Where Science Meets Muse

Innovations in Elder Care Demand a Different Paradigm

Posted by Plish on March 5, 2010

I’d like to have a spirited word or two with the person who popularized the concept that as adults get older they become children while their children become the parents.

This concept has warped elder care and hurt the cause of innovation in hospitals, nursing and rehab facilities around the country (and perhaps the world) as it is a classically misapplied case of: If A=B, and C=B, then A=C.

In other words:

Elderly people need help to bathe,  use the bathroom,  dress,  or eat.   Young children need help to bathe, use the bathroom,  dress, or eat.   Therefore Elderly = Children, and they should be treated as such.


A recent shocking study pointed out that speaking to elderly people like children actually took years off their lives!

This problem exists not only in the speech of caregivers but in the systems that are supposed to bring elderly back into society.  Take, for example, elderly going through rehab therapy.   The elderly individual, who perhaps only weeks earlier had made a meal for the family or gone hunting in the woods, is required to manipulate and stack plastic colored building blocks or pieces of felt into  certain patterns.   When that task is completed they’re congratulated with glee as if it was the first time this person ever accomplished that task.  “That was great sweetie!! Now try this one!”

Or take the elderly woman who painted  and scanned a modern Christmas card design on a computer only 6 months prior, and was  given a ‘paint-by-number’ task at a rehab facility.  For an elderly person who had never painted before this might be a significant accomplishment, but for this artist, it was a reminder of the frailty of the human person.

While physical attributes were perhaps improved through therapy, in neither case was the elderly person  elevated and treated with respect.   The system, although it had the best of intentions, did not treat the entire person and in fact may actually have contributed to future morbidity.

To innovatively change and design healthcare systems for the elderly there needs to be a change of perspective and greater empathy – empathy on the parts of nurses, doctors, therapists, and family members. 

Being elderly and being cared for is not the same as being a child being cared for.  It is an entirely different experience that demands better techniques and communication modalities that account for the fact that the elderly person is a living history, a person who simply can not do all the things they could do.  That is essentially different from working with children who never knew they could do something.

It is a simple, powerful, painful difference.

In one case there is the memory of a task, in the other there is rejoicing in new found potential.  The latter is decidingly easier to empathize with and perhaps that is why too many people opt for this perspective and treat the elderly like children. 

The former is painful and more difficult to empathize with, perhaps because it is what awaits us all in some way.

But, if we make the brave jump to truly empathize with the elderly, we rest assured that the innovations we bring to the table will not only improve the lives of those who are currently treated like children, but will one day make our lives better and allow us to experience, and live with, respect and dignity.

5 Responses to “Innovations in Elder Care Demand a Different Paradigm”

  1. Brad said

    I hae observed many physical therapists and occupational therapists in several organizations. Some do treat the frail elderly with too much bubbly good humor and “happy playtime” attitudes as if the elderly person was a child. But a majority of those who I have observed have treated the eldery with respect and show deep empathy towards their clients.

    It is very difficult for an elderly person who is aware that they are losing their memories and their cognative skills to keep working at their physical rehabilitation. At the same time, most do not want to be physically confined to wheelchairs or dependent on others for bathing, toileting and other such activities. They struggle with their therapy, and they need encouragment.

    Empathy, respect and love are important, as those who love us lose more small pieces of their past and cannot hold on to the present. Someone who is 103 may forget where they live, the year, may confuse a son for a brother or father. I also try to remember them as they were, before they became lost in time.

  2. Plish said

    Brad, I agree that there are many therapists who are respectful in their work. Encouragement is something that indeed needs to be done – doing it with respect and without belittling the elder person is the challenge.

    Having said that, I believe it goes deeper however in that it’s not simply attitudes of the caretakers but the types of tools and therapy methodologies. These too need to be (re)designed to give the elderly a sense of dignity.

    Great perspectives, thanks for sharing!

  3. Elder care is a difficult task, different individuals demand different kinds of attention. I agree that caring for a child and caring for an elderly person are different. I also agree that talking to them as if they were a child will somehow lessen their sense of dignity.
    Respect must not be forgotten in caring for our elders. They might not be able to eat on their own, but they are still older and much wiser than we are.

  4. Plish said

    Thanks for your wonderful work and for your comments!

  5. michigan caregiver…

    […]Innovations in Elder Care Demand a Different Paradigm « ZenStorming[…]…

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