Old Age as Health Vulnerability

Today, in the US and across the globe, the elderly population is expanding. Thanks to advances in health care, humans are leading longer and healthier lives. However, while it is important to celebrate the progress being made, it is also essential to recognize that as humans are living longer, new health problems are emerging while existing ones are compounded. Research and data has consistently shown that old age is a vulnerability that exposes individuals to wide range of poor health outcomes. Figures released by the US government indicate that over 46 million Americans are at least 65 years old and this figure is expected to rise (ODPHP, n.d). The number of elderly Americans accounts for over 14% of the country’s total population. An examination of statistics reveals that older adults in the US shoulder a disproportionately heavy burden of medical costs. Writing for the Journalist Resource, Alexander Raphel (2014) reported that in 2010, the average amount that an elderly citizen spent on healthcare stood at a whopping $18,424. For comparison, other adults spent a third of this figure on medical services. There is no doubt that given the amount that elderly adults spend on care, old age is a serious health vulnerability. Further evidence of how old age exposes individuals to poor health outcomes can be seen in the number of elderly Americans who are forced to return to the workplace. According to figures, as many as 19.2 million senior citizens have had to take up part-time or full-time employment and it is projected that this number will rise (Ziegler, 2017). It can be argued that the surge in the number of working elderly adults has been driven by dwindling pension payments and the fact that these individuals face financial difficulties and receive little support. There are other statistics that highlight how old age impacts health. For example, between 2009 and 2012, the obesity rate among the older adults was estimated at 40% (Mather, 2016). Social isolation is yet another problem that this population grapples with. Data shows that in 2014, 27% of those aged between 65 and 74 have no company as they live alone (Mather, 2016). These figures make it clear that old age is a vulnerability that limits access to affordable and high quality care, increases the risk of a wide range of illnesses and health conditions and reduces the overall quality of life.

Older Adults Falling Victim 

To understand how old age is a vulnerability, it is important to examine the mechanisms through which it leads to adverse health realities. Old age is a natural, normal and unavoidable stage of human development. However, when the aging process interacts with certain determinants of health, it can create adverse outcomes. For example, availability and access to healthcare services and support are among the determinants of health that influence the experiences of older adults. Wang et al. (2018) conducted a study whose primary purpose was to determine the impact of home healthcare on the recovery and experiences of older patients with cardiovascular diseases who had been discharged. Their observations indicated that being provided with adequate care at home enhanced recovery. The implication of this observation is that when provided with adequate and high quality care, older adults experience healthy living. On the other hand, when sufficient care is lacking, it can be expected that the older adults will suffer some of the negative outcomes discussed above. For example, their risk of obesity could increase.

Limiting access to care is not the only way that old age causes individuals to become vulnerable. Poverty, frailty and isolation are other mechanisms through which old age causes ill health (Schroder-Butterfill & Marianti, 2006). For example, many older adults are too frail to engage in gainful employment. As a result, many are forced to rely on their children for support. These children also have obligations that limit their ability to provide support. The ultimate result is that the older adults fall into poverty and are rendered unable to pay for care. It is little wonder that instead of retiring, an increasing number of older adults are seeking employment. Isolation is also a serious challenge that these individuals face. As noted earlier, many live alone. While isolated, the elderly face a worryingly high risk of such mental conditions as depression (Landeiro et al., 2016). It is evident that in order to improve the outcomes within this population, urgent interventions that combine the efforts of various stakeholders must be implemented.

The fact that old age is often accompanied with a range of comorbid health conditions is yet another way that old age leads to ill health. Beales and Tulloch (2013) authored an article in which they explore the vulnerabilities to which older adults are exposed. One of the messages that they convey is that when they attain the age of 75, many individuals will be suffering from as many as three health conditions. To understand the devastation that these conditions can cause, one should remember that poverty and low levels of access to care are other problems that this population faces. Being poor means that they cannot afford the treatment for their conditions while limited access to care compounds this problem. Instead of being a time to reflect on their life accomplishments, old age is quickly becoming a stage defined by ill health, agony and regret.

Old Age, Health Risks and Vulnerabilities 

Old age is not the only vulnerability to which individuals are exposed. There are numerous other vulnerabilities that older adults have to grapple with. Among these is poverty. As noted above, a large number of older Americans who are languishing in poverty. Using the official metric for determining poverty, it has been established that 4.7 million older Americans are poor (Cubanski, Koma & Neuman, 2018). This high poverty level helps to explain certain negative outcomes that the older population experiences. For example, in a previous section, the alarm was raised over the high obesity rate within this population. The obesity problem can be blamed on the fact that poor elderly Americans lack the financial resources needed to eat healthily and embrace active lifestyles. Poverty is also responsible for limited access to quality care and social isolation.

Racial minority status is another vulnerability that can interact with old age to create adverse outcomes. Wild racial disparities have been reported among older adults. For example, Menkin et al. (2017) noted that such minorities African Americans and Asian Americans have low expectations regarding their health in old age. The implication of this fact is that when older adults are from minority communities, their experiences are worse than those of elderly white Americans. Another observation that has been made concerns mortality. Thorpe et al. (2012) reported that the mortality rate among older adults is higher in minority communities. This disparity can largely be attributed to socioeconomic factors. Historically, minorities like African Americans have faced biting poverty that has made it difficult for elderly members to gain access to proper care. It is therefore not surprising that Thorpe and his colleagues determined that the mortality rate within the minority populations is worryingly high.

