I’m reflecting on the question of what is “age appropriateness” after reading some papers on young onset dementia (YOD) that use the term. This is what Alastair Burns and esteemed colleagues say in a blog on the subject of tackling the challenges of young onset dementia:
“People with YOD have distinctive needs due to their age and stage of life.” (see this link to their blog).
They go on to list some specific issues including:
- Having young children
- Wanting to continue working
- Wanting “meaningful social activities” andFinancial issues.
It strikes me that the concept of age appropriateness is tricky. Prominent celebrities have children late in life – is that “age inappropriate”? (See this piece about late fatherhood.) People may want to continue working past the traditional age of retirement (perhaps now an obsolete concept), but that itself may be seen as age inappropriate by some people. (See serial retirement article here.) And how irritating is it to be told to act your age?
People with dementia at all ages may have young children in the family that they wish to relate to. Many people work past the age of 65. And who doesn’t want to engage in meaningful social activities? Pension or no pension, finances are often a cause for concern, albeit for differing reasons. The costs of buying in care in late life are often considerable.
Alongside this, of course, there are changes that often go along with getting older: accumulating physical illnesses, loss of peer group, maybe loss of life partner, the approach of end of life, among many others. But these don’t suddenly kick in at age 65 or 70 or 75 or any milestone age. And for some people, unfortunately, they kick in earlier in life.
So, when we talk about being age appropriate, are we really talking about being person and relationship centred, about acknowledging that everyone is different and that support services should be tailored to the specific needs and wishes of individuals and their family members? Does a service need to be different for someone of 64 than it is for someone of 65? If you agree with me that yes it does, isn’t that about the person rather than a one year age difference? And doesn’t it argue for a flexible person centred approach to mental health in later life?