Socio-Eonomic Status of Elderly of Bangladesh: A Statistical Analysis

M. Taj Uddin, Md. Nazrul Islam, Md. Johurul Alam and Gias Uddin Baher

ABSTRACT
The present study was undertaken to gather overall information on socio-economic
and health profiles of the senior citizens of Bangladesh based on primary data of
from the three selected districts of the country. Simple statistical tools and logistic
regression model are used to analyze the data. The analysis shows that 46% of the
physically sound elderly are jobless and 15% arent engaged in job due to lack of
physical fitness and other causes. The logistic regression analysis reveals that
respondents age, level of education, physical fitness are significantly associated
with the current occupation of elderly people.
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How to cite this article:

M. Taj Uddin, Md. Nazrul Islam, Md. Johurul Alam and Gias Uddin Baher, 2010. SocioEonomic Status of Elderly of Bangladesh: A Statistical Analysis. Journal of Applied
Sciences, 10: 3060-3067.

DOI: 10.3923/jas.2010.3060.3067

URL: http://scialert.net/abstract/?doi=jas.2010.3060.3067

Received: July 24, 2010; Accepted: September 15, 2010; Published: October 14,
2010
INTRODUCTION

According to UN by the year 2025 the total number of elderly people in the world
will reach at 1200 million, which indicates that by this time 15% of the total
populations will reach 60 year or more (UN, 1997). UN also stated that the world is
experiencing an age-quake. Every month, one million people reach at 60 years of
age. In 1999 there were 593 million elderly people in the world and this figure will
be triple to nearly 2 billions by the year 2050 (UN, 1999). It is true that the number
of elderly people is increasing rapidly in the developed countries but it is also
increasing in the developing countries with a great speed. More than half of the
worlds older population lives in developing countries (UNFPA, 2002). In fact, the
number of elderly people is increasing day by day in a very alarming rate. In the
USA, there are a lot of care services for their elderly people. There are old homes,
day-care centers and elderly societies for elderly people. Eberstadt (1997) found
that population aging is a great challenge for the health care systems as nations
age, the prevalence of disability, frailty and chronic diseases, Alzheimers disease,
cancer and many other diseases is expected to increase dramatically. Rush (2006)
found that the incidence of lifestyle diseases increases among the elderly people
over the whole world which is not a sudden onset phenomenon but an accumulation
of changes in the expression of genes in response to nutrition and environment from
conception.

In Bangladesh, over the past decade there has been a significant decline in infant
and child mortality rate. Control and prevention of diseases, such as measles,
poliomyelitis and diphtheria along with extensive use of oral saline for diarrheal
diseases have greatly reduced childhood mortality, Bangladesh is on the margin of
Polio eradication and has already achieved the elimination goal for leprosy at the
national level. Kabir (1987, 1994) found that in poor families, both in rural and
urban areas, older people often unable to meet the demand due to extreme poverty
where food is the top priority needs. Ismail Hossain et al. (2006) found that aged
people in Bangladesh are mostly suffered from various complicated physical
diseases and the number is increasing day by day but the services provided through
government hospitals are inadequate in compare to needs. A small proportion
(around 6%) of the total population of Bangladesh constitutes the elderly
population, but the absolute number of them is quite significant (about 7.2 million)

and the rate of their increase is fairly high. This change in population characteristics
will have serious consequences on society as well as on the overall socio-economic
development of the country (Banglapedia, 2006). In order to improve the lives of
older people in Bangladesh, the national health system should allocate resources
and design strategies to prevent and treat chronic disease. After the independence,
the government of Bangladesh initiated some programs like pension, gratuity,
welfare fund, aged fund (Boyosko Bhata), group insurance and provident fund for
retired government officials and employees. SSocio-economic and health care issue
of the elderly people in Bangladesh has not yet gotten any importance though it is
increasing alarmingly. The following table of population projection of Bangladesh
may knock our sense to take proper steps for the health care issue of our elderly
people.

Adult children, particularly sons, are considered to be the main source of security
and economic support to their parents, particularly in the time of disaster, sickness
and in old age (Cain, 1986). As an Asian country, Bangladesh has a long cultural and
religious tradition of looking after the elderly and it is expected that families and
communities will care for their own elderly members. But rapid socio-economic and
demographic transitions, mass poverty, changing social and religious values,
influence of western culture and other factors, have broken down the traditional
extended family and community care system. Most of the elderly people in
Bangladesh suffer from some basic human problems, such as poor financial support,
senile diseases and absence of proper health and medicine facilities, exclusion and
negligence, deprivation and socio-economic insecurity (Rhaman, 2000). Aging is
one of the emerging problems in Bangladesh. This problem has been gradually
increasing with its far reaching consequences. A clear indication of increasing
Bangladesh demographic aging process has been found in the works of Nath and
Nazrul (2009) and Islam and Nath (2010). The present study is done to gather
overall information on socio-economic and health profiles of the senior citizen in
Bangladesh. This is motivated by the recognition that the best approach to enhance
the aged people's welfare in Bangladesh is to increase their self-reliance and to
provide them proper health care facilities so that they can make themselves to have
contribution to their family as well as their society. Specifically it tries to investigate
the determinants those influence the socio-economic specially job status of the
elderly people in Bangladesh.