Plan of Action 

From the discussion this far, one of the clear themes that have emerged is that old age is a vulnerability that should be addressed. Fortunately, there are interventions that have been developed and are being implemented as part of efforts to improve the lives and experiences of elderly Americans. These interventions will be the foundation of a plan of action that is recommended for implementation. Among the interventions is lending support to the families of older adults who are involved in the provision of care (Morbey, 2014). Some of the problems that older adults face can be traced to neglect and the failure by their families to provide support and care. It is understandable that many families of the older adults are simply unable to participate in providing care. For example, there are those who have work commitments and family obligations which severely impair their capacity to deliver support. However, working with the families of the older adults remains one of the most promising and realistic solutions for tackling the issues that the elderly face.

Above, lending support to family caregivers has been identified as among the interventions that should be implemented if the experiences of older adults are to improve. There are a number of positive outcomes that the implementation of this solution will yield. One, it could solve the poverty problem. For example, when they provide financial assistance to their elderly members, families shield these individuals against the devastating impacts of poverty. Two, the problem of social isolation could be addressed through supporting the families of the older adults. For example, the families could visit and offer company to their older members. However, for this to occur, the families should be provided with all the support and resources that they need. For example, fatigue and stress are some of the negative outcomes commonly reported by their caregivers (Clark et al., 2014). Many caregivers are overwhelmed by the demands of caring for older adults. To relieve the suffering that they endure, medical practitioners such as nurses could conduct regular visits and take over the care-giving role. Furthermore, the nurses could provide advice and moral support to the caregivers. These simple approaches promise to reduce the burden shouldered by the caregivers, thereby enhancing the experiences of the older adults.

Organizations involved in the provision of care to older adults are best placed to tackle the vulnerabilities that this population faces. However, regular individuals also have a role to play. Caregiver support is one of the simple solutions that they can implement. For example, a nursing student can spend a few hours offering company and warmth to their ailing grandmother. In addition to helping the grandmother feel valued, this solution will provide the student with the opportunity to gain a deeper understanding into the challenges of old age. Therefore, instead of waiting for the government or organizations with vast resources to take action, individuals should understand that there is a part that they can play in restoring the health and dignity of older adults.

Conclusion 

It is true that old age is mostly a problem for older adults. This is because it is this population that witnessed the adverse effects of aging. However, one should understand that old age presents a challenge for all. For example, the healthcare profession has a responsibility to shield older adults from harm. Families bear the burden of attending to the needs of their elderly members. The government is required to ensure that adequate resources are available to deliver proper care to older adults. Businesses have a mandate to provide the elderly with opportunities for engagement and should also contribute to meeting the cost of care. These examples show that old age affects nearly everyone. Old age is indeed a complex and complicated issue. The complexity arises from the fact that old age interacts with other factors to create complicated realities. For example, old age can combine with racial minority status to hamper access to care. What is fortunate is that the old age problem can be fixed. Concerted efforts from all stakeholders hold the key to eliminating the hardships that the elderly grapple with. While undertaking this project, there are some issues that have left me surprised. What I found to be most surprising is that hundreds of thousands of senior citizens suffer isolation. I think that it is a stain on our nation that we have abandoned our senior citizens who have played their role in building societies. I have been challenged to play my role by spending more time with senior citizens. However, I remain disturbed by the lack of action and the politicization of the welfare of older adults. It is indeed shameful that our leaders have reduced the wellbeing of senior citizens to an issued exploited to earn political points. Going forward, I will turn to my values as a medical student to fuel my vision of a nation where elderly citizens lead dignified and healthy lives. In particular, I will be guided by our professional obligation of promoting safety, restoring dignity and tackling all forms of discrimination, including ageism.

References

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Clark, M. M., Atherton, P. J., Lapid, M. I. et al. (2014). Cancer caregiver fatigue: a high level of symptom burden. American Journal of Hospice and Palliative Medicine, 31 (2), 121-5.

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Menkin, J. A., Guan, S. A., Araiza, D., Reyes, C. E., Trejo, L., Choi, S. E., Willis, P., Kotich, J., Jimenez, E., Ma, S., McCreath, H. E., Chang, E., Witarama, T., & Sarkisian, C. A. (2017). Racial/ethnic differences in expectations regarding aging among older adults. The Gerontologist, 57 (suppl 2), S138-S148.

Morbey, H. (2014). Who cares? Older family carers, their experiences and needs. In improving later life. Vulnerability and resilience in older people. Age UK. Retrieved April 18, 2019 from https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/rb_april15_vulnerability_resilience_improving_later_life.pdf

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Thorpe, R. J., Koster, A., Bosma, H. et al. (2012). Racial differences in mortality in older adults: factors beyond socioeconomic status. Annals of Behavioral Medicine, 43 (1), 29-38.

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Wang, J., Dietrich, M. S., Bell, S. P., Maxwell, C. A., Simmons, S. F. & Kripalani, S. (2018). Changes in vulnerability among older patients with cardiovascular disease in the first 90 days after hospital discharge: A secondary analysis of a cohort study. BMJ Open. doi: http://dx.doi.org/10.1136/bmjopen-2018-024766