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In the industrialized countries, life expectancy and, thus, the old age population have increased consistently over the last decades.[139] In the United States the proportion of people aged 65 or older increased from 4% in 1900 to about 12% in 2000.[140] In 1900, only about 3 million of the nation's citizens were 65 or older (out of 76 million total American citizens). By 2000, the number of senior citizens had increased to about 35 million (of 280 million US citizens). Population experts estimate that more than 50 million Americans—about 17 percent of the population—will be 65 or older in 2020.[141] By 2050, it is projected that at least 400,000 Americans will be 100 or older.[142] The number of old people is growing around the world chiefly because of the post–World War II baby boom and increases in the provision and standards of health care.[143] By 2050, 33% of the developed world’s population and almost 20% of the less developed world’s population will be over 60 years old.[144] The growing number of people living to their 80s and 90s in the developed world has strained public welfare systems and has also resulted in increased incidence of diseases like cancer and dementia that were rarely seen in premodern times. When the United States Social Security program was created, persons older than 65 numbered only around 5% of the population and the average life expectancy of a 65 year old in 1936 was approximately 5 years, while in 2011 it could often range from 10–20 years. Other issues that can arise from an increasing population are growing demands for health care and an increase in demand for different types of services.[145] Of the roughly 150,000 people who die each day across the globe, about two thirds—100,000 per day—die of age-related causes.[146] In industrialized nations, the proportion is much higher, reaching 90%.[146] Psychosocial aspects An elderly Somali woman. An elderly Khmer women. According to Erik Erikson’s "Eight Stages of Life" theory, the human personality is developed in a series of eight stages that take place from the time of birth and continue on throughout an individual’s complete life. He characterises old age as a period of "Integrity vs. Despair", during which a person focuses on reflecting back on his life. Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets. The individual will be left with feelings of bitterness and despair. Those who feel proud of their accomplishments will feel a sense of integrity. Successfully completing this phase means looking back with few regrets and a general feeling of satisfaction. These individuals will attain wisdom, even when confronting death.[147][148][149] Coping is a very important skill needed in the aging process to move forward with life and not be 'stuck' in the past. The way a person adapts and copes, reflects his aging process on a psycho-social level.[150] Newman & Newman proposed a ninth stage of life, Elderhood. Elderhood refers to those individuals who live past the life expectancy of their birth cohorts. There are two different types of people described in this stage of life. The "young old" are the healthy individuals who can function on their own without assistance and can complete their daily tasks independently. The "old old" are those who depend on specific services due to declining health or diseases. This period of life is characterized as a period of "immortality vs. extinction." Immortality is the belief that your life will go on past death, some examples are an afterlife or living on through one's family. Extinction refers to feeling as if life has no purpose.[151] Theories of old age Social theories, or concepts,[152] propose explanations for the distinctive relationships between old people and their societies. One of the theories is the Disengagement Theory proposed in 1961. This theory proposes that in old age a mutual disengagement between people and their society occurs in anticipation of death. By becoming disengaged from work and family responsibilities, according to this concept, people are enabled to enjoy their old age without stress. This theory has been subjected to the criticism that old age disengagement is neither natural, inevitable, nor beneficial.[153] Furthermore, disengaging from social ties in old age is not across the board: unsatisfactory ties are dropped and satisfying ones kept.[154] In opposition to the Disengagement Theory the Activity Theory of old age argues that disengagement in old age occurs not by desire, but by the barriers to social engagement imposed by society. This theory has been faulted for not factoring in psychological changes that occur in old age as shown by reduced activity even when available. It has also been found that happiness in old age is not proportional to activity.[155] According to the Continuity Theory, in spite of the inevitable differences imposed by their old age, most people try to maintain continuity in personhood, activities, and relationships with their younger days.