MATERIALS AND METHODS

The present study was based on data collected from three selected districts (Sylhet,
Mymensingh and Noakhali) of Bangladesh during October and November in 2007. A

questionnaire was adopted. A pilot survey was taken to make reliable and concise
questionnaires. Personal interview approach was followed for data collection from
the field. The districts and areas within the districts are selected purposively and
random sample was collected from the selected areas of each district. Finally a
sample of 300 elderly people were selected for interview where 100 from each
district. The data were analyzed by SPSS. Frequency distribution table and logistic
regression model were used to analyze the data.

Variables for the Logistic Regression Model

Dependent variable (Y): Occupation of the Elderly (coded 0 for not in job and 1 for
the elderly at job).

The explanatory variables used in the model are:

X1 = Age of the respondents (coded 1 for 60-64 years, 2 for 6569year and 3 for 70 and above)

X2 = Looking after family (coded 0 for others and 1 for yourself)

X3 = Level of education of the respondents (coded 0 for literate and 1

for illiterate)

X4 = Monthly income (coded 0 for 0-5000.00Tk. and 1 for 5000.00Tk.

and above)

X5 = Present state of health (coded 0 for not good and 1 for average)

X6 = Present physical problem (coded 0 for heart disease, 1 for

diabetes and 2 for others)

X7 = Bearing of medical expenditure by son and daughter (coded 0 for

noand 1 for yes)

X8 = Ability to remember important events of childhood or student life

(coded 0 for noand 1 for yes)
RESULTS AND DISCUSSION

Bio-demographic characteristics of the elderly: This part of the study aimed to

gather the basic data about respondents age, gender, religion, marital status (Table
A1 in the appendix). Majority of the respondents are in the age group 64-65
followed by age group 65-69 and 70 and above. Among the respondents 73.3%
were male and 26.3% were female. This finding of the sex distribution of the elderly
supports the work of Hossain (2006) where he observed that female elderly were
much lower than that of male. This may be due to unpaid family labor and sex
discrimination of healthcare and food consumption, more female population in the
study area died than that of male. Among the three hundred respondents 88.3 % of
them are Muslim, 10% were Hindu. About 85% elderly were married and a very few
(1%) were divorced. The remarriage rate of the elderly is higher at Mymensingh
than other two districts. In Bangladesh older people-including married couplestraditionally like to live with their sons. A vast majority of older people (53%) like to
live in joint or extended families (Khan et al., 2006). Among the 300 elderly people
in the study sites 53.7, 33.3 and 13% of them are living in joint, unitary and
extended respectively. Most of the family (43.3%) has the total member between
three and five and only 16.7% of them have up to two members. It was observed
that respondents of these three study sites in respect of level of looking after family
among them 44% were found that still they are able to supervise their family and in
45.3% cases son of the elderly people lead or take care of their family. A very few
cases (2.3%) daughter take care of their family. It was observed that among the
three study sites 80% respondents has number of son not more than three in the
total sample where only 4% of the respondents were found with having number of
sons six or more. About 86% respondents have number of daughters not more than
three.

Socio-economic characteristics of elderly: This part of the survey investigated the

respondents income, expenditure, level of education, occupation, sanitation etc.
(Table A2 in the appendix). Most of the elderly people in Bangladesh live in rural
areas where health and recreation facilities are very limited. The majority of them
are illiterate; economic facilities and job opportunities are limited. More than half of
the elderly are widowed, divorced or single. A large proportion of elderly men are
still in labor force both in rural and urban areas (Abedin, 1996).

The results showed that among the three study sites with respect to level of
education, about 30% of elderly were found educated up to S.S.C. where 8% of
them were found that they were able to read only the religious books the Holy
Quaran, the Geta etc. Hence, it also showed that among three hundred elderly
respondents 45% of them were illiterate. In this study, it is found that 33% of them
were their previous occupation was agriculture whereas, a very few of them were

engaged in fishing. It was also found that 22% elderly were engaged in business
and 15.3% were in Government services.

It was found that 77% elderly using tube well water followed by 21.3% supply water
and only 1.3% pond water. About 49% of the elderly were found with monthly
income between one and five thousand taka where only 10% were found with
monthly income around one thousand taka. Only 11% of the respondents had
monthly income more than ten thousand taka. Again, it was found that 46.7% of
elderly monthly expenditure varies between one and five thousand taka. About 18%
elderly were doing their monthly expenditure within one thousand taka. The poor
number (7.7%) of elderly was living with monthly expenditure more than ten
thousand taka. About 66% of them were dwellers of tin shade house followed by
21% in building and slightly more than 8% in semi-building. Approximately 93 and
84% of them had their own house and land respectively. Most of the respondents
(66%) have electricity facilities. The result also showed that a significant number of
elderly (88%) had changed their economic status last fifty years. About 20% of the
elderly get remittance from their family members. About 46% elderly expressed
that they werent engaged in job due to lack of physical fitness followed by 15% due
to other causes (age limitations, gender discrimination etc.). There were only 2% of
them didnt find work. Majority of the family (54%) use wood as fuel in their cooking
system followed by 22% having gas facilities.

