Stress of Old Age

The natural aging process can be a very stressful event. Some people adapt better than others, but there are similar issues for anyone as they age. Their identity can be closely attached to their work and that identity decreases when they retire. The income decreases too. Adjusting to a different level of income can be very stressful. Aging can increase stress due to the fearing of becoming an invalid or even death. They are stressed with increased social isolation and loneliness. The social isolation can be increased if they begin to experience failing memory, seeing or hearing. This decreases their social input and others tend to stay away more because of the decrease in their abilities. The elder have to accept their decrease in physical attractiveness that directly affects their self image and self concept. This can be extremely difficult in a society that values youth and beauty and devalues the aged. People at any age experience stress, but coping mechanism to handle stress can drastically decreasing with the aging process. Old people can have stress because of the pressure of being old, biological changes, loss of spouses, family members, friends and even pets. Some of the more specific situations that can cause stress for the elderly are depression, substance abuse, delirium and dementia.

Depression in old people involves sadness, emptiness, low self esteem, guilt, pessimism, loss of appetite and sleep disturbances. Depression can lead to recovering more slowly and completely from heart attacks, hip fractures, pneumonia and other illnesses and diseases. Elderly people with depression are more likely to commit suicide.

Elderly people with stress can have substance abuse problems. These problems are caused by the decline in health and reduced loss of financial status. Men are 30 times more likely to have substance abuse problems. Substance abuse can cause dizziness, blacking out, secretive drinking and social withdrawal. Elderly people who are admitted to hospitals and institutions are more likely to drink. Substance abuse can be caused by the reaction of getting older, the pressures of getting old, unwanted retirement and living alone. Sometimes elderly people can unintentionally misuse medications without even knowing it by confusing medications, skipping doses and doctors over subscribing.

Elderly people can have delirium which is a mental disturbance by the clouding of consciousness. They can have difficulty concentrating, difficulty focusing, and difficulty keeping attention and thinking sequentially. They can be easily distracted by unimportant things, get stuck on a certain topic instead of answering questions, poor memory in recent events, disorientation, rambling, difficulty speaking and recalling words, difficulty reading and writing and difficulty understanding speech. They can also have agitation, irritability, combative behavior and extreme emotions of anxiety, fear, depression and anger. They can also have misinterpretations, illusions and hallucinations. Delirium is caused by diseases, infections, poor nutrition, head injuries, strokes, limited ability to perform tasks, visual and hearing impairment, dehydration, chronic and terminal illness, AIDS, surgery, stress and drugs.

Dementia can cause stress for the elderly because especially in the early stages of the dementia they are aware that they are “loosing it”. A dementia progress involves significant memory loss, loss in abstract thinking and language. Some other symptoms of dementia are the inability to remember new information, difficulty communicating, difficulty organizing and planning, difficulty in coordination and motor functions, inability to reason, paranoia, agitation and hallucinations. People with dementia can have personality changes and behave inappropriately. Causes of dementia can be due to poor nutrition, brain disease and injuries.

Mary is a 75 year old alcoholic who recently fell at her home and broke a hip. She has been having periods of delirium where she became very distracted and would burn her food on the stove. Her husband died 15 years ago and her 3 children live away and had recently been talking about moving her into a home for care. Mary is aware that her substance abuse, physical and mental health are declining and she has no close relatives to assist and keep her in her own home. Her life stressors are mounting and her coping mechanisms are decreasing. She maybe facing going into a nursing home and she is becoming depressed and thinking about ending her life.