Scholarship on ethnic minority families and aging has wrestled implicitly or explicitly with the understanding of a theoretical dichotomy not uncommon in the field of sociology as a whole: the role that culture plays as either an epiphenomenon and/or as an integral element of the social structure. Interpretations of that basic structural versus cultural duality may derive from broader ideological perspectives, but they may also reflect a superficial framing of the concept of culture in scholarly analyses of ethnic minority families. This chapter presents a review of ethnographic literature on minority families and aging that is grounded in both racial/ethnic and feminist perspectives. It discusses three major topics that emerged as most salient in recent ethnographic studies: the concepts of familism, family obligations, and filial piety; the role of living arrangements, urban/rural space, and the neighborhood context on family experiences; and intergenerational relations, health, and caregiving.
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This book provides a multidisciplinary compendium of research pertaining to aging among diverse racial and ethnic populations in the United States. It focuses on paramount public health, social, behavioral, and biological concerns as they relate to the needs of older minorities. The book is divided into four parts covering psychology, public health/biology, social work, and sociology of minority gang. The book focuses on the needs of four major race and ethnic groups: Asian/Pacific Islander, Hispanic/Latino, black/African American, and Native American. It also includes both inter- and intra-race and ethnic group research for insights regarding minority aging. The chapters focus on an array of subject areas that are recognized as being critical to understanding the well-being of minority elders. These include psychology (cognition, stress, mental health, personality, sexuality, religion, neuroscience, discrimination); medicine/nursing/public health (mortality and morbidity, disability, health disparities, long-term care, genetics, nutritional status, health interventions, physical functioning); social work (aging, caregiving, housing, social services, end-of-life care); and sociology (Medicare, socioeconomic status (SES), work and retirement, social networks, context/neighborhood, ethnography, gender, demographics).
- Go to chapter: Introduction: Psychology—Rising as a Discipline to Meet the Challenges of an Aging, Increasingly Diverse Society
Introduction: Psychology—Rising as a Discipline to Meet the Challenges of an Aging, Increasingly Diverse Society
This chapter presents an illustration of the complexities involved in studying ethnic and racial influences on psychosocial processes and how they are intimately tied to physical outcomes in later life. It focuses on psychology as a discipline, minority aging research during the last several decades has revealed the need for multidisciplinary and intersectional conceptual and research approaches. The chapter also focuses on the age, gender, socioeconomic, cultural, and racial and ethnic graded influences on life course development that eventuate in unequal burdens of psychological and physical health morbidity and mortality for certain groups in late life. No section on psychology could be complete without a discussion of religion and spirituality among racial and ethnic minorities. Generational processes are clearly implicated in ideas about the cyclical nature of poverty and health behaviors that are intricately linked with environmental factors and social influence.
This chapter focuses on aging and health issues in all of America’s major minority populations including African Americans, Hispanics/Latinos, Asian Americans, as well as Native Americans. It addresses the issues of health inequality and health advantage/disadvantage. The chapter introduces relatively new areas of inquiry including long-term care, genetics, nutrition, health interventions, and health policy issues. In addition to possible genetic factors, the literature has emphasized the influence of poverty and socioeconomic status as well as stressors associated with minority group status. The system of long-term care services will need to be restructured to take into account issues affecting minority populations such as health care coverage, housing and income supports, as well as cultural issues as filial piety and trust. The field of minorities, aging, and health has been dominated by a health inequality perspective that has been illustrated by the application of cumulative disadvantage/cumulative inequality theory.
This chapter discusses the history, organization, development, and the future of Medicare and applies Andersen’s Behavioral Model of Health Services Use to understand utilization among the elderly and conduct a systematic literature review. It analyzes racial/ethnic disparities in health care utilization among the elderly using Andersen’s model and discuss the implications of the current proposals for changes in Medicare for health care utilization especially among minority aging. Racial/ethnic differences in seniors’ use of medical care were sizable before the Medicare program. The focus on deficits and controlling the cost of government has in turn increased the focus on health care and entitlement programs like Medicare. Medicare is important to ensure access to health care for the elderly, particularly the poor and minorities. However, with the rising health care costs and changing demographics, it is clear that Medicare needs some type of reform to ensure its continuing viability.
This chapter examines the Older Americans Act (OAA) through the prism of the coming nexus of aging and ethnic/racial diversity. It explains that the OAA can serve as a foundation for building a home- and community-based set of services for all older adults and persons with disabilities and for addressing aging in the 2lst century. The OAA is the primary federal program providing a host of services that enable older persons and their families to live in their homes and communities with a measure of dignity and independence. The OAA, Administration on Aging (AOA), and aging network today provide five major categories of services: access to social and legal services, nutrition, home- and community-based long-term social and supportive services, disease prevention and health promotion, and vulnerable elder rights protections. The OAA and the AOA remain secondary players in national agenda setting for an aging population.
This chapter presents a case for examining aging in the United States through an inter-sectionality lens. It begins by presenting age, gender, and race/ethnicity as social constructions, followed by a conceptual overview of intersectionality to highlight strengths as well as challenges in this approach, particularly as it relates to health. The chapter reviews the most current thinking on gender and minority health, with special attention to social roles and contextual factors, and methodological approaches. The social construction of gender has been widely addressed in the sociological literature, with identified insights for better understanding health and the aging process. Research on gender and physical health outcomes draws much greater scholarly attention than mental health in later life. The intersectionality paradigm has provided new directions for identifying the importance of gender as a key element for predicting health across the life course.
This chapter focuses on the role that Adult Protective Services (APS) and related service systems play in protecting vulnerable older adults and adults with disabilities from abuse, neglect, and exploitation. It articulates policy issues connected to elder justice. The chapter also explores human rights issues related to elder abuse, aging, and disabilities, particularly how to balance rights to self-determination and safety when working with abused, neglected, and exploited older adults. APS operate within a continuum of services that challenge social workers in their efforts to respond effectively to elder abuse. In addition to knowledge of aging, disabilities, the dynamics of family violence and care giving, and community resources and skills in capacity assessment, working in multidisciplinary teams, advocacy, and systems navigation, social workers need commitment to values of self-determination and empowerment to guide their work in this system.
This chapter presents a broad and general overview of the structural and physiological changes that occur with aging as well as the underlying pathophysiology of age-related diseases. The body comprises eleven organ systems that include the integumentary, muscular, skeletal, nervous, circulatory, lymphatic, respiratory, endocrine, urinary/excretory, reproductive, and digestive systems. As such, the ensuing sections are arranged by organ system and structured to cover age-related physiological changes and common disorders. Older adults experience a myriad of physiological changes as they age. While some of these physiological changes are benign, other changes increase the risk of age-associated pathophysiological changes, which can result in significant functional impairment or morbidity. These pathophysiological changes are not to be considered part of the normative aging process. Thus, it is essential that providers distinguish between the two states.
The general topic of successful aging (SA) has long been a major theme in gerontology and has been an especially prominent and growing aspect of gerontological research and program development over the past 25 years. This chapter focuses on substantial empirical research that builds on the general concept of SA to inform theory evolution and various forms of program development at the individual and community level. There has been very substantial theoretical work, over several decades, on the interrelated but differentiated dual approaches of the life-course and life-span perspectives on aging. Usual aging was seen as laden with risk of disease and disability mediated by lifestyle-related increased lipids, glucose, and blood pressure, and decreased renal, pulmonary, cardiac, immune, and central nervous system (CNS) function. A successfully aging society can be seen as one that is productive, cohesive, secure, and equitable.
Social support from close relationships is one of the most well-documented psychosocial predictors of physical health outcomes. Social support is distinguishable from other health-relevant social processes including social integration and social negativity. This chapter reviews epidemiological work on social support and health, and explores the major life-span models that have implications for understanding these issues. Importantly, the link between social support and mortality was consistent across age, sex, geographical region, initial health status, and cause of death. In order to elaborate on the developmental processes over time that might impact social support from close relationships and health, a life-span model of support has been proposed that attempts to integrate prior work and models across disciplines. Most social support interventions also target individuals who are most at risk or who already have psychological, behavioral, or medical problems.
