Aging is as natural as sunlight. Still, during 99% of human history, most humans did not live past the age of forty due to primitive technologies, sciences and medicines. Today, aging past 65 may is no longer a novel act. According to the Hamilton Project, more than one in three women and one in five men who are age 65 today will live to age 90. That brings with it a new set of challenges.
Though we may want to look into the mirror and see the fairest of them all – a beckoning call to the days that felt as young and hopeful as Snow White – our bodies are no longer sleek. Long gone are the moments of humming like an Aston Martin, as we’ve transitioned to an old Cadillac, replete with oil leaks and a sputtering engine.
And it’s not just a few of us gliding into the twilight years. In the coming decades, millions of Americans are reaching senior citizen status. In fact, the baby boomer generation – 78 million strong – will be over the age of 65 by the middle of the century, reports the Census Bureau. This means that 1 in 5 Americans will be a senior citizen – the largest group of older citizens in American history. In addition to the United States, the world’s population of elderly folks will double – from roughly 500 million to nearly 1 billion adults over the age of 65 by 2030.
With the turn in demographics, a challenging question is posed for policymakers and health care professionals: how does our society prepare for and take care of an older population? More importantly, this population of Americans are experiencing upward trends in substance abuse, chronic pain, disease and other physical maladies, grief and loss, suicide, and process disorders such as gambling, financial issues, excessive shopping, disordered eating, etc. Accompanying these issues is an increase in depression and anxiety. These multiple forces – the greying of baby boomers and increase in addiction and physical and behavioral health issues amongst this group – are merging together and creating a cacophony of dilemmas in our country and abroad.
What factors are driving these struggles amongst aging adults? First and foremost, as we age one experiences physical changes in the body. Our bodies endure wear and tear, eyesight changes at least 4 times in a lifetime. We may require hip and knee replacements, surgeries, rehab and physical therapy. Other diseases that arise from physiological changes and aging include arthritis, heart disease, cancer, Alzheimer’s, osteoporosis, diabetes and obesity. In addition to the financial strain this may put on aging folks and their families, these maladies open the door to chronic pain and co-occurring issues.
Chronic pain syndrome is a serious condition – pain that lasts beyond 90 days and remains even after the source has healed – affecting 133 million Americans (1 in 5 adults globally), many of which are in this aging demographic. Since many adults in this population are readily prescribed medications for their ailments, including opioid painkillers for chronic pain, the door is opened to substance abuse and addiction. In fact, 30% of all prescriptions in the U.S. are given to adults over 65, which represents a mere 13% of the population.
Physical changes, chronic pain and the ensuing over-prescribing aren’t the only culprit. Life transitions such as retirement, children growing up and moving away, grief related to loss of loved ones, and even depression, loneliness and isolation can trigger a substance abuse, mental health or process disorder. According to SAMHSA, alcohol and drug abuse is one of the fastest growing healthcare problems for Americans 60 years and older. In fact, alcohol is the most widely abused substance for Americans over the age of 50, nearly 50% of nursing home residents have alcohol related issues, and widowers over 75 have the highest rate of alcoholism in the U.S.
Despite substance abuse issues being a major problem for aging adults, there are certain barriers to treatment this population may encounter. Some barriers include:
- Misdiagnosis – doctors and healthcare professionals may believe older Americans won’t have a cocaine or marijuana addiction (because it is assumed only younger people abuse these drugs) and will instead look to other symptoms.
- Shame & stigma – family and friends close to the individual don’t want to talk about real struggles. For instance, STD’s are a major health concern for this population, as dramatized in this humorous physician written & performed public health Youtube video, yet few will discuss sex because of shame and taboo surrounding the topic.
- Ageism – a belief that time and resources should not be spent on these individuals because they are too old or won’t be open to changing and improving behavior.
- Denial – family and friends may look the other way or explain it as “the only thing that makes grandpa or grandma happy.”
Mental health issues such as anxiety and depression, suicide ideation and mood disorders also cause problems in the aging population. The CDC reports that 1 in 15 people who are 65 and older experience depression, which contributes to 20% of all suicides per year. Unfortunately, only 10% of the 65 and over crowd who suffer from depression seek out help. If this group of people are going to double in the next 30 years, it behooves healthcare professionals and lawmakers to bolster healthcare programs for elderly folks. We can’t put it off until the problem doubles in size.
Another growing trend is gambling and casino visits. Since senior citizens may feel isolated or lonely, they visit casinos for socializing, entertainment, food and drink and distraction from what ails them. Once inside, elderly folks are at risk for overspending and gambling because they have expendable cash, drink alcoholic drinks which can disrupt medications, and lose the ability to make sensible decisions. Casinos cater to this behavior – some supply scooters, wheelchairs and oxygen tanks, encourage birthday celebrations, and may even have discard boxes in bathrooms for insulin injections.
Aging adults are also susceptible to online scams. Because this population is not comprised of digital natives (analog devices and rotary phones ruled the day), online fraudsters that peddle the grandparent scam, medicare fraud, mortgage and funeral scams get away with cheating vulnerable older folks out of their money. Online dating for senior citizens also boasts its own share of fakes and frauds, reports CBS News. “According to the FBI, [romance scammers] fraud cost users nearly $82 million… many of those being targeted are senior citizens longing to get back in the dating pool.”
If the aging population is growing and troublesome issues such as substance abuse, mental health, chronic pain and process disorders are on the rise within this cohort, we’re charged with implementing lasting solutions to ensure economic and social vitality for all Americans. As I wrote in my recent piece on coming into middle age, aging doesn’t have to be about taking something from us, it can be and MUST BE about giving us the tools to become a better version of ourselves. Our twilight years can be just as fruitful and productive as the ones that came before.
In many ways, life and the process of growing old is like baseball. Life will pitch you some curveballs, but the important thing is that you are at the plate, taking swings. As such, we all must become vigilant and open in our policies and practices. We must create a society in which age is celebrated – not put on a plastic surgeon’s shelf lined with fillers. To do so we must start by:
- Educating professionals and students by building a culture of change and raising consciousness
- Engage regional leadership and governments
- Build public awareness and seek broader support and participation
- Create intergenerational publications, living centers etc
- Challenge ageism by improving images
- Disseminate targeted messages across key sectors by Age Wave
- Create specialized tracts for older adults
- Set up peer mentorship programs
Last week I was consulting at a center. I met Tom (alias) who was my age, 72. He had been a successful broker and alcohol took him away from his values as well as his family. His wife was bitter and angry. She admitted she drank too much. Their adult son was weary from their fights. In time, together this family worked through their struggles and discovered joy and hope.
There are so many more Tom’s and Wendy’s out there. So don’t throw grandmother or grandfather under the bus. Let us acknowledge the problem and work together on an individual, community and world-wide level to improve our perceptions and our practices. As I do each and every day, look in the mirror and be grateful for your life as you are one day older! To Aging! Let us celebrate, cheer, rejoice and plan for the future!