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Introduction to Social Issues Affecting Older People

by Daniel B. Kaplan, PhD, MSW, Barbara J. Berkman, DSW, PhD

With aging, the ability to do daily activities (functional ability) declines to some degree in every person. Also, older people, on average, tend to have more disorders and disabilities than do younger people. But the changes that accompany aging are more than just changes in health. Social issues (such as living arrangements or type of work) influence an older person's risk and experience of illness.

Doctors often do what is called a social history to help them and other members of the health care team evaluate a person's care needs and social support. Doctors use the social history to help the older person and any caregivers make plans for care. Doctors may ask questions about the following:

  • Familial and marital or companion status

  • Living arrangements

  • Financial status

  • Work history

  • Education

  • Typical daily activities (for example, how meals are prepared, what activities add meaning to life, and where problems may be occurring)

  • Need for and availability of caregivers

  • History of trauma, losses, and coping strengths

  • History of substance use and legal issues

  • The older person's own caregiving responsibilities (because older people who are caring for family members may be reluctant to report their own symptoms lest any resulting medical procedures or hospitalization interfere with caregiving)