In my early days as a researcher, I had proudly produced what I believed to be an excellent piece of research only to be told – after the fact, of course – that it wasn’t what sponsors were looking for. It was easy to blame them; their real dissatisfaction was a result of hoping for a fairy tale with a happy ending and getting the facts of life instead. The big realization for me was how I had failed to get all involved to agree on the definitions of what we were looking for before we started, and I vowed it wouldn’t happen again. Years later, along came an assignment that was to focus on the attitudes and behaviors of a highly targeted elderly population. Like many words, “elderly” is defined in many ways, and we needed to ensure that sponsors and investigators agreed upon just what elderly meant for our purposes and why. Before continuing, pause briefly and say out loud your definition of “elderly.”
How many of these things does your definition of elderly include?
The most common way to define elderly is by age. Not so simple as it seems, we found definitions of 55, 60, 62, 65, and 70 in published studies. These differences made age-based data comparisons from one study to the next quite useless. Another way of looking at age is through the eyes of the beholder. When we were children, 18 was old. When we were teenagers, 40 was ancient. To a 60-year old, 80 is elderly. Dictionaries say elderly is defined as “characteristic of later life” and “showing signs of age.” Less attractive synonyms include “over the hill” and “on one’s last legs.”
So what are some of the signs that are characteristic of later life?
The process of aging is a biological reality that occurs at different rates for different people. Some in their 70s are highly active; others in their 50s are well into decline. Many people with excellent vision are surprised to find they need reading glasses when they are in their early 40s.
Age-related decline results in the gradual accumulation of disabilities involving hearing, seeing, and getting around. Aging begets disabilities, usually gradually. There is an entire class of impairments that are age-related, and not congenital or the result of an accident. These are generally the result of the gradual and inevitable decline of our bodies, minds, and senses.
Foremost among age-related problems are a reduction in or loss of vision and hearing. We all recognize blind people by their canes, but have to pay much closer attention to identify people with poor vision. We also recognize older people by their difficulties with walking, climbing stairs, maintaining their balance, getting up and down from their seats. Who hasn’t felt sympathy for someone’s grandmother shakily approaching an escalator with the very real fear of losing her balance and falling? Age-related cognitive decline is not apparent from a distance. Cognitive decline is likely to leave the person who can’t remember things or struggles to follow instructions with anxiety, confusion, and disorientation.
It’s not like stepping though a doorway as a fully-functioning adult and coming out the other side as a blithering idiot.
For most, it is more like slowly going down a very long slope. As our skills decrease, our feelings of disorientation, frustration, and anxiety increase. And these emotions lead to feelings of vulnerability, which is defined as “needing special care, support, or protection because of age or disability.” We ended up evolving a more holistic definition that included chronological age, but was more focused on diminishing physical, sensory, and cognitive skills. We created a Continuum of Declining Abilities.
Examples of minor levels of decline are:
- Physical. Reduction in one’s ability to walk and maintain balance.
- Sensory. Reduction in one’s ability to hear and see.
- Cognitive. Reduction in one’s ability to remember.
Examples of moderate levels of decline:
- Physical. Needing assistance to walk or stand, such as with a cane or walker.
- Sensory. Needing hearing aids, glasses, and magnifiers.
- Cognitive. The ability to function mentally is restricted to comfortable, non-threatening situations.
Examples of severe levels of decline:
- Physical. Unable to walk or stand unassisted.
- Sensory. Unable to hear or see.
- Cognitive. Unable to function mentally.
Never assume we all share the same definitions: always create your own team-evolved definitions.
What is your definition of elderly now?