Mislabeling and Aging

Far too often, labeling a person as ‘senile’ is a thoughtless expression steeped in prejudice. ‘Diagnosing’ a person as ‘senile’ is accurate only when we mean there is a continuing pattern of progressively deteriorating thought and behavior coupled with a medically proven diagnosis of an irreversible brain disease. Careless use of this single word (senile/senility) suggests that we think we know what is wrong and there is nothing more to understand or to be done. This attitude is not justified even when the person is, in fact, suffering some form of a progressive cerebral change. But the attitude is particularly destructive when the individual is troubled, yet far from ‘senile’.

Even professionals are capable of making such errors. International mental health teams and researchers in the field of gerontology who have been studying this problem have discovered that many elderly persons who were labeled with the term senile/dementia have come to realize that the problem is, in fact, functional in nature. If this can happen, then people without professional or scientific training may be even more prone to error. Any sign of confusion or mental lapse in an elderly person may be erroneously taken as ‘proof’ of senility.

Let’s consider some of the common mistakes:

  • Few of us are at our best mentally when our bodies are beset by illness, distress or fatigue.
  • We tend to be more charitable to ourselves than we are too old people. Yet many so-called ‘senile’ qualities of thought and behavior are really associated with states of poor health, little different from our own.
  • Malnutrition is a common cause, whether from a bad or inadequate diet.
  • The prolonged deprivation of sleep can affect both behavior and proper functioning of the mind in all of us.
  • Physical disorders such as heart or kidney illness may upset the normal rhythm of bodily functioning and may result in the accumulation of toxic body products.
  • Drugs administered to treat a physical condition may result in a measure of drowsiness, agitation, or confusion resulting in society mislabeling and thereby suggesting he or she may be genuinely ‘senile’.

Frequently the signs of ‘senility’ disappear rapidly when the physical problem has been attended to. In my long career as a Registered Professional Nurse I have had the pleasure of talking with numerous recuperating old persons who but a few days previously had been admitted to a geriatric facility and diagnosed as hopelessly ‘senile’. A person who appears senile may be tormented with grief and anxiety. His ‘demented’ state may have been brought about by emotional pain. Loss and grief are frequently common in old age as death removes loved ones. An old person may have suffered other significant losses of occupation, residence, physical mobility, belonging, or usefulness, all of which produce a grief response that can mimic symptoms perceived as early signs of dementia. The question that begs asking: is there a solution and hopeful outlook?

Research has demonstrated improvements in mental and physical functioning when the aged individual who has been declared ‘senile’ is placed in a socially enriched environment. Although impaired brain tissue may not always be reparable, the individual has the opportunity to be motivated and to make better use of his/her remaining functions with the aid of caring professionals, a loving family and, if available, a significant other. Good nutrition, careful use of medications and exercise can also dramatically modify this condition.

There is great satisfaction in seeing dignity and self-esteem return to an old man or woman who has been treated with respect and an understanding of that old person’s dilemma.

Consider: Before affixing that label, remember that poor health and senility are not always one and the same.

Consider: Every day can be a cause for celebration.

Consider: Many of the difficulties encountered by old people are caused or intensified by a lack of basic amenities.

Consider: Social connectivity and a healthy physical environment that meet the old person at least halfway do much to sustain self-respect, morale, and purpose to live.

Addendum: I have been using the term dementia because it is in general use. However, it is important to know that the term has been discontinued. In 2010 the American Psychiatric Association posted in the DSM-5(Diagnostic Statistical Manual) the new terminology for dementia as neurocognitive disorder (Mild, Moderate, etc.).

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