Far too often, labeling a person as ‘senile’ is a thoughtless expression steeped in prejudice. ‘Diagnosing’ a person as ‘senile’ is accurate only when we mean there is a continuing pattern of progressively deteriorating thought and behavior coupled with a medically proven diagnosis of an irreversible brain disease. Careless use of this single word (senile/senility) suggests that we think we know what is wrong and there is nothing more to understand or to be done. This attitude is not justified even when the person is, in fact, suffering some form of a progressive cerebral change. But the attitude is particularly destructive when the individual is troubled, yet far from ‘senile’.

Even professionals are capable of making such errors. International mental health teams and researchers in the field of gerontology who have been studying this problem have discovered that many elderly persons who were labeled with the term senile/dementia have come to realize that the problem is, in fact, functional in nature. If this can happen, then people without professional or scientific training may be even more prone to error. Any sign of confusion or mental lapse in an elderly person may be erroneously taken as ‘proof’ of senility.

Definition: keen-minded – “mentally alert” – (Merriam-Webster Dictionary)

Why are some elderly people more keen-minded than others? In youth and middle age some people are more mentally alert and vigorous than others. Keen-mindedness tends to be habit forming: a combination of fortunate genetic endowment and a lifestyle that keeps the intellect well honed.

Despite the obstacles, love can triumph for the old as well as for the young. The importance of a sustained love relationship in old age is hard to overestimate. Sex brings more than direct physical gratification, although this by itself is not to be slighted. It also reaffirms each partner’s identity as a person who can offer something worthwhile, and who can be someone worthwhile to another person. The body is still a means of giving and receiving pleasure.

But there is another important function of sexual intimacy in old age. The old person is all too often ‘typecast’ to the outside world. He is the secondary character, belonging on the fringe of the real action.
We tend to remain at an emotional distance from him. Every day we walk past, almost through old people on the street, without clearly registering their existence as individuals.

Several decades ago two prominent psychologists wondered whether giving institutionalized elderly people a tiny amount of control over something in their lives would have a positive influence on their personalities.

What they did was to give a house plant to each resident in a nursing home. Half of the residents were told that the plants would be cared for by the nursing staff. The other half were told that they were responsible for the care of the plants. They were to decide when to water the plant and how much sun it should have. At the beginning of the study, the two groups were similar in physical and mental vigor. Three weeks later, there was no difference in the health of the plants, but there was a lot of difference in the psychological adjustment of the residents who were put in charge of caring for their plants. The group given personal responsibility rated themselves as more alert, active and vigorous.

A grim choice confronts some people when they face problems associated with advancing age.  Do they have to accept insecurity and deprivation? Must they surrender much of their independence and integrity in order to be helped?

Elderly men and women may prefer to go it alone instead of taking advantage of available resources to which they may appear as stubborn and unrealistic.  But they many feel life would no longer be worthwhile if they were to become too dependent on others for their needs.

Our society will continue to insist on using chronological age for many purposes. We can live with this practice if we recognize that to set up a chronological checkpoint for calling a person ‘old’ is simply a matter of administrative or statistical convenience. It is an unfortunate usage but difficult to avoid. We can, as a society, minimize the negative impact of this practice by making a clear distinction in our own minds between chronological age and the individual’s actual physical, mental and social situation. We can also refuse to be swept along by the implicit relationship between chronological age and human value. ‘Ten years older’ does not mean ‘ten years worse’ or ‘ten years less valuable.’

            Age-grading emphasizes society’s interest; functional age emphasizes the direct facts about the individual.

“I feel like a mushroom.  They keep me in the dark, so I keep them in the dark.”

A key member of a leadership team muttered these powerful words when we conducted an organizational assessment for his company.  This is what happens when organizations fail to create a culture that embraces open communication.

Consider how damaging it is when an influential member of your leadership team withholds information.  From you. From staff. From residents. The negative impact is tremendous.

Creating culture candor.

Organizations that have a strong culture that focuses on communication will outperform those left “in the dark.”  Transparency allows organizations to run more efficiently and effectively.

It starts with sharing information.  Anytime you have an important message to communicate, we suggest doing so in at least five ways.  Some ideas include:

A person who appears demented may be tormented by grief and anxiety. His demented behavior may have been brought about by emotional pain. A grieving person at any age is less able to pay close attention to everything that happens around him. He takes less care in grooming and dress. He has less emotional energy to welcome new opportunities or to respond to challenges. He feels uncomfortable with his body. His mind may be constantly uneasy or tortured.

Loss and grief are common in old age as death removes loved ones. An old person may have suffered other significant losses, of occupation, residence, physical mobility, belonging, or usefulness – all of which produce a grief response.

by Sheldon Ornstein Ed.D, RN, LNHA

             There are many individuals in their later years who question their continued mental functioning with this thought, “Will I become senile?” The fear of growing old casts a shadow over many lives in our society long before the first deep wrinkle announces that old age has arrived. Yet, most people retain resources and powers well into and far beyond what we or they imagine.