Behavioral Health Across the Continuum of the Over-50 Divide

Few care managers have studied the continuum of care across the aging family. Gerontologists see the aging continuum as essentially half of our lives. Aging starts around 50, and these days it is not uncommon for people to live to be 100 or more. In a growing number of cases, half of our lifespan is spent growing old.

Yet individuals do not grow old in a vacuum. Family members age with them, effectually creating the continuum of the aging family. The less aged of this aging family is often referred to as the “young old,” which today includes the much-analyzed baby boomers but can range up to those as old as 85. This group is generally healthy yet tasked with care for the second group — the “old old,” or the frail elderly.

When over 85, elders routinely suffer the effects of chronic conditions. In fact as, Cathy Mullahy writes in a chapter on communication in Care Managers: Working With the Aging Family, a new book on geriatric care management, these frail elders are complex patients with several chronic conditions who see multiple treating physicians and take numerous medications. The continuum of care in the aging family involves the “young old” family caregivers trying to kick up their heels and have fun while often spending their retirement as unpaid caregivers to their elderly family members who may suffer complex health.

This continuum in the elderly family can be substantially affected by several behavioral health issues suffered by both generations — meaning that both the givers and the receivers of care, beginning as early as the 50s and 60s, are prone to disease states and afflictions that can include anger management, sexual dysfunction, memory loss and Alzheimer’s disease.

Not only do we see behavioral health issues across the continuum of the aging family, but as in all systems, the threads that connect the outer ends of the family are intertwined and interactive.

The family is a living, breathing system. It operates as all systems do. When one part changes — like an elderly parent needing care — then the entire system must change. Yet this can be problematic. Even with a plethora of “how-to” books on caring for an aging parent, the younger generation often fails to see this change coming. They may feel overcome by the stark and immediate family transition when an aging parent needs care and can no longer act as the titular head of the family. This shock originates in a basic premise that governs many systems: they hate to change.

When one part of a family breaks down, like an aging parent needing care, the system goes on red alert. Change is a dangerous life transition in the aging family, because the parts have to be reshuffled and the younger members must emerge to assume the former duties of their elders — in addition to caring for them.