The title for this article asks two questions: can the elderly survive in a youth-oriented America? And does a healthy age exist in a growing older society?

America, a young and vibrant nation! Not necessarily so! We are young in years, 247 to be exact, but old with a prevailing and burgeoning aging population. We are, unquestionably, growing old. This can be validated by the following factors. One in particular is a major decline in the birth rate. This is, in part, attributed to (1) a delay in young couples getting married, (2) the high cost of living, (3) living in smaller dwellings, and (4) caring for an aging parent with complex medical issues. And let’s not forget an increase in a longer life expectancy, the rise of the baby boomer generation (1946-1964) and a vast growing elderly population, 65 and older.

According to current research, 1) “the elderly tend to overconsume empty calories, 2) remain undernourished and 3) can cause a biological imbalance with a selection of foods.” Nutritional patterns that are held by the elderly don’t always reflect healthy dietary practices regarding the choice of foods. Nutritional awareness involves 1) a proven learning process concerning the numerous varieties of appropriate foods that are readily available, and 2) can bolster the body’s response and ultimately, an improvement in nutrition.

Economic considerations and a lack of mobility can, unfortunately, place the older person in what dietitians call “a serious nutritional jeopardy.” Eating habits that evolve from early childhood tend to encourage specified dietary choices. Although these diets are primarily favored by the elderly, they don’t necessarily provide healthy meals. Store bought foods that are prepared as a “fast food” are often purchased for convenience instead of health. Fast foods may satisfy the palate but will also contain excessive salt, high saturated fats and refined sugars. In addition, caloric consumption also needs to be decreased while the need for healthy nutrients should not!

An 89-year-old woman told her daughter, “Please don’t hide the truth from me. At my age, I can cope with just about anything. It’s the uncertainty that I can’t understand.”

Crisis and stressful situations occur throughout life but are thought to be more devastating in the later years when one may begin experiencing a slowing and/or decline in mental reserve. Therefore, whenever a crisis is coupled with cumulative stress, it tends to stretch the limits of one’s coping capacity. What can emerge is helplessness, lack of self-control and eventually, dependence on others.

The continuity theory proposed by the researcher Havighurst, is focused on “the relationship between life’s satisfaction and activity as an expression of enduring personality traits.”

According to the research, “Personality is considered an important factor in determining a relationship between the many roles we play in life and life-satisfaction.” Neugarten & Associates present three ideas on personality that are fundamental to the belief about the aged individual. They are:

I would like you to participate in a brief mental exercise.

Close your eyes and visualize the images you see when you say the following words: “old man, elderly gentleman, old woman, elderly lady.” 

For too many years “senile” just meant old without being pejorative. Even “geriatric” was originally a value-free term rather than part of the lexicon of contempt toward old people. Yet today, the language used to describe the changing age makeup of the elderly population is short of an apocalypse.

Older people are likely to be seen as a burden and a drain on resources. Their only contribution, it seems, is to make worse the “dependency ratio,” a term that enshrines dubious assumptions about who will be financially dependent on whom.

The National Governor’s Association characterizes a homeless person as “one who is unable to secure permanent and stable housing without assistance.” The term “homeless” includes many categories such as the de-institutionalized, the chronically mentally ill, skid row alcoholics, street people, etc.

According to the researchers Damrosch and Strasser, “Many shelters focus on assisting the situationally distressed new poor.”

Researchers are aware of the detrimental effects of a practice called scapegoating. Many of us, during our life, have often played several roles that periodically we cast upon others. The aged parent, like it or not, often “inherits” one of these roles and becomes an unwitting scapegoat.

The researcher Archer suggests, “The focus of negative energy, arising out of scapegoating flows from a younger generation in the form of unfulfilled dreams, whereas the elder is the receiver or carrier of these multiple disappointments and worn traditions.” He further states, “The elderly individual tends to personify all of the facets of life that the young are conditioned to avoid i.e. death, illness, depression and uselessness.” It then becomes relatively easy for a young person to transfer their negativity and project it onto the aged parent in the form of an unwanted feeling, although the parent may in fact have already internalized the social rejection that is felt.

In August of 2022, a Japanese woman by the name of Kane Tanaka died at the amazing age of 119, just two weeks shy of the biblical 120. When questioned at her 116th birthday what was her best diet for staying healthy and living a long life, her answer was simple, “I appreciate anything I eat.” When Mrs. Tanaka died she became the world’s oldest recorded person. She, in fact, lived seven years longer than the oldest American veteran of World War II.

The current average life span for a Japanese woman today is 87.7 years and 81.6 for a man. And the statistics continue growing! Government data reports that at present, Japan has the greatest number of centenarians (100 years plus) than any other country. As of August 2021 there were 86,000 individuals in Japan who have turned 100 in a country with a population of 125 million.

According to the researcher Hogstel, “Anxiety is a diffuse feeling of panic, dread and lack of control that can be insufferable in its acute stages.” He further states, “Little is known about anxiety and its numerous manifestations even when it has not reached negative clinical proportions. It is a multi-response to helplessness, isolation, alienation and emotional insecurity. Evidence of anxiety in the elderly is often not as apparent as in younger clients.”