Socio-economic determinants of current occupation of elderly: This section of the

study investigated the factors that are strongly connected with getting the job of
elderly population (Table 1). According to the socio-economic framework of
Bangladesh, current occupation is a vital determinant of measuring socio-economic
condition. More than 70% of men in both rural and urban areas are paid workers
and the proportion of elderly men in paid work is found to decline with increasing
age (Kabir et al., 1998). It was found that most of the cases (63%) elderly people
were jobless whereas only 15 and 14% of them were continuing with agricultural
works and business respectively. This result is worse than that of Tehran city of Iran
where 85% elderly are unofficially employed (Kaldi, 2005). Almost half (45.7%) of
the elderly are illiterate. Among the secondary level educated person 30% were
found with jobless while 35% were found with some sort of jobs.

Similarly, the percent of jobless elderly completed higher secondary and graduated
level are 54 and 74, respectively. The findings reveal a clear indication that the
jobless elderly was increasing according to their level of education. So, it can be
inferred that education plays a key role on the current occupation of elderly people.
Ownership of land also plays an important role on the over all solvency of elderly as

well as their family. According to the present socio-economic framework of

Bangladesh, elderly current job status depends on the number of family members
residing in foreign country. Our sample profile indicates that only a few families
having elderly person get foreign remittance. Again, it is found that maximum
number of elderly without having any job belong lower class family.

Results of logistic regression analysis: In this part of the study, the logistic
regression model was fitted considering current occupation as a dependent variable
and tried to identify different factor that are related to elderly occupation (Table 2).
The odds ratio shows that the young elderly (60-64) are almost three times more
likely to have some sort of job than elderly aged 70 and above. Similarly elderly
aged between 65 and 69 is slightly (1.15 times) more likely to have some job than
the elderly having age more than 70.

Table 1:
Distribution of current occupation of the respondents according to
socio-economic determinants

Values within the afterthought indicate percent of the column. *Significant at 5%

level, **Significant at 10% level

Table 2:
Logistic regression analysis of current occupation according to some
selected background characteristics

*Reference category
These findings indicate a negative association between age of the elderly and
current occupation of them. It was observed that elderly who look after their family
by themselves is 1.53 times more likely to involve with some sort of job than those
whom arent.

Again, there is a positive association has been found between the current
occupation of the elderly with their level of education. It is observed that educated
elderly were 1.42 times more likely to have some sort of job than those of illiterate.
Monthly family income is also associated with the current occupation of the aged
person where higher elderly of higher income family is more likely to involve with
some type of job. Elderly with average health condition is 1.59 times more likely to

continue some sort of job than that with not good health status. The elderly, having
diabetes, are 1.56 times more likely to involve with some sort of job than those of
suffering from heart diseases. It was also found that elderly people who are
suffering from other kind of diseases (high pressure, low pressure and digestion
problem) are 1.74 times more likely to have some sort of job than those who are
suffering from heart diseases. So, there is a significant association between current
occupation and type of physical problems of the respondents. Again, there is a
positive association between bearing medical cost of the elderly by their offspring
and current occupation of them.

CONCLUSION

This study is an attempt to obtain a better understanding about socio-economic and

health status of the elderly people. Various socio-economic and bio-demographic
characteristics that are related to the elderly people had been studied in this study.
From this study, it is found that age of the elderly, educational qualification,
monthly income, present health status, physical problems are statistically
significant with their occupational status. Majority of the elderly are without having
any job. For the betterment of the socio-economic status of the elderly some
initiatives should be started. At first, to ensure the financial solvency of the elderly
people, proper regulations should be developed to encourage their offspring so that
they could help their parents much more. Secondly, employment opportunity should
be made for the elderly people according to their physical and mental fitness,
educational qualification, needs and preferences. Thirdly, elderly people mostly
suffer from some physical illness and they need comprehensive medical care
services. So, separate ward or unit in a hospital or clinic need to establish for elderly
people. Finally, poor elderly people should be involved in the development and
implementation of programs and policies according to their minimum needs. Since,
the data does not represent the whole Bangladesh, generalization of the findings
and recommendations are risky. A comprehensive study is needed to explore the
exact status of the elderly, their needs and proper recommendation for their well
being.

APPENDIX

Table A1:
Percentage distribution of bio-demographic characteristics of the
respondents

Table A2:
Percentage distribution of socio-economic characteristics of the
respondent

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Problems of the Elderly

FACTS ABOUT ELDERLY IN INDIA

MISSION & VISION
PROBLEMS OF THE ELDERLY
PROGRAMMES AT GLANCE

S. No. Problem

Need

Failing Health

Economic insecurity

Isolation

Inclusion

Neglect

Care

Abuse Protection

Fear

Reassurance

Health
Economic security

Boredom (idleness) Be usefully occupied

Lowered self-esteem

Loss of control

10

Lack of Preparedness for old age

Self Confidence

Respect
Preparedness for old age

Equity Issues are relevant to all the above

Failing Health
It has been said that we start dying the day we are born. The aging process is
synonymous with failing health. While death in young people in countries such as
India is mainly due to infectious diseases, older people are mostly vulnerable to
non-communicable diseases. Failing health due to advancing age is complicated by
non-availability to good quality, age-sensitive, health care for a large proportion of
older persons in the country. In addition, poor accessibility and reach, lack of
information and knowledge and/or high costs of disease management make
reasonable elder care beyond the reach of older persons, especially those who are
poor and disadvantaged.

