The medical model in psychiatry assumes medical intervention is the treatment of choice for the constellations of diagnosed symptoms that comprise various mental disorders. These treatments may include pharmacotherapy, electroconvulsive treatment, brain stimulation, and psychosurgery. Therefore, psychopharmacology for older adults can be considered palliative rather than a cure for a brain disease causing psychopathology. Older adults experience many psychopathological problems, including anorexia tardive, anxiety disorders, delusional disorders, mood disorders, personality disorders, schizophrenia, and co-occurring disorders with substance abuse/dependence disorders. Therefore, it is critical for the social worker to understand the various manifestations of psychological problems in older adults from the perspective of an older adult, rather than extrapolating information commonly taught in social work programs that neglect to focus on older adults and restrict teaching to psycho-pathological problems in younger and middle-aged adults.
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For older adults, the phenomenon of death is accepted and does not induce the fear experienced by younger adults. Older adults who do not engage in end-of-life planning may receive unwanted, unnecessary, costly, and painful medical interventions or withdrawal of desired treatment. Many older people feel that the goal of palliative care is to make the best possible dying experience for the older adult and his/her family. In addition to palliative care, an older adult will most likely find himself or herself in an intensive care unit as part of his or her terminal care. Euthanasia, or hastened death, is seen by some as an alternative to palliative care. A psychological aspect of death that an older adult is concerned with, in addition to place of death, is whether he or she will die in his or her sleep or die suddenly, making the death experience an individual phenomenon.
This concluding chapter summarizes the major points regarding elder abuse (EA) presented in the preceding chapters. It concludes the chapter by taking one last opportunity to encourage exploration and initiation of system-level efforts to solve a major public health problem. The socioecological framework for violence prevention utilized within domestic and global public health work is applicable and extendable to EA. Throughout this book, the authors have argued that EA is a public health problem and that EA may well be among the most under-recognized and under-resourced population health problems of the early 21st century. Public health has frameworks, tools, approaches, relationships, structures, systems, and a variety of agents and organizations poised to address the problem of EA. The imprimatur of the growing population of older adults and the character of demographic transitions occurring globally provide the perfect rationale for action—now.
This chapter provides a brief introduction to approaches to coping theory-from its early roots in psychodynamic defense mechanisms, through cognitive and personality approaches to coping styles, to more current work on coping and adaptive processes. The coping process approach recognizes that coping strategies are influenced not only by person characteristics such as personality, values, and developmental history but also by environmental demands and resources. The chapter develops a definition of ‘resilience’ as the ability to recognize, utilize, and develop or modify resources at the individual, community, and sociocultural levels in the service of three goal-related processes: maintenance of optimal functioning, given current limitations; development of a comfortable life structure; and development of a sense of purpose in life. A common assumption of life-span developmental theories is that the increasing physical and sometimes cognitive limitations with age necessitate changes in adaptive processes.
This chapter reviews biodemographic theories of aging that attempt to answer the proverbial ‘why’ and ‘how’ questions in gerontology. Biodemography of aging represents an area of research that integrates demographic and biological theory and methods and provides innovative tools for studies of aging and longevity. The historical development of the biodemography of aging is closely interwoven with the historical development of statistics, demography, and even the technical aspects of life insurance. The chapter also reviews some applications of reliability theory to the problem of biological aging. Reliability theory of aging provides theoretical arguments explaining the importance of early-life conditions in later-life health outcomes. Moreover, reliability theory helps evolutionary theories explain how the age of onset of diseases caused by deleterious mutations could be postponed to later ages during the evolution this could be easily achieved by simple increase in the initial redundancy levels.
This chapter describes the interpretive perspective in all its richness and variability in guiding research and advancing understanding of a wide range of phenomena in aging and life-course research. It discusses the interpretive perspective with other variants of social science theorizing, particularly normative perspectives on aging and life course-placing its development in historical context. The chapter addresses the contentious issue of causal explanation, as understood in diverse disciplinary contexts. It highlights some prominent normative theoretical approaches in social gerontology, by way of providing a comparative context for our primary consideration of the interpretive perspective. A given theoretical perspective in gerontology can focus solely on macro level, structural phenomena, on micro-level behavior and social interaction, or on understanding of the links between macro and micro phenomena.
This chapter traces the development of concepts and theories in the sociology of aging from the 1940s through the mid-1970s through seven themes. The first theme describes the importance of age in social structure and the place of the aged in changing societies. The second theme focuses on the issue of ‘successful aging’: how to define, measure, and achieve it. The third theme highlights the tension between social structure and individual agency in the activity versus disengagement theory controversy. The fourth theme concerns the social meanings of age, age cohorts, and generations, as well as interactions between age groups. The fifth theme focuses on families, aging, and intergenerational relations. The sixth theme of age stratification deals with the interplay between cohort succession and the aging of individuals. The seventh theme addresses the life course as a socially constructed process.
There can be little doubt that older people have today assumed a special place in the American social policy and political landscape. They constitute a large and growing population, they are increasingly well organized, and they are the recipients of public benefits that are the envy of every other social policy constituency in the nation. This chapter reviews and assesses different theoretical approaches that may help account in all or in part for these fairly recent and remarkable developments. The organization here centers on six distinct theoretical avenues for better understanding these political and policy developments: the logic of industrialization and policy development, the role of political culture and values, the presence of working-class mobilization, the impact of individual and group participation, the weight of state structure, and the effects of policy in shaping subsequent events.
- Go to chapter: Theories of Environmental Gerontology: Old and New Avenues for Person–Environmental Views of Aging
This chapter provides some integrative perspectives to some of the enduring conceptual challenges in the area, such as place dimension while we age; what available theories in the ecology of aging are telling us; and what kind of new impulses refinement in this area are needed. It argues that the current trend toward intensive measurement designs in the daily ecology and the related increasing use of ambulatory assessment, taking into account short-term, interindividual variability in areas such as cognitive and emotional functioning, and daily stress experiences, may benefit from environmental gerontology perspectives. As we see it, environmental gerontology rests on three main principles two more related to the concept level and one more related to research strategy: importance of person-environmental (P-E) transaction and developmental co-construction; importance of explicitly considering the environment, with a focus on the physical-spatial dimension; and importance of optimizing ecological validity in research.
The lifelong manifold process of aging implicates biological, psychological, social, and environmental factors that interact over time and across place in complex ways to direct and temporally organize the shapes and boundaries of lives. As such, aging is a long, broad, and deep process: long, because it occurs continuously across the life span; broad, because it continuously integrates diverse factors from across levels of observation; deep, because it is never fully and directly observable as an ongoing generative process. Over the last two decades, theory building in aging inequality has focused on defining the role of health in the aging process. Arguably, health is now the core metric of aging; the diverse and complex patterns of disease, disability, and mortality with age have become the central problem for aging researchers, especially those concerned with social inequality and its pervasive and enduring effects.