According to the research, “Anxiety is the motor that keeps people moving toward mastery of new and threatening situations.” The researchers Jarvik & Russell claim, “Anxiety runs with a soft, pleasurable purr that is not always perceptible. However, when it’s an extreme or prolonged personal stress, it is likely to initiate episodes of anxiety that is experienced as a noticeable jittering hum in the gastric area.”

Volunteer services provide an attractive role for many aged individuals. Interestingly, women have traditionally volunteered, but the greatest increase in volunteering has been among elderly men. The number of older women who volunteer has remained relatively constant.

Statistically, 35% of the 65 and older population are engaged in some type of volunteer work. Most of the work is with religious organizations. Those who are involved as volunteers feel they are contributing to their community and are filling gaps in services that otherwise might be unmet. Their self-esteem and usefulness appears to prevail. Here is a list of several programs that include senior volunteer opportunities:

The aged frequently experience a decrease in their ability to cope with the multiple stressors of life that can result in a waning of their capacity to adapt. The following is a review of several themes that are recommended by the researchers and that offer practical suggestions for those who are dealing with the excessiveness of life’s stressors.

Theme I – Progressive Relaxation

By definition, “comfort is a state of ease and satisfaction, of bodily freedom from pain and anxiety.” According to recent research, “The absence of physical pain is not always sufficient to provide comfort. The aged may have their biologic needs satisfied but still be emotionally distressed.”

Nurses understand the significance of the word “comfort” which describes the goals and outcomes that aid in determining the nursing measures needed to administer care. However, the meaning remains vague and essentially abstract to the person who is the recipient of that nursing intervention. The researcher, Hamilton, studied the meaning and attributes of comfort from the point of view of the chronically ill elderly who is hospitalized in a geriatric setting. Hamilton’s definition of comfort is “multidimensional, and means many things to different people.” The researcher, McCaffery’s definition of pain is “whatever the person experiencing pain says it is.”

The geriatric orphan is described as an elderly person with no close friends nor survivor or family members who are available to provide emotional support. He or she has had significant others and lost them to death, distance or fractured relationships. This individual has not, however, desired to be alone. The researcher, Boyack suggests, “It is imperative to establish a surrogate network, assist the individual through their grief, resolve any unfinished business and seek appropriate resources for maintenance in the community as long as desired and able.” However for some, it can be a welcome relief to be among others in a congregate or institutional setting despite a commonly held belief against residing in a nursing facility or setting.

As we observe this individual we begin to understand the three Rs that define the tasks of aging as identified by the researcher, Cynthia Kelly. They are “accepting reality, fulfilling responsibility, and exercising rights.”

The researcher Goldstein, coined the term “catastrophic reaction” to describe the overreaction to minor stresses which occur in patients with advanced dementia. It is precipitated by fatigue, overstimulation, an inability to meet expectations, and persistent misinterpretations. According to Goldstein, “When the environment is misperceived and one feels threatened, the following signs are noted:

According to the researcher Mace, “Intervention becomes necessary to avert or minimize these reactions.” Any sudden deterioration in cognitive function with worsened behavior should be considered as a warning that the patient may be physically ill and will act out.

A legacy is one’s tangible and intangible assets that are transferred to another and may be treasured as a symbol of the individual who is bequeathing it. The elderly should be encouraged to identify that which they would like to leave and who they wish their recipients to be. This process has great significance and tends to prepare one to “leave” with a sense of meaning.

Legacies can provide a feeling of continuation and tangible ties to their survivors. Legacies may range from memories to material bequests that will live on in the minds of others. The researcher Erikson’s seventh stage of man identifies the generative function as the main concern of the adult years and the last stage, the eighth, as that of reviewing with integrity or despair what one has accomplished.

The elderly, because of reasons of pride or because of mental impairment may not always state their problem or problems directly. Tolerance and patience may be required in teasing out the issues. Often a great deal of trust must be present before a frail elder will confide in a professional who may be caring for them.

Working with this group of older individuals simply takes more time to form a strong relationship to be effective. That relationship must also include a sincere and caring attitude. The older individual in return for that care may worry and want to give “gifts” of some sort to staff and caretakers. It is their way at an attempt of feeling less dependent and an attempt to have greater control over their situation.

In this article, I will be examining the concept of belonging, i.e. relationships with family, friends, and community as it relates to the aged individual.

There is a classic study by the researchers Lowenthal and Haven who qualify the importance of a caring relationship as a buffer against, what they declare “age-linked social losses.”

The peak years of creativity has been a subject of inquiry among many developmental psychologists. Kastenbaum, a social scientist, believes “the end of life often stimulates that creativity. It’s then when people who are about to jump into the void can sometimes be more creative and most able to transform their situation. At times like this, people can be tense, actually more alive.” Creativity can, in fact, triumph over the debilitation of an aging body as it has with many individuals.

The researcher Simonton has studied the aged and their creative genius and concludes that, “Creative productions are not necessarily tied to chronology but to successive acts of self-actualization.” A definition of self-actualization is “the full realization of one’s creative intellectual and social potential through one’s internal drive versus external drive like money, status, power” (Merriam Webster’s Dictionary).

Music therapy is an established, evidence-based concept that promotes the health goals within a therapeutic setting. Its benefits are recorded in numerous studies that recommend a personalized approach to conditions that include autism, brain injury, Alzheimer’s, pain management and more.

Music therapy benefits people of all ages, but especially the aged individual.