Society's image offrailty in old age may be characterized as one of a poor, wizened, old woman,
wasting away from neglect until her heart finally stops. This article seeks to develop a more
scientific profile of the "frail" elderly by examining mortality records of those deaths listed
under International Classification of Diseases Ninth Revision code, E-904, distinguishing deaths
due to neglect, lack offood or water, exposure, and privation, for the period from 1979 to 1985.
Approximately 200 deaths for people over 60 years old were listed under this code annually. An
analysis of the demographic and locational characteristics of these decedents yielded two
distinct profiles. Hunger decedents were older, White, and female, fitting the frail elderly
stereotype. Exposure decedents were younger, male, and more likely to be nonmetropolitan or
minority elderly. Strategies to reach these two groups are discussed.
Get full access to this article
View all access options for this article.
References
1.
Breckman, R.S., & Adelman, R.D. (1988). Strategies for helping victims of elder mistreatmentThousand Oaks: Sage.
2.
Butler, R., Gertman, J., Oberlander, D., & Schindler, L. (1979-1980). Self-care, self-help, and the elderlyInternational Journal of Aging and Human Development, 10, 95-119.
3.
Cicirelli, V.G. (1986). The helping relationship and family neglect in later life In Karl A. Pillemer and Rosalie Wolf (Eds.), Elder abuse: Conflict in the family (pp. 49-66). Dover, MA: Auburn House.
4.
Clements, M. (1993, December 12). What we say about agingParade Magazine, 4-5.
5.
Douglass, R.L., & Hickey, T. (1983). Domestic neglect and abuse of the elderly: Research findings and a systems perspective for service delivery planning In J. I. Kosberg (Ed.), Abuse and maltreatment of the elderly causes and intervention (pp. 115-133). Boston: John Wright/PSG Inc.
6.
Fanelli, M.T., & Kaufman, M. (1985). Nutrition and Older Adults In H. T. Phillips, H. T. & S. A. Gaylord (Eds.), Aging and public health (pp. 70-100). New York: Springer.
7.
Filner, B., & Williams, T.F. (1981). Health promotion for the elderly, reducing functional dependency In A. R. Somers, & D. R. Fabian (Eds.), The geriatric imperative. An Introduction to gerontology and clinical geriatrics (pp. 187-204). New York: Appleton-Century-Crofts.
8.
Fulmer, T.T., & O'Malley T.A. (1987). Inadequate care of the elderly: A health care perspective on abuse and neglect.New York: Springer.
9.
Gallaher, M.M., Fleming, D.W., Berger, L.R., & Sewell, C.M. (1992). Pedestrian and hypothermia deaths among Native Americans in New MexicoJournal of the American Medical Association, 267, 1345-1348.
10.
Glasgow, N. (1993). Poverty among rural elders: Trends, context, and directions for policyThe Journal of Applied Gerontology , 12, 302-319.
11.
Hardy, M.A., & Hazelrigg, L.E. (1993). The gender of poverty in an aging populationResearch on Aging , 15, 243-278.
12.
Hensyl, W.R. (1990) Stedman's Medical Dictionary (25thed.). Baltimore: Williams and Wilkins.
13.
Holtzman J.M., Akizama H., & Maxwell A.J. (1986). Symptoms and self-care in old ageThe Journal of Applied Gerontology, 5, 183-200.
14.
Horwath, C.C. (1991). Nutrition goals for older adults: A reviewThe Gerontologist, 31, 811-821.
15.
Hummert, M.L. (1993) Age and typicality judgements of stereotypes of the elderly: Perceptions of elderly vs. young adultsInternational Journal of Aging and Human Development, 37, 217-226.
16.
Keigher, S.M., & Pratt, F. (1991). Growing housing hardship among the elderlyJournal of Housing for the Elderly, 8, 1-18
17.
Lawton M.P. (1985) Housing and living environments of older people In R H Bmstock & E. Shanas (Eds ), Handbook of aging and the social sccences (2nded.) (pp 450-478). New York: Van Nostrand Reinhold.
18.
Macey, S.M. , & Schneider, D.F. (1993). Deaths from excessive heat and excessive cold among the elderlyThe Gerontologist , 33, 497-500.
19.
McCulloch, B.J., & Lynch, M.S. (1993). Barriers to solutions: Service delivery and public policy in rural areasThe Journal of Applied Gerontology , 12, 388-403.
20.
McLaughlin, D.K., & Holden, K.C. (1993). Nonmetropolitan elderly women: A portrait of economic vulnerabilityThe Journal of Applied Gerontology , 12, 320-334.
21.
National Center for Health Statistics (1979-1985 ). Mortality detail files [Machine-readable]. Hyattsville, Md. Distributed through Interuniverity Consortium for Political and Social Research (Ann Arbor, MI).
22.
National Center for Health Statistics (1987 ). Vital Statistics of the United States, 1985, Volume II, Part B [Electronic data tape] DHHS Publication No. (PHS) 85-1102. Public Health Service, Washington, D.C.: United States Government Printing Office.
23.
Rabin, D.L. (1985). Waxing of the gray, waning of the green. In Committee on an Aging Society, America's Aging: Health in an Older Society (pp. 28-56). Washington D.C.: National Academy Press.
24.
Rabushka A., & Jacobs B. (1980). Old folks at home.New York: Free Press.
25.
Rubinstein, R.L. (1985). The elderly who live alone and their social supports In M. P. Lawton & G. L. Maddox (Eds.), Annual review of gerontology and geriatrics. (Volume 5, p. 163-195). New York: Springer.
26.
Solomon, S.A., & Adams, K.H.R. (1993). Attitudes of relatives to autopsies of elderly patientsAge and Aging, 22, 205-208.
27.
Silver, A.J. (1993). The malnourished older patient: When and how to interveneGeriatrics, 48, 70-74.
28.
United States Bureau of the Census (1990). Census of Population and Housing [CD-ROM, Summary Tape File 3A]Washington, D. C.: United States Department of Commerce .
29.
Wynne, H.A., Yelland, C., Cope, L.H., Boddy, A., Woodhouse, K.W., & Bateman, D.N. (1993). The association of age and frailty with the pharmacokinetics and pharmacodynamics of metaclopramideAge and Aging , 22, 354-359.