To address the issue of failing health, it is of prime importance that good quality
health care be made available and accessible to the elderly in an age-sensitive
manner. Health services should address preventive measures keeping in mind the
diseases that affect or are likely to affect the communities in a particular
geographical region. In addition, effective care and support is required for those
elderly suffering from various diseases through primary, secondary and tertiary
health care systems. The cost (to the affected elderly individual or family) of health
has to be addressed so that no person is denied necessary health care for financial
reasons. Rehabilitation, community or home based disability support and end-of-life
care should also be provided where needed, in a holistic manner, to effectively
address the issue to failing health among the elderly.

Economic Insecurity

The problem of economic insecurity is faced by the elderly when they are unable to
sustain themselves financially. Many older persons either lack the opportunity
and/or the capacity to be as productive as they were. Increasing competition from
younger people, individual, family and societal mind sets, chronic malnutrition and
slowing physical and mental faculties, limited access to resources and lack of
awareness of their rights and entitlements play significant roles in reducing the
ability of the elderly to remain financially productive, and thereby, independent.

Economic security is as relevant for the elderly as it is for those of any other age
group. Those who are unable to generate an adequate income should be facilitated
to do so. As far as possible, elderly who are capable, should be encouraged, and if
necessary, supported to be engaged in some economically productive manner.
Others who are incapable of supporting themselves should be provided with partial
or full social welfare grants that at least provide for their basic needs. Families and
communities may be encouraged to support the elderly living with them through
counseling and local self-governance.

Isolation
Isolation, or a deep sense of loneliness, is a common complaint of many elderly is
the feeling of being isolated. While there are a few who impose it on themselves,
isolation is most often imposed purposefully or inadvertently by the families and/or
communities where the elderly live. Isolation is a terrible feeling that, if not
addressed, leads to tragic deterioration of the quality of life.

It is important that the elderly feel included in the goings-on around them, both in
the family as well as in society. Those involved in elder care, especially NGOs in the
field, can play a significant role in facilitating this through counseling of the
individual, of families, sensitization of community leaders and group awareness or
group counseling sessions. Activities centered on older persons that involve their
time and skills help to inculcate a feeling of inclusion. Some of these could also be
directly useful for the families and the communities.

Neglect
The elderly, especially those who are weak and/or dependent, require physical,
mental and emotional care and support. When this is not provided, they suffer from
neglect, a problem that occurs when a person is left uncared for and that is often
linked with isolation. Changing lifestyles and values, demanding jobs, distractions
such as television, a shift to nuclear family structures and redefined priorities have
led to increased neglect of the elderly by families and communities. This is
worsened as the elderly are less likely to demand attention than those of other age
groups.

The best way to address neglect of the elderly is to counsel families, sensitise
community leaders and address the issue at all levels in different forums, including
the print and audio-visual media. Schools and work places offer opportunities where
younger generations can be addressed in groups. Government and non-government
agencies need to take this issue up seriously at all these levels. In extreme
situations, legal action and rehabilitation may be required to reduce or prevent the
serious consequences of the problem.

Abuse
The elderly are highly vulnerable to abuse, where a person is willfully or
inadvertently harmed, usually by someone who is part of the family or otherwise
close to the victim. It is very important that steps be taken, whenever and wherever
possible, to protect people from abuse. Being relatively weak, elderly are vulnerable
to physical abuse. Their resources, including finances ones are also often misused.
In addition, the elderly may suffer from emotional and mental abuse for various
reasons and in different ways.

The best form of protection from abuse is to prevent it. This should be carried out
through awareness generation in families and in the communities. In most cases,
abuse is carried out as a result of some frustration and the felt need to inflict pain
and misery on others. It is also done to emphasize authority. Information and
education of groups of people from younger generations is necessary to help
prevent abuse. The elderly should also be made aware of their rights in this regard.

Where necessary, legal action needs be taken against those who willfully abuse
elders, combined with counseling of such persons so as to rehabilitate them. Elderly
who are abused also require to be counseled, and if necessary rehabilitated to
ensure that they are able to recover with minimum negative impact.

Fear

Many older persons live in fear. Whether rational or irrational, this is a relevant
problem face by the elderly that needs to be carefully and effectively addressed.

Elderly who suffer from fear need to be reassured. Those for whom the fear is
considered to be irrational need to be counseled and, if necessary, may be treated
as per their needs. In the case of those with real or rational fear, the cause and its
preventive measures needs to be identified followed by appropriate action where
and when possible.

Boredom (Idleness)
Boredom is a result of being poorly motivated to be useful or productive and occurs
when a person is unwilling or unable to do something meaningful with his/her time.
The problem occurs due to forced inactivity, withdrawal from responsibilities and
lack of personal goals. A person who is not usefully occupied tends to physically and
mentally decline and this in turn has a negative emotional impact. Most people who
have reached the age of 60 years or more have previously led productive lives and
would have gained several skills during their life-time. Identifying these skills would
be a relatively easy task. Motivating them and enabling them to use these skills is a
far more challenging process that requires determination and consistent effort by
dedicated people working in the same environment as the affected elders.

Many elderly can be trained to carry out productive activities that would be useful
to them or benefit their families, communities or environment; activities that others
would often be unable or unwilling to do. Being meaningfully occupied, many of the
elderly can be taught to keep boredom away. For others, recreational activities can
be devised and encouraged at little or no additional cost.

Lowered Self-esteem
Lowered self-esteem among older persons has a complex etiology that includes
isolation, neglect, reduced responsibilities and decrease in value or worth by oneself, family and/or the society.

