|The Aging Process: Unique Challenges
Men and women age differently, both in terms
of physical health and psychological well-being. In general,
men live shorter lives and suffer more from fatal conditions,
while women live longer lives and are more likely to be afflicted
with debilitating conditions. The losses associated with aging
can quickly erode men's sense of well-being and can lead to
withdrawal, anger, and depression. The following information
outlines the many unique challenges men face with the aging
process and provides helpful strategies for enhancing men's
sense of self-worth.
Life Expectancy, Health Factors, and Gender
A great difference exists in the life expectancy between
males and females. According to 1995 estimates by the U.S.
Bureau of the Census, life expectancy at birth for males is
estimated at 73.2 years, while for females it is 79.8 years.
This gender gap in life expectancy has declined somewhat in
the 1980's and it is expected to decline in the future, with
more women experiencing the stresses of the workforce.
In general, women live longer than men because they are much
less afflicted by the leading causes of death, particularly
diseases of the heart. For men between the ages of twenty-five
and sixty-five, the death rate from heart disease is about
three times that of women in the same age group. As Andrew
Kimbrell points out in his book The Masculine Mystique, "Though
heart attacks are also the number one killer of women, almost
three-quarters of women who die of heart attacks are seventy
five years or older. By this time the average man has been
dead for almost two years."
Men are also at higher risk for other fatal diseases including
lung disease, liver disease, and hypertension. Men are at
an increased risk of developing and dying of cancer. Over
the last thirty years, the overall cancer death rate for men
has increased twenty-one percent, while the rate for women
has remained about the same. Each year over 55,000 more men
than women develop cancer, and 30,000 more men than women
die of cancer.
It is generally accepted that both biological (hormonal or
genetic) and psychosocial factors (for example, men's greater
smoking, alcohol consumption, and predisposition to risky
and violent behavior) are involved in explaining the differentials
in life expectancy. While women live longer and suffer less
from major fatal conditions, they are more likely to be afflicted
with more nonfatal but debilitating conditions such as arthritis.
In addition, women appear to suffer more from various minor
illnesses and conditions which limit their activities of daily
living. As a whole, women live more of their years in a disabled
status and have a greater chance of being institutionalized.
Proof of this fact is seen in the census of Illinois nursing
homes, where the ratio of women to men is approximately ten
A gender statistic that has been widely accepted is that
a significantly greater number of old women are afflicted
with Alzheimer's disease. The incidence of Alzheimer's disease
increases exponentially with age so that the extended survival
of women skews the statistics. Recent age-adjusted statistics
show that men have Alzheimer's disease more frequently than
One of the most frightening statistics involves suicide rates
for elderly men. While suicide rates for women have been stable
over the last twenty years, among men they have increased
rapidly. Overall men commit suicide at four times the rate
of women, Approximately twenty-five thousand men take their
own lives each year.
Psychosocial Challenges Men Face with the Aging Process
The aging process can be difficult for both men and women,
but research has shown that men generally have a harder time
in adjusting to the changes. Conditioned throughout their
lives to be strong, controlling, and independent, men can
be devastated by the losses that are associated with aging.
They may feel that they no longer have anything to contribute
to society and may find it very difficult to depend on others
for everyday tasks.
One of the biggest challenges men face with growing old is
no longer being gainfully employed. Work has always been a
central concern in the lives of men, symbolizing their identities
and sense of self-esteem. Unfortunately, our society views
older men as little more than useless when they can no longer
fulfill their primary role as productive workers.
No longer employed, many elderly men do not know what to
do with their time. They generally had few opportunities for
recreation in the past and may now find it difficult to pursue
leisure involvement. They may look at recreation activities
as a "waste of time" and feel that without a job,
their lives lack purpose and meaning.
The male stereotypical role men lived in the past still exists
for many. Society taught these men to be strong, not to complain,
and not to become upset. The World War II generation values
toughness and stoicism, and men were socially discouraged
from revealing their feelings. In not being able to disclose
emotion, many elderly men are at risk of developing depression,
turning to alcohol or drugs, and committing suicide as a means
of coping with stress.
Studies of recently widowed adults indicate that men suffer
more emotional problems after the loss of a spouse than do
women. The reasons for the gender gap remain unclear, but
researchers contend that women apparently have more social
ties that help is easing the distress. As one recent widower
declared, "It's not easy to be a man. If I express my
grief I lose, because I violate the male stereotype of the
strong man who shows no emotions. However, I know that if
I do not express the pain of grief, I will also lose because
suppressing my feelings will bring me more problems. I'm in
a no-win situation."
Recent studies of friendship show that men become more isolated
from friends as they approach their later years. Elderly men
may withdraw from others as they face the challenges of growing
old and do the work of revising their sense of self internally.
This withdrawal of men may either reflect old age or help
to stimulate it. Research reveals that men who are involved
in friendship groups tend to manifest better psychological
health than those without friends.
Meeting the Quality of Life Needs of Elderly Men
In considering the challenges men face with the aging process,
nursing home staff can design interventions which will enhance
these individuals' feelings of achievement, independence,
and well-being. The following are some ideas which have been
successfully implemented at Illinois Council facilities:
- Provide men "work" opportunities and responsibilities.
Men may enjoy doing tasks around the facility such as leading
an activity program, fixing an item, or writing a newspaper
column. Be sure to praise the men for a job well done.
- Those men who are more isolated may enjoy doing more individualized
or smaller group activities. Examine the activity assessment
to identify past interests. For instance, a man with an
interest in cars may enjoy reading through car catalogs.
- Intergenerational involvement can do wonders in boosting
men's self-esteem. Having the opportunity to share knowledge,
skills, and wisdom with a younger person can help men feel
important and valued.
- Men respond well to tangible signs of achievement and
success. They enjoy having goals and being recognized for
accomplishing these goals. For instance, a man may enjoy
participating in a fitness program if specific goals are
set for him to achieve. A certificate signifying the achievement
of his goal can boost his feelings of self-esteem.
- Make every effort to recognize and validate the male resident's
history and identity. Encourage family members to display
awards, pictures, and diplomas in the resident's room. Discuss
these personal items during caregiving interventions. Consider
writing a biography of the resident for the facility newsletter.
- Research shows that social contacts play a key role in
coping behaviors. Consider pairing up a male resident with
another male resident with similar interests. Encourage
community members to spend time a resident. Invite a pastoral
counselor to encourage the resident to discuss personal
Men face many challenges with aging, including shorter life
expectancy, increased health problems, and eroded self-worth.
By developing interventions that recognize the unique needs
of elderly men, nursing home staff can make great progress
in enhancing these individuals' feelings of strength, independence,
STATISTICS ON AGING, HEALTH, AND GENDER
|Age 65 and over
|Life Expectancy at Birth
|Life Expectancy at 65
|Need Help with ADL's
|Annual Days of Restricted Activity
|Alzheimer's deaths per 100,000 (age adjusted)
|Heart Disease -- Related Deaths per 100,000
-- Geriatric Nursing, July/August 1996