Medical Categories and Inclusion of the Aged - Case Study Example

SICK OLDER PEOPLE ARE DEEPLY PROBLEMATIC FOR CONTEMPORARY FORMS OF HEALTH CARE ORGANISATION. DISCUSS It has pertinently been observed that all human societies from most primitive to the most modern ones are socially stratified in one way or the other. This stratification is based upon caste, class, creed, clan, community, tribe, socioeconomic status, gender and age. “Looking at different cultures of the world, one finds that no society is classless i.e. un-stratified. There are some primitive communities so small that no class strata appear, the social organisation resting almost entirely on age, sex and kinship; but even here chieftain individual prowess and clan or family properly introduce an incipient stratification.” (Davis & Moore, 1945: p 242: quoted in Zaidi, 1999: p 29) Age-group is one of the most important factors of social stratification that divides human society into the categories of children, young, middle-aged and elderly. Among these categories the elderly or older people make up a noteworthy proportion of every society and maintain the same significance observed by the young and adult individuals. Researches view ageing as a universal phenomenon that exists in all cultures and societies of the globe. Though old age is assessed and estimated through divergent scales, yet the individuals crossing 60 years of age are stated as old people or senior citizens all over the globe. “Aging is”, Sijuwade observes, “judged by different criterion in different societies. The transition to old age is identified with several factors such as chronological age, ill health, retirement, physical/mental deterioration, and death of spouse. Studies reveal that changes in social role (widowhood, grandparenthood, retirement) and physical health dominate the definition of age identity.” (2009: p 1) Special attention is paid to the cause of elderly in contemporary era and disciplines of gerontological sociology and cultural anthropology have been established, which concentrate upon the study of life, culture and activities of the old people. As ethnography is a branch of cultural anthropology, that discusses human cultural traits in a scientific way, the older people also come in the fold of the study of aged. Political authorities and social welfare organisations aim to strive for the sound health of the population at large. It is the therefore the concerns regarding the falling health and medical problems of the elderly are of great significance for them. Governmental departments introduce new policies and revise them time and again for the welfare of the elderly. These social reforms, related to the betterment of the aged stratum, are not confined to one specific nation or state; on the contrary, the advanced countries en mass have adopted the same strategies for the uplift of the health of elderly. “European governments”, Lopez & Domenech state, “have intensively fostered telecare and telemedicine as an economically sustainable and efficient way to chronic health problems and disorders associated with an increasing ageing population.” (2009: pp 181-182) The inclusion of telemedicine has provided great relief to the old people. “Telecare appears as a service that favours autonomy because it preserves the configuration of interdependencies that makes a person feel at home. It does not discipline users’ bodies.” (Tirado & Demenech, 2001: quoted in Lopez & Domenech, 2009: p 184) Old age brings sickness and weakness in its wake. Medical science has also proved that the old age decreases physical and mental capabilities of humans and they are unable to understand the things and issues in their environment as they used to do when they were young. The researchers are of the opinion that the adverse health conditions of the elderly should be examined with a broader perspective by looking into the social, financial and domestic problems, so that a healthy and strong society can be established to meet the new challenges of modern era. Joanna Latimer (2000) opines the health problems of the elderly as more social in nature than medical ones; it is therefore their health condition must be measured in environmental perspective. “The panacea to medical hegemony has been a discourse of empowerment. This discourse insists upon allowing individual meaning, as well as personal and social aspects of health, illness and bodily troubles to inform medical decision-making.” (Latimer, 2000: p 384) Since the elderly have rendered valuable services in the advancement and growth of the economy of their country in their young life, their contributions cannot be declared lesser than those made by the young stratum. It is therefore, their wellbeing, protection and appropriate look after etc is regarded as an imperative responsibility of both the state and society. It is reality beyond suspicion that the elderly are not such useful for society as youthful individuals, due to their weak physical and mental conditions, yet the society should not negate and discard their dynamic role they have performed in past for their social establishment in one or more financial, cultural and social organisations at their young age. The main reason behind their not giving the same services as they rendered in their youth includes deficiency in their mental and physical abilities that have become great hurdle on their way in old age. It is therefore they are considered as burden on economy of their country. An overwhelming majority of social establishment seems to be annoyed at government’s allocation of funds on the aged. “The splendid overall improvement in the economic status of the