To restore self-confidence, one needs to identify and address the cause and remove
it. While isolation and neglect have been discussed above, self-worth and value can
be improved by encouraging the elderly to take part in family and community
activities, learning to use their skills, developing new ones or otherwise keeping
themselves productively occupied. In serious situations, individuals and their
families may require counseling and/or treatment.

Loss of Control
This problem of older persons has many facets. While self-realization and the reality
of the situation is acceptable to some, there are others for whom life becomes
insecure when they begin to lose control of their resources physical strength, body
systems, finances (income), social or designated status and decision making
powers.

Early intervention, through education and awareness generation, is needed to

prevent a negative feeling to inevitable loss of control. It is also important for
society and individuals to learn to respect people for what they are instead of
who they are and how much they are worth. When the feeling is severe, individuals
and their families may be counseled to deal with this. Improving the health of the
elderly through various levels of health care can also help to improve control.
Finally, motivating the elderly to use their skills and training them to be productive
will help gain respect and appreciation.

Lack of Preparedness for Old Age

A large number of people enter old age with little, or no, awareness of what this
entails. While demographically, we acknowledge that a person is considered to be
old when (s)he attains the age of 60 years, there is no such clear indicator available
to the individual. For each person, there is a turning point after which (s)he feels
physiologically or functionally old. This event could take place at any age before or
after the age of 60. Unfortunately, in India, there is almost no formal awareness

program even at higher level institutions or organizations for people to prepare

for old age. For the vast majority of people, old age sets in quietly, but suddenly,
and few are prepared to deal with its issues. Most people living busy lives during the
young and middle age periods may prefer to turn away from, and not consider, the
possible realities of their own impending old age.
The majority of Indians are unaware of the rights and entitlements of older persons.

The problem of not being prepared for old age can only be prevented. Awareness
generation through the work place is a good beginning with HR departments taking
an active role in preparing employees to face retirement and facing old age issues.
For the majority who have unregulated occupations and for those who are selfemployed, including farmers, awareness can be generated through the media and
also through government offices and by NGOs in the field. Older people who have
faced and addressed these issues can be recruited to address groups at various
forums to help people prepare for, or cope with, old age.

+1 Social Inequity

Top 5 Problems Faced in Old Age

by Shuani India
Advertisements:

A mans life is normally divided into five stages namely: infancy, childhood,
adolescence, adulthood and old age. In each of these stages an individuals finds
himself in different situations and faces different problems. Old age is viewed as an
unavoidable, undesirable and problem ridden phase of life. Problems of aging
usually appear after the age of 65 years.

These problems may be divided under 5 heads:

(i) Physiological

(ii) Psychological

(iii) Social

(iv) Emotional

(v) Financial

1. Physiological Problems:

Old age is a period of physical decline. Even if one does not become sans eyes, sans
teeth, sans everything, right away, one does begin to slow down physically. The
physical condition depends partly upon hereditary constitution, the manner of living
and environmental factors. Vicissitudes of living, faulty diet, malnutrition, infectious,
intoxications, gluttony, inadequate rest, emotional stress, overwork, endocrine
disorders and environmental conditions like heat and cold are some of the common
secondary causes of physical decline.

Due to the loss of teeth, the jaw becomes smaller and the skin sags. The cheeks
become pendulous with wrinkles and the eye lids become baggy with upper lids
over hanging the lower. The eyes seem dull and lustreless and they often have a
watery look due to the poor functioning of the tear glands. Loss of dentures affect
speech and some even appear to lisp.

The skin becomes rough and looses its elasticity. Wrinkles are formed and the veins
show out prominently on the skin. Perspiration is less profuse and other skin
pigmentation appears as the age advances. The hair becomes thin and grey, nails
become thick and tough. Tremors of the hands, forearms, head and lower jaw are

common. Bones harden in old age, become brittle and are subject to fractures and
breaks.

Changes in the nervous system have a marked influence on the brain. Atrophy is
particularly marked in the spleen, liver and soft organs. The ratio of heart weight to
body weight decreases gradually. The softness and pliability of the valves change
gradually because of an increase in the fibrous tissue from the deposits of
cholesterol and calcium. The aged are also prone to heart disease, other minor
ailments and chronic diseases.

Due to the weakening regulatory mechanism, the body temperature is affected.

Therefore the old persons feel the change in climate more profoundly than others.
They suffer from digestive troubles, insomnia. Due to dental problems they are not
able to chew or swallow well.

The old are more accident prone because of their slow reaction to dangers resulting
in malfunctioning of the sense organs and declining mental abilities, the capacity to
work decreases. Eyes and ears are greatly affected Changes in the nerve centre in
the brain and retina affect vision and sensitivity to certain colours gradually
decreases. Most old people suffer from farsightness because of diminishing eye
sight.

With advancing age, the sexual potency decreases along with a waning of
secondary sex characters. Women go through menopause generally at the age of
45 50 years accompanied by nervousness, headaches, giddiness, emotional
instability, irritability and insomnia. The movements of the aged are fewer coordinates. They get fatigued easily. Due to lack of motivation, they do not take
interest to learn new skill and become lethargic. Above all visits to the doctor
becomes a routine work for them.

