Working with Seniors: Health, Financial, and Social Issues

Chapter 10: Chronic Illness in Seniors

Hannah is a widowed former farm wife, mother of 7 children and grandmother to 18, who recently celebrated her 90th birthday with a large party in her town’s community center. After the death of her husband she moved to a modest house in a small town in the Midwest. She is responsible for maintaining the house with the assistance of three of her children who also live in the area. Until recently she walked most days on a three-mile path in the town but prior to winter switched to daily use of a treadmill in her house. She has also decided to reduce her house maintenance responsibilities by selling her home and moving to a senior housing complex in the same town. She plays cards several times a week with her friends. Her health is excellent and she frequently expresses annoyance with friends who she says “spend too much time complaining about their aches and pains.”

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Harry is a 75-year-old retired professional who lives with his wife in an apartment in a large Southern city. Gregarious and fun-loving, he has enjoyed with family and friends social occasions, animated discussions, and fishing. Harry was first diagnosed with hypertension 15 years ago. Treatment was established with good control. However, two years ago his blood pressure began fluctuating, and controlling it became more difficult. One day on his way to a fishing outing with a friend, he suffered a massive stroke and was rushed to the hospital. He was paralyzed on the right side of his body. His speech was affected. Months of physical, occupational, and speech therapy followed. He is now able to walk with a cane, but requires from his wife much assistance with his activities of daily living. Harry is able to understand speech but unable to express himself, which leads to frustration on his part. His wife, who is dealing with health problems of her own, wonders how much longer she will be able to care for him at home.

Introduction

As Hannah’s story exemplifies, today’s seniors are, as a group, healthier and less limited by disabilities than previous generations. However, chronic conditions remain a significant factor for many seniors such as Harry. Understanding and supporting your senior clients requires a familiarity with the most common chronic illnesses they face, as well as signs of those diseases, symptoms, treatments; and their potential impact on daily life. As a CSA, such knowledge will help you communicate effectively with your senior clients, appreciate the limitations that illness may bring, and support your clients during treatment and adaptation.

As medical breakthroughs and other advancements have extended and improved lives, more individuals are living longer with chronic illnesses. According to the Centers for Disease Control (CDC), the world has experienced a transition in the primary causes of death. As medicine has increasingly controlled infectious disease and acute illnesses, chronic disease and degenerative illness now account for most deaths. Treatments will undoubtedly improve and life spans will continue to lengthen, but not without exacting a huge toll on our health care system (CDC, 2004c).