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Internal Medicine => Geriatrics => Gerontology
Gerontology
INTRODUCTION
Gerontology, scientific study of old age, emphasizing the social and behavioral aspects of aging. Although aging is a lifelong process and varies in its effects on individuals, old age has been commonly defined as beginning at the age of 65. Since 1920 the number of people living to old age in industrial societies has increased greatly. In the United States in 1990, for example, life expectancy-the average age that members of a society will reach-was 79.5 years for white females, 72.9 for white males, 74.7 for black females, and 66.8 for black males. Other non-white groups had slightly higher life expectancies: 81.8 years for Native American females, 73.7 for Native American males, 86 for Asian females, and 79.9 for Asian males. As childhood diseases are eliminated and better sanitation methods are used, life expectancy will also rise in developing nations.
PROBLEMS OF THE ELDERLY
Gerontologists study how older people are treated within a society and how the elderly deal with the inevitable problems of aging, particularly those involving health and income. Health problems include normal losses in hearing, eyesight, and memory, and the increased likelihood of chronic diseases. These losses are gradual and proceed at different rates for each individual. Many people do not experience declines until very old age, and the great majority of the elderly learn to adapt to the limitations imposed by health problems. In general, the health of older people today is superior to that of previous generations-a condition that is likely to improve still further as more people receive better medical care throughout their lives. In most industrial societies, the high cost of treating chronic illness has been assumed, at least partially, by national health plans such as Medicare and Medicaid in the United States.
The second major problem of the elderly involves income and economic welfare. Because most old people are no longer in the labor force, some form of income maintenance is necessary. Industrial societies are characterized by systems of pensions and benefits such as Social Security in the United States, which currently is increased automatically as the cost of living rises, thus reducing somewhat the impact of inflation. Although the income of retired people is about half that of working people, most manage to maintain themselves independently. In the United States, however, about 20 percent of the elderly live below or slightly above the poverty level; these are predominantly women and members of minority groups for whom economic security has always been a problem. In numerous other industrialized nations, more extensive systems of social welfare have reduced the proportion of the elderly who lack adequate housing, transportation, and social services.
People age 65 and over made up less than 3 percent of the United States civilian labor force in the late 1980s, and the trend has been toward increasingly earlier voluntary retirement. Income needs and health are the primary considerations in the decision to retire. Eliminating the mandatory retirement age is not expected to cause many workers to stay on the job if they can afford to retire. The need to relieve strains on the Social Security system, however, has led to legislation that gradually raises the age of eligibility for full benefits, which might force people to work longer in the future.
The vast majority of elderly men are married and live with their wives in homes of their own. Because of the higher death rates for men than for women, however, most older women are widowed. In the United States today, most widowed women are able to maintain an independent one-person household. Thus, fewer than 20 percent of the elderly live in the household of an adult child, and only 5 percent are in institutions such as hospitals or nursing homes. Those who live with an adult child or who are institutionalized are typically very old or have serious health problems. Although both the elderly and their children express a strong preference for independent residence, most old people live within a few hours of one of their children. Members of different generations often visit one another and provide help in emergencies. Few elderly parents are abandoned or neglected by their children.
Social relationships might be difficult to maintain in old age because of health limitations, death of family members and friends, loss of workmates, and lack of transportation. Still, the majority of old people are deeply involved in friendships and family, and many find companionship at special senior centers.
ATTITUDES TOWARD THE ELDERLY
In many ways, the aged in the United States are victims both of the youth orientation of modern times and of a tendency toward denial of death. In the past, old people commanded respect because they controlled the sources of power: wealth, land, political office, information, and the fate of other family members. In most modern societies, however, young people are independent; they choose whom they will marry, and receive public education. Groups such as the Gray Panthers, the National Coalition on Aging, and the American Association of Retired Persons (AARP) strive to reverse the stereotype of old people as weak and dependent, and to improve the status of the aged.
Elderly people themselves often display high levels of morale, satisfaction with life, and feelings of self-worth. The important variables are health and income. The task of modern societies is to ensure that the aged have their basic needs met and that they have the resources to continue to function in the community.
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