This chapter considers the major paradigm shifts that have occurred in geropsychology as it has progressed over the course of the 20th century. It also considers the consequences of increased interdisciplinarity for studies of aging within the discipline of psychology. The chapter describes the recent interest in research-based psychological interventions in the aging process, and of the more recent influence of advances in neuroscience. The study of aging, however, was early on recognized in the context of American psychology, and the division of adulthood and aging was one of the first 20 substantive divisions of the American Psychological Association (APA). The development of structural and functional Magnetic resonance imaging (MRI) has had a revolutionary enhancement of neuroscience, allowing for the first time the conduct of direct tests of the relationship between age changes in behavior and brain changes during normal and pathological aging.
This introduction presents an overview of key concepts discussed in the subsequent chapters of this book. The book focuses on theoretical and conceptual developments in research on aging, both within and across disciplines. Recent years have brought major investments in longitudinal data, investments essential to understanding aging as a dynamic, multifaceted, and interactive process. The book summarizes what is meant by theory, and why theory is so important to advancing aging-related research, policy, practice, and intervention. The theory portrays the relationships among the complex variables suggested by a theory. A good theory identifies the problem and its most important components based on the separate findings and empirical generalizations from research. As the field of gerontology and research on aging continue to rapidly expand, the need for a strong theory will only grow.
Policy and Program Planning for Older Adults and People With Disabilities, 2nd Edition:Practice Realities and Visions
This book attempts to build students’ understanding of policy development through a critical analysis and review of policy frameworks, and the policy implementation process. The book is organized into four parts comprising twenty-one chapters. Part one of this book lays out a background as to the current and future demographic trends of older adults and makes the case for the reader that there are a variety of philosophical, political, economic, and social factors that affect public policy development. The chapters help the reader to explore a range of perspectives that define, shape, and impact the development and implementation of public policy. It intends to prepare the reader to critically analyze public policies related to aging. Part two provides an overview to major federal policies and programs that impact older adults and people with disabilities. It examines some historical developments leading up to the actual development and implementation of the policies. Policies include social security, medicare, the Older Americans Act, and the Americans with Disabilities Act, the Community Mental Health Centers Act, and Freedom Initiative. The last part of the book outlines specific programmatic areas that flow from aging policies, and specific components that flow from federally mandated policies. Each chapter contains same basic outline: an overview of the programs, specific features and strengths of the programs, gaps and areas for development, and challenges for the future.
The book summarizes what is meant by theory, and why theory is so important to advancing aging-related research, policy, practice, and intervention, and can keep researchers and practitioners in gerontology abreast of the newest theories and models of aging. It addresses theories and concepts built on cumulative knowledge in four disciplinary areas, biology, psychology, social sciences, and policy and practice, as well as landmark advances in trans-disciplinary science. Since longevity is indirectly governed by the genome it is sexually determined, and because aging is a stochastic process, it is not. Chapters cover major paradigm shifts that have occurred in geropsychology, theories in the sociology of aging, evolutionary theories pertaining to human diseases, theories of stem cell aging, evidence that loss of proteostasis is a central driver of aging and age-related diseases, theories of emotional well-being and aging, theories of social support in health and aging, and other theories such as environmental gerontological theories and biodemographic theories. Many chapters also address connections between theories and policy or practice. The book also contains a new section, "Standing on the Shoulders of Giants", which includes personal essays by senior gerontologists who share their perspectives on the history of ideas in their fields, and on their experiences with the process and prospects of developing good theory.
This chapter discusses prismatic history a selective, select account of theory building in the field, which ideally stirs gerontological imaginations about future theoretical work. Several of gerontology’s founders promulgated or borrowed theories to guide research on aging. Based on work in pathology, cytology, and immunology, Metchnikoff formulated ‘phagocytosis‘, an interdisciplinary theory of aging hypothesizing that large intestinal white blood cells destroyed microbes that hastened premature senility in humans, apes, dogs, and plants; the construct anticipated various degenerative and wear-and-tear theories. Biologist Vincent Cristofalo, endorsing no unified biological theory of aging, reduced models into groupings of stochastic and developmental-genetic theories. Gerontologists demolished disengagement theory in Unripe Time. Not even a giant like Robert Havighurst could salvage parts of activity theory in order to sustain his pioneering theory of successful aging.
This chapter describes the fundamental evolutionary theories that seek to explain the presence of aging despite its apparent detrimental effects on individual fitness and explores key evidence and shortcomings of these theories. It focuses on the observed trade-offs between life span and reproduction, highlighting potential molecular mechanisms by which selection can fail to eliminate, or even promote, patterns of senescence. An underexplored avenue by which selection can act on aging, mate choice, and sexual selection is then discussed leading to the development of a verbal model whereby mate choice could promote senescence as a by-product of honest sexual signaling. The chapter then explores how the described evolutionary theories pertain to human diseases, and identifies the critical absence of some important evolutionary processes in the evolutionary theory of aging and disease. Finally, it provides an in-depth understanding of why species age, and implications on human aging.
This chapter focuses on three major areas of investigation into the role of religion and spirituality in older people’s lives: age differences in the nature of religious and spiritual belief and practice; health benefits that accrue to older people who profess a religious faith and engage in spiritual activities; and influences on social and intergenerational relationships and support resulting from membership of a faith tradition. Social gerontology’s recent concern with religion and spirituality in later life has had a relatively limited impact on theorizing about aging and social relationships. Hinduism is also widely regarded as an age-friendly religion, which ascribes a distinct more mature stage of being to the last stages of life, in preparation for the transition to a new life beyond death. The chapter concludes with a stress on the importance of conducting research on religion, spirituality, and aging in non-Western and non-Christian cultures.
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.
This chapter focuses on sources of evidence for evidence-based policy development. It explores some of the dilemmas with developing an evidence base and provides a range of empirical sources within the aging and disabilities arenas that can be used in building an evidence-based approach to policy development. The journey, however, will not be without struggle—since philosophical paradigms, and social and economic factors will interface and play a role in the development of evidence-based policy. The chapter helps the reader to be aware of healthy people 2020 benchmarks that are used to guide program planning and policy development. Benchmarks currently have been established in order to identify where health goals for the nation and individual states should be, and the program is evaluated routinely by local and state health departments. Healthy people 2020 is also used to gauge the impact of health policy.
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 reviews age-related changes in personality and emotional functioning. There are several theoretical approaches to studying personality, and most of them have examined the extent to which the theory applies to older adults. For example, Joan Erikson's proposal of a ninth stage of psychosocial development, as well as ways in which attachment processes may be important in late life, and ways in which coping strategies change with age, all represent the application of existing theories to later life. The chapter focuses on emotional functioning in late life. Overall happiness and life satisfaction tends to increase with age. Older adults also show more effective strategies for regulating emotions, including situation selection and attentional deployment toward more positive features of the situation. Some of these changes can be accounted for through two theoretical models: socioemotional selectivity theory and the strength and vulnerability integration (SAVI) model.
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.
Mounting evidence has shown that an array of proinflammatory cytokines and mediators is frequently elevated in aging populations, including interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP). In addition to chronological aging, sterile inflammation can be associated with a number of age-related disorders and diseases, including cardiovascular diseases, cancers, type 2 diabetes mellitus (T2DM), bone diseases, neurodegenerative diseases, chronic obstructive pulmonary disease (COPD), and frailty. Many types of cancer are also related to or are preceded by chronic inflammation at sites of tumor development. Although more studies are required, evidence to date suggests that drugs that target age-related chronic inflammation and related fundamental aging processes, including cellular senescence or the age-related increase in mammalian target of rapamycin (mTOR) activity, might play an important role in reducing age-related disability, frailty, and multiple chronic diseases as a group.
