Impairments = Missed Opportunities

Reduced mobility creates hardships for seniors interacting with the world around them. When one experiences falls, broken hips, broken wrists, lower back pain and or a reduction in or cessation of driving, opportunities for interpersonal communications diminish.

My grandfather developed severe back pain brought on by a crushed disc in his lower back earlier this year. Lower back pain in the elderly is common, as a recent national survey proved that in “patients aged 75 and older…back pain is the third most frequently reported symptom” (Bressler, et. al., 1999). His back pain caused him trouble walking and difficulties rising from chairs, walking up stairs, walking to the phone, and getting in and out of vehicles. Additionally, just a few months prior, he suffered a fall that resulted in a broken wrist. The broken wrist reduced his ability to write and in combination with the loss of mobility from the lower back pain, he experienced a lack of communications with family and friends.

While the impairments in the ability to walk and write do not initially sound related to traditional communication barriers like hearing or vision losses, they have affected my grandfather’s ability to do many things related to interpersonal communication. He is no longer able to walk to the phone fast enough to answer it. When he finally does receive a phone call, he seldom holds the phone for long because of the pain in his wrist. When someone comes to his front door, he seldom makes his way across the house to open the door quickly enough. He no longer writes letters or sends birthday cards to friends and family. These impairments have led him to hire a caregiver to run errands for him, drive him and write out checks for him, though the caregiver’s assistance does not improve his communications with outside family, friends or society.

Further compounding the lack of communication that my grandfather experiences with avoiding calls and not writing, is the fact that he has ceased driving due to the lower back pain. Now that he must rely on the caregiver’s schedule for transportation, it has lessened his opportunities for outings and social interactions. “The older person who reduces or ceases driving bears the brunt of the changes that occur in terms of monetary, social, psychological, and emotional costs” (Burkhart, 2007). Knopp (2009) notes, that “isolation and loneliness experienced by nondriving seniors can result in deteriorated physical and mental health.” Plus, older drivers who generally drive on six outings per week usually reduce outings down to two per week when they become reliant on receiving rides from others (Burkhart, 2007). Hence by discontinuing driving, my grandfather has lost additional opportunities to engage socially with others outside his home.

Sadly, the number of seniors who do not drive is not as uncommon as one might think. “SCOPE, the community planning group, cites national research indicating that about 21 percent of Americans age 65 or older don't drive and that, on any given day, 50 percent are home-bound due to lack of transportation options” (Knopp, 2009).

Falls in the elderly are also not uncommon. Warshaw (2006) reports that “after age 85, over half of women will suffer a fall” while “31 percent in the 80- to 84-year age group” of men experience falls. The complications from falls include fractures of the hip, and forearm [or wrist] (Warshaw, 2006). Earlier this month, the Pope at age 82, fractured his wrist when he fell (B92.net, 2009). A good friend, Marie, who was in her mid-70’s when she fell on pavement broke both her wrist and hip. “Because bones become brittle with age, fractures are common among the elderly” (Joseph, 2008). Interestingly, Warsaw (2006) also points out that “after a few falls, some people become so frightened and anxious that they will not attempt to stand even when there is adequate help and support.” As people become afraid to stand or walk after falls, they are not likely to return to outings that require walking or standing which also decreases their opportunities for interpersonal communications with friends, family and society.

When Marie experienced the impairments of a fractured wrist and broken hip, I witnessed a loss in her interpersonal communications. Like my grandfather’s experience, Marie’s reduced mobility in walking and writing, resulted in her not taking telephone calls, seldom answering the door and the end of her writing to friends and family. Additionally, Marie had been a very social person before her accident and had engaged in many senior group tours overseas and spent much of her time out with friends shopping and dining out. Her reduced mobility led to the end of her overseas vacations as well as her social outings with friends.

When looking at the losses of mobility from back pain, falls, broken wrists and broken hips, compounded with the cessation of driving, it becomes clear that seniors and the elderly lose opportunities for social engagement as mobility is reduced and they become increasingly homebound. Thus, even impairments unrelated to hearing and sight can equal losses in interpersonal communications for seniors and the elderly.

References
Bressler, H., et. al. (1999, Sep., 1). The Prevalence of Low Back Pain in the Elderly: A Systematic Review of the Literature. Lippincott Williams & Wilkins, Inc. Retrieved from: http://journals.lww.com/spinejournal/pages/articleviewer.aspx?year=1999&issue=09010&article=00011&type=abstract

Burkhart, J. (2007, Jan. 30). Mobility Changes: Their Nature, Effects, and Meaning for Elders Who Reduce or Cease Driving. Ecosometrics Incorporated. Retrieved from: http://trb.metapress.com/content/dlk6vw1r15245554/

Joseph, T. (2008, July 28). Colles’ Wrist Fracture. Medicine Plus. Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/article/000002.htm


Knopp, T. (2009, July 12). Nonprofit service helps seniors retain mobility. Herald Tribune. Retrieved from: http://www.heraldtribune.com/article/20090712/COLUMNIST/907121023/2080/OPINION?Title=Nonprofit-service-helps-seniors-retain-mobility.

Pope Falls and Suffers Broken Wrist. (2009, July 17). B92.net. Retrieved from: http://www.b92.net/eng/news/world-article.php?yyyy=2009&mm=07&dd=17&nav_id=60560

Warshaw, G. (2006, Apr. 10). Falls and the Elderly. University of Cincinnati. Netwellnes.org. Retrieved from: http://www.netwellness.org/healthtopics/aging/faq9.cfm

All content © Village Memorial. 2009-2010.