2. Psychological Problems:

Mental disorders are very much associated with old age. Older people are
susceptible to psychotic depressions. The two major psychotic disorders of older
people are senile dementia (associated with cerebral atrophy and degeneration)
and psychosis with cerebral arterio sclerosis (associated with either blocking or

ruptures in the cerebral arteries). It has been observed that these two disorders
account for approximately 80% of the psychotic disorders among older people in the
civilized societies.

(1) Senile Dementia:

Older people suffer from senile dementia. They develop symptoms like poor
memory, intolerance of change, disorientation, rest lessens, insomnia, failure of
judgement, a gradual formation of delusion and hallucinations, extreme-mental
depression and agitation, severe mental clouding in which the individual becomes
restless, combative, resistive and incoherent. In extreme cases the patient become
bed ridden and resistance to disease is lowered resulting in his days being
numbered.

(2) Psychosis with cerebral Arteriosclerosis:

This is accompanied by physiological symptoms such as acute indigestion,

unsteadiness in gait, small strokes resulting in cumulative brain damage and
gradual personality change. Conclusive seizures are relatively common. This is also
associated with symptoms such as weakness, fatigue, dizziness, headache,
depression, memory defect, periods of confusion, lowered efficiency in work,
heightened irritability and tendency to be suspicious about trivial matters.
Forgetfulness is one of the main psychological problems of old age. General
intelligence and independent creative thinking are usually affected in old age.

3. Emotional Problem:

Decline in mental ability makes them dependent. They no longer have trust in their
own ability or judgements but still they want to tighten their grip over the younger
ones. They want to get involved in all family matters and business issues. Due to
generation gap the youngsters do not pay attention to their suggestion and advice.
Instead of developing a sympathetic attitude towards the old, they start asserting
their rights and power. This may create a feeling of deprivation of their dignity and
importance.

Loss of spouse during old age is another hazard. Death of a spouse creates a feeling
of loneliness and isolation. The negligence and indifferent attitude of the family
members towards the older people creates more emotional problems.

4. Social Problems:

Older people suffer social losses greatly with age. Their social life is narrowed down
by loss of work associated, death of relatives, friends and spouse and weak health
which restricts their participation in social activities. The home becomes the centre
of their social life which gets confined to the interpersonal relationship with the
family members. Due to loss of most of the social roles they once performed, they
are likely to be lonely and isolated severe chromic health problem enable them to
become socially isolated which results in loneliness and depression.

5. Financial Problem:

Retirement from service usually results in loss of income and the pensions that the
elderly receive are usually inadequate to meet the cost of living which is always on
the rise. With the reduced income they are reversed from the state of Chief bread
winner to a mere dependent though they spend their provident fund on marriages
of children, acquiring new property, education of children and family maintenance.
The diagnosis and treatment of their disease created more financial problem for old
age.

Old age is a period of physical deterioration and social alienation in some cases,
loss of spouse, friends, Job, property and physical appearance. In old age physical
strength deteriorates, mental stability diminishes, financial power becomes bleak
and eye sight suffers a setback. It is a period of disappointment, dejection, disease,
repentance and loneliness.

Nevertheless grandparents provide an additional source of affection and enrichment

of experience in respect of child care and family business. Despite various problems
of old age, one must keep himself actively engaged for the personal well being and
social good as well.

Challenges Facing the Elderly

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Summary
Aging comes with many challenges. The loss of independence is one potential part
of the process, as are diminished physical ability and age discrimination. The term
senescence refers to the aging process, including biological, emotional, intellectual,
social, and spiritual changes. This section discusses some of the challenges we
encounter during this process.
As already observed, many older adults remain highly self-sufficient. Others require
more care. Because the elderly typically no longer hold jobs, finances can be a
challenge. And due to cultural misconceptions, older people can be targets of
ridicule and stereotypes. The elderly face many challenges in later life, but they do
not have to enter old age without dignity.
Poverty

While elderly poverty rates showed an improvement trend for decades, the 2008
recession has changed some older peoples financial futures. Some who had
planned a leisurely retirement have found themselves at risk of late-age destitution.
(Photo (a) courtesy of Michael Cohen/flickr; photo (b) courtesy of Alex Proimos/flickr)
For many people in the United States, growing older once meant living with less
income. In 1960, almost 35 percent of the elderly existed on poverty-level incomes.
A generation ago, the nations oldest populations had the highest risk of living in
poverty.
At the start of the 21st century, the older population was putting an end to that
trend. Among people over 65, the poverty rate fell from 30 percent in 1967 to 9.7
percent in 2008, well below the national average of 13.2 percent (U.S. Census
Bureau 2009). However, with the subsequent recession, which severely reduced the
retirement savings of many while taxing public support systems, how are the elderly
affected? According to the Kaiser Commission on Medicaid and the Uninsured, the

national poverty rate among the elderly had risen to 14 percent by 2010 (Urban
Institute and Kaiser Commission 2010).
Before the recession hit, what had changed to cause a reduction in poverty among
the elderly? What social patterns contributed to the shift? For several decades, a
greater number of women joined the workforce. More married couples earned
double incomes during their working years and saved more money for their
retirement. Private employers and governments began offering better retirement
programs. By 1990, senior citizens reported earning 36 percent more income on
average than they did in 1980; that was five times the rate of increase for people
under age 35 (U.S. Census Bureau 2009).
In addition, many people were gaining access to better health care. New trends
encouraged people to live more healthful lifestyles, placing an emphasis on exercise
and nutrition. There was also greater access to information about the health risks of
behaviors such as cigarette smoking, alcohol consumption, and drug use. Because
they were healthier, many older people continue to work past the typical retirement
age, providing more opportunity to save for retirement. Will these patterns return
once the recession ends? Sociologists will be watching to see. In the meantime, they
are realizing the immediate impact of the recession on elderly poverty.
During the recession, older people lost some of the financial advantages that theyd
gained in the 1980s and 1990s. From October 2007 to October 2009 the values of
retirement accounts for people over age 50 lost 18 percent of their value. The sharp
decline in the stock market also forced many to delay their retirement
(Administration on Aging 2009).
Ageism