This chapter looks toward the future of theory development in research on aging, and offers some perspectives that will be helpful to graduate students, postdocs, and junior investigators. It highlights some directions for theory development and theory-driven research and application that are likely to be the most fruitful arenas for explanatory inquiry in the decade to come. These include: successful and positive aging; longevity, health, and well-being in aging; environments, and transactions among aging individuals and their environments; the life course and its effects on aging; and variations in trajectories of aging. Within the realm of health, we want to make special note of the surge in aging research on social genomics and epigenetics, which is certain to continue growing in the future and is in need of theories to explain the interplay between genes and environments as well as the transmission of effects across multiple generations.
- Go to chapter: The Multiplicity of Aging: Lessons for Theory and Conceptual Development From Longitudinal Studies
This chapter offers a new perspective on the development of theories of aging by proposing that the complexity of the aging process requires accounting for its multiplicity, specifically, its multiple time frames, multidirectionality, multidimensionality and interplay of factors, and multilevel influences. It takes advantage of the increasing number of longitudinal studies in the aging and developmental field to outline some lessons about the way theories on aging may be developed in the future to gain a more comprehensive picture of development and aging. The chapter proposes the principle of multidimensionality and interplay of factors as a third way of developing heuristic theories. It reviews several longitudinal studies that show that interplay between biological, psychological, and social factors affects important outcomes, such as subjective health or well-being.
The first theories of emotion and aging began simply, following assumptions established in biological and cognitive aging research. This chapter outlines findings and theories generated in the early years of gerontology, when the formal study of emotions and aging had just begun. The selective optimization with compensation (SOC) model acknowledges the reduced reserve capacities that often accompany aging and that lead to fewer domains of functioning. The amygdalar aging hypothesis, for example, posits that age-related declines in the amygdala are responsible for age-related reductions in negative emotional experiences. The study of emotion and aging has burgeoned in recent years, with researchers carefully distinguishing between different types of emotion regulation strategies and assessing various aspects of emotional well-being. Theories on emotion and aging have varied, with some focused on deterioration and decline, and others on gains.
Aging policy is shaped by a variety of demographic, social, and economic factors. However, these factors are not the only influences on the development of public policy or aging/disability policies. Philosophical paradigms and theoretical frameworks also influence the actual development of policy and play a strong implicit role in how public policy is drafted. Values and philosophies guide the development of specific philosophical paradigms and shape how aging and disability policy is developed and implemented. This chapter explores how these realities play a role in the development and implementation of public policy and aging/disability policy. It showcases some of the realities that may prevent the implementation of the policy or program as envisioned. As a safeguard against a subjectively devised policy and program base, objective evidence and empirically driven initiatives can be developed by aging and disability policy advocates.
Gerontology has an uneasy and codependent relationship with chronological age. This chapter describes the meanings and uses of age in research on aging, focusing mainly on concepts and theories but also making a few observations on methods. To advance theories of social phenomena, investigators must reveal the relevance and irrelevance of age in contemporary social life. Researchers often use age as a proxy for things that are highly age-related but have not been measured-say, some biological, psychological, or social aspect of development. Age-based explanations are about maturation, but cohort-based explanations are about historical events and social change. Larger life phases can be the basis for ageism and age stereotypes-common images or perceptions of people of different ages, and their physical, psychological, and social characteristics. Stereotype embodiment theory (SET) has advanced recent research on ageism and age stereotypes.
This chapter helps the reader to be familiar with the role coalitions play in advocacy and policy development and to understand the various types of coalitions that affect the policy landscape. It also helps the reader to be familiar with the various roles that exist within groups and coalitions that contribute to the success or non-success of the group process. A number of strategies can be used to develop initiatives to impact one’s advocacy efforts. These strategies can be used to promote the development of new programs and services and can include the use of and/or development of coalitions, the media and media advocacy, and consumer advocates. The chapter addresses each of these strategies in greater depth. It outlines a variety of issues related to coalitions, group development, and coalition building for aging policies and programs.
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.
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.
Wisdom tends to provide a sense of mastery and meaning in life that sustains well-being even under adverse circumstances. This chapter provides a summary of explicit and implicit wisdom theories. It explores the contextual life-course approach to address the divergent trajectories of personal wisdom development, with focuses on the importance of social support networks and role models. The chapter also explores the associations among wisdom and culture, religion/spirituality, and well-being in old age. Most wisdom literature concurs that advanced cognitive development is necessary but not sufficient for wisdom to arise. In older adult samples of mixed educational and socioeconomic backgrounds, wisdom, assessed as analytic and synthetic wisdom modes and an integration of cognitive, reflective, and compassionate wisdom dimensions was positively associated with subjective well-being, even after controlling for physical, health, socioeconomic status, financial situation, physical environment, and social involvement.
Studies in model organisms strongly support the idea that proteostasis is critical for healthy longevity and that enhanced proteostasis is associated with longevity both across species and within species. This chapter provides an overview of the evidence supporting the theory that loss of protein homeostasis is a conserved mechanism of aging. It also provides an overview of current evidence that loss of proteostasis is a central driver of aging and age-related disease, based on studies from a variety of model systems and clinical data. Although the link between loss of proteostasis and disease is strongest in age-associated neurodegenerative disorders, there is growing evidence that misfolding and aggregation of proteins also contribute to other age-related diseases, as well as functional decline in numerous tissues and organ systems accompanying the aging process. The heat shock response (HSR) has been strongly implicated in aging in several organisms, including yeast, worms, and flies.
Older adults experiencing cognitive decline and any of the dementias are suffering in ever increasing numbers. With the aging of the baby-boom generation, the incidence of cognitive decline and dementia will exponentially escalate over the coming years. With this coming tsunami of dementia, older adults experiencing dementia, as well as their family members and caregivers, will need the services of psychologists. Psychologists are needed to help families recognize the importance of end-of-life planning for an older adult when first diagnosed with a dementia. When an older adult understands that he or she has responsibility for and choice in the decision to abuse a psychoactive substance, there is a greater probability of successful treatment and recovery from a substance abuse problem. Psychologists are in a unique position to assess whether older abuse is occurring and, when discovered, to intervene with advocacy initiatives.Source:
- 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.
Scholars studying social connectedness draw on the sociological theory of social capital. In recent years, social scientists have proposed theoretical and conceptual models to explore the role of social connectedness in the specific context of aging. Recent data on the social networks of older adults paint a rich picture of the individual, or egocentric, social networks of the elderly community-dwelling population. This chapter discusses the theory of social capital, and explores the main effects and stress-buffering models of social connectedness and health. Although social capital theory has effectively guided empirical research, new ideas and concepts in aging research are generating interest among scholars, and are taking the field in innovative directions. A series of studies based on the Veterans Affairs Normative Aging Study (NAS), an ongoing study of aging established in 1963, documents a relationship between air pollution and various health conditions such as increased blood pressure and inflammation.
This chapter illustrates that aging in place is richer and more dynamic than simply understanding aging as loss and place as a static physical environment. The conceptual cornerstone of environmental gerontology is Lawton and Nahemow’s Ecological Model of Aging, otherwise known as the ‘competence-press model’ of aging. The concept of aging in place has evolved from the simple homeostatic notion of person-environment (P-E) fit to a more dynamic conceptualization that considers people, places, the programs they embody, constructive selective and accommodative processes, and the goals that motivate the entire enterprise, as they all evolve over time. The ecological framework of place (EFP) identifies a variety of factors that are hypothesized to affect P-E fit, including characteristics of individuals, places, and time.
Efforts to understand the biology and cause of human aging are as old as recorded history. Even during the Age of Enlightenment, and the major discoveries made in biology in the 20th century, the fundamental cause of aging is still a mystery. Age changes can occur in only two fundamental ways-either by a purposeful program driven by genes or by stochastic or random events. But, once reproductive maturation is reached, thought is divided with respect to whether the aging process results from a continuation of the genetic program or whether it occurs by the accumulation of dysfunctional molecules. The quantitative variation in physiological capacity, repair, and turnover accounts for the differences in longevity both within and between species. Because longevity is indirectly governed by the genome it is sexually determined. Because aging is a stochastic process, it is not.
