Senior Citizens as a Vulnerable

Senior Citizens as a Vulnerable Population

In recent years there has been a change in the perception and understanding of the ageing population and what it means to be an elderly or senior citizen. While many assume that the elderly are much better off in the contemporary world than in past historical periods, yet research reveals that in many instances the elderly are still a very vulnerable population demographic.

On the other hand it is also true that prospects for the elderly have improved considerably since approximately the middle of the Twentieth Century. This includes aspects such as improved medical research, which has provided the elderly with more positive health and healthcare possibilities. There is also the fact that in the majority of developed countries the elderly are in a position to enjoy old age more, with easier access to modern amenities and technology. This is also helped by an increasing emphasis in many sectors on learning and personal development after retirement.

However, despite these more positive aspects, the elderly and senior citizens in countries like the United States and Canada are still vulnerable to many facets of society and life in general. This vulnerability can include physical and health dangers as well as a myriad of psychological and socio-cultural aspects which may cause the elderly to be more susceptible to depression, crime and abuse and many other variables.

There are, for example, many reports of elderly abuse within families and from other sectors of society. The elderly are often considered to be a 'nuisance' or as redundant and without purpose or function in society. They are often vulnerable in that they are sometimes treated with disrespect and are open to abuse and intolerance. There have even been reports of abuse of the elderly in old age homes and institutions (Abuse of the elderly). Furthermore, the decline in the number of institutions that care for the elderly in the last decade has increased the vulnerability of the elderly to abuse from other sectors of the society.

The vulnerability of this age group is also related to demographics and to the increase in the numbers of older people in many developed countries. Canada is a case in point and research indicates that, "While only 5% of the population was age 65 and over in 1921, the figure had risen to 12% in 1991" (Enhancing Safety and Security for Canadian Seniors: Chapter 2: Vulnerability in Later Life). In addition it is estimated that by the year 2026 more than fifteen percent of the Canadian population will be older than sixty-five years. These figures therefore indicate that the problems, such as healthcare and finances that are being faced by the elderly individual today, may be exacerbated in the future

This paper will explore the various aspects of vulnerability among the elderly and the way that these vulnerabilities are experienced. An attempt will be made to build a clear and comprehensive overview of these vulnerabilities and to present a realistic picture of what old age really means and how it is experienced.

Physical vulnerabilities

In the first instance the elderly are vulnerable from a physical point-of-view. It should be remembered that independence and the ability to be self-sufficient are important aspects of life and normal well-being. As one grows older these aspects may be compromised by ill-health or the biological progress of ageing, which in turn make the individual more vulnerable both physically and psychologically. There is a common fear that old age means illness and dependency on others.

This situation of vulnerability can be inferred from most definitions of old age. For example, a definition that takes into account the decline in health and functionality that can be a part of the ageing process is as follows; "... aging refers to the biological process of growing older in a deleterious sense, what some authors call "senescence"..." (What Is Aging? Definitions and Concepts in Gerontology). Senescence is understood as a progressive functional decline in the individual or as "...a gradual deterioration of physiological function with age, including a decrease in fecundity, or the intrinsic, inevitable, and irreversible age-related process of loss of viability and increase in vulnerability" (What Is Aging? Definitions and Concepts in Gerontology).

In other words, senescence as a component of ageing refers explicitly to the aspect of an increase in the vulnerability of the individual to physical as well as other factors. Simply stated, the bodily senses and functioning begin to deteriorate. While these physiological changes related to old age are part of the natural life process they also "...limit our normal functions and render us more susceptible to a number of diseases" (What Is Aging? Definitions and Concepts in Gerontology).

