A Guide to Issues Affecting The Elderly

The first thing we usually think about when considering issues affecting the elderly are health and mobility problems, and, of course, they are a major concern for many older people.

However, there are also social issues to contend with such as isolation and loneliness, financial issues due to reduced income and feelings of inadequacy after retirement when people no longer have a working role in society.

With almost a quarter of the world’s population predicted to be over 60 years old by 2050, according to the World Health Organisation, the unique health and social issues associated with aging are set to become increasingly more important in the coming years. Encouraging the population to take preventative measures against a decline in health, for instance, before they reach old age, will become critical if our health services are not to be overwhelmed in the next few decades.

Equally planning for retirement and a new phase of life in our later years is also essential in order to avoid the social issues such as less human interaction, loneliness or low self-esteem which can result in social isolation or depression.

As we age the ability to do everyday tasks that we may have previously taken for granted is likely to decline for the majority of the population. These abilities are also impacted because older people tend to have more health problems than younger people. However, declining abilities are not just the result of underlying health conditions but can also be due to social issues.

You can read more about health issues affecting the elderly further down the page. But let’s first take a look at the most common social issues facing people as they get older.

Social Issues Affecting Older People

It is important to recognise that aging does not have to have negative connotations and older people can be valued, respected members of a community. There are plenty of older people who live full, active, independent lives with few health or social problems; but people with health or social issues are equally able to live satisfying, fulfilling lives. Sometimes society assumes older people will be less physically able or less mentally alert but this is clearly not always the case and not all older people conform to the typical stereotypes.

Mobility problems, for instance, do not affect mental capabilities so even though someone might find it difficult to get around unaided they can still take part in activities and past-times that don’t require agility.

Nevertheless, there are some social issues that are more likely to affect the quality of life of older people. Here are some of them:

Loneliness from losing a spouse, partner or close friends that formed their main circle of acquaintances and their social life.
Social isolation because adult children are busy with their own lives, careers and families and do not live nearby.
Retirement – losing a sense of self-worth and a reason to get up in the mornings.
Grief from the loss of a spouse or life partner
Losing contact with family members
Marital/Partner status – you may become widowed or divorced
Living accommodation – this may have to change due to financial issues, an inability to maintain a larger property or due to later-life divorce (which is becoming increasingly common)
Unable to manage everyday activities such as shopping and cooking
Difficulty accepting the physical changes caused by aging
Bored by retirement and the associated lack of routine
Financial concerns due to the loss of a regular income
Eating habits can change as you age, especially if you live alone
Fewer social activities to become involved with
Acting as a family caregiver (maybe to a spouse or partner)

Let’s take a close look at some of these issues affecting the elderly…

Loneliness

As of 2017, according to the Office for National Statistics 28% of UK households have only one person living in them. That means there are 7.7 million people living alone in the UK. For those aged 65 and over, the majority of people living alone are women (66.5%). because statistically men have tended to die before their wives because they are typically older. However, this is now changing and the number of widowed women is falling due to life expectancy increasing faster for men compared with women.

There are many specific challenges to living alone:

People who live alone are typically poorer.
Loneliness and social isolation.
Lack of adequate nutrition because older people who live alone frequently do not eat proper balanced meals because they don’t see the point of “cooking for one”.
Health problems such as hearing impairment are more likely to go undetected for longer.
Difficulties rehabilitating after surgery or adapting to new physical capabilities following an illness or injury

Loneliness is a particular concern because it can accelerate the onset of dementia, have a negative effect on the cardio-vascular system and result in depression. According to the Campaign To End Loneliness living alone and having poor social connections are as bad for your health as smoking 15 cigarettes a day and worse for your overall health than obesity. For these reasons it is likely to increase your risk of death by 29% – a shocking statistic when it is an avoidable situation.

Fortunately, there are many effective strategies to help avoid loneliness. Making an effort to stay in touch with friends and family is a very simple strategy as they are people you already know.

Helping others through volunteer work is also a good way to increase your social connections. Charities, religious organisations and even primary schools are always in need of volunteers, and volunteer work can help build new relationships between people who share similar interests.

Another way to avoid loneliness and various other issues affecting the elderly is to take a further education class, take up a new hobby or explore new interests.

Living alone does not have to be a negative experience and many older people enjoy the independence of living alone. They engage in physical activity and social activities with like-minded people. Nevertheless, people have to be prepared to make the effort to avoid loneliness and social isolation.

The charity Independent Age work to help older people stay connected to friends, family and community to reduce loneliness and improve mental health. They also campaign to make mental health services more readily available and effective for all older people.