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.
- Go to chapter: Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy
Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy
This chapter helps the reader to be familiar with the demographic and social factors that influence and shape aging and disability policy over time and to be aware of policy changes over the past century within disability and aging public policy. It explains the contrast between advances in science and technology and public policy related to people growing older and people with disabilities. Landmarks serve as essential tools to help us recall specific historical events in time. Historical landmarks, science, and technology have played significant roles in the evolution of social policies; however, aging and disability policies may not have made as many strides as other areas throughout history. The chapter briefly discusses: the role of historical landmarks in shaping social trends and public policies; the relationship between historical landmarks and aging and disability-related policies; and trends in policy, social, and political influences and landmarks in the United States.
This chapter combines the increasing number of studies that pertain to the stereotype embodiment theory (SET) and reflects upon to represent the current state of this theoretical perspective and how it can help explain age stereotypes’ contributions to health and aging. It describes the history, cultural context, and nature of age stereotypes and age self-stereotypes in a largely ageist society. The chapter presents SET, which provides a framework for explaining how age stereotypes are acquired to subsequently influence health outcomes. It discusses replication studies conducted in different countries, as well as meta-analyses, to demonstrate the validity of this theory as well as to illustrate the meaning and impact of its components. The chapter illustrates how SET may be applied to shape future healthy aging research, policy, and practice. Empirical evidence supports the importance of age stereotype self-relevance among older adults.
While high-income nations have experienced increasing life expectancy as a consequence of better healthcare and healthier lifestyles, this does not mean that the size of the aging population will be the highest globally. The issue of HIV and older adults will continue to be a public health issue across the globe and will require the attention of factors related to socioeconomic context as well as sexual health and education. Regardless of the income of specific nations, families provide essential and important support for elders. The support of the oldest-old and those who require long-term supports and services earlier in life will be the most pressing issue for all nations going forward—rich and poor alike. These issues, in and of itself, is a great reason to participate and learn about international issues and global aging so that we can in fact face the challenge of change in our aging world.
This chapter briefly discusses housing and housing education activities that offer several unique perspectives on understanding issues of housing for older adults. The housing education activities are as follows: (1) Find a Nursing Home, (2) Field Trips to Senior Facilities, (3) Household Disaster Planning Kits, (4) Long-Term Care Residence Disaster Planning and (5) Applying Anti-Racist Pedagogy to the Exploration of Senior Housing. Activity 1, simulates some of the challenges older adults and their families face by actively engaging participants in the process of evaluating nursing home quality. Activity 2, provides hands on context to understanding the diverse housing options in the senior housing continuum. Activity 3, addresses an often overlooked concern for persons aging in place. Activity 4, similarly addresses the issue of emergency preparedness, this time in the context of conducting research and a focus on institutional rather than individual planning.
When one considers the prospects of aging, considerations of variables that could be found to help individuals age more gracefully are paramount to appreciate. This chapter provides an overview in regard to the importance of animals in our lives; more specifically, it addresses how animals help support individuals in their later years. It is amazing to appreciate that the warm heart, cold nose, and wagging tail of a four-legged creature would make such an impact. The chapter gives attention to considerations for people who may want to adopt pets in their later years as well. It provides a brief description on: pets and older family members; why we love animals; what is the human–animal bond?; physiological and psychological benefits of human–animal interactions; and understanding the human–animal bond. It also briefly discusses how to select a pet.
Research is a key component in every discipline and is often considered the most difficult to teach and the most boring to learn. Many undergraduate and graduate courses in research methods are across two semesters, which include a course on statistics and then a course on research methods, with a melding of the two during the second course. Universities are encouraging undergraduates to complete a research project with a professor in order to show their abilities prior to joining the workforce or attending graduate school. This chapter discusses research education activities. In Activity 1, Diversity of the Aging Experience, students utilize their newly acquired knowledge of research methods to locate current research on older adults. Activity 2, Final for Biology of Human Aging Course, incorporates acquired knowledge on biological aspects of aging and links an individual to each biological aging process.
The topic of death has tremendous biopsychosocial complexity. This chapter discusses it under the social aspects of aging because familial, societal, and cultural norms provide the context for understanding the how, when, and where of our deaths as well as our experiences of bereavement and grief. And yet, near the end of life, it is important to note that each person prepares for and faces the challenges differently. The varying illnesses and physical conditions combined with the individual uniqueness that we bring to the dying and bereavement processes create this biopsychosocial complexity. The challenge of our legal, health care, and community systems is to meet these diverse individual needs while evolving with society's changing norms. The chapter aims to introduce readers to the tremendous biopsychosocial complexity of understanding death and loss, in consideration of the diversity found among older adults.
This chapter provides insight into the demographics of aging, and an overview of potential benefits and challenges of using technology to help older adults. It outlines four interconnected challenges of an aging population. With the expected increase in care needs that coincides with an aging population, the first challenge is the question of how to provide relevant high quality-care to older persons. Second, with fewer caregivers available in relation to the growing population in need, we can expect that the relative burden of care experienced by caregivers will increase. The third challenge is to increase the relative number of healthy and independent seniors by taking a more proactive approach with prevention and health maintenance strategies. The final challenge addressed concerns the development of health care systems and policy changes that are more inclusive of needed assistive technologies and medical devices.
This chapter takes a step-by-step approach to identifying and securing an internship, practicum, field work placement, or similar experience in gerontology. Readers are taken from the initial stages of career exploration all the way through the process of applying for potential internship, practicum, or field placements. Professional development and reflection activities in the chapter include determining short- and long-term professional goals, assessing personal and professional strengths, and evaluating which internship opportunities might best fit one’s personal and professional requirements. Additional content and activities address practical aspects of the internship-seeking process, including networking, informational interviews, initial resume construction, cover-letter writing, and assessing one’s social media presence.
Demography studies include examining how many people are in a given geographic location; population growth or decline resulting from trends in fertility, mortality, and migration; where people are located and why; and characteristics of the population. The two activities in this chapter offer students opportunities to apply demography and demographic ideas to our aging world and their own hometowns. In Activity 1: Applying the Demography of Aging to Countries Around the World, students can learn how countries have changed over time and can become more savvy about the information they are exposed to regarding trends in populations. In contrast, Activity 2 Hometown Age Demographics moves the focus to the student's local area, making the information more personal and contextualizing the data in a different manner. The activity seeks to challenge students to examine their own communities to discern whether their hometowns are experiencing population aging or not.
The importance of social factors and relationships on health status has strong support in the literature. Furthermore, the impact of social support for positive health outcomes or providing a buffer from poor health indicates that understanding social networks and relationship status is essential to determining how to promote health in the aging population. This chapter seeks to delve into these societal trends and examine how they are affecting the physical health and well-being of the globally aging population. The first section looks into trends in nuptial and relationship status and the impact this has on physical and psychological health of older adults. This is followed by a discussion of the impact of living arrangements for older adults. The chapter concludes with an examination of the impact of caregiving on the psychological well-being of older adults.
Myriad statutory, procedural, and technological innovations have been made in the criminal and civil justice systems to increase access to courts and legal services for older people and people with disabilities. This chapter describes basic legal concepts that pertain to individual rights and explains some of the criticisms that have been leveled against aging and elder abuse policy on legal grounds. It points out the role that courts play in interpreting rights, determining when they have been violated, and finding that statutes and executive actions are invalid. It focuses on a few examples that have attracted scrutiny, particularly with respect to elder abuse and neglect. Among the constitutional amendments that are most relevant to elder justice are the Fifth, which limits the government's authority to infringe on life, liberty, and the pursuit of property without due process, and the Fourteenth, which provides equal protection under the law.