Are these street signs humorous or offensive? What shared assumptions make them
humorous? Or is memory loss too serious to be made fun of? (Photo courtesy of
Tumbleweed/flickr)
Driving to the grocery store, Peter, 23, got stuck behind a car on a four-lane main
artery through his citys business district. The speed limit was 35 miles per hour,
and while most drivers sped along at 40 to 45 mph, the driver in front of him was
going the minimum speed. Peter tapped on his horn. He tailgated the driver. Finally,
Peter had a chance to pass the car. He glanced over. Sure enough, Peter thought, a
gray-haired old man guilty of DWE, driving while elderly.
At the grocery store, Peter waited in the checkout line behind an older woman. She
paid for her groceries, lifted her bags of food into her cart, and toddled toward the
exit. Peter, guessing her to be about 80, was reminded of his grandmother. He paid
for his groceries and caught up with her.

Can I help you with your cart? he asked.

No, thank you. I can get it myself, she said and marched off toward her car.
Peters responses to both older people, the driver and the shopper, were prejudiced.
In both cases, he made unfair assumptions. He assumed the driver drove cautiously
simply because the man was a senior citizen, and he assumed the shopper needed
help carrying her groceries just because she was an older woman.
Responses like Peters toward older people are fairly common. He didnt intend to
treat people differently based on personal or cultural biases, but he did. Ageism is
discrimination (when someone acts on a prejudice) based on age. Dr. Robert Butler
coined the term in 1968, noting that ageism exists in all cultures (Brownell). Ageist
attitudes and biases based on stereotypes reduce elderly people to inferior or
limited positions.
Ageism can vary in severity. Peters attitudes are probably seen as fairly mild, but
relating to the elderly in ways that are patronizing can be offensive. When ageism is
reflected in the workplace, in health care, and in assisted-living facilities, the effects
of discrimination can be more severe. Ageism can make older people fear losing a
job, feel dismissed by a doctor, or feel a lack of power and control in their daily
living situations.
In early societies, the elderly were respected and revered. Many preindustrial
societies observed gerontocracy, a type of social structure wherein the power is
held by a societys oldest members. In some countries today, the elderly still have
influence and power and their vast knowledge is respected.
In many modern nations, however, industrialization contributed to the diminished
social standing of the elderly. Today wealth, power, and prestige are also held by
those in younger age brackets. The average age of corporate executives was 59 in
1980. In 2008, the average age had lowered to 54 (Stuart 2008). Some older
members of the workforce felt threatened by this trend and grew concerned that
younger employees in higher level positions would push them out of the job market.
Rapid advancements in technology and media have required new skill sets that
older members of the workforce are less likely to have.
Changes happened not only in the workplace but also at home. In agrarian
societies, a married couple cared for their aging parents. The oldest members of the
family contributed to the household by doing chores, cooking, and helping with child
care. As economies shifted from agrarian to industrial, younger generations moved
to cities to work in factories. The elderly began to be seen as an expensive burden.
They did not have the strength and stamina to work outside the home. What began
during industrialization, a trend toward older people living apart from their grown
children, has become commonplace.

Mistreatment and Abuse

Mistreatment and abuse of the elderly is a major social problem. As expected, with
the biology of aging, the elderly sometimes become physically frail. This frailty
renders them dependent on others for caresometimes for small needs like
household tasks, and sometimes for assistance with basic functions like eating and
toileting. Unlike a child, who also is dependent on another for care, an elder is an
adult with a lifetime of experience, knowledge, and opinionsa more fully
developed person. This makes the care providing situation more complex.
Elder abuse describes when a caretaker intentionally deprives an older person of
care or harms the person in their charge. Caregivers may be family members,
relatives, friends, health professionals, or employees of senior housing or nursing
care. The elderly may be subject to many different types of abuse.
In a 2009 study on the topic led by Dr. Ron Acierno, the team of researchers
identified five major categories of elder abuse: 1) physical abuse, such as hitting or
shaking, 2) sexual abuse including rape and coerced nudity, 3) psychological or
emotional abuse, such as verbal harassment or humiliation, 4) neglect or failure to
provide adequate care, and 5) financial abuse or exploitation (Acierno 2010).
The National Center on Elder Abuse (NCEA), a division of the U.S. Administration on
Aging, also identifies abandonment and self-neglect as types of abuse. Table shows
some of the signs and symptoms that the NCEA encourages people to notice.
Signs of Elder AbuseThe National Center on Elder Abuse encourages people to
watch for these signs of mistreatment. (Chart courtesy of National Center on Elder
Abuse)
Type of Abuse

