If the numbers continue to develop the way they are today, by 2050 (in just 36 more years) there will be more than 19 million people over the age of 85, needing very senior care in the United States. That is not a message of foreboding. However, it is a clarion call for people who are considering the medical professions today to focus their attention on senior care issues.
The shortage of nurses across the nation is well-known, but what is not spoken of as much is the shortage of physicians that are experts in geriatric care. Doctors that specialize in not just promoting health, but in preserving independence and quality of life in the face of decades of chronic disease and disability are already rare, and demand for that kind of expertise is only going to grow.
Health is Holistic: Physical, Social, Emotional, and Mental All Play a Part
The most important part of any health care offered to patients of advanced age is the evaluation of their state of being. Not just the areas of their life that are directly affected by known diseases or injuries, but everything about how they live on a daily basis.
Here are some common questions that need to be asked during the evaluation:
- Do you leave your house regularly?
- Are you able to bathe or shower regularly?
- Do you have any troubles moving around inside your own home?
- Are you able to prepare meals for yourself and do you have enough food to do so?
- Do you fall with any regularity? Are you worried about what might happen if you fall?
- Are you able to drive or take public transportation?
These ADLs (Activities of Daily Living) are the foundation of independence; someone who requires constant assistance with them is very likely to consider themselves ‘dependent’ and thus feel a lower overall quality of life than someone who can handle them on their own. It is because of this interrelation between physical ability and emotional strength that senior care issues are starting to be seen as holistic problems rather than specific diagnoses that need to be addressed.
Social Health Leads to Physical Health
Repeated studies that have been performed steadily since the early 1980s have shown us that seniors who have active social lives live longer and feel better about themselves than those who do not. Furthermore, they have shown that it is a sliding scale; the more active and dynamic one’s social life, the happier one will be and the longer one will live.
What is more surprising is that the immune systems of the more engaged, socially-active seniors function on a higher level than those who are solitary. In short, being social (which, again, relies on being independent) leads to being more healthful.
Mental Health Can be Difficult to Maintain
The very elderly require a more profound focus on mental health as well. Seniors suffering from a moderate or severe mental illness lose an average of 20 years of life compared to their mentally-healthy counterparts.
To compound the issue, many people (upwards of 20% of folks who were mentally and emotionally fit for their entire lives) can abruptly develop mental illness after age 65. And since there are very few geriatric mental health professionals in the United States, these folks do not receive anywhere near the attention they need.
Hope Is Out There
In part, that may be because we in the United States tend toward a view of the brain that says ‘once you are done growing, your brain is done growing, too.’ According to Terry Elliss of the Boston University Center for Neurorehabilitation, the brain is “modifiable” and often times significant improvement can be made with, for example, stroke victims; even years after traditional post-stroke therapy has ended.
The phenomenon is known as ‘neuroplasticity,’ and it boils down to ‘even if a part of your brain is damaged, focused effort over a long period of time can cause a different part of the brain to step in and fill the role that the damaged part once performed.’ But because there are so few people studying this particular niche of elder care science, it is not progressing as quickly as it could; more manpower could see this turn into a blossoming field of study.
The complex web of relationships between social, mental, emotional, and physical senior care issues is only starting to be understood, and the fact that there are relatively few professionals looking at these issues in the first place is making progress a challenge. As the number of venerable members of our society increases, these studies and their practical applications are going to become more vital in keeping our families and our communities together.