抄録
The post-war progress of medicine, medical technology, nutrition and sanitation has brought Japan the greatest longevity in the world. With people living longer and the birthrate in decline, the proportion of elderly people in the total population is rising fast. This situation has caused growing concern about such questions as pensions, medical treatment and care services in recent years.
Perhaps because of these changes in society, increasing numbers of patients have been complaining about persistent pains and abnormal feelings in the oral area with no obvious cause. Elderly people report a particularly wide variety of complaints of considerable complexity, and it appears that in some cases these cannot be resolved without first grasping their situation in the family and local community.
This paper describes a study of the stress and feelings of isolation experienced in old age, in view of the characteristics of elderly people, on the basis of three cases in which it was suspected that feelings of isolation in a cohabitation situation had disposed the patient towards glossodynia.
All three subjects were women and they had an average age of 79. They had recently lost a husband of friend through bereavement and were living with the family of a first or second son whose wife was excessively competent, leaving the elderly person with nothing to do in the home. In effect, they all had in common the loss of role. It is hypothesized that having lost the person who is thought to have provided them with psychological support, whether a husband or friend, their situation was exacerbated by their relationship with a daughter-in-law and gave rise to the symptoms described.
The elderly frequently manage to overcome the stress caused by various experiences of loss. Social and somatic changes may, however, make them more susceptible to psychiatric disorders than younger people. It is, therefore, especially important to understand the social situation of the elderly patient when responding to his or her psychiatric difficulties.
Medical, psychological and social support must be provided that can respond seamlessly to the stressful experiences of the elderly. Clinical data must be gathered and effective measures and techniques established on this basis.