Signs and Symptoms

Physical abuse
Bruises, untreated wounds, sprains, broken glasses, lab findings
of medication overdosage
Sexual abuse
Bruises around breasts or genitals, torn or bloody underclothing,
unexplained venereal disease
Emotional/psychological abuse Being upset or withdrawn, unusual dementia-like
behavior (rocking, sucking)
Neglect

Poor hygiene, untreated bed sores, dehydration, soiled bedding

Financial
Sudden changes in banking practices, inclusion of additional names on
bank cards, abrupt changes to will
Self-neglect Untreated medical conditions, unclean living area, lack of medical
items like dentures or glasses

How prevalent is elder abuse? Two recent U.S. studies found that roughly 1 in 10
elderly people surveyed had suffered at least one form of elder abuse. Some social
researchers believe elder abuse is underreported and that the number may be
higher. The risk of abuse also increases in people with health issues such as
dementia (Kohn and Verhoek-Oftedahl 2011). Older women were found to be victims
of verbal abuse more often than their male counterparts.
In Aciernos study, which included a sample of 5,777 respondents age 60 and older,
5.2 percent of respondents reported financial abuse, 5.1 percent said theyd been
neglected, and 4.6 endured emotional abuse (Acierno 2010). The prevalence of
physical and sexual abuse was lower at 1.6 and 0.6 percent, respectively (Acierno
2010).
Other studies have focused on the caregivers to the elderly in an attempt to
discover the causes of elder abuse. Researchers identified factors that increased the
likelihood of caregivers perpetrating abuse against those in their care. Those factors
include inexperience, having other demands such as jobs (for those who werent
professionally employed as caregivers), caring for children, living full time with the
dependent elder, and experiencing high stress, isolation, and lack of support (Kohn
and Verhoek-Oftedahl 2011).
A history of depression in the caregiver was also found to increase the likelihood of
elder abuse. Neglect was more likely when care was provided by paid caregivers.
Many of the caregivers who physically abused elders were themselves abusedin
many cases, when they were children. Family members with some sort of
dependency on the elder in their care were more likely to physically abuse that
elder. For example, an adult child caring for an elderly parent while, at the same
time, depending on some form of income from that parent, would be considered
more likely to perpetrate physical abuse (Kohn and Verhoek-Oftedahl 2011).
A survey in Florida found that 60.1 percent of caregivers reported verbal aggression
as a style of conflict resolution. Paid caregivers in nursing homes were at a high risk
of becoming abusive if they had low job satisfaction, treated the elderly like
children, or felt burnt out (Kohn and Verhoek-Oftedahl 2011). Caregivers who tended
to be verbally abusive were found to have had less training, lower education, and
higher likelihood of depression or other psychiatric disorders. Based on the results
of these studies, many housing facilities for seniors have increased their screening
procedures for caregiver applicants.
WORLD WAR II VETERANS

World War II (19411945) veterans and members of an Honor Flight from Milwaukee,
Wisconsin, visit the National World War II Memorial in Washington, D.C. Most of

these men and women were in their late teens or 20s when they served. (Photo
courtesy of Sean Hackbarth/flickr)
World War II veterans are aging. Many are in their 80s and 90s. They are dying at an
estimated rate of about 740 per day, according to the U.S. Veterans Administration
(National Center for Veterans Analysis and Statistics 2011). Data suggest that by
2036, there will be no living veterans of WWII (U.S. Department of Veteran Affairs).
When these veterans came home from the war and ended their service, little was
known about posttraumatic stress disorder (PTSD). These heroes did not receive the
mental and physical health care that could have helped them. As a result, many of
them, now in old age, are dealing with the effects of PTSD. Research suggests a
high percentage of World War II veterans are plagued by flashback memories and
isolation, and that many self-medicate with alcohol.
Research has found that veterans of any conflict are more than twice as likely as
non-veterans to commit suicide, with rates highest among the oldest veterans.
Reports show that WWII-era veterans are four times as likely to take their own lives
as people of the same age with no military service (Glantz 2010).
In May 2004, the National World War II Memorial in Washington, D.C., was
completed and dedicated to honor those who served during the conflict. Dr. Earl
Morse, a physician and retired Air Force captain, treated many WWII veterans. He
encouraged them to visit the memorial, knowing it could help them heal. Many
WWII veterans expressed interest in seeing the memorial. Unfortunately, many were
in their 80s and were neither physically nor financially able to travel on their own.
Dr. Morse arranged to personally escort some of the veterans and enlisted volunteer
pilots who would pay for the flights themselves. He also raised money, insisting the
veterans pay nothing. By the end of 2005, 137 veterans, many in wheelchairs, had
made the trip. The Honor Flight Network was up and running.
As of 2010, the Honor Flight Network had flown more than 120,000 U.S. veterans of
World War II, and some veterans of the Korean War, to Washington. The round-trip
flights leave for day-long trips from airports in 30 states, staffed by volunteers who
care for the needs of the elderly travelers (Honor Flight Network 2011).
Summary
As people enter old age, they face challenges. Ageism, which involves stereotyping
and discrimination against the elderly, leads to misconceptions about their abilities.
Although elderly poverty has been improving for decades, many older people may
be detrimentally affected by the 2008 recession. Some elderly people grow
physically frail and, therefore, dependent on caregivers, which increases their risk of
elder abuse.
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