The Human life cycle moves through various stages from the immaturity of childhood to the maturity of adulthood and then the senility of old age. Every Stage is characterized by certain concomitant changes in the physical, emotional as well as the social realms (Pai, 2000)
Of these stages the last one, that is old age had failed to attract the attention of the society until recently. This was apparent even from the vocabulary of social welfare, for, though included the terms like destitute, dependents and vulnerable groups, connoting children, women and to certain extent the youth, it had not considered the aged.
Even the British Medical Association confirms the considerable indifference shown toward ‘Geriatric Medicine denouncing it as a second-rate speciality, looking after third-rate patients in fourth-rate facilities’ (BMA, 1986 P.4)
Is Old Age a Social Problem?
Today despite being considered for the receipt of welfare services, the aged continue to be practically left out of development, indicating the continued neglect from and indifference to these aged in the society. The old age, therefore, has almost become a bugbear striking fear in the minds and hearts of people about the real and imaginary ordeals of it.
The decline in the status of older people could be attributed, among many other factors, to the shift of society from ‘agrarian economy’ to ‘industrial’ and also to the replacement of ‘oral tradition’ to ‘written tradition’.
Cowgill and Holmes (1972) opine that deterioration in the status of older people in the West began in the nineteenth century. Predicating on the idea that ageing was a biological process of deterioration, it carried the assumption that older people are a burden (Toucault, 1991)
Accordingly a number of myths have come to be associated with old age. viz., All older people become senile and suffer from brain deterioration, which makes it difficult for them to learn; the inevitable debilitating physical illness, coupled with memory loss and mental deterioration, they become unproductive; older people are lonely; it is useless to provide therapy to older people, because they cannot benefit from it; etc.,
Unfortunately perpetuation of these and other myths has not only lowered their status, and devalued them, but also has developed ageism and contributed to age prejudice and age dissemination, both in the developing and the developed countries. Many older people seem to believe and internalize ageist stereotypes and reproduce these in their ways. Ageist assumptions present older people as homogeneous group and configure them as a weight that has to be borne by the work of young people. In this world view, older people are presented as dependent, incapacited and incapable. (Serutton. 1989)
Ageist attitudes ignore the interdependence and solidarity that exist between people, young and old, and do not acknowledge the burdens that older people have borne for younger people in the past by seeing them through infancy, childhood and into adulthood (Phillipson 1982). Moreover, constructing older people as not having a useful role in society, because physical impairments limit their involvement in waged labour; it also subjects them to disablist stereotypes and a consequent exclusion from the main stream.
The situation in India is no different from the West. Owing to the shifts in the employment patterns, and consequent separation and migration, besides the negative images of older people are central to the changes in their status and roles. Marulasiddaiah (1969) based on his research findings reports a decline in filial piety and the loss of authority, respect and recognition of the old, even in the rural India. The 'aging' and the ‘elderly population’ are perceived as 'social problem' and because the society is expected to support them with its resources, the elderly are viewed as burden.
Phillipson (1998) states that the ageist attitudes contributed to the medicalization of old and its unhelpful approaches to older people. Thus the ageist view reinforces socially constructed negative images of elderly and projects them as unproductive and dependent members of the society.
Constructing old age:
The reality, however is that, not all elderly are dependents or in need of care and protection. They are not a homogenous group as projected by these ageist discourses. There are a number of persons who are more than seventy five years and above, but still active independent, working and contributing to the society in several ways. They do not look forward to or when offered they may not accept the gerontological services. They may not qualify any of the standards set by the society to consider them old except that they have advanced in chronological age.
The question before social workers, therefore would be, what should they call them- 'the elderly' “senior citizens”, “golden agers” “old adults”, or some other appropriate term be coined? With the increasing life span and enhancement of the quality of life, what once was considered as old age, does not seem to be appropriate today.
The social workers therefore need to be more conscious and cautious while providing gerontological services. They cannot devise and standardize services, and render them uniformly to all elderly alike, considering all older citizens as having lost their physical powers and the capacity to contribute to the society economically. They should avoid the negative construction of old age and be more pragmatic while working with them.
Social Work Intervention with the Elderly:
Research in the field of gerontology has proved that, although changes in the brain do take place as one grows older and the body has outlived its sell-by date, yet severe deterioration of mental functioning or physical debility is not inevitable. Most elderly people remain mentally alert through out their lives and enjoy good health. Several of such persons take on new activities after retirement, learn new skills and make significant contributions to their society.
Thus, severe physical and mental deterioration is not necessarily an out come of old age. Moreover, most physical and mental problems associated with aging are treatable. All the same, the ‘very old’, the ‘frail old’ may need attention of the young.
The social workers therefore should first and foremost dispel the negativistic attitudes toward the aging. They should prepare themselves to accept that aging per se and all aged do not pose problems to the society. The negative portrayals of the aged be challenged, and endeavour to develop positive images and attitudes toward aging not only among the people in general but among the aged themselves in specific.
Whenever, the latter they are intervening with the aged, they should always believe that they deserve full attention and respect because, they too have skills and strengths which can be harnessed. The social workers could intervene at three levels ;
To do this, the social workers have to restrain themselves from replicating ageist projections of elderly in and through practice. Their concern with vulnerability should not prevail on them and cause them to put all elderly in that group.
Those social workers who decide to work in the field of gerontology and geriatric care besides having a comprehensive knowledge–biological and physiological, psychological, sociological and political–economic, should have an aptitude, compassion and patience to accept the elderly as they are.
Gerontological Social Work has practically assumed the status of a specialized service. A worker here is called upon to work not only with the elderly but also with their families and other resource systems. A worker therefore may have to convince the concerned that the well-being of the elderly in their penultimate stage of life is as important as the well-being of children, youth or even the adult members. Social Workers, therefore, have to perform a number of roles such as friend, philosopher and an enabler besides being a clinician, broker, advocate and an outreach worker. He/She needs to liaise with various resource systems, including families to identify the potential strengths and capacities of the aged and harness them for the benefits of the society.
The families especially the 'sandwiched' carers should be helped and assisted in making appropriate decisions about maintaining the old at home or shifting them to old-age communities or care centres. The professional intervention of the social workers should strengthen both the older clients and the care givers as the case may be and enable them self determine.
In our contemporary society old age being an ageist construct, and the service being commodified, Social Workers have a crucial role to play in challenging the negative image constructed about it. Their intervention should also succeed in doing away with the negativity developed among the old towards the younger generation. A mutual trust between the old and the young, and compassion shall go a long way in benefiting the entire society.
Dr. (Ms.) Vineeta B. Pai
Prof. & Chairperson, Karnataka University
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