Fostering a full life for seniors

The growth of our population of seniors continues at an accelerating pace. Every day, about 10,000 Americans reach age 65.  Today, fully 20% of the population in Iowa has attained this status. Numbers are even higher in Florida. Other states soon will follow. Demographers tell us that this trend will continue for the next decade, so about 1 in 5 of all Americans will be age 65 and older by 2030.

As a result of this major demographic shift, we are witnessing the early stages of the development of a new life phase that soon will evolve its own culture and lifestyle. Until this transformation actually takes place, however, we cannot permit this period of advanced age to be one where social isolation, poor health, and minimal wellbeing predominate. 

As seniors grow older, they are at increasing risk of social isolation. Friendships from work life recede over time, children move away, spouses and close friends die, and younger people replace long-time neighbors. This dynamic can lead to depression, inappropriate substance use and even death, sometimes by suicide. Social isolation can be as deadly as smoking.

At the same time, communication capacities can decline with the onset of hearing problems, reduced physical mobility, and declining visual acuity. All of these changes also take a toll on one’s sense of personal worth and wellbeing.

Good social connectedness promotes the reverse: longer life, better health and increased wellbeing. Such connectedness actually can thrive in communities that promote engagement and participation. This engagement can occur for seniors if health issues are addressed early (e.g., hearing aids are available, good healthcare is accessible on a routine basis, and physical activity is integral to the community).

Many of our urban centers have developed communities of seniors with these characteristics. In these communities, seniors help each other with transportation needs, cross visit and entertain, and engage each other intellectually and emotionally. Many have community sites where seniors can congregate. Examples of these communities would include several senior villages in the Washington, D.C., area and in other major cities.

Yet, at the same time, it is important not to paint too rosy a picture of our urban centers. Income and racial divides separate more affluent seniors from those who live in poverty and those who are part of minority communities. Clearly, the latter groups should be afforded the same opportunity to engage and participate in communities of seniors.

Rural communities present even greater challenges. Distances are much farther, fewer transportation and health resources are available, and many areas lack nearby informal places where seniors can congregate. About one quarter of all seniors live in rural or small town areas. Further, 30% of these rural seniors live in poverty or near poverty.

Thus, an important question arises about how to improve our social support networks for seniors. Below are a few thoughts about this question.

• First, we will need to improve seniors’ access to health care and to essential communication devices, such as hearing aids and eye glasses. In both urban and rural areas, physician extenders, such as physician assistants and nurse assistants, could be deployed as primary links between seniors and health care entities. These providers could use modern video IT to communicate virtually with seniors on a regular and predictable schedule, and also to monitor key vitals each day. Because hearing aids and many eyeglasses now are over the counter items, enhanced competition will lead to lower costs and pharmacies can be encouraged to offer them.
• Second, retired baby boomers can be recruited to organize communication and support networks among seniors. This demographic group represents an almost unlimited supply of persons with energy and passion, who are capable of assuming leadership in our urban and rural areas. The preferable approach would be to create actual groups of seniors that meet both formally and informally, with baby boomers providing necessary support and leadership. Where this is not feasible, virtual groups could be organized using modern video technology. Health eVillages represents a very good example of the latter.
• Peers represent a very important third workforce that could be recruited to work with seniors, and especially with seniors who have behavioral health conditions. Some social support groups could be composed entirely of seniors with these conditions.

If one looks out far enough into the future, one can foresee a day in which the sheer number of seniors in the United States (estimated to be 100 million by 2060) will lead to a dramatic cultural shift in how our younger citizens view and interact with seniors. When that shift does occur, seniors no longer will be an afterthought, but an integral part of our society at every level. Until that day arrives, however, we will need to be very vigilant to assure that our seniors have an engaging, rewarding, and healthy life.