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Being a Family Caregiver

Family caregivers play a key role in caring for chronically ill older people yet they may themselves be elderly and have their own health problems. They may ignore their own issues in order to prevent their loved one having to move into a residential care home or nursing home.

This is just one reason it is important to be aware that there are other care options that don’t mean your loved one needs to leave the family home. Home care services can provide help during the day to support the family caregiver and, if necessary, a carer can live in your home to provide for more complex care needs. 24/7 live-in care at home can be permanent or temporary, for instance during a rehabilitation period after surgery.

Other support services such as “Meals on Wheels” can also alleviate the burden for an elderly family caregiver.

Although being a carer can be very rewarding, when the carer is also older it can result in exhaustion and isolation as they are no longer able to take part in their own social activities. To avoid caring becoming an unmanageable burden here are some coping strategies:

Don’t neglect your own physical, emotional or recreational needs – if these aren’t being met you won’t be able to provide good care for your loved one.
Ask for help and practical support from other family members or consider some form of homecare.
Find out about respite care in your local area to give yourself a break from time-to-time.
Find out about local support groups for family caregivers so you can meet people in the same situation.

Adjusting To Retirement

Retiring from work after a lifetime in the workplace is a major event in older people’s lives. Attitudes towards retirement vary from person to person and many people will have looked forward to retiring for years. It can improve the quality of life of some people because of a reduction in the stresses associated with work and the free time available to pursue hobbies and other interests.

However, for some people the transition can have negative effects on both physical and mental health especially if retirement was not an active choice and your career defined who you were as a person, your status and your place in society.

People can become disengaged from their family, friends and community following a forced retirement; they can become isolated and depressed and lose their sense of self-worth. But there isn’t (or there shouldn’t be) a stigma attached to being retired – it is the natural consequence of a lifetime of work and contributing to society so it is important to view it as a positive new chapter in a person’s life.

One way to avoid problems in retirement is to plan for that period of your life in advance, wherever possible, so that you or a loved one doesn’t develop a later-life crisis and find it difficult to cope with the change. This is particularly important as there is often the misconception that retirement is an easy way of life with few stresses, plenty of holidays and the freedom to do what you want when you want.

The reality for many people is that retirement can bring its own problems and can be a more complex situation to deal with than many realise. People often aren’t prepared for the impact of leaving work, even if they were looking forward to it, and they may miss the human interaction, especially with people with the same skills and experience as themselves.

It takes effort to create a new lifestyle in your retirement phase that provides regular social contact, structure and engagement. There are many options to do what you are good at, what you enjoy and to use your skills and experience to create a stimulating life including:

Voluntary work
Adult education classes
Joining a club
Gardening
Learning a new language
Swimming, tennis, rambling or other physical activities
Becoming a business mentor
Writing a book
Joining a choir
Getting involved in community projects

There’s no right way or wrong way to live your later life but most people need something that provides a sense of meaning and purpose in their lives so they can avoid the most common social issues affecting the elderly.

Relocation

It’s very common for people to move house as they become older – many people will have long dreamt of moving away from a town or city to the coast or countryside for a better quality of life once they are no longer tied to where they work. This can be the perfect opportunity to down-size or right-size to a home that requires less maintenance and upkeep. Or it could be a time when people choose to move to new home on a warden-assisted site or in a retirement village for independent living but with support available if needed. It may even mean moving in with adult children.

Moving house is stressful at any age but moving in later life to a different area can be particularly difficult. It means getting to know your new location and community and adjusting to the differences. It means finding a new doctor, dentist, optician, pharmacy, library etc. Some people do not respond well to relocation, even if they know it is the most sensible decision and it can take time to adjust to a new environment both within the home and in the wider community.

Where we live and how happy that place makes us feel is important to our well-being. So even though it may be a sensible decision, taken rationally, it still has to feel right. Don’t be pushed or persuaded into moving if it doesn’t feel right.

Adjustment to the new environment will be much easier if people have control over the move and have actively chosen to move for themselves. Of course there may be financial considerations and keeping on a large family home, with all it’s associated upkeep, for one or two people may not be the sensible option. Freeing up some of the capital for a better standard of living may be preferable but only you can make that decision.

If you have chosen to move then acquaint yourself with the new location well in advance and you are more likely to feel comfortable with the relocation and view it as a positive step.