elderly”, Levy (2001) states, “was not without a cost. When we look at the distribution of consumption, we see that retirees have been getting ever larger slices of the economic pie, growing portions of the nation's consumption goods and services.” (Quoted in http://findarticles.com) Not only this that they have become encumber on economy because they have turned financially ineffective, frail and weak, but also the elderly turn extremely nagging and complaining in their later years towards their family members, relatives, neighbours, organisations and nation at large. It is partially due to their sickness and ill health that they start losing their temperament on petty issues; consequently, they start behaving like small children in an irritating way, which badly tells upon the staff of healthcare organisations. Despite the fact that the unpleasant behaviour of the elderly badly perturbs the young and middle-aged individuals, the health care organisations are the worst victims of their demanding attitude and complain. “Laurent (1990: p 20) commented on attitudes to old people in Great Britain, that they are regarded as ‘stupid, decrepit, feeble, or unusually eccentric, wise or sweet natured, and in any event to be patronised.’ She then referred to a report from the King's Fund that claimed that ‘...such attitudes (as above) pervade the health service and mean that services are based on deep seated stereotypes of what old people are like, rather than what they need or want.’” (Retrieved from Parsons, 1993) The staff members of health organisations including doctors, nurses, counsellors and medical attendants have to bear the brunt of the illness and sickness of the elderly, as they have first hand knowledge and experience of the activities of the aged people. The poor workforce of healthcare organisations is always busy in providing the elderly with best available comforts, care, mental relief and satisfaction according to the policies devised by the state; even then the elderly look displeased and dissatisfied with the behaviour of their family, relatives and medical attendants. They pretend to be leading a miserable life at their homes, in old houses, hospitals or therapeutic centres under the most unfavourable circumstances. It is universally believed that elderly people are incapable of learning new things, depressed and that intelligence declines with age; consequently, they always appear to be gloomy and miserable. The role of healthcare organisations has increased to a great extent after the cultural changes in social establishment all over the planet. The nuclear families are not ready to keep their elderly along with them. Consequently, they become rolling stones and on the discretion of governmental and healthcare organisations. “In the UK with the breakdown to a degree of families to a singular nuclear unit the state took up some of the slack. Old people’s homes and care homes, some good, some bad, sheltered housing, care in the community etc. all pitch in to make up the difference of our less familocentric society. More people live on their own, more families find they can't or don't want elderly relatives moving in, worse the pensions raid by Labour (thanks Gordon) have left many in a position where their pensions today wont cover a decent quality of life in the future.” (quietmanmyblog.blogspot.com) Before embarking upon the attitude of elderly towards health organisations, it will be appropriate to define health care organisations. Health care organisations refer to the organisations that deal with eradication, prevention and treatment of any physical or medical illness under the management and supervision of professional and technical medical staff. Health care organisations take special heed to the patients suffering from various mental and physical diseases. The organisations particularly make plans and implement them regarding the diseases the elderly have been suffering from due to age factor or some other problem. Hence, healthcare organisations serve as blessings for the old people and are the most important source of their relief and assistance. But in return these organisations do not receive even the words of gratitude and thanks from the old people. A large proportion of the individuals affiliated with the healthcare profession are of the opinion that the senior citizens are mostly problematic towards them and rarely acknowledge their services being made through the platform of these organisations. But it does not mean that every old person is problematic towards others. On the contrary, a significant proportion of the elderly is co-operative and complying towards the healthcare staff, which is considered as the outcome of their socialisation in their childhood. Hence, the innate characteristics, initial years’ education and training, and the environment under which they have been brought up leave indelible influence upon their personality even during their old age. Theorists vehemently regard socialisation process of the individuals as the most effective way to determine the future role, mental approach and social behaviour of the individuals. The psychologists submit to state that the socialisation plays pivotal part in personality traits as well as in the determination of attitudes of the people. They are of the opinion that influence of earliest mode of upbringing and childhood experiences remain active and powerful even in the last years of individuals. It is therefore different people behave differently while entering into social interaction with their environment. Consequently, it is social atmosphere that creates law-abiding civilised individuals on the one hand, and