July 28, 2008

Healthy Longevity of senior Citizen is not just an unreachable dream

Perception of Mortality and the Psychological Well-Being of Older Persons
By
Yakob Abdul Rahman Wilhelm Scholer
Home Nursing Providers
Malaysia

Reigning measures of psychological well-being have little theoretical ground, despite an extensive literature on the contours of positive functioning. Aspects of well-being derived from literature are: self-acceptance, positive relationship with others, autonomy, environmental mastery, purpose in life, and personal growth.
Unquestionable these are very universal goals of the elderly, yet more often a dream than reality.
Happiness, however, is not being the only indicator of positive psychological functioning. Much literature has also been generated on well-being defined as life satisfaction. Prominent measures in this domain (e.g. Life Satisfaction Index, or LSI; Neugarten, Havighurst, & Tobin, 1961) were also developed for purposes other than defining the basic structure of psychological well-being. We have to differentiate persons who were aging successfully from those who were not.
Early retirement is supposed to give you extra golden years to enjoy. But that may not happen, a new study suggests.
A study of Shell Oil employees shows that people who retire at age 55 and live to be at least 65 die sooner than people who retire at 65. After rhe age 65, the early retirees have a 37% higher risk of death than their counterparts who retired at 65.
That's not all. People who retire at 55 are 89% more likely to die in the 10 years after retirement than those who retire at 65.
"This difference could not be attributed to the effects of sex, socioeconomic status, or calendar year of the study, although the poorer health status of some early retirees may play some part, noted Shan P. Tsai and colleagues at Shell Health Services.

The researchers looked at all past employees of Shell Oil who retired at ages 55, 60, or 65.
"Mortality improved with increasing age at retirement for people from both high and low socioeconomic groups,” they found. "Retiring at 65 was not associated with a greater risk of mortality than retiring at 55 or 60.” British Medical Journal.
What then are the reasons for earlier death in early retirement? Surely not overwork! There are hardly any sicentific studies that will shed light on the reasons of this evident phenomena.
Let me make some psychological assumption as to the possible reason of early mortality of early retirees. When I say early retirees I realy mean those who after their formal retirement also live in this retirement. This is not meant for those who after retirement embark on a new challenge in life. It is abvious from the above observation what complacency in retirement can mean.

Perception of Mortality and the Psychological Well Being of Older Person: By Yakob Abdul Rahman Wilhelm Scholer

A BIASED VIEW OF RETIREMENT
Are the daily activities of the retired engaging or alienating? We might see the retirees portrayed as alienated, withdrawn from society, disconnected from productive work, socially isolated from others and living an unfullfilled, boring, useless and routine existance. In this view retirement presents as jobless. In retirement people who have had a meaningful role are now seperated from themselves and others, with little attachement to productive activity.
In comparison to full time employees, those of retirees are more alienated in some aspect but more engaged in others. Retirees’ activities are more routine, provide less chance to learn new things, provide less social interaction with others, and they are especially less likely involved in problem solving activities. However, retirees’ activities are also equally enjoyable and more autonomous compared to those with full time work. Autonomous fullfilling activities which are enjoyable and provide opportunities to learn new things and integrated activities are all positively associated with a sense of control and negatively associated with psychological distress.
Journal Health and Behavior Catherine E. Ross & Patricia Drentea

Possible reasons leading to early death of retirees could be:
1. Lack of meaning in life. The retiree is suddenly removed from the respected position he/she had in the working life into oblivion, no more Yes Sir, No Sir, Please Sir, Good morning Sir, etc. While in Position he was some one. In retirement he is reduced to no one. This leads to a sense of emptiness and depression.
2. Empty nest syndrome. This refers to the often expirienced reality that prior to retirement their children who were part of the family have made the journey towards their own destiny. Leaving suddenly the house empty, quiet, abandoned. This physical feeling is also perceived emotionally. Creating a sense of abandonment and emptiness, not expirienced to this extend while in a working life.
3. Complacency. The long expected retirement has come, suddenly the “freedom” of job obligations are to be enjoyed. Time routines are changed, personal neglect developes, laziness surface, boredom creeps in etc.
4. Personal life style change. Boredom, feeling of emptiness etc. create a new demand for satisfaction, often resulting in a pleasure seeking behavior, in particular of oral satisfaction = eating. Not merely to fill the daily nutritritional demand but rather as emotional pacification, leading to overweight with all the subsequent health complications.
5. Financial constrains. Suddenly the bank account shows a reduced monthly statement. Yet obligations may not have deminished. Suddenly the previous life style can hardly be maintained. On the other hand the personally perceived, social obligations may have increased, such as marriages of children, arrival of grand children etc.
6. Social/Sexual activities. Many people equate retirement also with sexual passivity. Reduced social contacts with friends, and former working colleges, due to the declining economic status, or just as symptom of depression. This too often leads to a negative attitute towards sexuality particularly when the female spouse is still in employment. Retirement here influences also the balanced sexual life, which may be reduced to a mere obligatory function as the mental attitute towards sexuality has “retired”. However the oposite has also been noted, that retirees need to prove their sexual “attractiveness and ability” by overt sexual activities.

