The Difference In Caring for Older Men vs. Older Women

Person-centered caregiving for older adults requires more than helping with the physical tasks such as meal preparation, dressing, bathing, walking, etc. Caregiving that results in quality outcomes is mostly based on mutual trust, good communication and a connection between caregiver and care receiver. This article provides insights for direct care workers (DCWs) and other health professionals to how to understand the biopsychosocial needs of clients and how, in some instances, the needs of caring for older male clients can be different from caring for older female clients.

According to the Administration for Community Living (ACL), 70% of people age 65 and older – a population estimated to increase by 30 million over the next 35 years to almost 90 million by 2060 – are likely to need long-term care at some point in their lives.^1,2  However, the number of family members able to provide all the care needed for this growing group of older adults is shrinking. According to a report from McKinsey & Company, in 1950 there were almost 12 working-age people who could provide care for someone over age 65. In 2022, that number shrank to just seven, and it is estimated it will shrink again to only 4.4 by 2040.³ 

This highlights the growing need for professional direct care workers (DCWs) to fill the caregiving gap since the majority of older adults want to stay living in their homes as long as possible.

We know the physical, mental/cognitive and social health of people can change dramatically every decade after age 60.  As aging progresses, there are subtle differences in how older men and women respond to these changes. It is helpful for direct care workers (DCWs) to understand these nuances. The following information is meant to enlighten health care professionals on possible differing gender care needs. It is not intended to reinforce negative stereotypes or overlook the most important fact of caregiving: each person needing care is unique making the care delivery a very personalized effort. But it does help to understand these differences as delineated in a biopsychosocial model as outlined below.

BIO - Disease Prevalence Among Older Men and Women

We begin with the physical and cognitive aspects of aging. While both men and women experience cellular senescence (a normal function of aging such as graying hair, sagging skin and muscle loss)  statistics show women will outlive men on average by four years and will need 3.7 years of care versus 2.2 years for men.⁴

When it comes to various chronic illnesses, twice as many women have Alzheimer’s than men (65% vs. 35%)⁵ yet men who develop dementia have a tendency to wander more (8% increase) and become more physically combative as the disease progresses (30%).⁶  Three times as many women as men will develop multiple sclerosis (MS).⁷ When it comes to eye health, women have a higher risk of closed angle glaucoma and are diagnosed more frequently with macular degeneration.⁸

For older men, more males die from various cancers than females, including a higher incidence of lung cancer and melanoma, and men are 1.5 times more likely to have Parkinson’s disease.⁹ Men are also three times more likely to have kidney stones after age 50 and four times more likely to suffer from gout.

Both sexes still face heart disease as their #1 killer, yet more men are likely to die from coronary heart disease and develop heart disease on average a decade before women.¹⁰ And, both sexes face risk of stroke in their late 70s and 80s, especially if they have higher blood pressure, are obese or have diabetes.¹¹

Knowing these differences may help home care workers to understand some of the physical changes and challenges clients face and how to best address them. This can include meal preparation, protection from harmful UV rays outside, ensuring good sleep, helping prepare a nutritious diet and aid in some form of exercise such as walking, etc. DCWs are a key support in ensuring clients are protected and are taking measures to prevent certain health issues. DCWs can also become the first to note physical and cognitive changes and can inform the client or the client’s family to have a physician check on their health status.

PSYCHO – The Emotional Aspect of Aging

As we age, two elements of life become more critical: the need for control and the desire to be safe. While both sexes want more of these things, typically, older men crave the former and older women desire the latter.

Men have traditionally been more concerned about maintaining control over their lifestyle choices and environment.  Aging can diminish men’s control over their physical functioning and also how they view their role within their families and society. An older man who is retired from a job where he was more in charge or had a leadership role, or if his family lives long-distance where he is no longer seen as an authority or protector, can feel a loss of his role in life. It is important in communicating with men to understand this need for control and to engage them in questions or conversation that provide them a forum for a sense of being in charge, helpful, wise and relevant.

Women, especially if widowed or divorced, typically focus more on their personal and financial safety. The fear of feeling alone or unprotected can manifest in anger or frustration over small things that are seemingly irrelevant when it is actually a bigger issue at play. Humans are social animals and the ancient part of our brain that triggers the fight or flight stress response is based on being part of a tribe where protection within a group was inherent. If a woman perceives herself as “alone” this means she is vulnerable and thus, in danger. Taking time to ensure a female client feels protected and feels connected where someone is watching out for her becomes vital to her care. Also, helping guide clients to resources that can help protect them from elder financial abuse or identify theft is another helpful aspect of caring for older adults, especially women.

SOCIAL – How Older Men and Women Communicate and Stay Connected

Social health is as vital as physical or mental health. For many solo agers, loneliness is now seen as a crucial risk factor in overall health status. In 2023, the U.S. Surgeon General reported 1 in 2 adults are chronically lonely. For older adults, losing a spouse, friends and peers to illness and death can inflame feelings of loneliness.¹²

Also, some older adults experience in this later life stage what psychologist Erik Erickson called “integrity or despair” where they reflect over their lifetime and either feel a sense of satisfaction and contribution or a feeling of failure. It is important to understand this stage of life to better work with clients on how to help them overcome despair and find a sense of meaning. A meaningful life is the ultimate goal for both men and women in later life. Finding activities, whether through online engagement or at local senior center or other community program, that engage a client in finding that meaning becomes helpful to their overall holistic biopsychosocial wellness needs.