- Go to chapter: Our Aging Future—Persistent and Emerging Issues for the Aging Networks: A Call to Action
This chapter addresses emerging and persistent issues that need attention for the benefit of today's elders and the elders of tomorrow. It discusses several persistent and emerging issues that need to be addressed by the aging networks and by the field in general. The persistent issues include: ageism; professional competencies; the aging workforce on all levels; and LTSS in the community. The emerging issues include: goodness of fit and changing cohorts; diversity; and innovation and the aging networks. Services and programs of the aging network are components of the home- and community-based care system that, by definition, is a long-term care system. As the field of gerontology grows and the population of older adults continues to increase, the need for a gerontologically educated workforce becomes a critical factor in our ability to provide a good old age for everyone in our society.
The broad array of community-based services for older adults has developed over time as a result of the Older Americans Act (OAA) and the Administration on Aging (AoA) and the funding allocated to this act by Congress. With an expanding consumer base, the result of population aging, the aging networks have had to evolve over time, and while there have been and will continue to be some growing pains, there continues to be concerted efforts on many fronts to be support for providing services and programs that increase the quality of life for older adults. This chapter explores the expanding consumer base of the aging. It describes how long-term services and supports (LTSS) can be better managed and paid for to support those who need long-term support and services. Finally the chapter discusses how aging networks can and will evolve over time to serve the changing cohorts of older adults.
This chapter aims to discuss the cohort effects, health disparities and cultural stressors, and factors contributing to the resiliency and growth of ethnic, sexual, and gender minority older adults. Being part historian, student, and investigator can help clarify how these multifaceted aspects of identity affect the experiences of older adults in your personal and professional lives. The intersectionality of these factors makes for complex, inspiring, and sometimes distressing stories about overcoming adversity, achieving new heights, and at times sitting with the pain and frustration of discrimination and prejudice. The diversity within older adult populations also affords invaluable research opportunities to improve our knowledge of aging and enhance our provision of care. Moreover, developing a greater appreciation for older adults, including their strengths and hard-fought battles, can help us appreciate the privileges and civil rights we often take for granted.
Public policy is an essential component to quality of life for older adults and provides funding and guidelines for the agencies and staff that provide services. This chapter provides activities that help students to develop a better understanding of public policy and aging. Activity 1, Examining Organizations that Benefit Older Adults in the Local Community (Rodriguez), provides a venue for students, community, and educators to "explore the local network of organizations that exist for older adults". In Activity 2, Letter to A Legislator: Civic Engagement for Gerontology Students (Temple), students have the opportunity to "write a persuasive letter to a legislator to support or oppose a proposed aging related social policy". Activity 3, What Will Your Future Look Like? Financing Retirement Exercise (Baker & Brown) provides a means for students to understand how "events in the economy, political spheres, and personal health status can influence their retirement income".
Health professionals are often called upon to intervene in complex ethical dilemmas that involve respecting an older adult's autonomy while also considering protective interventions to ensure safety. This chapter addresses the foundational ethical competencies for psychologists and geropsychologists including the unique challenges associated with surrogate decision making, legal, clinical, and psychosocial interventions specific to working with vulnerable older adults, ethical dilemmas that can emerge within various situations including assessment and integrated care settings, detection and intervention strategies in cases of elder abuse, neglect, and exploitation, and ethical approaches to research with older adults. Finally, the authors discuss the multicultural dimensions that influence how ethical and legal issues are conceptualized and addressed. The micro-and macrosystems in which older adults live and thrive require a level of cultural sensitivity, an understanding of aging processes, and knowledge about professional ethics and legal standards involved in decision making.
- Go to chapter: Older Americans Act Legislation and an Expanding Consumer Base: The Evolution of a Network
This chapter briefly outlines the history and structure of the Older Americans Act (OAA). It reviews the aging network of services and the network's development. In addition, the chapter provides an overview of the first major change in the operation of the OAA since its inception in 1965. The objectives of the OAA in Title I set the stage for a service philosophy that continues today, nearly 50 years after its enactment. The other titles of the act address specific policy initiatives and programs that address the policy intent of the act. Since its inception, the OAA has been an entitlement program based upon age and, more recently, special status such as being a family caregiver. Funding levels of OAA continue to be limited and most aging network services and programs are required to use additional resources to support the programs of importance to older adults.
The growth of the aging population in the United States is expanding, but our knowledge of sexuality among older adults is not keeping pace, allowing the ongoing perpetuation of myths about sexuality and aging. Aging couples may benefit when they understand that they may not be able to restore the sexual health they remember from their teens, 20s, or 30s but can expect to determine realistic, attainable goals that may include a variety of changes in routine, expansion of their sexual repertoire, and the incorporation of medications. This chapter briefs on the social context of aging, myths about sexuality in older adults, and challenges to sexual activity as people age. It then describes biological, psychological, and relationship changes and aging; and sexual behavior in residential healthcare. Older adults need to be counseled about practicing safer sex as 12% to 22% of all new
AIDSdiagnoses occur in this population.
This chapter describes many of the processes associated with aging in people with spinal cord injury (SCI), starting with a brief update of SCI mortality and life expectancy, followed by a body system-by-body system discussion of how aging in SCI has an impact on both physical and psychosocial health, now and in the future. The first organ system is the genitourinary (GU) system. Following SCI, disruption of GU function is characterized by the loss of volitional control over micturition as well as the loss of coordination of detrusor and sphincter reflexes. The method of bladder management appears to be associated with certain urinary complications and frequently changes with both aging and years post injury. The chapter also discusses the gastro intestinal system and presents aging effects on integument system, nervous system, musculoskeletal system, and immune system. Finally it talks the psychosocial aspects of a person's life.Source:
This chapter explores changes that occur to the brain, beginning with an overview of modern technologies that are used to answer questions about brain functioning in older adults. Next it summarizes the changes that occur to the brain with normal aging. Finally, the chapter presents an overview of neuroplasticity. Although the human brain clearly loses volume with age, the brain also shows plasticity that can be used to maintain functioning in old age. Research in the coming decades can use the principles of neuroplasticity described previously to enhance the functioning of older adults, whether they are experiencing normal age-related change or damage to the brain following strokes or other neurological events. Neuroimaging methods will continue to be developed that allow us to determine what happens to the brain with age, and in response to neurological events, and how neuroplasticity enables the brain to adjust to such changes.
The baby boomer generation is driving the increase in the percentage and numbers of Americans over the age of 65. This chapter discusses the current status of older Americans and the social, political, and economic consequences of the demographic shifts we are going through today. The older population is becoming more diverse in terms of race and ethnicity. Projections of diversity among elders suggest that this trend will accelerate in the coming years. The chapter reviews some of the elements of population aging including life expectancy and the changing social characteristics of the “new” cohorts entering old age, such as increasing diversity among the older cohorts and increasing educational attainment. It discusses health status, the trend toward aging in place, and the relationship between educational attainment and poverty. In addition, the chapter looks at the old-old and centenarians. It concludes with a discussion of the new “work and retirement equation”.
This book is part of the Critical Topics in an Aging Society series. It serves as a catalyst in the technological transformation of aging services through organized presentation and evaluation of tools for a broad health care audience. Geriatrics interprofessional care is a fundamental part of older adult clinical practice modeled on a team approach inclusive of various fields, among them social work, pharmacy, nursing, rehabilitation, administration, and medicine. All clinicians who treat older adults, from the independent to the frail, are engaged in geriatrics team care which is continually adapting and evolving for individuals based on functional status changes, new treatment paradigms, and different settings of care. The need for advanced technology is clearly evident as one enters a hospital, nursing home, or geriatric care setting, including the patient’s home. Older adults have limited abilities to adapt to changes across these care locations, and thoughtfully implemented technology may eliminate these obstacles while providing safer, more enjoyable, and cost-effective care. The book presents some of the latest medical technological innovations and discusses options to help improve not only transitions of care, but also independence and quality of life for older adults. It is organized into four sections. The first section discusses current major challenges in aging and targets for technology, and promoting technology adoption and engagement in aging. The second section focuses on transitions of care and technology integration, home telehealth, and telemedicine and its effects on elder care in rural areas. Section three explores technology design for frailty, technology and cognitive impairment, advances in medication adherence technology, and technological advancements in pain management in elderly population. The final section describes personalized medicine and wearable devices, social robots and other relational agents to improve patient care, artificial intelligence and its potential to improve health, and advances in health education technology.
