Challenges of Caring for an Aging Population

The word aging has negative connotations associated with it despite the inevitability of the process. All living organisms age, the only alternative to it is death. Advances in medicine, and the ability to make more informed choices regarding diet and lifestyle, have enabled people to live longer, healthier lives. The debilitating effects of aging are being postponed as people invest in living a more health conscious life. Slogans such as, “40 is the new 30”, are declarations of a revolutionary attitude to keep “Father Time” at bay. There are a multitude of procedures to erase the visual and surface evidence of our time on Earth, likewise there are also a plethora of procedures to replace our damaged and worn out parts. In the end we all know we will lose the battle against aging, but in the meantime- we will do all we can to win the war against getting old. Let us hope that the challenges of caring for our aging population will be met with the same fervor as with the enthusiasm centered on disguising our age.

There is an old adage that says, “Once a man, twice a child”. I have heard this repeated often throughout the course of my life. As a child, I did not really understand the foreboding warning embedded in the axiom. As I have grown older, I have had the opportunity to bear witness to the truthfulness of this saying. I have seen the hands of time bend and debilitate men and women that were indeed strong and resilient, reducing them to a state of helplessness equitable to that of an infant. Unable to walk, talk, feed, or cleanse themselves when soiled. Time became a rapacious creditor, reclaiming all the abilities it had once given them.

Studies have shown that remaining active is unequivocally beneficial in the latter stages of life. An analysis performed in Taiwan that centered on circumstances that effect the aging process, found that in people ages 55 years and older; “educational level, health, primary source of income, and living conditions were the leading factors that influence successful aging” ( Lin, et al., 2014). With dynamics such as educational levels, sources of income, and living conditions being vital to the prospect of aging well- the question becomes, how to assist those who may face financial difficulties, including living in low income conditions, and having little education?

According to the web site, worldlifeexpectancy.com, the average life expectancy in the United States is 78.5 year, meaning America ranks 34th overall worldwide in longevity. This distinction places us far behind our northern neighbor Canada, that ranks number 7 in longevity with the average life span of 82.8 years, but the U.S. is slightly above our neighbors to the south where the average life span is 76.7 in Mexico ; placing them at number 48. The gap between the Canadian end of life cycle and that of the United States, and Mexico can be attributed to several factors; one important one is Canada’s healthcare system.

Canadian citizens and permanent residents can apply for public health insurance. With this system in place, Canadian citizens do not have to concern themselves with the stress of how they will are going to pay for most health-care services. This system of universal healthcare is paid for through the tax dollars contributed by the residents of Canada. To use public health-care services, Canadians must show their health insurance card to the hospital or medical clinic, with each province and territory having their own health insurance plans (Canada.Ca., 2018). I do not believe it to be a coincidence that Canada’s population is ranked number 7 and their citizens are receiving universal healthcare, whereas America- where we don’t have universal healthcare, ranked far behind them at number 34 based on life expectancy. What is surprising is that, “the United States spent more than twice as much compared to Canada- at $9,900 for every man, woman and child based on per capita spending” (Canada.Ca., 2018). Consequently, we are spending more in America to live shorter lives.

On a global scale, a phenomenon known as “population aging” is taking place. Population aging is a term that defines “the process of a transition in the demographic of a society, this is primarily related to increases in longevity, paired simultaneously against a noticeable decrease in fertility” (Natarajan, et al., 2017). This pairing has led to a global occurrence of older people’s longevity, out pacing the world’s birth rates. As projected by the Washington Post, by 2030 America’s seniors will account for 20?percent of the population, an increase of approximately 13 percent above the previous twenty years (Daschle & Thompson, 2013).

According to the United Nations, this growing global development will produce far-reaching consequences of the fiscal and socio-political nature. By 2050, it is estimated that the number of people aged 60 and older will more than double from its current levels, reaching around 2 billion, with a projection that over 400 million people aged 80 or over will account for 21 per cent of the global population over age 60 (U.N.org, 2015). With this understood the issue of caring for those in the geriatric phase of life must be addressed as a present day concern that requires a long-term solution.

