Florida Scott-Maxwell poignantly shared what it means to be an older woman; she was an octogenarian when she wrote her journal. One of her impressive thoughts is: "So I still care. At my age I care to my roots about the quality of women, and I care because I know how important her quality is."1 At times, I am dubious about the value that health-care professionals place on the quality of life for older women, and especially the very old, the very frail, and the very vulnerable.
The idea is not mine alone. Robinson conducted an exhaustive literature review and wrote: "Older women need special attention and study in the health-care profession, yet this attention has not been forthcoming. Age has a serious impact on women."2 Another excellent article reminds us that the elderly poor consist mostly of women: nearly 72% of all the poor over the age of 65 are women. We know that although American women live longer today than they once did, and also longer than men, they may not have longer periods of good health. Furthermore, they do not enjoy an increased quality of life. Women age differently than men; they are less likely to have their needs met because the health-care system "largely focuses on the male model of care."3
Many health and medical needs are unmet among older women, and any geronto logica I nurse can name problems without hesitation. Robinson offers a list of some of the areas gleaned from her literature search: support networks, widowhood, caregiving relationships, and retirement. Those brush strokes, however, do not paint the entire picture; one needs to come back with smaller brushes to complete the picture. There are other problems: falls; broken hips; osteoporosis; poverty; inability to be in control of their homes, lives, schedules; lack of mobility and transportation; isolation and loneliness (regardless of the living arrangements); and being a caregiver even when the older woman is in poor health herself. Lack of safe housing is still another problem; owning a home is not a guarantee of avoiding poverty.
What will gerontological nurses, and particularly nurse educators, do about it? For example, is there course content about older women in all levels of nursing? Are there any courses that specifically deal with the nursing care of older women?
Now that I am older myself, my empathy increases when I am with elderly women. I have had great empathy for a 99-year-old woman I have been seeing for some time. The empathy has also been mixed with awe, admiration, and appreciation. She remains in control of her life despite health problems (pacemaker, limited mobility, and cancer). For her 99th birthday party, she asked if I could shop for some black stockings for her. She said, "They would go with my black shoes much better, don't you think?" Then she added, "And besides, they would cover up all these black and blue spots on my shins where I have bumped into stuff." I can only hope that, if I reach 99, I will be concerned about black stockings.
It is predicted that by the year 2000, one person out of every 14 in the United States will be a woman over the age of 65 .4 Will gerontological nurses be ready to meet our unmet needs, black stockings or other, when so many of us become the older women in need?
- 1. Scon-Maxwell F. The Measure of My Days. New York: Knopf; 1968; 104-105.
- 2. Robinson K. Older women: A literature review. JMvNurs 1986; 11:153-160.
- 3. Older Women's League. The Road ?? Poverty: A Repon on the Economic Status of Midlife and Older Women in America.
- 4. Uhlenberg P. Older women: The growing challenge to design constructive roles. Gerontología. 1979; 19:232-241.