of countries, elders are treated with the utmost respect. It is considered an honor to grow old. Japanese society, for example, associate elderly people with wisdom and knowledge. Moreover, many elderly adults hold positions of power and are still an integral part of society—and not just in Japan, but all around the world in countries as far ranging as Guatemala and Senegal, Iran and Korea.

In Greek and Greek-American culture, old age is honored and celebrated, and respect for elders is central to the family.

The expression “old man” in English is a pejorative, but in these cultures the word describing an old person is often associated with experience and leadership. Yet, in the United States, the situation is starkly different. One prevailing attitude is to pretend aging doesn’t exist. How many times have you heard of an elderly fellow who is mentally quick and physically limber that decides to retire, moves to Florida, just to die a year later? It's scary thought for most of us working toward social security benefits—and it’s not simply the change of lifestyle that might not be suitable to all—but how we are treated when we age, including the facilities in which we receive health care. Imagine if day-care centers were dangerous and caused youth deaths. Would we be angry? No, we’d be irate, and as a result myopic policies would be swiftly addressed. Yet, would it surprise you if I said that most geriatric care facilities have a negative impact on the health of our grandmothers and grandfathers? Maybe even our aging parents?

As a person ages and transitions into an institutionalized care facility, significant negative impacts can be severe regardless of which option for late-life care is selected: assisted living homes, nursing homes or even live-in nurses. And beyond the subconscious oversight that leads to inadequate treatment, each of these create a living environment that may be perceived as an unnatural infringement on one’s privacy, dignity and personal freedom. As a consequence, the sudden transition to an elder care facility—and loss of independence can invariably contribute to the decline of mental well-being of new residents. It must be truly hard to sustain a positive self-image in America as you age, because, as Richard Currey tells us, “...our country is an ageist one, where age-positive images can be hard to come by."

The stark reality is that most doctors and geriatric caregiver’s are not trained to create positive social atmospheres. Much of geriatric practice revolves around physical actions like prescribing medicine, and when that doesn’t work, it is acceptable to chock it up to old age. 

Furthermore, there is substantial empirical research to suggest the positive impacts that an age-empowered society can have. One study conducted by researcher Becca Levy, PhD, of Yale University School of Public Health slashes the nationally adapted assumption that poor health outcomes in older adults are strictly related to age. In her progressive research it was found that the “positive self-perceptions of aging can improve memory, thinking, mood, self-confidence, overall functionality, and longevity (adding 7.5 years).” The preconception has long been that functions such as memory or hearing simply deteriorate with age, and there was nothing to be done about it,” Levy says. “Our work demonstrates that how a person feels about getting older plays a vital role in how their body functions. Aging brings inevitable change, of course, but much of the decline we’ve taken for granted isn’t necessarily an absolute. Such research suggests that positive views of aging can promote a stronger body, improved cognitive capacity, and even add years onto one's life."

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This research, important as it is, has not transitioned into mainstream thought in this country. The stark reality is that most doctors and geriatric caregiver’s are not trained to create positive social atmospheres. Much of geriatric practice revolves around physical actions like prescribing medicine, and when that doesn’t work, it is acceptable to chock it up to old age. Perhaps the scariest fact about geriatric care in America is the lack of standards on a state or federal level.

In recent years evidence has been mounting to suggest that, there is prevailing bias – ageism – that is at odds with the best interests of older people.
— Alliance for Aging

As also found in a report by Alliance for Aging there are many serious short-comings in medical training, prevention screening and treatment patterns that disadvantage older patients—and this can be seen in hospitals, nursing homes and assisted living facilities. The report highlights five key dimensions of ageist bias in which U.S. healthcare fails older Americans:

1. Healthcare professionals do not receive enough training in geriatrics to properly care for many older patients.

2. Older patients are less likely than younger people to receive preventative care.

3. Older patients are less likely to be tested or screened for diseases and other health problems.

4. Proven medical technologies for older patients are often ignored/not used, leading to inappropriate or incomplete treatment.

5. Older people are consistently excluded from clinical trials, even though they are the largest users of approved drugs.

 But how can we, everyday people, begin to remedy these problems? There has already been important advances made by healthcare professionals (such as Dr. Becca Levy); however, what’s needed is for the general public to adapt a more supportive attitude toward aging. Hospitals, nursing homes, and assisted living centers are as much businesses as they are health facilities, and they will respond to what the public wants. Having a strong and supportive consensus in the country toward aging will force institutions to pay better attention to the well-being of elderly people. But we can also emphasize a simpler idea: respecting our elders. Only a simple change in attitude will go a long way to start treating elderly people with the same care and attention as we would young ones. One needs to accept the fact that we, as humans, will age and rather than pretend it is some far away phenomenon, these natural cycles of life ought to be embraced.  Going a little further, even architecture could assist. According to a study by the AARP, 9 out of 10 Americans over the age of 60 would prefer to stay in their own homes. Yet, can the elderly live in their own homes after a certain age? There could be impediments such as excessive stairs or slippery surfaces that would make life challenging. Universal design however, promises to have immediate solutions.

In the most general sense, universal design is an architectural and design concept intended to provide an accessible home environment for all people, regardless of their ability.
— AARP

Designing for all phases in life can greatly enhance a person’s quality of life, in addition to making life more tolerable for everyone. As stated by Mary Marshall, Emeritus Professor of University of Stirling United Kingdom, “An aging population is something you can plan for. It need never be a surprise." And this type of design is becoming more standard-practice in various regions around the world, and if the demand is there, especially if that demand is positively supported by younger generations, our system will respond.

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As for Jean, she did get a second opinion from another eye doctor, but unfortunately it was too late. The second doctor quickly detected the cataract upon her initial visit, and scheduled her for immediate eye surgery. Yet, after two failed surgeries to remove the excessively-progressed cataract, her eyesight did not improve. She is now blind in the right eye.

Whether it has to do with geriatric care in hospitals, treatment of older adults in a nursing home, or renovating a house for an elderly person, we must address our problematic attitudes toward aging. Our treatment of the elderly as a whole is, of course, difficult to single out to one or even multiple discriminatory acts because it is a mindset. The discrimination will not stop until society can adapt a different attitude toward aging. And the support of a community as we age, in this respect, is critical. Should you have the fortune to reach old age, wouldn’t you want to be treated as a person rather than someone who is taking up space and should haste on to wither and die? 

 

References

AARP Guide “Rivatlize Your Home – Beautiful Living for the Second half of Life.” NY, New York: Sterling Publishing Co, 2010. Print.

Alliance for Aging. “Ageism: How Healthcare Fails the Elderly.” 19 May 2011. Web.

Community Development Department. “Aging in the Cambridge Community.” Cambridge, MA: Department of Human Service Programs, June 2010. Print.

Currey, Richard. “Ageism In Healthcare: Time for a Change.” Aging Well. Vol. 1 No 1 P. 16, Jan. 2008. Web

Day, Thomas. “The American Perspective on Aging and Health.” 2014. Web.

Heft, Sarah. “The Effects of Long-Term Care on the Mental Well-Being of the Elderly: An Extensive Literature Review.” Humboldt State University. Web

Huffington Post. “7 Cultures that Celebrate Aging and Respect their Elders.” 25 Feb 2014. Web.

Jeffery Anderzhon, David Hughes, Stephen Judd, Emi Kiyota, Monique Wijntes. “Design for Aging.” International Case Studies of Building and Program. New Jersey: John Wiley & Sons, Inc, 2012. Print. 

 

Nicole Pearson can be reached at pearson@aesirlab.com.

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