On the Aging and Homebound

Sometimes at CONTACT Reassurance we get the question, “Why do seniors need a daily call?” And, well, they need them for many reasons. I listed below some information on health and safety risks, as well as common factors the elderly and homebound individuals CONTACT Reassurance calls daily.


Demographic and Social Change

Older Americans are the fastest-growing segment of the American population. Between 1989 and 2030, the 65+ age population is expected to double. By 2030, there will be proportionately more elderly than young people. The population 85+ is expected to triple during that time.

This rapid growth has been accompanied by greater attention to the elderly. Technology is helping older people to live with greater independence. Innovations in the field of health and medicine are enabling people to live longer, healthier lives. Many are starting second careers, going back to school, traveling, and contributing to the communities.

In addition to growth and improvement in the quality of life for many older people, a variety of problems may also be anticipated. The rise in numbers in the elderly population increases the incidence of disability, sickness, isolation, and low income. Losses are a common problem; the loss of physical health, death of important persons, lowered income, and reduced social status are all facts of life for the aged.

Older Americans want to continue to live in their homes and neighborhoods. However, many are on the verge of losing their independence. They need help coping with some aspects of their lives if they are to remain independent. The specter of losing independence and entering a nursing home is particularly haunting to many of the 8 million who live alone, the great majority of them women. Studies of institutional care conclude that up to one-third of elderly persons already in institutions might be able to live in the community if support services were available.

Maintaining frail, older people outside of nursing homes can mean significant savings of public funds. Community is the key to assuring a decent life for them. The United States is at last developing networks of comprehensive coordinated social services, which already significantly help many older persons remain independent. But such services hardly begin to meet the scope and scale of the problems facing the millions of elderly.


Physiological Changes Related to Aging

Old age is not synonymous with disease or disability. Older people are active and healthy throughout their lives. There are, however, a number of physiological changes that almost everybody experiences as age increases. These are regarded as normal changes related to age. In addition to these normal changes, the chances of acquiring certain diseases increase as well.

Visual loss – Visual loss usually begins when an individual is in his or her 40s. As the lenses of their eyes begin clouding, the size of their pupils decreases and light is prevented from entering. Depth and distance perception also deteriorate, as the eyes lose their ability to converge images. Failing vision may also be the result of several illnesses or conditions, including glaucoma, diabetes, hypertension, or lack of oxygen.

Hearing – Some hearing loss is common to everyone and usually begins during the individual’s 20’s. Changes in hearing that the elderly experience include the following:

  • Loss of the ability to hear high frequencies. For this reason, it is often easier for an older person to understand a male than a female, as the pitch of men’s voices is usually lower than that of women.
  • Ringing in the ears
  • Hypersensitivity to very loud speech that would be acceptable to a younger person
  • Loss of the ability to localize where sound is coming from. This makes it difficult for many older people to discriminate among the sounds heard in a noisy environment.
  • Many people who have hearing loss compensate for it by relying more heavily on visual clues such as facial expressions.

Touch and pain -The elderly have reduced tactile sense. As a result, they experience less pain and may be less likely to notice injuries or conditions such as heart attacks or strokes. Declines in the sensation of touch may result in a loss of balance and may increase the risk of falls. Older people are also especially susceptible to adverse effects of weather, including hypothermia heat stroke, and heat exhaustion. Conditions that may make older people even more susceptible to temperature extremes are: chronic illness, inability to afford enough heat or cooling, inactivity, obesity, alcoholism, and use of certain medications.

Muscular-Skeletal Changes – Up to the age of 30, people’s bone content increases. It remains constant until about the age of 45, after which it falls progressively. While this is true for both men and women, bone content falls more rapidly for women after menopause. Muscular-skeletal changes make it difficult for older people to perform some daily tasks such or getting up from a chair or bed. This also makes falls more dangerous.


Disease and Chronic Conditions of the Elderly

Older adults are very susceptible to certain acute and chronic illnesses. Chronic conditions that are long-term (more than 3 months), are often permanent, and leave a residual disability that may require long-term management or care. Some are acquired earlier in life and never cured, while others are more likely to be attained with advanced age.

Other Physical Changes Associated with Aging – seniors are more prone to a number of non-disease related conditions, including:

Fractures and falls – The elderly often sustain fractures without direct trauma. The majority of fractures are caused by falls in the home. While fractures may result from the direct impact of hitting the ground, they may also result from the forces of muscles exerted against bone.

  • Factors that contribute to the risk of falling:
  • Poor illumination
  • Poor vision
  • Confusion
  • Distraction
  • Diminishing reflexes

Incontinence – the inability to control the flow of urine or fecal matter, Incontinence is extremely disabling and a major source of stress for elderly and their caregivers. It also increases the chance that an older person will be institutionalized.

Dehydration – The elderly are at risk of dehydration as a result of diminished thirst sensation, immobility, or mechanical difficulties in swallowing.

Social and Emotional Changes Related to AgingDepression is one of the most frequently diagnosed form of emotional problems associated with the elderly. While women are more likely to report depression in middle and early old age, men are more likely to suffer from clinically diagnosable depression at the age of 80 or above.

The “grumpy old man” demeanor can often be attributed to undiagnosed depression.

Anxiety is also frequently diagnosed in elderly populations, though many attribute anxiety to “worry.” Anxiety is most common in older women, but can be found in elderly men as well.


Isolation and Loss

To grow old in America often means to be alone. The death of a spouse or the separation from children who are living in distant locations makes isolation a reality for many.

Counseling with an elderly person often requires gaining a perspective on both what has been lost and what has been gained through the aging process. The things that have changed in a person’s life must be recognized and acknowledged; those that continue should be affirmed.

Often losses in an older person’s life may be so overwhelming that it is difficult for them to acknowledge anything positive. In the death of a friend or loved one, it is often helpful, while acknowledging and affirming the pain of the loss, to talk about how positive the years of friendship and love were. Try to help the person by validating his or her pain of loss, but talk about integrating his/her old self with what has now become his/her new self.

With every loss, there can be a gain (e.g., retirement provides more time for hobbies and grandchildren). In talking with the older person about their losses, after they have dealt with their feeling surrounding them, have them focus on what they have gained in their life as a result. It will, at times, be appropriate to help them identify those things that have remained constant during the process of other changes (e.g., a dear friend has died, but he still has his home, children, grandchildren, etc.).

Every loss is difficult, and for the elderly losses become more frequent. It is important to remember that each person grieves and recovers from a loss in his/her own way. For some people losing his/her driver’s license can be more difficult to overcome than the loss of a friend. Some seem to recover from the loss of a spouse in months, others take years, and some never recover.


There you have it. There are many, many reasons why getting that daily call is important to seniors. CONTACT Reassurance hopes that you got some helpful information from this post.

Also, if you are interested in joining the CONTACT Reassurance team, please go to our volunteer page. Our next 6-hour training is coming up in early October!

Post by Meredith Denney, Reassurance Program Coordinator