The Whales of August

Having recently been catching up on the long, historic career of Bette Davis, I was looking forward to watching one of her last films, “The Whales of August.” In the film, Bette Davis and Lillian Gish play elderly sisters. Bette’s character, “Libby” is blind and her sister “Sarah” (Lillian Gish) cares for her and maintains the home they share.

This film shed a very positive light on aging. Seniors were depicted as independent and able to care for themselves. They helped each other instead of relying on younger friends, family or caregivers. I wish I saw more of this in television and advertising. The only other media depiction of seniors I’ve seen that comes close is the “Golden Girls” where the women support each other through life’s events. However, even one of the characters on the Golden Girls, (Sofia), is cared for by a younger, though senior aged, daughter.

“The Whales of August” depicts seniors as active (walking, cleaning, cooking, maintaining health and wellbeing, visiting friends, paining oil paintings and arranging flowers). The characters blend their past, present and futures in healthy ways as they hold onto and honor traditions, but still find enjoyment the present and find future events to look forward to.

What was also notably different in this film was the way the characters embraced aging. Blind Libby asks her sister if her hair was as white as a swan. When her sister says she believes it is, Libby comments that she’d always had beautiful hair. I cannot recall any film or media character embracing age so gracefully. The two sisters in the film also dressed up for company and took great pride in the care of their hair. They did not complain about their age, appearance, or life. While I do not see this as being realistic for many, as many people have real problems to contend with, I do see it as a model for enjoying life.

By not focusing on the negatives (not once does Libby complain she is blind or cannot see what others are discussing - photos, jewelry, flowers, ocean view), there is more time to focus on the positives or approach things a new way. For instance, blind Libby is able to feel the flowers, jewelry, or sunshine, and hear a description of the photographs. She even agrees to the installation of a picture window in their living room, though she won’t be able to see out of it herself. She comments on how nice the day feels by the warmth of the sun coming in through the window. Libby depicts a woman who is perfectly content with these filtered observations, and I imagine the lesson to viewers is to enjoy interacting with others regardless and not feel sorry for oneself.

Anderson, L. (Director), Berry, D. (Writer). (1987). The Whales of August. [DVD]. USA: MGM.

All content © Village Memorial 2009-2010.

Seniors & Communication - 4 Important Issues

Medical Needs Must Be Communicated
Mr. S., an artist in his 80s, kept communicating to a friend a plaguing pain he was dealing with. Although Mr. S had seen his doctor for other issues he only communicated his current problem to a close friend, never his doctor. Finally, when he became too ill to ignore his problems, he went to ER and it turned out that he had an advanced stage of prostate cancer. Had Mr. S. communicated to his physician earlier of the pain he was experiencing his condition might have been curable.

When seniors do not communicate their issues and concerns to the health professionals treating them, they do not get the proper care they need. This results in less productive office visits, which in turn would likely end up costing them more (financially and health wise) as they might require additional follow up appointments to diagnose problems and if a condition were serious it might not be as treatable upon later diagnosis.

Physical Impairments Preventing Communication = Depression
The National Institute of Mental Health has proved the “relationship between hearing loss and depression” due to the social isolation the impairment causes. Additionally, I would add another couple impairments to this list: walking and writing.

Mrs. R, a good friend and elderly neighbor in her late 70’s, fell on pavement. Her fall resulted in a break of her right wrist and hip. She discontinued writing letters (because of her broken wrist) and shopping, eating out, or getting together with friends (because her walking was impaired by the accident.) It was even a chore for her to walk to answer her telephone. Although her body seemed to have healed several months later, she never returned to writing friends and family from out of state, she seldom answered telephone calls, and she gave up walking to do her own errands (shopping, bank, Laundromat). A once vital and independent person became socially withdrawn and very depressed once she no longer was able to communicate and perform the tasks she once had.

Lack of Communication With Regard to Government Benefits/Programs
It has been proven that “many retirees are not receiving an appropriate level of care or are ending up in nursing homes because they don’t know about services that would have allowed them to remain independent.” On the flip side of this, some seniors might not even be aware of programs or services that can help them afford retirement/assisted living homes, by significantly reducing their financial burden.

Mr. P, a WWII vet who recently moved into a retirement home, found he could benefit from Veteran’s Assistance when he was choosing his retirement home. The small 1-bedroom apartment in the transitional retirement to assisted living facility would have cost he and his wife $4,000 a month. However, because the home communicated the veteran’s discount to him, and provided him the necessary paperwork to fill out, he was able to register for a discount program that cut his monthly rent at the retirement home by 50%. For his $4,000 rental, he pays $2,000. For seniors living on fixed incomes, a financial saving of this proportion is crucial.

Senior Suicides and Mental Health Issues
It was most startling to learn of the number of suicides that take place among the senior population. While their percent of the population is just at 13.7%, they still make up “at least 25-30 percent of all successful suicides.” It is interesting and disturbing, how few senior suicides are brought to the attention of the public. Most news sources focus on suicides up through middle-aged adults. I actually cannot recall having heard of senior suicides before, other than in cases of the terminally ill where the individual chose when to end their life and suffering. This fact is one that should be communicated to society more widely. Without proper knowledge of issues such as senior addictions, senior mental health impairments and senior suicide rates, less attention is being paid to the very individuals who would benefit from the attention most.

All content © Village Memorial. 2009-2010.