Happiness/Wellbeing

“Contours of Well-Being: Alternative Perspectives
The extensive literature aimed at defining positive psychological functioning includes such perspectives as Maslow’s (1968) conception of self-actualization, Rogers’s (1961)
View of the fully functioning person, Jung’s (1933; Von Franz, 1964) formulation of individuation, and Allport’s (1961) conception of maturity. A further domain of theory for defining psychological well-being follows from the life span development perspective, which emphasizes the differing challenges confronted at various phases of the life cycle. Included here are Erikson’s (1959) psychological stage modes, Buhler’s basic life tendencies that work towards fulfillment of life. (Buhlers, 1935; Buhler & Massarik, 1968), and Neugarten’s 1968, 1973) description of personality change in adulthood and old age. Jahoda’s(1958) positive criteria of mental health, generated to replace definitions of well-being as the absence of illness, also offer extensive descriptions of what it means to be in good psychological health”
If we look at the aspect of well-being = well-feeling, we can not but must view it in perspective of happiness. This again can not be viewed in isolation but needs to be seen in the various aspects of psychology.

Self Acceptance The most importance criterion of well-being is in the individual’s sense of self- acceptance. This is defined as central feature of mental health as well a characteristic of self-actualization, optimal functioning and maturity. Lifespan Theory also emphasizes acceptance of self and one’s past life. Thus holding positive attitudes towards oneself emerges as a central characteristic of positive psychological functioning.
Positive relation with others The important emphasis here is on a warm trusting interpersonal relationship with a spouse or other family, or social community member
Self-actualization The realization of fulfillment of ones potentials, independency, autonomy, tendency to form few but deep friendships, a philosophical sense of humor, a tendency to resist outside pressures and a general transcendence of the environment rather than simply coping with it.

“The highest fulfillment of all good achievable by human action is happiness”
Aristotle (1069)

Discussion
Taking into consideration the afore said we do have to make an effort to seriously question the way we look at and treat senior citizen in this country. Are they in general, particularely those from lower income groups, in any way meeting the aforesaid criteria?

Can we speak of human dignity when we visit “Old People’s Homes”? Are senior citizens given even the basic opportunity to be accepted as respected members of society, when they are:
· excluded from Health Insurances coverage,
· not eligieble for a Credit Card,
· not even considered to get a Bank Loan, even if they can produce securities,

· not served in their home setting by medical doctors,
· treated as non persons in hospitals,

· lacking of urgent nursing help in their home setting, because Institutions do not do their home work etc.

We should consider retired persons as sources of knowledge, inspiration and resources of human capital. For most do have a wealth of knowledge and expirience accumulated in the years of their life and service.
The present practice of sending government servant into early retirement just to give “way for unemployed
youth” is unrealistic and counterproductive. How does anyone justify to sent an expirienced Medical Assistant into early retirement while the country is short of nursing personel?
Where are the seniors who can pass the knowledge and skills to the juniors in the employment sectors?
Is the poor performance in various fields in the country not a result of “ousting” expirienced work force, to make way for the young unemployed, albeit also inexpirienced persons. Would it not make more sense to all concerned if the seniors reduce their working hours, but stay on to pass the knowledge to the juniors? This would not only benefit the young but also give credit to the seniors that they are not being looked at as an obstacle of the younger generation’s aspiration, but catalyst to the improvement of service quality and sources of knowledge for the young. A rethink here is of urgent importance.

This approach would very well go a long way in preventing the retirees feel a sense of uselessness and depreciation of their self worth.
Where are the Senior citizen ‘Towns’, where they can enjoy life in a senior citizen compatible situation and surrounding?

When do we change our mentality of sending “burdening” old sick senior citizens into strange homes instead of providing them with the needed care in their own home setting?
When will the building authorities wake up and insist that new houses and flats have senior citizen compatible bathrooms where also a wheelchair or commode can be moved in and out?
When is society starting to realize that everyone, even the newborn is likely to become old one day and needs help.

When does the government start a compulsory saving scheme that would be available for nursing care once senior citizen need it?
When do professional organisations and individuals stand up and demand from all concerned to ensure that senior citizens can live a life in dignity and solace?
When do I AND YOU put aside personal convenience and initiate what needs to be done in one’s own area of service, related to the issue of improving senior citizen’s plight?

“A country and society will be judged by the way it looks at and treats those senior citizens who have served it and contributed to its deveopement”.


For further information and care for the elderly,
MOBILE NURSING/DOCTOR contact:

006 03-78777202
nursing@hnp-mobilenursing.com
www.hnp-mobilenursing.com

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