Images of aging--over the last 100 years.

Discussions on care of the elderly today often lack definitions of various issues and concepts relating to the elderly in question and their needs. One problem is the tendency to categorise the elderly in general as one homogeneous group of frail individuals. Another is an increasing tendency to paint a posy picture of the third age, overlooking the problems of "the fourth age". The categorisation of "the elderly" dates back 100 years in history, when the first political initiatives on pension policy were taken. Denmark was the first country to introduce such legislation, with old age (over 60) as the basic criterion. However, the basis for drawing a vertical line at the age of 60 was a series of findings by German and French scholars of medicine and statistics on age-related decline in various functions. The development of geriatric medicine occurred rather late in Denmark, probably because of a relatively high level of quality and capacity of social institutions and other services for the elderly. Thus, longterm care for old people was not a major issue in the health care system until recent decades. Today, the new images of aging are not limited to visualisation of old people in "the third age". Nursing homes are changed to individual flats and provision of 24-hour home care services is available. This development requires coordinated education, training, and management of staff. A better knowledge of the changing images of aging in history is an important element of staff development.