Literature relevant to the problem investigated is reviewed in this chapter. Literature is reviewed with respect to (1) physical and mental changes in the elderly which may cause a need for custodial care, (2) types of care and alternative venues for its provision, (3) funding alternatives for custodial care for the elderly, (4) a comparison of the provision and funding of custodial care for the elderly in the United States and Canada, and (5) demographics of the elderly segment of the Bermudian population.
Physical and Mental Changes in the Elderly
Physical and mental changes in the elderly which may lead to the necessity of custodial care are discussed in the contexts of (1) sensory change, (2) learning and memory, (3) depression, and (4) physical deterioration. Each of these categories is reviewed separately, although all may affect an elderly individual.
For purposes of this research, hearing loss is used as the vehicle to discuss the effects on older persons of sensory
5 6change. Further, this discussion is based on a hearing deficit which is not correctable through surgery or with electronic devices.
Sensory deprivation, including hearing loss, may lead to panic, delusions, and other aberrant mental behavior (Kaplan, & Sadock, 1984). While loss of hearing may occur as a consequence of the ageing process, it may also occur as a product of psychological disorders (Altschuler, 1971). In the analysis of problems associated with hearing loss in older adults, therefore, it is necessary to establish cause and effect relationships, because hearing deficits resulting from psychological disorders ordinarily disappear, upon correction of the disorder. This discussion, however, is primarily concerned with psychological problems induced by hearing loss.
A loss of hearing experienced by older adults tends to cause these individuals to be cutoff from their surrou...