Late adulthood, lovingly known as "The Golden Years," is typically between 65 and death. Although this stage represents a decline in physical abilities, a lifetime of positive life experiences and memories provides balance. Navigating these challenging years involves a late-life reevaluation of identity and purpose and inventorying one's resources to maintain health and vitality in the last stage of life. There is a complex interplay of physical, cognitive, emotional, social, and financial challenges to redefining meaning in the last stage of life.

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Physical Health Issues:

We have heard it all our lives: "We begin to age the moment we are born." True enough, but it comes ringing through with volume in the final stage of adult developmental stages. We usually don't wake up on our 65th birthday with the discovery that we have a 65-year-old body that is not working as well as it has in the past and seems to be betraying us now with a vengeance. As people age, they face problems such as chronic health conditions such as diabetes, cardiovascular disorders, arthritis and osteoporosis, respiratory issues, gastrointestinal issues, immune weaknesses, and many others. In our physical decline, we typically have mobility problems, sensory challenges with hearing and sight, and some memory issues, even without dementia or Alzheimer's. These issues continue to impact our quality of life, our ability to function, and our independence. These significant challenges affect all aspects of our lives, ultimately leading to the loss of autonomy and the need for assistance with everyday living activities like dressing, cooking, and bathing. Pride and ego may get in the way of asking for the help we need or accepting the help offered. This physical decline represents a loss of control over our lives. It can lead to social isolation and withdrawal because of self-consciousness about our physical limitations and requirements for help. It can be challenging to adjust to the new realities of old bodies, and difficulties with adjustment can impact emotional and psychological health even further.

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Cognitive Health:

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Late adulthood comes with some memory loss and slower processing of information, especially complex cognitive tasks. Cognitive decline affects our ability to perform daily activities, which leads to frustration and can impact social relationships. Planning and problem-solving get more complicated, leading to a loss of self-confidence and anxiety about the future. When trying to hide cognitive and other areas of decline, we might be especially inclined to avoid others and quit participating in social activities that were once important to us. This isolation and withdrawal can leave us feeling disconnected and alone.   

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Loss of Loved Ones:

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We have lost people along the way. In this stage of life, we check the obituaries for the names of our friends and acquaintances. Loss of our dearest friends, other family members, and our beloved spouse can leave us reeling. These losses involve intensive grief, sadness, and loneliness and seem to be even harder to deal with in the face of multiple losses. Loss of a partner or close friend can challenge our identities—"Who are we without this person?" It can be challenging to redefine yourself and find new sources of meaning or purpose without those relationships. Grief impacts us physically as well as emotionally and can lead to depression and anxiety.

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Mental Health:

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Loss, grief, and prolonged bereavement can lead to protracted sadness, an elevated sense of loneliness, and the onset of depression. Grieving, coupled with continually declining abilities, which create frustration and anxiety, can generate helplessness and fear of being a burden on others. The interconnection of physical symptoms of decline, chronic health conditions, and cognitive impairment can create a self-reinforcing relationship with depression. Some of the symptoms of geriatric depression include persistent low mood and sadness, appetite, weight, and sleep changes, fatigue, tiredness, worsening levels of energy, feelings of worthlessness, increased difficulties with concentration and making decisions, and thoughts of death or suicide.

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Retirement and the End of Paid Work:

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Retirement presents many kinds of loss and challenges to the late-life adult. Identity is much of the loss, especially if your sense of who you are revolves around your career or profession. Retirement can also present a loss of purpose, especially without a plan to redevelop interests or pursue new ones. Retirement usually involves some level of financial insecurity, especially for those who have not saved enough for retirement or face unexpected expenses. Without going to work daily or even regularly, retirement means a loss of a social community that came with work, and that possibly was the core of your friendship network. There are limited resources for older people to continue meaningfully contributing to the community, leading to a sense of irrelevance and loss of purpose.

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Downsizing and Change of Residences:

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All the changes we have discussed thus far require constant reassessment and problem-solving to maximize quality of life. With physical, cognitive, and financial decline, the kinds and numbers of activities we engage in also decline. The kids are gone; we are no longer rebuilding antique cars in the shop; we are not as active with our old hobbies. A two-story, four-bedroom house with a shop eventually becomes too much house for our needs. We find it appropriate to downsize. We may have difficulty letting go of a lifetime's collection of stuff. Many items have sentimental value, and sorting through them can lead to decision overload. Letting it go is emotionally challenging. The physical challenge of packing and moving may be too much and may have to be delegated to others. Downsizing also involves fear. We may be moving away from our long-time community and losing a sense of continuity and familiarity. Downsizing and moving to a new location represents a significant increase in stress. New locations usually involve increased attention to health and safety concerns and improving accessibility and support, which are generally quite influential in the decision to move.  

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Solutions:

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Creating a physical, emotional, and psychological environment that supports health, engagement, connection, pursuit of meaningful activities, independence, safety, and comfort can contribute to a sense of control and well-being. Any activities, services, and interventions that promote mental health, resilience, and a sense of purpose in late adulthood, ultimately supporting individuals in successfully navigating the challenges of old age.

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Late Adulthood: The Golden Years Articles

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By Peggy L. Ferguson, Ph.D.

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Table of Contents

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Alzheimer's: Can It Happen To Me?

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 Aging and Depression: Challenges and Protective Factors Explored

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Depression and Anxiety Prevention for Older Adults - SAMHSA TAC

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Older Adults and Depression - NIMH

 

 

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