For financial and non-economic reasons, gainful employment/work is a fundamental facet of having a sense of community and well-being. Acknowledging this could be an essential part establishing a solution. Being industrious and productive contributes so much more than monetary and material security, there is also a component of psychological welfare derived through social exchanges and opportunities for individual and professional growth.

In a similar manner, altruistic work, like volunteering, providing care work, and creative endeavors can provide these same benefits of feeling a sense of accomplishment. Focusing on these benefits could be a pivotal part of the solution to aging-related fiscal and social difficulties. Perhaps instead of focusing on retirement and not working anymore, the emphasis may need to shift to the positive effects associated with rewarding paid and unpaid work among the elderly.

Encouraging older workers to remain longer in the labor force is often presented as the most viable solution to fiscal pressures and macroeconomic challenges related to population aging. Some seniors have found that a phased or gradual retirement concept is a more workable alternative to traditional retirement. In gradual retirement, “employers would allow older workers to select a schedule where they would work fewer hours, but still remain active participants in the labor force” (opm.gov., 2018).

Gradual retirement would be beneficial to both the employee, by keeping them engaged and active, and good for the employers by having veteran workers who do not need time off to stay home with sick children, or maternity/paternity leaves. This new phase of retirement maintains stability in the income of the older employee, and reduces expenditures on pensions for organizations that employ them.

Another incentive for older people to maintain employment is to offset the potential financial issues incurred due to inadequate income. Many people in their advanced years, when relying on lesser income, find out that their financial stream is not keeping pace with rising prices and inflation. This is often painfully true for seniors relying on Social Security or fixed pensions who have to pay for the high cost of associated with purchasing needed medicines and medical care.

The costs of medical care has been on a steadily increasing course at a much faster pace than the yearly increases in Social Security. Added to that, the increased cost of maintaining a household due to higher utility bills, higher taxes, and the general escalation in cost of day-to-day life, many seniors realize that everything they have to pay for has risen faster than the cost of living increases of their Social Security income. As much as America has embraced the idea of retiring to the rocking chair with their comfortable slippers, or favorite fishing hole at 65, it may be in the best interest of the individual to delay retirement in exchange for more financial security, and better health.

At the individual level, each person has the responsibility of being the caretaker of their most important asset- their health. Many people view their health as an optional concern to be dealt with later, or after an illness or medical occurrence. The thought of being conscious of what we eat in regards to the nutritional benefits are consistently casted aside.

We have developed a taste for foods that we know are not the best sources of the nutrients that we need, and we also like these poor choice foods “Super-Sized”. We eat for taste, with no consideration of what these foods do to us.

Poor dietary choices come at a cost. Diabetes, obesity, cardiovascular issues, and other diagnosis that are side effects of toxic eating habits are a major contributor to health issues that plague the older population. In 2012, the Canadian Journal of Physiology & Pharmacology presented their findings relevant to the importance of diet in those diagnosed with cardiovascular disease (CV) and coronary heart disease (CHD) (Whayne, Jr. & Maulik, 2012). Their findings were not remarkable; in fact, their findings were in agreement with multiple other studies that evaluated the importance of a healthy diet. The Canadian study said, “The diet should always be a person’s first step towards developing a healthy CV lifestyle, but regrettably, many people will not follow any diet or modify their nutritional approaches” (Whayne, Jr. & Maulik, 2012).

When it comes to exercise the attitude for many people of all ages, is viewing it as some sort of punishment for eating recklessly, or not being born with “supermodel/super athlete” genetics. Making exercise a regular part of our lives should not equate with a form of penance, or penalty. In fact, exercise on a consistent basis can be the very act that slows and counters that tactics of Father Time. The couch, remote control, and television connected to 100 channels are his allies, and the gym, walking track, basketball or tennis courts are his foes.

A recent 2018 analysis on exercise in those who are already in the category of being in their advanced years found that “the therapeutic value of physical activity, which decreases mortality for numerous common health conditions at rates that are comparable to those of pharmaceutical treatments.