This chapter introduces some of the concepts that are important in the psychology of aging. It starts by discussing definitions of older adulthood and some characteristics, as a whole, of older adults. It then reviews the data on the projected increase in older adults in the United States and internationally. The chapter discusses the importance of birth cohort and continues to be an important theme throughout this book. Specifically, it reviews characteristics of the Baby Boom generation since most of the current generation of older adults were born in that era. Erik Erikson and Paul Baltes are two researchers who have made substantial contributions to the development of aging studies. The chapter then reviews development of the professional field and training resources that are available to students and professionals, and ends with a discussion of research methods that attempt to untangle the effects of age, cohort, and time of measurement.
This chapter provides an introduction to current theories and areas of investigation in the biology of aging. Telomeres are an important determinant of life span, and after a number of cell replications, the end replication problem becomes manifest. Antagonistic pleiotropy is the concept of biological properties that have developed through evolution to increase reproductive capability, even if they cause harm later in life. Free radicals drive the aging process but their effects can be ameliorated with antioxidants. Caloric restriction provides a well-established mechanism for extending the life span, but requires chronic food deprivation. The chapter finally provides an introduction to basic concepts in research on genes related to aging, such as single nucleotide polymorphism (SNPs) and several genes under focus, such as those related to apolipoprotein E (APOE), catechol-o-methyltransferase (COMT), and brain-derived neurotrophic factor (BDNF).
This chapter provides a brief description about artificial intelligence (AI) and presents several areas where AI methods are being used to solve health problems of an aging population. It presents examples where these methods may be found as part of various technologies designed to help maintain independence, safety, and function. Then the chapter moves to systems where AI can aid in clinical diagnosis, clinical decision support, and the use of electronic health record (EHR) and other health information technology (IT) data. Finally, it presents some areas where AI is being used to advance discoveries in medicine and pharmaceutical interventions, and ends with a coda, hardly fantastical, on how AI approaches may be used to semiautomatically mine large corpora of scientific literature to make new discoveries in aging and gerontology based on complex logical inferences across extremely large numbers of facts.
Because older adults have the highest rate of suicide in the United States, it is important to understand the epidemiological trends, prevalence, and incidence rates of older adult suicidality. This chapter deconstructs myths and misconceptions related to suicide among older adults. It presents a brief overview of empirically grounded strategies for effective assessment and treatment of this population. Although suicide risk increases with age, it is not uncommon for professionals to provide a lower standard of care and service to older individuals. It is critical to be aware of the factors that contribute to suicide in this group in order to design effective suicide prevention and intervention programs and to effectively assess for suicide risk in older adults. It is equally important to be aware of the factors that protect against suicide in this group in order to support and enhance these qualities in an effort to reduce suicide rates.
This book outlines the many changes that have taken place in both the policy arena and the demographics of aging. It is divided into four sections. The first section, Older Americans and the Aging Networks, shows how older Americans are increasingly diverse in a variety of ways, including racial and ethnic backgrounds, religion, spirituality, socioeconomic status, and sexual orientation. It presents the latest demographic data on the older population in the United States, as an important background to the planning and development of programs and services. It also addresses the current status of older Americans and the social, political, and economic consequences of the demographic shifts we are currently undergoing and must be prepared for to face tomorrow. The section two addresses Older Americans Act legislation and an expanding consumer base and the evolution from what we knew as a network to what we see now and will continue to witness in terms of an expanding set of networks attempting to work together to improve the lives of older adults. The section three brings us to a new era of community-based services that also includes issues related to the rights and well-being of older Americans. It introduces community-based services provided by the aging networks and addresses the community supports provided by the aging networks to assist older adults to age in place. Aging in place, as we define it, is anywhere an older adult is living, whether it is independent living, assisted living, skilled nursing, memory care, or in a family or group setting. The final section weaves together the landscape of survival, sustainability, and success. It discusses in detail the workforce issues of the aging network, the aging world and the challenge of change, and the persistent and emerging issues for the aging networks.
Experiential learning activities ranging from intergenerational service-learning to age-simulations and role-playing have also been shown to reduce ageist attitudes and increase empathy for the experiences of older adults. Devising or locating activities that are relevant, appealing, and appropriate can be a challenge for new faculty and veteran educators alike. Moreover, the inherently interdisciplinary nature of aging studies requires instructors to access expertise in a broad range of disciplines and content areas. This book A Hands-on Approach to Teaching About Aging should prove useful for anyone incorporating aging content into his or her courses, regardless of experience teaching aging-related material. The peer-reviewed activities in this book provide instructors from disciplines including but not limited to counseling, family studies, gerontology, geriatrics, medicine, psychology, public administration, public health, nursing, social work, sociology, and speech pathology with teaching strategies to readily engage students in the exploration of aging and older adults.
- Go to chapter: Disability at Developmental Stages: The Young Elderly (Ages 60–75), the Old Elderly (Ages 75 and Older), and the Longevity Revolution
Disability at Developmental Stages: The Young Elderly (Ages 60–75), the Old Elderly (Ages 75 and Older), and the Longevity Revolution
This chapter describes the addition of a new developmental stage. In the past, the years comprising the ages 60 to death were considered a single developmental stage, termed “elderly.” Owing to longer life spans, the elderly stage was divided into two stages, the young elderly (60–75) and the old elderly (75 to death). Certainly, 60-year-old individuals have different developmental tasks than 90-year-olds. This chapter describes the distinction between aging with a disability and acquiring a disability while aging. In the first, many individuals with disabilities (
IWDs) have congenital disabilities or early-onset disabilities and, therefore, on becoming elderly have lived most of their lives with a disability. Acquiring a disability while elderly requires a change of identity. Acquiring a disability in late life is the only life stage for which disability is somewhat “expected” or “normative.”
The field of gerontechnology is described along with how research endeavors can be aided by gerontechnology. Practical applications that enhance the daily life of older adults and their caregivers are also discussed. Caveats of appropriate use of gerontechnology are considered. The chapter concludes with discussion of family technologists who can support older adults and their primary caregivers.
This chapter provides a view of various biologic and psychosocial theories of aging and how they contribute to the understanding of human behavior. Maslow’s, Erikson’s, and Peck’s theories are given considerable attention.
Most of the oldest old experience physical and cognitive decline and suffer the loss of independence. This chapter concerns those 85 and beyond who are the “oldest old”. Often called the “Fourth Age” of life, a time of decline and disability, this life phase begins whenever health starts to decline dramatically, and for some this is well before 85. Acceptance of advancing age and its accompanying decline in health is a central developmental theme of the fourth age. Protective factors include adequate access to services and social support, nutritious food, spiritual beliefs, and regular exercise and activities. Risk factors for poor outcomes derive mainly from failing health. The chapter explains the theories of loss and grief that can guide practice with the oldest old and possible interventions useful for work with oldest-old adults experiencing loss.
Stress, burnout, and compassion fatigue are common among health and human service providers. Early adoption of effective coping mechanisms is essential for a healthy and productive career in aging. This chapter examines internal and external stressors and how they can lead to burnout if not addressed. A positive, proactive approach to self-care is presented with the goal of improving work-life balance. Self-care strategies that focus on physical, mental, and emotional well-being are considered, including setting clear personal and professional boundaries, time management, valuing oneself, and acknowledging one’s needs. Activities in this chapter include identifying stressors in a professional environment and implementing basic self-care practices.
