Black elders: aging, memory & mental health

Until the Civil Rights Act of 1964, segregation in public places such as schools, libraries, pools, theaters, restaurants and hotels was widespread, and job discrimination was legal. Many elders remember being turned away, or being told where they could and could not go.

Families moved to cities in the North, Midwest and West to escape racial violence and Jim Crow, and to find work and schooling. Many elders were raised far from the places their parents called home, or left family behind themselves.

Migration brought new chances, and also loss: of land, of kin nearby, of familiar churches and food. Elders may still carry both pride and grief about it.

The Civil Rights Act of 1964 was described as the most sweeping civil rights law since Reconstruction. It happened because ordinary people pushed for it, at real risk. Some elders took part directly; others kept families going through dangerous years.

Some elders were born in the Caribbean, Africa or Latin America and came to the U.S. as adults. Their memories may include colonialism, independence movements, or starting over in a new country. Rural and city lives also differ a great deal.

Older Black Americans are more likely than younger ones to attend religious services. In a 2021 survey, 26% of the Silent Generation said they seldom or never attend, compared with about half of Millennials and Gen Z.

Of Black adults who attend services, 60% go to mainly Black congregations. Church can offer friendship, purpose, rides, meals and someone who notices when you’re missing.

Telling your story can help you make sense of hard times and feel proud of what you came through. It also gives younger relatives roots and belonging.

Ways to share

• Cook a family recipe together and tell where it came from
• Label old photos with names and places
• Record a phone video of an elder telling a favourite story
• Write down sayings and prayers you grew up with

Many elders stretched little into enough, and kept going when doors were shut. That resilience is real. It can also make it hard to ask for help now, when help is available and deserved.

In many Black families, elders are honoured as heads of the family and sources of wisdom. Feeling needed and respected is good for mood at any age.

From 1932 to 1972, the U.S. Public Health Service study at Tuskegee followed about 600 Black men in Alabama without their informed consent. Men with syphilis were not given treatment, even after a cure became widely available. It ended in 1972, and the U.S. president formally apologized in 1997.

In a 2021 Alzheimer’s Association survey, half of Black Americans said they had faced discrimination when seeking health care. Two-thirds felt it was harder for them to get excellent dementia care because of their race, and fewer than half felt confident they could find providers who understood their background.

Ideas

• Ask, “Can you explain that another way?” until it makes sense
• Bring a trusted relative, church member or friend
• Keep a written list of worries, and say the most important one first
• Remember you can ask for time to think before agreeing to anything

Later life often brings many losses close together. Having health conditions like heart disease, or trouble with everyday tasks, also raises the risk of depression.

In 2018, 39% of African Americans age 65 and over lived alone. Living alone is not the same as being lonely, but it can make it easier for low mood to go unnoticed.

Ways to stay connected

• A daily phone call with a relative or church member
• A senior center or church seniors’ group
• Inviting a neighbour for coffee
• Volunteering, mentoring or teaching a skill

Feeling sad, empty or hopeless most of the time, losing interest in things, and changes in sleep or appetite are worth telling a clinical provider about at any age.

High blood pressure is more common in Black adults (59.6%) than in White, Hispanic or Asian adults. A major 2024 review named 14 risk factors for dementia that can be changed, including high blood pressure, diabetes, inactivity, smoking, hearing loss and social isolation.

The same review estimated that nearly half of dementia cases might be prevented or delayed if these risk factors were addressed.

Some families call memory changes “old age” or “senility”, or keep them private out of respect or shame. In a 2021 survey, 1 in 5 Black Americans said a doctor suggesting a memory check would feel insulting.

Talk with a clinical provider if someone is

• Blanking on the names of close family or friends
• Getting lost in a place they know well
• Losing old memories
• Struggling with routine tasks they used to manage
• Using odd words for everyday things

The CDC advises talking to a health care provider if you notice these signs. Checking early also gives families time to understand what is happening and plan together.

In the 2021 survey, 62% of Black Americans believed medical research is biased against people of color. This history makes trust hard to rebuild.

African American family caregivers provide over 31 hours of care a week on average, compared with a national average of 23.7 hours. About a third (34%) care for more than one person, often elders and children at once.

57% of African American caregivers report moderate to high financial strain from caregiving, compared with 45% of all caregivers.

Outside help, such as adult day programs or home aides, can feel like breaking a family promise. Using support can actually help you keep caring for longer, and keep your own health.

Ways to share the load

• Ask the church for a rota of visits or meals
• Hold a family meeting and split tasks clearly
• Look into adult day programs for a few days a week
• Schedule one break a week for yourself, and keep it

Half or more of non-White caregivers in a 2021 survey reported facing discrimination when dealing with health care for the person they care for.

You may love having the children close and still grieve the retirement you planned, or the troubles of your own grown child. Both feelings can be true.

Local aging services and family service agencies may offer support groups, legal help or financial help for relatives raising children. The Eldercare Locator can point you to your local Area Agency on Aging.

Ideas

• Keep daily routines as steady as you can
• Let them know they are wanted and loved
• Share family stories so they know where they come from
• Tell the truth about why they live with you, in words that fit their age

Try this

1. Call or visit at a regular time.
2. Ask, “How are you really doing?” and wait for the answer.
3. Listen without rushing to fix or correct.
4. Notice changes in mood, memory, eating or the home.
5. Offer specific help, like a ride or a meal, rather than “let me know”.

Ideas for ministries

• A visiting team for members who can’t get out
• Phone trees for check-in calls
• Rides to appointments
• Talks on memory and mood with a trusted health speaker
• Making sure sermons and bulletins say it’s okay to get help

Sudden money problems, fear of a certain person, or unexplained injuries can be signs of abuse or exploitation.