The types of changes that are commonly perceived as part of the ageing process can involve a wide range of factors. These can include a lower metabolic rate which can lead to lower reaction times as well as a decline in memory functionality and sexual activity. Commonly noted facts of ageing are a significant decline in audition, olfaction, and vision, declines in kidney, pulmonary, and immune functions, as well as declines in exercise performance, and multiple endocrine changes. (What Is Aging? Definitions and Concepts in Gerontology)

It should also be emphasized that these facts are not always present in the elderly and not every older person suffers from these facets of physical decline. In other words, the aspects that makes the elderly more vulnerable are not inevitable and not necessarily an ineluctable factor of ageing. However, these facts are generally found to be present in the ageing population and they contribute to the vulnerability that is experienced by many senior citizens. This view is also supported by other general definitions of ageing; for example, "Aging is a constant decrease in the capacity to do things, both physically and mentally, and a constant increase in age-related diseases" (What is the simplest definition of aging?).

Older people the therefore more prone and vulnerable to suffer from various disabilities and diseases compared to younger age groups. Statistical data indicates that "... By age 85, about one half of Canadians experience at least one disability in relation to sight, hearing, cognition, mobility or manual dexterity" (Enhancing Safety and Security for Canadian Seniors: Chapter 2: Vulnerability in Later Life). This factor should also be taken into consideration in terms of safety and security. Due to the fact that senior citizens are more likely to have poor vision and hearing makes them more vulnerable to intruders and criminal attacks.

The Types of sensory loss that seniors often experience, and which consequently can cause them to be more vulnerable, includes the deterioration in the ability to communicate with others and to express themselves clearly. For instance, if the elderly person is not able to communicate his or her feelings adequately, then this may have an adverse effect on health; for example, when an ill individual is unable to communicate or articulate feelings and symptoms to a healthcare worker. As a medical professional states, "...Communication with elderly surgical patients is essential to perform accurate patient assessments and to identify perioperative nursing diagnoses" (Hazen, S. et al., 1997).

One of the most common and debilitating aspects of old age is the loss of vision. As one statistic points out, deterioration and loss of vision is one of the most reported health complaints in patients over forty years of age. (Hazen, S. et al., 1997) a prevalent type of sight loss among senior citizens is Presbyopia. This is defined as a condition in which the lens of the eye loses its ability to focus, making it difficult to see objects close-up. (Presbyopia)

Aspects such as the reduction of smell may also make the senior citizen more vulnerable in certain instances. A study entitled Odor Memory in Normal Aging and Alzheimer's Disease by Steven Nordin and Claire Murphy (1998) notes that, "... both immediate and delayed recall of odors, both free and cued, as well as the ability to learn across trials is impaired in normal aging" (Nordin S. And Murphy C. 1998, p. 686) Studies also note that a loss of the sense of smell is a contributory factor in the malnutrition of senior citizens.

There are many other factors relating to physical vulnerabilities among this age group that could be mentioned. These include the loss of hearing as well as a loss of the sense of balance. "Ten percent of adults 65 to 75 years of age and 25% of those older than 75 years of age have a hearing loss" (Hazen, S. et al., 1997).

All of these and other factors can make the elderly person more vulnerable to mishaps and health issues.

Social and cultural vulnerabilities.

There is a general consensus that the number of elderly and senior citizens is increasing in the world. This fact has a number of consequences in terms of the care and quality of life for senior citizens. In essence, what this means in terms of vulnerability factors are that the social requirements for dealing with a burgeoning number of elderly people has increased and become strained. While it is true that in many countries like Canada there has been a reduction in vulnerabilities such as poverty among the elderly, it is equally true that;

some 3.3 million seniors still live below the poverty line Good housing and proper medical care are often out of reach for the poor elderly -- or so expensive that little money is left over for other needs. Hundreds of thousands of elders go hungry every month. (Callahan, 1999, p. 74)

Poverty is however also a strong indicator of elderly vulnerability in Canada; where the lack of resources is also linked to safety and security issues. Many elderly people live alone and they become more vulnerable to abuse and attack if they so not have enough funds to afford adequate home security. As one Canadian resource notes; "Examples include safety devices that would reduce their chances of a fall or an alarm system that would protect against break-ins" (Enhancing Safety and Security for Canadian Seniors: Chapter 2: Vulnerability in Later Life).

