Should Older People Be Protected from Bad Choices? The Controversy Unveiled

1. Controversy 6 Should Older People Be Protected From Bad Choices?

2. The Vulnerabilities of Older People • Individuals have different competencies as they age • We’re finding that some of our stereotypes about the vulnerabilities of older people are inaccurate • So why should the old be protected from risky choices that may lead to a greater quality of life for them?

3. Interfering When People Make Bad Choices • Dilemma: When is it right to interfere with other people’s actions if those actions constitute a danger to themselves? • Legally, we’re not permitted to curtail a person’s freedoms unless they are unable to make decisions for themselves • There are differences between child abuse and elder abuse • An adult is always presumed to be mentally competent until proven otherwise

4. Elder Abuse and Neglect • Reliable statistics are hard to obtain, but there seem to be several types of elder abuse: • Physical violence • Chronic verbal aggression • Neglect • Abuse appears to be prevalent in about 1.6% of people over the age of 65 not living in institutions • Risk factors for elder abuse include: • The presence of psychopathology (especially alcohol or substance use) • Family history of violence • Caregiving burdens • Social isolation • Recent occurrence of stressful life events

5. Perceptions of Quality of Life • Defining “quality of life” and measuring well-being in later-life are serious problems for gerontology • Life satisfaction – as person’s attitude toward past and present life as a whole • Morale – a specific feeling, whether optimistic or pessimistic, about the future • Researchers use many scales to try to measure subjective well-being • Life Satisfaction Index and The Philadelphia Geriatric Center Morale Scale are most common • Old age alone isn’t related to poor morale or unhappiness • But physical health is a strong predictor of subjective well-being

6. Sexuality in Later Life • No single pattern of personal relationships is perfect for all people, and human beings need intimacy and love in many different ways throughout the life course • Yet, sex among the elderly has long been a topic for humor • Sexual decline is more likely to be determined by marital status, general physical health, or the feelings of an older person about sexuality – rather than chronological age • Sexual activity in late life is best explained by the continuity theory of aging: • The best predictor of sexual behavior in late life is earlier sexual behavior

7. Sexuality in Later Life (cont.) • The difference in statistical findings on sexuality between men and women reflect the changing sex ratio in later life • Women tend to outlive men by an average of 6 years, and each year 7 in 1,000 men remarries, while only 1 in 1,000 women remarries • Men typically remain fertile into their 80’s • Women, however, experience menopause and loss of fertility • Decreased estrogen production can also increase the risk of osteoporosis • Many artists and authors have picked up on the many positive themes of later-life development, especially in post-menopausal women

8. Crime and the Elderly • People over age 65 have lower rates than other age groups for serious crimes such as robbery, personal theft, assault, and rape • The victimization rate for the elderly is lower than the rate for the rest of the population • The biggest threats to older people come from financial exploitation • However, defining “exploitation” is difficult; we still have many questions unanswered about: • How to prove a crime was committed if the presumed “victim” doesn’t report financial exploitation • Whether or not we’re justified in interfering for a person’s own good • How we go about determining what a person’s “own good” actually is

9. Intervention in the Lives of the Vulnerable Elderly • It is possible to restrict people’s freedoms for their own good through legal procedures intended for that purpose • Civil commitment is a legal procedure whereby people can be place in psychiatric hospitals against their will • However, more often today, formal court proceedings are undertaken to declare someone mentally incompetent to manage their finances, etc.

10. Intervention in the Lives of the Vulnerable Elderly (cont.) • Appointing a guardian or a conservator is possible when someone is unable to manage money or make decisions • Guardianship can take two forms: • Guardianship of the person – the guardian has the power to determine where the older person will live and what treatment or services he/she may receive • Guardianship of the estate – the guardian has power to manage property and take over financial affairs • Often times, relatives are willing and able to take over as guardians • However, some of the worst failings of the guardianship system come from the rights of older adults being disregarded in terms of financial incentives for the guardians, preferences given to well-connected lawyers, and guardianship rarely being revoked