- Go to chapter: The Aging Process as It Relates to Diseases Common to the Nursing Facility Population
This section helps the reader to identify the ten different basic body systems and the difference between chronic and acute care. The ten body systems are: cardiovascular; respiratory system; nervous system; endocrine system; digestive system; integumentary system; musculoskeletal system; urinary system; lymphatic system; and reproductive system. It is helpful for the administrator to be familiar with biological processes, human anatomy, and basic physiology to understand what parts of the body are affected by the aging process. This knowledge allows the administrator to appreciate problems specific to the facility and its residents. Additionally, the administrator will understand basic medical terminology to improve professional communication with their clinical staff. Chronic illness is thought of as a long-term or permanent illness that often results in disabilities that may require help with various activities. The nursing facility administrator typically cares for persons with chronic illnesses.Source:
This introductory chapter presents a brief description of the book and its contents. It begins with description of the concepts of truth, justice, and the American way. This book assumes that advocates for older people can increase their effectiveness by achieving a clearer understanding of Americans’ not-so-self-evident nor inalienable rights. It explores how social justice and human rights principles have applied to older adults in the past and are viewed today. The book examines how the interests of older adults compare to and are intertwined with those of other groups. In essence, it frames elder justice as the intersection between aging policy and policy that promotes human rights and justice. Finally, the chapter describes the organization of the book and presents a brief overview of each chapter.
Work plays a major role in our lives. It provides an organizing force in our activities and helps form our self-concept. Who we are and how we see ourselves is influenced by our work. The study of aging focusing on the employment and retirement issues of middle-aged and older workers is called industrial gerontology (Sterns & Alexander, 1987). The aging of the work force creates such issues as choosing to work longer, early retirement by choice or imposed, career patterns, finances, and health and disability. This chapter addresses many of these issues. As the population ages, the nature of work and retirement need to adjust accordingly. There is a greater need than in times past for nations to develop policies, work-places to identify strategies to maximize the value of an aging workforce, and individuals to plan for what work life and retirement pathways best suit their needs.
Social workers, both in the community and within the Veterans Administration (VA), provide a comprehensive range of services to a broad demographic of veterans. Service provision for veterans can address a wide range of issues including aging, homelessness, reintegration, sexual assault, physical and psychological war injuries, and substance abuse. Research-informed practice allows social workers to effectively address the special needs of veterans. This chapter discusses the landscape of social work practice with veterans and the interconnectedness of research, policy, and service delivery. It offers an introduction to working with veterans from a practice, policy, and research perspective. Social workers should have a working knowledge of military culture, the impact of deployment, subsequent redeployments, reintegration, and adjustment to civilian life. It is essential for social workers to have knowledge about the physical and psychological aspects of trauma, particularly war-related trauma.
This book fills a gaping void in the selection of textbooks to use in graduate courses on the psychology of aging. It serves as a primer for any graduate student who is going to work in a clinical setting with older adults, or in a research lab that studies some aspect of the psychology of aging. The book introduces students to the background knowledge needed in order to understand some of the more complex concepts in the psychology of aging. Additionally, it provides clear explanations of concepts (e.g., genetics of aging research, neuroimaging techniques, understanding of important legal documents for older adults). The book focuses solely on older adults, providing in-depth coverage of this burgeoning population. It also provides coverage on cognitive reserve, neurocognitive disorders, and social aspects of aging. The book is intended for graduate students or upper-level undergraduate students in psychology, biology, nursing, counseling, social work, gerontology, speech pathology, psychiatry, and other disciplines who provide services for, or perform research with, older adults. It is organized into four sections. Section I presents introduction to the psychology of aging. Section II gives a core foundation in biological aspects of aging. It covers general biological theories of aging, common physical health problems in older adults, and normal changes that occur to the brain with aging. Section III describes the psychological components of aging such as changes in personality and emotional development, mental health aspects of aging, normal changes in cognitive functioning, cognitive reserve and interventions for cognitive decline, neurocognitive disorders in aging, aging's impact on relationships and families, and working in late life and retirement. The final section presents the social aspects of aging, which includes death, bereavement, and widowhood, aging experience in ethnic and sexual minorities, and lastly, aging and the legal system.
Significance of changes in biological, psychological, and social aging and their impact on lessened reserve capacity; the importance of understanding slowness, stress, pacing, and accidents in working with older adults; and the role of health promotion, disease prevention, and health maintenance in successful aging conclude the chapter.
Older Americans Act (
OAA) has far reaching effects on older Americans, both inside and outside the facility. The Older Americans Act can be characterized as Congress’s response to non-institutional, primarily non-healthcare needs of the elderly. Title 20 of the Social Security Act is also a response to the primarily non-institutional needs of the elderly. Events that laid the foundation for the passage of the Older Americans Act began about 1945, when the first state, Connecticut, set up a commission concerned with the needs of older individuals. Title 1 of the Older Americans Act states the goals of the Act. Title 2 established the Administration on Aging within the Office of Human Development Services, which is within the federal Department of Health and Human Services. Title 3 authorized grants to the states to create Planning and Service Areas within which the local Area Agencies on Aging function.Source:
Diverse components of the aging networks have been involved in research, education, and practice in the area of emergency and disaster planning. This chapter covers a broad array of topics related to the well-being and the rights of older adults, including elder justice, the Ombudsman program, and legal assistance. It is important to view the supports for older adults from the perspective of empowerment and autonomy rather than from where we have been in the past with programs that foster dependence and operate from a paternalistic attitude about aging, including the view that professionals know what is best and, at the very least, someone other than the older adult knows what is right and what is needed. The aging networks can achieve this by promoting programs that are “active aging” focused and grounded in the social determinants of health as the organizing principle.
This chapter reviews the typical changes in cognitive functioning that occur with aging. It presents an overview of the concept of crystallized and fluid intelligence. More recently intelligence has been conceptualized as consisting of multiple abilities, not adequately represented by a general quotient. The Seattle Longitudinal Study was the first major longitudinal study of cognitive changes with age. The chapter discusses changes in specific cognitive abilities with age. The inhibitory deficit hypothesis was presented as an explanation for changes with attention with age. One consistent finding has been that processing speed declines with advancing age. Visuospatial and language abilities remain fairly stable compared to other abilities. Memory comprises several types of memory, which are affected differentially by aging. Executive functioning also consists of several separate skills, affected differently by aging. Lastly, the chapter discusses two important implications of cognitive changes with age, driving and mandatory retirement ages.
It is vital that those who will interact with older adults in professional and health settings be well prepared to understand the variability of people's aging experiences. In teaching about physical aging, therefore, it is important to balance providing students with an understanding and empathy for the physical challenges some older adults might face with the important caveat that not all older adults are in poor health, nor do the stereotypical notions of physical aging happen to all, or even most, older adults. This chapter briefly discusses the housing education activities that offer the opportunity to provide such balance to students. The housing education activities are (1) How it Feels to be Old, (2) Hands on Experience with the Americans with Disabilities Act (ADA), (3) Hearing Aids and Pizza, and (4) Thinking Critically about Autonomy and Dependency in Aging.
Social connectedness—formal participation in activities, groups and informal contacts with friends, neighbours, and other residents—is important for everyone in a community to thrive, but is critical for the health and well-being of older residents. An "age-friendly" community promotes active, healthy, socially connected aging through inclusive policies, infrastructure, and services. It is easier for older people to involve in the community when it has age-friendly features, such as reliable public transportation; safe, welcoming gathering places; and accessible services. One way that some states, counties, cities, towns, and villages structure a commitment to age-friendly municipal planning is by joining the AARP Network of Age-Friendly Communities. This chapter presents original findings from a study the authors did to explore the strategies age-friendly communities employ to encourage people to spend time with others in their community. It discusses benefits of age-friendly communities; AARP network of age-friendly communities; and age-friendly network communities and social connectedness.
Health promotion, exercise, and the need to focus on these to enhance a healthy long life are discussed. Identification of significant areas of health promotion and barriers to achieving good health are presented. Next, disease prevention along with primary, secondary, tertiary, and quaternary preventive measures are listed. Healthy People 2030, the fifth national health initiative, and its objectives are outlined along with the Patient Protection and Affordable Care Act. Exercise, its meaning, and value in modifying age-related changes are briefed. Types of exercise programs; isometric, isotonic, and aerobic and their recommended use by older adults are listed.
