Ageism. Ageism may be defined as the prejudice or discrimination that occurs on the basis of age. Although it can be used against people of all ages, older people are most frequently its target and it may often result in forced retirement. Stereotyping of the elderly is also an aspect of ageism, as seen in such a statement as “He drives like a little old lady.”
Physical changes. People typically reach the peak of their physical strength and endurance during their twenties and then gradually decline. In later adulthood, a variety of physiological changes may occur, including some degree of atrophy of the brain and a decrease in the rate of neural processes. The respiratory and circulatory systems are less efficient, and changes in the gastrointestinal tract may lead to increased constipation. Bone mass diminishes, especially among women, leading to bone density disorders such as osteoporosis. Muscles become weaker unless exercise programs are followed. The skin dries and becomes less flexible. Hair loss occurs in both sexes. There is also decreased sensitivity in all of the sensory modalities, including olfaction, taste, touch, hearing, and vision.
Cognitive changes. The study of cognitive changes in the older population is complex. Response speeds (neural and motor) have been reported to decline; some researchers believe that age‐related decrease in working memory is the crucial factor underlying poorer performance by the elderly on cognitive tasks.
Intellectual changes in late adulthood do not always result in reduction of ability. While fluid intelligence (the ability to see and to use patterns and relationships to solve problems) does decline in later years, crystallized intelligence (the ability to use accumulated information to solve problems and make decisions) has been shown to rise slightly over the entire life span. K. Warner Schaie and Sherry Willis reported that a decline in cognitive performance could be reversed in 40% to 60% of elderly people who were given remedial training.
Dementias are usually responsible for cognitive defects seen in older people. These disorders, however, occur only in about 15% of people over 65. The leading cause of dementia in the United States is Alzheimer's disease, a progressive, eventually fatal disease that begins with confusion and memory lapses and ends with the loss of ability to care for oneself.
Retirement. Retirement at age 65 is the conventional choice for many people, although some work until much later. People have been found to be happier in retirement if they are not forced to retire before they are ready and if they have enough income to maintain an adequate living standard. Chronic health problems such as arthritis, rheumatism, and hypertension increasingly interfere with the quality of life of most individuals as they age.
Widowhood. Women tend to marry men older than they are and, on average, live 5 to 7 years longer than men. One study found ten times as many widows as widowers. Widowhood is particularly stressful if the death of the spouse occurs early in life; close support of friends, particularly other widows, can be very helpful.
Death and dying. Death and dying has been studied extensively by Elisabeth Kübler‐Ross, who suggested that terminally ill patients display the following five basic reactions.
Denial, an attempt to deny the reality and to isolate oneself from the event, is frequently the first reaction.
Anger frequently follows, as the person envies the living and asks, “Why should I be the one to die?”
Bargaining may occur; the person pleads to God or others for more time.
As the end nears, recognition that death is inevitable and that separation from family will occur leads to feelings of exhaustion, futility, and deep depression.
Acceptance often follows if death is not sudden, and the person finds peace with the inevitable.
People who are dying are sometimes placed in a hospice, a hospital for the terminally ill that attempts to maintain a good quality of life for the patient and the family during the final days. In a predictable pattern after a loved one's death, initial shock is followed by grief, followed by apathy and depression, which may continue for weeks. Support groups and counseling can help in successfully working through this process.