Focus on the aged as a discrete and problematic population tends to create a marked division between the "productive" and "post-productive" groups and disdain for the elderly as useless members of society. There is a perception that older people are a burden on society. The solutions of many societies only deepen the rift.
Countries vary in their approach to dealing with an ageing population. In socialist countries particularly, old age used to be seen as a deserved rest from a lifetime of work - an entitlement to enjoy the "golden years". In traditional cultures, old age would also be a time of respectful care by younger members of the family. In capitalist countries, private pension systems combined with a strong social net have, in the past, provided adequate support for retirees. However, everywhere family and social responsibilities are changing. There is increasing emphasis on economic performance, efficiency and short term benefits, and the desire to eliminate waste and redundancy has resulted in a coarser social net that allows more to slip through. As a result, the elderly in many countries may be relegated to a marginal existence. Dignity, safety and economic security are replaced by a battle for subsistence.
A panoply of specialists attend to the problem of ageing, each with a unique perspective: gerontologists, general practitioners, social workers, mayors, planners and architects. All have a solution to part of the problem, at the expense of the whole human context. Often older people are "warehoused" in quasi-institutional settings in undesirable locations, frequently located outside of town. Quite often the elderly are segregated from society in large complexes which are disconnected from the community. In these situation older persons seems to be relegated to a state of animated suspension between the community and the graveyard.
Reports concerning ill and elderly patients have frequently revealed situations in geriatric wards where the standard of care has been unacceptably low. Examples of poor standards included lack of consideration of patients' feelings; failure to maintain dignity, privacy and personal identity; and lack of social, remedial and recreational stimulation. Emphasis is consistently placed on the failure to provide for the psychological and social needs of patients. Cultural conditioning, whereby the elderly are often disregarded, discourages the flow of resources and produces poor working conditions, which in turn influence the day-to-day experience of nurses and students, and consolidate attitudes of indifference and even despair.
The root cause of the geriatric problem is not shortage of money, equipment or personnel, but a defective attitude to old age, in which the medical and nursing professions share.