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Laura
was killed by anorexia. She was 80 Her
granddaughter India Faulkner-Wiley on a condition that is just as
likely to affect the elderly as the young
Laura Faulkner was 80 when she
died on April 19 this year. She was my grandmother and she was an
anorexic. Although anorexia nervosa is
most commonly associated with teenage girls and young women, the latest
research shows that it is as likely to occur in the elderly - and that
eating disorders in the elderly are more deadly, accounting for 78% of all
anorexia deaths. Psychologists at the University
of British Columbia examined 10.5m death records, for a four-year period,
in the US. They found that the average age of death from anorexia nervosa
for women was 69 and for men 80. And while in younger cases anorexia
victims are 90% female and 10% male, for those over 45, the percentage of
men doubled to 21%. Their findings astounded them. They scoured the
literature and found that other doctors had found anorexia nervosa in
people in their 60s, 70s, 80s, but not understood the scale of it. Anorexia is a very secretive
illness that is easier to hide for those who are unsociable, lonely or
depressed - which means it is especially easy to hide if you are elderly. A friend of my grandmother
Laura says that her weight loss was never taken seriously, and was even
encouraged, ironically, for health reasons. "I made an effort to
visit regularly, and she would seem as though she were in denial when I
pointed out her weight loss," she says. Just like a teenage anorexic,
Laura would say that she was full, not hungry, or feeling sick. These
symptoms, the classic symptoms of a sufferer, were not picked up on by her
caring friends and family. Even her GP did not notice anything until it
was too late. The granddaughter of an
86-year-old woman who died in March from anorexia tells me: "The
family thought, like everyone, that anorexia only occurs in teenage girls.
I even had a spurt of anorexia in my teens, and certainly didn't recognize
the same signs in my grandmother. "We were informed by her
doctor, whom she had been seeing regularly for many years - on his final
house call - that she had the eating disorder." We believe that the main cause
for anorexia in teenagers is poor self-image - that the disease revolves
around perceptions of the body. It's thought that the reasons why an
elderly person may suffer from the same eating disorder can range from the
emotional to physical or financial reasons. Typical causes may include
depression, a lack of enthusiasm for life, a form of protest, an attempt
to attract attention from friends and family members, medication (which
can affect the appetite), and economic hardship. Of course, wasting illnesses
such as cancer can cause a loss of appetite, and, anyway, as we get older
the appetite decreases. The capacity to taste and smell food declines.
False teeth may make eating more difficult. A spokesman for the British
Nutrition Foundation says: "As a person gets older, they tend to eat
less because they become less active and there is a fall in their basal
metabolic rate, the energy needed for processes such as breathing and
digesting food. "Arthritis can make it
difficult to prepare food and some people may lose interest in food if
they live alone, have difficulty shopping or have financial problems. "The physical effects of
ageing alter the efficiency of many body processes. The ability to digest,
absorb, metabolise and excrete nutrients decreases with age, though it
varies between individuals. For this reason it is difficult to make
specific dietary recommendations for this group." This natural loss of appetite,
and the effects of illness, complicate the problem, and make it harder for
professionals to sort those with true eating disorders from those with
other problems. Ian Rommory, head of care at
the Kensington nursing home in west London, says: "I have seen
patients give up eating. Either they can't be bothered, or those with
dementia can't remember to. "I blame depression in the
elderly for eating disorders, and would not say that they have the same
reasons as teenagers, who have anorexia, because it has very little to do
with distorted body image. It is a way of ending their life in old age. "There was a recent case
here with an 85-year-old lady who was slim anyway, but refused to eat
after a while. She was unwell for other reasons, but I believe that she
died because she stopped eating, and was malnourished as a result of her
refusal to eat." Jane Wood, head nurse in a
nursing home in Willesden, London, says: "Some patients do stop
eating. A glass of milk is often the only thing they will take down. Some
patients go through phases, it depends on how they feel that day depending
on whether they wish to eat or not." But it remains a fact that the
elderly may develop eating disorders with all the same symptoms as appear
in the young. Experts say that the elderly and teenagers share the most
obvious underlying reason for an eating disorder occurring at any age,
which is to gain control over an aspect of their life. Deanne Jade, founder of the
National Centre for Eating Disorders, says: "Anorexia always follows
a diet, which has been initiated by feelings of inadequacy and often
triggered by thoughtless or unguarded comments. "When original size or
weight goals are achieved however, they are unable to stop dieting. The
world becomes an unsafe place in which all food is an enemy. "Being thin is no longer
as important as losing weight, and yet the more weight decreases the more
the anorexic perceives themselves as fat." There are proven psychological,
emotional, biochemical, hormonal and even genetic reasons for eating
disorders. The British Medical Association says that eating disorders are
serious psychological illnesses which require considerable medical
intervention and may be, in part, genetically determined.
Copyright
© 2002 Global Action on Aging
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