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Bereavement

Whilst bereavement does not solely affect older people it is far more common for older people to have lost friends and family. Bereavement can affect many aspects of an older person’s life – if you lose a spouse or partner of many years there will be the loss of close companionship and shared interests, you may go out less or your social status may be affected. Grief can cause sleep to be disturbed and increase anxiety. In addition, a change in financial circumstances can exacerbate the normal anxiety that follows the loss of someone close to you.

Bereavement can also affect your own physical and mental well-being. You may feel overwhelming sadness; you may feel exhaustion, anger or guilt. Any or all of these feelings are normal and grief will ease as time passes.

Talking to someone can help and often this will be friends and family but if you can’t or don’t want to talk to them then there are other ways to get the support you may need to start re-building a new life. If your loved one died in a hospice then there will usually be a support group for people in similar situations. Or a bereavement counsellor could help you to talk about your feelings. The Cruse Bereavement Care charity can put you in touch with local bereavement support services.

Self-Neglect

When living alone it can be easy to start neglecting things like personal hygiene, to avoid cleaning and maintaining the home, not eat properly balance meals and not take prescription medicines when necessary. Social isolation, depression or impaired mental faculties, such as in the case of those living with dementia, can all contribute to self-neglect.

However, elderly issues that might seem like self-neglect could be the result of a decline in physical capabilities making it difficult to wash and dress or to clean the house. If this is the case, talk to your doctor or social worker about getting help with these tasks for yourself or a loved one. There are plenty of homecare services available for as little or as much help as you need.

Common Elderly Health Issues

Chronic Health Conditions

The most common chronic health conditions among the older population include cancer, heart disease, stroke and diabetes, which cause the majority of deaths each year. Good nutrition for the elderly is essential so having a healthy diet, maintaining a healthy weight and taking regular exercise can all help to minimise the risks associated with these conditions. Doctors may be able to prescribe medication to manage these conditions but it is also important to take control of your own health with healthy living habits.

Cognitive Health

Dementia is the most typical cognitive health condition affecting older people in the UK and worldwide. The World Health Organisation estimates that around 47 million people worldwide are living with dementia. The most common form of dementia is Alzheimer’s disease but there are actually several different types of dementia with different symptoms and treatments. Understanding Dementia better will help support those living with dementia and their family members who often provide unpaid care during the early stages of the condition. It will also help to raise awareness of certain risk factors for developing dementia such as depression and smoking for example.

Mental Health

It is estimated that as much as 70 percent of the older population suffer from depression but it is not always diagnosed or treated. In some cases it can be a side-effect of chronic health conditions so treating those effectively can alleviate the symptoms of depression. Just as a healthy diet and lifestyle with plenty of exercise can help minimise the risk of chronic health condition such as heart disease and stroke it can also help reduce depression.

Physical Injury

Falls in the older population are one of the most common causes for hospital admissions; they can result in serious injuries such as hip fractures and the consequences of reduced mobility after a fall can be life-threatening for the elderly. As we age our bone density decreases and our muscles become weaker and less flexible. This means older people are more likely to lose their balance and more likely to fracture or break a bone when they fall. Previous research from our Better At Home report revealed that in the UK six people over 65 suffer a fall every minute and 30% of over 65s and 50% of over 80s fall at least once a year . A month after suffering a hip fracture 1 in 12 people will have died as a result of the injury and only half will have returned home.

Malnutrition

We tend to think of malnutrition occurring predominantly in poverty-stricken third-world countries but it is also a recognised problem and one of the common elderly issues in the UK. It can be due to underlying health conditions which can cause a lack of appetite but it can also be due to social situations such as isolation or financial issues such as a lack of adequate income.

Malnutrition can result in a weakened immune system and weak muscles which can lead to further health problems and physical injuries. Meal delivery services such as Meals on Wheels are available for those on a limited income or for those who are unable to prepare their own meals.

Incontinence

Incontinence is a common problem with aging and can affect the quality of life of older adults. As with so many elderly health issues a good diet, maintaining a healthy weight and exercising regularly can all help with incontinence but there is also very effective medication available from your doctor so don’t be too embarrassed to ask.

Vision and Hearing Impairment

Sensory impairments to sight and hearing are also very common problems for people as they age. Fortunately, glasses or contact lenses can correct most sight problems and technological advances mean practically invisible hearing aids can resolve hearing problems.

Expert Author – Trudi Scrivener

Trudi has more than 30 years’ experience in the care sector and is the founder of Ashridge Home Care, the award-winning specialist live-in care provider. She is also a board member of a The Princes Centre charity and an ambassador at the Heart of Bucks charity. As a Dementia Champion she seeks to raise awareness of how life can be improved for those living with dementia.