[155] Socioemotional Selectivity Theory also depicts how people maintain continuity in old age. The focus of this theory is continuity sustained by social networks, albeit networks narrowed by choice and by circumstances. The choice is for more harmonious relationships. The circumstances are loss of relationships by death and distance.[156] Life expectancy Life expectancy by nation at birth in year 2011 ranged from 48 years to 82.[157] In most parts of the world women live, on average, longer than men; even so, the disparities vary between 12 years in Russia to no difference or higher life expectancy for men in countries such as Zimbabwe and Uganda.[158] The number of elderly persons worldwide began to surge in the second half of the 20th century. Up to that time (and still true in underdeveloped countries), five or less percent of the population was over 65. Few lived longer than their 70s and people who attained advanced age (i.e. their 80s) were rare enough to be a novelty and were revered as wise sages. The worldwide over 65 population in 1960 was one-third of the under 5 population. By 2013, the over 65 population had grown to equal the under 5 population. The over 65 population is projected to double the under five by 2050.[159] Before the surge in the over 65 population, accidents and disease claimed many people before they could attain old age, and health problems in those over 65 meant a quick death in most cases. If a person lived to an advanced age, it was due to genetic factors and/or a relatively easy lifestyle, since diseases of old age could not be treated before the 20th century.[160] Old age benefits German chancellor Otto von Bismarck created the world's first comprehensive government social safety net in the 1880s, providing for old age pensions.[10] In the United States of America, and the United Kingdom, 65 (UK 60 for women) was traditionally the age of retirement with full old age benefits.[161] In 2003, the age at which a United States citizen became eligible for full Social Security benefits began to increase gradually, and will continue to do so until it reaches 67 in 2027. Full retirement age for Social Security benefits for people retiring in 2012 is age 66.[162] In the United Kingdom, the state pension age for men and women will rise to 66 in 2020 with further increases scheduled after that.”[163] Originally, the purpose of old age pensions was to prevent elderly persons from being reduced to beggary, which is still common in some underdeveloped countries, but growing life expectancies and older populations have brought into question the model under which pension systems were designed.[164] The dominant perception of the American old age population changed from “needy” and “worthy” to “powerful” and “greedy,” old people getting more than their share of the nation's resources.[165] However, in 2011, using a Supplemental Poverty Measure (SPM), the old age American poverty rate was measured as 15.9%.[166] Assistance: devices and personal Old man at a nursing home in Norway. In the USA in 2008, 11 million people aged 65+ lived alone: 5 million or 22% of ages 65–74, 4 million or 34% of ages 75–84, and 2 million or 41% of ages 85+. The 2007 gender breakdown for all people 65+ was men 19% and women 39%.[167] Many new assistive devices made especially for the home have enabled more old people to care for themselves activities of daily living (ADL). Able Data[168] lists 40,000 assistive technology products in 20 categories.[169] Some examples of devices are a medical alert and safety system, shower seat (making it so the person does not get tired in the shower and fall), a bed cane (offering support to those with unsteadiness getting in and out of bed) and an ADL cuff (used with eating utensils for people with paralysis or hand weakness).[170] A Swedish study found that at age 76, 46% of the subjects used assistive devices. When they reached age 86, 69% used them. The subjects were ambivalent regarding the use of the assistive devices: as “enablers” or as “disablers.”[171] People who view assistive devices as enabling greater independence accept and use them. Those who see them as symbols of disability reject them.[172] Even with assistive devices as of 2006, 8½ million Americans needed personal assistance because of impaired basic activities of daily living (ADLs) required for personal care or impaired instrumental activities of daily living ( IADLs) required for independent living. Projections place this number at 21 million by 2030 when 40% of Americans over 70 will need assistance.[173] There are many options for such long term care to those who require it. There is the home care in which a family member, volunteer, or trained professional will aid the person in need and help with daily activities. Another option is community services which can provide the person with transportation, meal plans, or activities in senior centers. A third option is assisted living where 24 hour round the clock supervision is given with aid in eating, bathing, dressing, etc. A final option is a nursing home which provides professional nursing care.[174] |
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