Keep in mind that men like action-oriented activities and women tend to like conversation-based activities. Men also tend to like written information or facts as their brains resonate more visually (sight) than verbally (sound).

When it comes to social relationships, typically, women engage more in friendship circles whereas men tend to rely more on familial relationships. Helping clients to seek these social activities – meeting girlfriends for lunch or having them over to the home; transporting a client to a grandchild’s birthday party; engaging in faith-based events or classes at the local library and social activities online from home – all of these are ways DCWs can help older adults focus on their social health. But also, becoming a confidante to a client develops a bond that helps both client and DCW and has been shown by the Harvard Adult Development research study over the last 85 years to be the secret to living longer, healthier and happier.¹³

Finally, finding positivity and joy and using this in communication with clients is critical. As we age, older adults experience the “positivity effect” which is part of the socioemotional selectivity theory (SST) identified by psychologist and researcher, Laura Carstensen at Stanford University. What her research shows is that older adults prune out negative messaging and focus on or follow more positive messaging. Rather than communicating about the vulnerabilities of age and what a client can no longer do (dress themselves, cook their meals, etc.) flip the script to “You’ve earned the assistance of a personal stylist – how about wearing this today?” or “You deserve a home cooked meal or personal chef.” This speaks to the positive accomplishments of aging where a client has achieved a stage of life where this kind of help elevates them and their spirit.

Comfort Keepers^® Can Help

Comfort Keepers^® provides uplifting in-home care that helps seniors thrive. Our specially trained caregivers, including dementia care, focus on developing genuine relationships with clients, keeping them physically and mentally engaged while ensuring they experience joy in their daily activities. And, our mission to uplift the human spirit and spread joy is something we give to our clients but also to our direct care workers staff.

If you know a patient or family that could benefit from Comfort Keepers’ services, they can reach out for a free consultation. Let’s work together to help individuals age comfortably and confidently at home.

REFERENCES

¹ Administration for Community Living (ACL), LongTermCare.gov website. U.S. Department of Health and Human Services, Washington, D.C.. Retrieved: https://acl.gov/ltc/basic-needs/how-much-care-will-you-need#:~:text=Someone%20turning%20age%2065%20today,for%20longer%20than%205%20years 

² Administration for Community Living (May, 2021). 2020 Profile of Older Americans. U.S. Department of Health and Human Services, Washington, D.C. 

³ Dewhurst, M. Linzer, K, Maud, M., C. Sandler (November 11, 2022). Living longer in better health: Six shifts needed for healthy aging. McKinsey & Company report, New York, NY. Retrieved from: https://www.mckinsey.com/mhi/our-insights/living-longer-in-better-health-six-shifts-needed-for-healthy-aging#/

⁴ Administration for Community Living (ACL), LongTermCare.gov website. U.S. Department of Health and Human Services, Washington, D.C.. Retrieved: https://acl.gov/ltc/basic-needs/how-much-care-will-you-need#:~:text=Someone%20turning%20age%2065%20today,for%20longer%20than%205%20years

⁵ Alzheimer’s Association (March, 2024). 2024 Alzheimer’s Disease Facts and Figures Report. Alzheimer’s Association, Chicago, IL.

⁶ Heritage Senior Communities (March 10, 2015). “Understanding Challenging Behaviors in Men with Alzheimer’s disease,” blog post. Retrieved: https://www.heritageseniorcommunities.com/understanding-challenging-behaviors-men-alzheimers-disease/

⁷ Coyle, P. K. (2021). What can we learn from sex differences in MS?. Journal of personalized  medicine, 11(10), 1006.

⁸ Vajaranant, T. S., Nayak, S., Wilensky, J. T., & Joslin, C. E. (2010). Gender and glaucoma: what we know and what we need to know. Current opinion in ophthalmology, 21(2), 91-99.

⁹ Wooten, G. F., Currie, L. J., Bovbjerg, V. E., Lee, J. K., & Patrie, J. (2004). Are men at greater risk for Parkinson’s disease than women?. Journal of Neurology, Neurosurgery & Psychiatry, 75(4), 637-639.

¹⁰ Lerner, D. J., & Kannel, W. B. (1986). Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. American heart journal, 111(2), 383-390. 

¹¹ Vyas, M. V., Silver, F. L., Austin, P. C., Yu, A. Y., Pequeno, P., Fang, J., ... & Kapral, M. K. (2021). Stroke incidence by sex across the lifespan. Stroke, 52(2), 447-451. 

¹² Office of the U.S. Surgeon General, (2023). Our Epidemic of Loneliness and Isolation - The U.S. Surgeon General’s Advisory on the   Healing Effects of Social Connection and Community. Washington, DC.

¹³ Schulz,.M & Waldinger, R. (March 10, 2023). The Good Life: Lessons from the World's Longest Scientific Study of Happiness, Simon and Schuzter, New York, NY.

RESOURCES

U.S. Surgeon General’s 5 for 5 Connection Challenge Survey on Loneliness

CALTAP Lifespan Developmental Framework for Older Adults – DCW training and a good tool to use for intake of new clients

“How to Say It to Seniors” by David Solis – great resource on communicating with older adults

Comfort Keepers “National Day of Joy” Survey and Activities