1. UNDERSTANDING THE ELDERLY Presented by: Jeff Ashley, LCSW, ACHP-SW

2. Who is old anyway? ▪ Young-old: 65-74 years old ▪ Old-old: 75 – 84 years old ▪ Oldest-old: 85 + years old

3. And the Lord said, “My Spirit shall not strive with man forever, for he is indeed flesh; yet his days shall be one hundred and twenty years.” Golden Age?

4. Aging — Progressive Changes During Adult Years Chronological: number of years since birth Biological: changes reducing the efficiency of organ systems Psychological: changes in memory, learning, adaptive capacity, personality, and mental functioning Social: changes in social roles, relationships, and social context

5. Aging Revolution: Demographics of Aging ▪ The population of Americans 65 years and older has greatly exceeded the growth of the population as a whole. The oldest-old are most rapidly growing elderly age group. ▪ Between 2010 and 2030, the leading edge of the baby boom generation (those born between 1946 and 1964) will reach the age of 65.

6. Cultural Values and Attitudes Historical Context ▪ 1600-1800: Gerontophilia — honor, respect, and status for the elderly, especially older males ▪ 1800 to present: Gerontophobia — emphasis on youth instead of age with older people seen as victims

7. What do you think? ▪ What are some of our ideas about what the elderly are like? ▪ How do we expect old women to look? ▪ How do we expect old men to act?

8. Stereotypes ▪ Need to categorize and/or oversimplify ▪ Self fulfilling prophecies ▪ Based on some level of truth ▪ Positive stereotypes ▪ Negative stereotypes

9. Ageism The prejudiced behavior of individuals and systems within the culture against older adults, including the negative consequences of inaccurate stereotyping of the elderly

10. The Critical Perspective ▪ The critical perspective draws attention to inequalities in the system. ▪ Cumulative disadvantage: negative effects of inequality in wealth, status, and opportunity over the lifespan ▪ Example: An older black female living in poverty will experience greater disadvantage than an older white middle-class male.

11. Breaking Negative Stereotypes ▪ Draw attention to those who have made significant contributions in their old age ▪ Counter the stereotype with accurate information ▪ Consequences/Implications of stereotyping ▪ Perpetuates ageism ▪ Affects professional objectivity ▪ Relate better to employees ▪ Fosters fear ▪ Stifles the potential of older people

12. Considerations with the Elderly… Helpful tips when interacting with the elderly

13. Patronizing Communication ▪ Over accommodation in communication based on stereotyped expectations ▪ Can be offensive ▪ What are some types of patronizing communication?

14. Hearing Loss ▪ This makes you harder to understand, so be patient and speak more clearly. ▪ Face the person when you talk ▪ Avoid talking while you eat or chew gum ▪ Don’t shout at them, but be willing to repeat patiently if they don’t hear you the first time.

15. Vision Loss ▪ This can make it harder for the elderly person to recognize you, so don’t take it personally. They may need your help to be their ‘eyes’ at times.

16. Speaking ▪ Some elderly persons experience changes in their speaking ability, and their voices become weaker, or harder to understand. ▪ Be patient when listening, and be aware of when the elderly person gets tired and wants the visit to end.

17. Memory Loss ▪ This is very normal as people grow older, especially short term memory loss. ▪ Keep this in mind and practice patience. ▪ If the elderly person has some dementia or is getting Alzheimer's, they may repeat stories over and over. This is normal! They may let you tactfully change the subject or start a new topic of conversation occasionally, but be patient with the repetition!

18. Emotions ▪ Remember when someone lives to be very old, it’s normal for them to experience feelings of loss. Deaths of relatives and friends, losing the ability to work and be independent, changes in their health and ability to be active, changes in their finances, and being unable to make simple decisions can all affect an elderly person’s emotions. ▪ These losses can create sadness and grieving. Grieving can lead to depression, social withdrawal, and irritability, so look for these symptoms in the elderly person and seek advice from your supervisor as to how to get help for your senior companion.

19. Complaining ▪ Because of their frustrations, they may complain about their family, friends, the facility, their living conditions, their finances, their aches and pains, etc. Sometimes the best thing you can do is to listen to their complaints. Show by your body language and facial expression that you care and that you are listening. ▪ Practice “active listening” if they want your feedback, which means to repeat back to them what you think they said and offering sympathy. Don’t necessarily feel you have to solve their problems for them.

20. Background ▪ Because an elderly person’s life experience may be different from yours, it’s important to let the person express their thoughts and feelings, and to respect them even if you disagree.

21. Physical Limitations ▪ Seniors may have aches, pains, and stiffness that slow them down. They may not want to admit this to you. Go at their pace and be sensitive to when they may be getting tired or having pain.

22. How to start a conversation with an elderly ▪ Always be very respectful. Avoid talking in condescending, “baby” talk. Address them as Mr. or Mrs. unless they direct you otherwise ▪ Make positive observations about their room, home, decorations, yard, photos, hairstyle, etc. Whatever you can find to sincerely compliment, do so! (but don’t over-do it) ▪ Act interested, but not nosy, ask questions to try and get a dialogue going ▪ Ask if there is anything you can do to help them (within your limits)

23. What do the elderly want? ▪ They want to feel in control of their own lives. They don’t want to be told what to do or not to do. They like to feel they can still do some things, so let them do what they can! ▪ They want dignity and respect. Don’t dismiss what they have to say or who they are, accept them for who they are and who they were. ▪ They want recognition for their contributions ▪ They want some hope. They know they are getting older and have more physical and sometimes mental limitations, but they still want to know that good things are possible in their lives.

24. What do the elderly want? ▪ They want attention from those they love and respect. They hate being ignored. ▪ They want privacy and respect for their ‘space’ ▪ They want friends, young and old. ▪ They want the people close to them to understand that they are often depressed and suffer from low self-esteem. At those times, they need someone to listen. ▪ They want freedom for as long as possible. ▪ They want to be in touch with their spirituality. This will help them face their own mortality.

25. QUESTIONS