This chapter considers several aspects of aging as a global phenomenon, starting with the role of culture in shaping how we view old age and then turning to the far-reaching social and economic impacts of an aging world within countries and across regions. It provides a framework for thinking about how culture influences aging. The chapter examines some basic economic concepts as a way to help understand how systems and supports for older persons function within countries. It provides a very basic overview of some population-wide economic terms that are helpful in looking at global aging across countries and regions. In addition to economics, geography also plays an important role in global aging. The chapter provides a context for issues and concepts related to global aging, and addresses why it is worthwhile to study global aging, regardless of one’s career plans or academic major.
Comparative global aging research presents extraordinary opportunities to get at the heart of what is universal and what is unique in our “ageways” (expectations in a particular culture for how one ages, views older people, and treats them). These opportunities, however, are accompanied by some challenges in attempting to sort out the complex interactions of policies, cultures, economic development, and other unique aspects of nations being compared. Comparative studies accomplish two important objectives: (a) distinguishing between culture-specific and universal behaviors and experiences and (b) isolating the culture- or location-specific factors that explain differences. Comparative research requires investigators to be better than they might otherwise be, taking nothing for granted and focusing on the underlying principles of good design and respect for participants, not just the pragmatics. This chapter discusses the challenge of measuring complicated ideas such as happiness across cultures where it might be defined and experienced differently.
There are positive and negative aspects of life at every age throughout the life span, and aging is no exception. This chapter presents a more balanced view of older adults’ mental health and cognitive abilities, one that moves away from the stereotypes. It focuses on mental health and cognitive abilities as people age, with a presentation of the many positive characteristics of older adults’ psychological and emotional well-being as well as difficulties some may face, such as depression and dementia. The chapter also describes how personality changes over the life span and how the creative arts can positively impact the lives of older adults. Finally, it discusses factors that can positively and negatively affect older adults’ mental and cognitive abilities. The Practical Application presented at the end of the chapter focuses on unique challenges faced by individuals currently around 80 and above due to mental health stereotypes and stigmas.
Improving the lives of older adults is the primary goal of those who work in the field of gerontology, and doing so invariably also improves the quality of life of those who spend time with them, whether they are family members, friends, neighbors, or those who work with and for older adults. This chapter explores the many career opportunities within the field of gerontology and explains how the study of aging can be applied to any position in any field. It outlines educational pathways, professional organizations, credentialing opportunities, and job-seeking resources for those interested in a career in gerontology. The chapter also highlights the importance of entrepreneurship and innovation to help address the unmet needs of older adults. The Practical Application offers concluding remarks about the unlimited opportunity in the field of gerontology.
There is no specified common timetable for human aging; instead, there are enormous individual differences in the aging process, and all older people do not experience all possible changes. Nevertheless, as people grow older, changes that may be hardly noticeable at first tend to occur throughout the physical systems of the body. Among the physical changes that can be expected to occur as we age, some, such as gray hair and wrinkling skin, are more visible, while others, such as hearing loss and hypothermia, may be less visible. This chapter outlines the normal physical changes that accompany aging and differentiates them from the diseases and conditions that become more common with age. It also provides a discussion of the adaptations that older people can make to accommodate such changes in their health. The chapter concludes with a summary of the two basic paradigms of the biological theories of aging.
This textbook has been developed for introductory courses in gerontology, as well as other courses with gerontology components. Gerontology is multifaceted and interdisciplinary. By necessity, it encompasses a broad range of subjects including psychology, sociology, architecture, biology, communications, economics, education, humanities, law, medicine, nursing, political science, public administration and policy, public health, public safety, social work, and vocational skills. Indeed, gerontology encompasses every academic discipline that in some way relates to the lives of older people in contemporary America. The book is divided into six parts. Part I focuses on the longevity dividend and the importance of mobilizing all sectors of the society to realize the opportunities and address the challenges of an aging society. Part II deals with physical and mental well-being. It discusses in detail the following: physical changes and the aging process; health and wellness for older adults; mental health, cognitive abilities, and aging; sexuality and aging; and death, dying, and bereavement. Part III focuses on economic and social aspects of aging. It focuses on economics, work, and retirement, explores family, friends, and social networks of older adults and discusses how older adults contribute to their communities and how they receive support. Part IV focuses on formal support systems. It discusses in detail the following: older adults giving and receiving support; medical conditions, assisted living, and long-term care; and medicare, medicaid, and medications. Part V focuses on Americans at risk for poor economic and health outcomes as they age — women, people of color, and lesbian, gay, bisexual, and transgender (
LGBT) individuals. It also describes elder abuse and highlights its consequences. Part VI explores the many career opportunities within the field of gerontology and explains how the study of aging can be applied to any position in any field.
This chapter focuses on older people’s living environments—where and how they live. Their living environments include the communities in which they live, with whom they share their accommodations, and the type of housing in which they live. As with most aspects of older adult life, great diversity is common in all of these areas. The opening scenarios indicate just that, with some older people aging in place, others moving to retirement communities with enticing amenities, and yet others sharing their accommodations with others. This chapter discusses living arrangements, housing options, and age-friendly communities for older adults. It stresses the importance of living environment to older people and outlines the factors that influence their decisions about where to live. The chapter also outlines the advantages and disadvantages of living alone and investigates the issue of homelessness among older adults.
A review of the anatomy, physiology, and function of the musculoskeletal system; age-related changes in the musculoskeletal system; specific disorders experienced by older adults along with diagnostic and treatment options; and the role of exercise, pacing, and environmental modalities in maintaining health and recuperation were discussed.
This chapter reviews the anatomy, physiology, and function of skin, hair, and nails and the role skin plays in an individual’s life. Age-related changes in each of these entities along with selected disorders including xerosis; rashes, senile purpura, pruritus, solar elastosis, keratosis, psoriasis, skin tags, herpes zoster, pressure ulcers, and skin cancer are discussed. Lastly, there are recommendations on how to maintain healthy skin and prevent skin cancer.
This chapter focuses on the postinternship process of transitioning from student to professional, or for those who are already professionals, transitioning to new and advanced roles in gerontology. The breadth of careers in aging is explored, ranging from long-established opportunities to more recent entries into the field. Future career options in aging are also considered. The paths to gerontology are varied and several stories of gerontology interns who found their professional positions in the field are shared. Additionally, practical information on how to prepare and pursue a career in aging is provided, covering essential elements such as establishing a professional identity and presence, building a strong resume and portfolio, and preparing for professional interviews. Consideration is also given to the importance of engaging in continuing education throughout one’s career in this ever-changing, interprofessional field.
The anatomy, physiology, and functions of the endocrine system are reviewed. Age-related changes and specific disorders are grouped together to better understand their impact on the system and health of the older adults. Special attention is given to hyperthyroidism, hypothyroidism, and prediabetes and type 1 and type 2 diabetes. Recommended care for diabetics is also outlined.
Brief anatomy and physiology of each sensory systems is described. The effects of aging on each sense and the implications for older adults are detailed. More commonly experienced aging-related diseases that affect sensory function in older adults, along with their respective treatments, are also discussed including cataracts, glaucoma, advanced macular degeneration, tinnitus, and Ménière’s disease.
The anatomy, physiology, and function of the immune system, lymphatic system, and lymph nodes are reviewed. Age-related changes of the immune system along with selected specific disorders that may be found in the older age group are discussed.
HIV/ AIDSin this population along with the cause, diagnosis, and treatment of the disease is defined.
This chapter reflects on how this book focuses on aging as a global phenomenon and attempts to see how our local knowledge plays in Indonesia or Bolivia, to compare what we think we know about our own ageways with what can be learned about the thoughts of other cultures on the subject. This chapter identifies 13 major global themes and describes how the world community—through the United Nations and nongovernmental organizations—is responding to the burdens that economic and demographic changes are placing on older people and their families. The chapter concludes with a call to readers for global leadership.