# Developmental psychology/Chapter 14 & 15/The Frail Elderly

As opposed to being active, the frail elderly are inactive and may be disabled, causing a loss of strength and energy. Some may be tied to illnesses or not. A way to measure frailty is through the activities of daily life (ADL) test. This measures eating, bathing, toileting, dressing, and transferring from a bed to a chair. Most people who have issues with ADL can recover, mainly through physical therapy. On the other hand, the physical ability to maintain daily life, known as instrumental activities of daily life (IADLs), may serve to be more useful in assessing whether an adult can maintain themselves.
The symptoms of frailty may include general weaknesses (an example being sarcopenia and osteoarthritis). Bones and one's ability to keep balanced may be impaired. Methods to prevent general immobility include diet, excersise and strengthening. To prevent frailty, they may be encouraged to take walks outside and attend to a physical therapist while doing so. This, once again, highlights the importance of excersise - both mentally and physically.
For individuals suffering in one or more themes of IADLs, social companionship and adequate health maintainship are all crucial in preventing/delaying neurodegenerative disorders. Overall, assisting an individual that suffers with ADL or IADLs (or both) can be difficult. In assisting an elder who suffers with ADL, it may be easier as you can physically see any defects - but with IADLs, it is a difficult situation. In this case, would it be better for someone who is familar with the elder to take care of them?
In some countries, such as India, it has been obligated upon the children to take care of their elderly parents. The issue with care for elderly parents is that some elders require intensive care, something that may not be avaliable or adequatly supplied. Another issue is that the children may erraneously believe this responsibility belongs to a closer person, resulting in the elder missing adequate care. Sometimes, the responsibility may be set upon the spouse - but even this is problematic as the spouse, usually the wife, is frail herself and doesn't have experience in treating frail relatives. Nursing homes are an unpopular destination, but may be improved by professional and consistent care and proper responses to resistance/irrational behavior by elders (friendly music, friendly dogs, patience).
The only acceptable method is to combine all methods of care: integrated care. Experts and family members combined to provide adequate care either at a medical facility, the home or another person's home.
Mentioning this method also comes with its own negative aspects: elder abuse is prevalent. This may arise from the caregiver suffering from addiction, care reciever is careless and the care location is an isolated place. Abuse can go unnoticed for years and can result from at home (by the caregiver) or at a facility (by other, irrational elders). It is important for caregivers to notice any warning signs, such as extreme injury or massive loss of weight. Abuse may even happen towards the caregiver, for example: an elderly wife could be abused by her irritated husband.
Other alternatives may be living-assisted facilities or "village" cares.