Correspondingly, physical activity, when in the form of structured exercise, produces a positive effect on walking and balance, muscular strength, cardiovascular fitness, and overall quality of life” (Leirós, et al., 2018). Therefore, while it is important to have adequate healthcare available for the aging population, it is my belief that it is equally as important to encourage behaviors that may minimize the need for healthcare assistance.

Having worked in a major hospital for eleven years, I have had the opportunity to observe the number of people that end up as patients due to refusing to be accountable for their health. There are the men and women who have continued to be active in their retirement. They have been vigilant and observant about what they eat- both in content and in portions, stopped smoking, or never smoked, and have continued to engage their minds. These are the people that recover most efficiently, and are least likely to become “frequent flyers” that are in and out of facilities for weeks, or months at a time.

It is not a secret that a balanced diet and regular physical activity are important components of a healthy lifestyle for all ages. However, for adults over the age of 60, eating well and staying active can have a significant impact on even life expectancy and quality of life. In order for seniors to maintain their functional independence, including their mobility and maintain a healthy weight, which can assist in impeding illnesses such as type 2 diabetes, heart disease, and certain cancers, a diet that is high in nutrients and keeping a consistent exercise routine are necessary (ncoa.org, 2018). Reversing decades of unhealthy eating habits will not happen overnight, but with patience and persistence, many seniors can be convinced to modify their food choices, especially if the possibility of feeling and functioning better is an option.

Patience and persistence go hand in hand when assisting someone who finds themselves facing their own limitations brought on by simply continuing to live.

During my days at the hospital, there were times when you could see the hurt in the faces of older patients when the reality of never being able to drive, or play ball with their grandchildren, or live in their own homes set in. There is a component of psychological duress that can sometimes accompany the aging process. Even in those that are fortunate enough to evade Alzheimer’s or dementia sometimes find themselves in a state of disbelief when one day they are driving to the store, and the next morning they can’t dress themselves.

Relationships and the bonds of family and friends are especially important during periods such as these. I know this through the personal experiences of being part of a “care-team” for my grandmother. My son and I care for her with the assistance of paid professionals from various disciplines of home health. Our daily experiences concur with the research conducted by alliances such as Psychology, Health & Medicine. In their study, it was noted that there is a direct correlation between the patient’s emotional recovery and the support from his or her family and loved ones. Researchers found that “higher positive support was proven to be a predictor of lower symptoms of depression” (Hung, et al. 2017). Even the most advanced medicines, medical procedures, and interventions can only do so much.

It is important to the older person to feel valued, and not like a burden. At a certain point, age will have taken away many abilities. They are no longer breadwinners, or meal providers, or carvers of the holiday turkey. The aging family member must be made to feel like an intrinsic and essential member of the family unit, whether the family is constructed through biology or circumstances. Research has shown that “the most significant contribution of elderly family members often is their wisdom that results from lifelong experiences, passing on acquired knowledge to the younger generations” (Fernanda, et al., 2017).

This creates a symbiotic and mutually beneficial relationship between family members that adds a sense of worth and importance to the aging family member.

Caring for the aging population is an investment in our future, as we are all sure to become a part of it- provided we live to meet the goal. So perhaps the solution to how best to care for our aging population lies in asking ourselves some questions; “What should I do now to prepare for when I am older”, and “How do I want to be cared for when I am an aged member of the population?” When I look into the two proposals, I can begin to address how I am treating my health and my body now, and how do I view the older people I come in contact with? On more than one occasion, I have found myself embarrassed at my behavior after road raging at an elderly driver, because obviously it was more important for me to get where I was going than it was for him to drive as safely as he possibly could.

In my opinion, the most important aspect in caring for the aging population is CARING for the aging population, with more emphasis on the word “caring”, than the word elderly. Caring is an action word when used in its best context. Let our actions be evidence that we “care” for the aging population, not our words.

Let the challenge of caring for the aging population include talking to them, engaging them about developing better eating habits, assisting with taking medicines on time, and in proper dosages, taking them for walks and encouraging exercise and activities. In reference to the bible verse that says, “Do unto others, as you would have others do unto you”, I want to set a standard for caring for the elderly that I will be comfortable in receiving myself. By accepting the challenges of caring for the aging population, we are making a better environment and society for us all.   

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