law-breaking offenders and criminals on the other. Sociologists have defined various theoretical approaches of social behaviour to estimate the reasons behind some specific attitudes and activities of individuals. These theories are also helpful for the healthcare specialists with particular reference to the elderly. Such theories, have been articulated on the foundation of the researches have been made to estimate the behaviour of the elderly towards health organisations. The most recognised theories include Psychological Theories of Ageing, behavioural, communication accommodation, and socio-cultural ones, which are being discussed as following: Psychological Theories of Ageing: Psychological theories of ageing concentrate upon the psychological changes occurred in humans on the basis of the changes they witness in growing years. Psychological theories declare sickness among the elderly as a result of lack of proper work and scheduled activities. Since the individuals have the habit of working from dawn to dusk during their young life at job, their retirement brings depression and disappointments in the wake of jobless hours. The elderly start considering themselves as non-productive stratum of society, which badly hurts their feelings and emotions. In addition, the family members, relatives and neighbours also realise them as useless individuals, which create financial and social insecurity on the one hand and psychological problems and disturbances on the other. The most noteworthy psychological theories of ageing are as under: Role Theory of Ageing: Role theory of ageing lays stress upon the very reality that change in role performing leaves adverse impact upon the elderly. Since elderly have led a dynamic and thrilling life as earning hand, their role is central both at home and society. Moreover, they have been financially supportive for their family members for the last many years during their job or business boom. On the contrary, when these elderly get retired and their income level declines to some extent, their role falls down from head of the family to mere an ordinary and useless member of family. “The special dilemma of role change for older people is that they are more likely to lose roles than to acquire new ones. Further, these losses, such as the loss of the worker role with retirement, are largely irreversible and may lead to erosion of social identity and decline in self—esteem.” (Rosow 1985) If the elderly are given the same importance that they had been enjoying in past, it would be extremely beneficial for the diminishing of their health problems and keeping them mentally happy and contented. . Disengagement Theory of Ageing: Disengagement theory focuses upon the relationship of elderly with other members of society. It explains how relationship between different individuals are altered and changed with the change in position, status and age. The theory simply means that with the retirement of the elderly from respectable post, the behaviour of the individuals take a drastic change and the persons paying imperative importance to the words and decisions of the elderly start ignoring them and neglecting their presence altogether. It is quite hurtful for the elderly, which become sick and disturbed both mentally and physically. If they accept their current social position and do not take these things to heart, it will be a positive sign for their health. Otherwise, they will become patient suffering from diseases of various kinds. The elderly also look for the extreme care from the healthcare organisations, put feel the attitude of the staff as inappropriate one because of the psychological problems they are undergoing. Otherwise, these organisations are fulfilling their duties in a professional way. “Healthcare organisation”, “does not seem to know how to care. For instance, healthcare organisations for the elderly meet, better or worse, the basic instrumental needs of feeding, cleansing or clothing those they ‘care’ for, while the extensive, existential and life world needs of the ‘cared for’ are generally ignored.” (Letiche, 2009: pp 63-64) Activity Theory of Ageing: Activity theory aims to submit that if elderly transfer their energies to some other positive and creative activities, it would be highly beneficial for their health and fitness. It not only keeps hands busy, but also man’s brain remains active and well-alert. Renowned theorist Michael Foucault is of the opinion that it is brain that regulates all the functions of body. It is therefore he lays stress upon the examination of brain to keep elderly healthy and active. It is brain that turns a body active or docile. “A docile body is”, Foucault submits, “one that may be subjected, used, transformed, and improved; and that this docile body can only be achieved through the strict regimen of disciplinary acts.” (1995: p13) “Activity theory emphasizes the importance of ongoing social activity. This theory suggests that a person's self-concept is related to the roles held by that person i.e. retiring may not be so harmful if the person actively maintains other roles, such as familial roles, recreational roles, volunteer & community roles.” (Retrieved from angelfire.com) Hence, shifting one’s concentration from professional activities to some other engagements turn out to be fruitful and productive in respect of both financial and fitness perspectives. Continuity Theory of Ageing: “Continuity theory states that the older adults try to preserve & maintain internal & external structures by using strategies that maintain continuity.” (Retrieved from angelfire.com) The theory simply refers to the very fact that the elderly usually