Allied with this view is the perception that senior citizens who do not have the necessary finances are unable to take part in educational and health and fitness programs, which may help to reduce their vulnerability. The following tables provide some indication of the number of elderly people who live below Canada's low-income cut-off. It is significant in terms of vulnerability factors that the number of those who live alone tends to increase with an increase in age.

Figure 1. Percentage of older people below Statistics Canada's low-income cut-off, by Age, Sex and Living arrangements, 1991.

Females (%)

Age group

Living alone

With spouse

With others

1984-56

1984-2009

1984 -- 2009

1984-2009

Males (%)

Age group

Living alone

With spouse

With others

Source: Statistics Canada 1995: (http://www.phac-aspc.gc.ca/seniors-aines/pubs/enhancing/chap2_e.htm)

Related to the above is the important issue of medical insurance and assurance for the elderly. While in many countries this is a central area of concern and contention, the Canadian situation has been noted for its insightful and comprehensive approach.

One aspect that is mentioned is Ontario's program of Human Habitat. This program is based on a concept called the Eden Alternative which "...emphasizes a holistic atmosphere of a living environment." Home care is another aspect of the Canadian governments attempts to enhance the self-worth of the elderly by helping them live in their own familiar homes with dignity and comfort. (Cheng-tek) This is also bolstered by other studies which state that "Canada's health care system is frequently offered as a model for American national health insurance" (Barer and Clyde Hertzman, 1992, p. 763).

The elderly are also made vulnerable in terms of ageism and social and cultural stereotypes that are often used to typify and denigrate their sense of self-worth and self-esteem. The Ontario Human Rights Commission describes ageism as "...a tendency to structure society based on an assumption that everyone is young, thereby failing to respond appropriately to the real needs of older persons" (Ageism: Canadian Network for the Prevention of Elder Abuse). This is also related to negative stereotypes about the elderly. A Canadian report underlines the way in which ageism make the elderly person more vulnerable.

Ageism is pervasive in Canada and many other societies...It is very common to see the individual and broader social problems that older people face, being rationalized or discounted out of hand. Serious social and legal problems affecting older adults such as abuse and victimization by family, staff, or people in position of authority may be characterized as "rare events"

(Ageism: Canadian Network for the Prevention of Elder Abuse).

In other words, abuse of senior citizens sometimes becomes 'rationalized' or accepted by the society and not questioned as being abnormal. Furthermore, the Ontario Human Rights Commission notes that abuse of older adults '...occurs in large part due to negative attitudes towards older people or their economic or social vulnerability" (Ageism: Canadian Network for the Prevention of Elder Abuse).

Other social factors such as lack of adequate housing can also make the elderly more vulnerable. This refers particularity to those individuals who may have certain illnesses, impediments and limitations which require specialized accommodation - for instance, those who cannot climb stairs or those who require a regulated temperature.

A crucial factor with regard to security and the physical and psychological well-being of the senior citizen is the family. In most developed countries of the world there has been a decline of the extended family. This is a central factor in elderly vulnerability as the extended form of the family usually provides a safe and caring environment for the elderly person. The virtual demise of the extended family in many areas of the world has therefore resulted in the elderly individual becoming more vulnerable.

For example, as one study notes, there has been a "...notable shift... In many of the world's nations from the extended family-kinship system to the nuclear family kinship system." (Popenoe, 1988, p. 46/47) This has reduced the social and personal support structure of the elderly in modern society. Consequently, with the decline of the family as a support structure the aged may find themselves forced to live in unsafe and uncomfortable living arrangements. They may also be 'farmed out' "...to spend the rest of their days in clinical old age 'homes or small apartments to care for themselves " (Tobin and Lieberman, 1976, p. 1).