seek escape and relief in continuing the similar activities that they have professionally been doing in past. It is perhaps in human nature that they are a bit retrospective and traditional. Instead of enjoying new situation and adapting themselves accordingly, they try to stick to the old traditions and past memories in order to soothe themselves with the help of the beautiful moments have been passed away for long. They also intend to keep their old habits with them as the memory of sweet days. Hence, if the old people are able to get involved into same sort of work, they will remain happy, fit and active. On the contrary, if they are deprived of performing these activities, it may turn them sick and tensed. It is therefore the healthcare organisations should provide the elderly with an atmosphere which is close to their past life. Thus, the elderly will not prove more problematic, nagging and disturbing towards them. Error and Fidelity Theory of Ageing: The Error & Fidelity Theory explains the causes behind irritating behaviour of the elderly include the change in the DNA statistics in their blood cells. The theory submits that old age brings imperative change in the statistics of human cells and pituitary gland. Old age turns all organs and their muscles if humans frail, weak and exasperating; and the elderly turn rude and coarse towards the healthcare staff too. “In the mid twentieth century, phenomenological existential psychology tried to elucidate the fundamental existential qualities of the clients or other.” (Litche, 2009: p 64) Consequently, the aged make mistakes and get annoyed immediately because their nerves cannot tolerate even the slightest thing against their disposition or aptitude. If the elderly take proper diet, regular medical check up and walk or exercise on daily basis, it will keep their nerves and muscles strong and active. And if they do not observe these things in their daily life, they are prone to fall into the hands of frailty and weaknesses. Communication Accommodation Theory: Developed and presented by American theorist Howard Giles, communication accommodation theory lays stress upon the divergence in communication style and mode applied and observed by the individuals during their communication with others. “Communication Accommodation Theory focuses on the role of conversations in our lives. The theory has been incorporated in a number of different studies.” (West & Turner, 2006: retrieved from highered.mcgraw-hill.com) The theory above mentioned concentrates upon human behaviour at large, where individuals make significant alterations in their attitude and behaviour while entering into communication with different people. For instance, man looks obedient and complying while interacting with parents, teachers, bosses and clergy; but the same man appears to be very strict and disciplinary while dealing with his sub-ordinates and students etc. Similarly, he is a romantic person during interacting with spouse of lover. In the same way, he appears to be very frail and weak while getting examined by a doctor or medical attendant. It is therefore, he behaves in a nagging way at healthcare centres, so that he can take maximum attention of the staff. To conclude, it becomes evident that the sick elderly badly turn upon the members of their family, their friends, healthcare organisations and care-givers during the illness. Some of the elderly refuse to take latest medicines and insist on age-old formulae and techniques, which they had observed taking by their elders in past. The researches show that the sick people generally looking irritating and annoying, and the case increases to a great extent when the sick are elderly stratum. Such sick people do not take any care of the staff members of the hospitals and therapeutic centres, and always demand one thing or the other from them. The care-givers have to tolerate a lot while providing the elderly with food, medicine, health tips and other relevant services. “Caring for a sick or disabled elderly family member can be a deeply enriching and personally fulfilling experience. For some, it offers a rare opportunity to spend extended time with a loved one. But the responsibility and challenges of care giving can be overwhelming. Watching a loved one decline, experience pain or discomfort, or act in unfamiliar ways can be disturbing. Caring for an ill elderly family member can be physically demanding and exhausting; it can leave caregivers feeling overwhelmed, frustrated or fearful. If the relationship between a caregiver and an ill family member was poor to begin with, care giving can aggravate tensions or cause resentment. Some caregivers feel guilty that they’re not doing enough, while others fear that they will lash out or harm the person for whom they provide care.” Quoted in www.ncea.aoa.gov) The sick elderly suffering from psychological problems and mental trauma are the worst of all, and health-givers become exhausted by their nagging attitude. The researches conducted in the UK show that though latest technological advancements have increased life expectancy by overcoming diseases, yet the sick elderly cause great tension and disturbances for the healthcare organisations. The theories cited in this paper also support the notion that more the proportion of elderly in a country, more miserable the situation of healthcare staff members. LIST OF REFERENCES: Latimer J. Socialising Disease: Medical Categories and Inclusion of the Aged. Sociological Review. 2000, 48 (3): 383-407. Letiche H. (2009) Bodily Chiasms In: Joanna Latimer & Michael Schillmeier Un/Knowing Bodies. 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