Reference no: EM133318017
Question 1. Write what was most memorable about and what you learned from the reading?
Question 2. How you might use your knowledge of late adulthood in practice during the assessment and intervention phases of social work practice?
Case Study: he ethnic/racial diversity of the older population in the United States underscores the complexity and importance of taking cultural differences in perceptions of aging into account. A salient example of cultural differences in approaches to aging is the contrast between traditional Chinese and mainstream U.S. beliefs and values. China has been described in anthropological literature as a "gerontocracy," wherein older people are venerated, given deference, and valued in nearly every task. Benefiting from the Confucian value of filial piety, older people hold a revered position in the family and society.
The ethnic/racial diversity of the older population in the United States underscores the importance of taking cultural differences in perceptions of aging into account.
By contrast, consider the traditional cultural influences in the United States, where individualism, independence, and self-reliance are core values that inherently conflict with the aging process. In the United States, older people have traditionally been collectively regarded as dependent, and cultural values dictate that older people living independently are given higher regard than those requiring assistance. As people age, they strive to maintain independence and avoid-at all costs-becoming a burden to their family. Older people in the United States typically resort to intervention from private or social programs to maintain their independence rather than turning to family. By contrast, Chinese elders traditionally looked forward to the day when they become part of their children's household, to live out their days being venerated by their families (Gardiner, 2018).
No discussion of comparisons between cultures would be complete without mention of differences that occur within groups. An individual Chinese person might value independence, whereas an individual in the United States might be closer to the Confucian value of filial piety than traditional U.S. values. Additionally, processes such as acculturation, assimilation, and bicultural socialization further influence the norms, values, expectations, and beliefs of all cultural groups, including those considered the dominant cultural norm. Globalization of economic and information exchange also impacts and changes the cultural norms of all countries so that culture must be construed as something that is dynamic, fluid, emergent, improvisational, and enacted (Gardiner, 2018). In fact, U.S. values of aging appear to be shifting, influenced in part by political and market forces. In the United States, we are now bombarded with contradictory information about aging-media presentations of long-lived, vibrant older adults are juxtaposed with media presentations of nursing home horror stories.
In his book Aging Well, George Vaillant (2002) raises the question, "Will the longevity granted to us by modern medicine be a curse or a blessing?" (p. 3). The answer, he suggests, is influenced by individual, societal, and cultural values, but his research makes him optimistic. Vaillant (2002, 2012) reports on the most long-term longitudinal research available, the Study of Adult Development. The study includes three separate cohorts of 824 persons, all of whom have been studied since adolescence. A significant limitation of the study is the lack of racial and ethnic diversity among the participants, who are almost exclusively white. The great strength of the study is its ability to control cohort effects by following the same participants over such a long period of time.
[Page 564]Much of the news from the Study of Adult Development is good. Vaillant reminds us that Immanuel Kant wrote his first book of philosophy at 57, Titian created many artworks after 76, Ben Franklin invented bifocals at 78, and Will Durant won a Pulitzer Prize for history at 83. Unless they develop a brain disease, the majority of older adults maintain a "modest sense of well-being" (Vaillant, 2002, p. 5) until a few months before they die. Older adults are also less depressed than the general population and have a tendency to remember pleasant more than unpleasant events (Vaillant, 2012). Many older adults acknowledge hardships of aging but also see a reason to continue to live. Vaillant (2002) concludes that "positive aging means to love, to work, to learn something we did not know yesterday, and to enjoy the remaining precious moments with loved ones" (p. 16). Although he found many paths to successful aging, Vaillant (2012) identifies six traits for "growing old with grace":
Caring about others and remaining open to new ideas
Showing cheerful tolerance of the indignities of old age
Maintaining hope
Maintaining a sense of humor and capacity for play
Taking sustenance from past accomplishments while remaining curious and continuing to learn from the next generation
Maintaining contact and intimacy with old friends.
Another recent study using longitudinal data from the Americans' Changing Lives (ACL) study continues to examine the question of the impact of life expectancy and quality of life as a person ages. This is a nationally representative sample of adults age 25 years and older, first interviewed in 1986 and then interviewed again in 1989, 1994, and 2001-2002 (House et al., 2005). A fifth wave of data collection was completed in May 2012, and a sixth wave began in 2019 (Americans' Changing Lives, 2020). The sample for this study has more racial diversity than the Study of Adult Development. The ACL was designed to address one central dilemma of research on aging and health: whether increased life expectancy in the United States and other economically advanced nations foreshadowed a scenario of longer life but worsening health with the result of increasing chronically ill and functionally limited and disabled people requiring expensive medical and long-term care or whether, through increased understanding of psychosocial as well as biomedical risk factors, the onset of serious morbidity and attendant functional limitation and disability could be potentially postponed or compressed. Beginning in 2019, the researchers introduced an epigenetic component to the data collection, collecting DNA to understand how neighborhoods and lived experiences affect gene expression.
These researchers focus on socioeconomic disparities in health changes through the middle and later years. They represent a set of scholars who are examining a theoretical concept of cumulative advantage and disadvantage and its role in understanding differential aging among various populations (Ailshire et al., 2017; Schöllgen et al., 2010). (See Chapter 10 for a discussion of these concepts.) They argue that multiple interacting factors throughout the life course impact the quality of the health of older individuals. For example, early poverty, a lifetime of poverty, poor environmental conditions, poor education, race, and gender have a direct impact on how a person will age. It is not a simple linear, causal track but instead reflects the complexity of interacting risk and protective factors.
Reviewing research findings from the ACL study, House and colleagues (2005) examined the impact of two factors related to socioeconomic status (SES)- education and income-on poor health. They found that overall socioeconomic disparities do impact health outcomes rather than the reverse. Additionally, they found that education has a greater impact than income on the onset of functional limitations or disabilities. Income, however, has a greater impact on the progression of functional limitations. Finally, the impact of educational disparities on the onset of functional limitations increased strikingly in later middle and early old age, with more highly educated individuals postponing limitations and thus compressing the number of years spent with limitations.
Psychosocial Theoretical Perspectives on Social Gerontology
How social workers see and interpret aging will inspire our interventions with older adults. Social gerontology-the social science that studies human aging-offers several theoretical perspectives that can explain the process of growing old. Ten predominant theories of social gerontology are introduced here.
[Page 565]1. Disengagement theory. Disengagement theory suggests that as elderly individuals grow older, they gradually decrease their social interactions and ties and become increasingly self-preoccupied (Cumming & Henry, 1961). This is sometimes seen as a coping mechanism in the face of ongoing deterioration and loss (Tobin, 1988). In addition, society disengages itself from older adults. Although it was the first comprehensive theory trying to explain the aging process (Achenbaum & Bengtson, 1994), disengagement theory has received much criticism and little research support (see, for example, Cornwell et al., 2008). Disengagement theory is now widely discounted by gerontologists (Hooyman et al., 2018). The theory does not explain the fact that a growing number of older persons, such as Ruby Johnson, continue to assume active roles in society.
2. Activity theory. Activity theory states that higher levels of activity and involvement are directly related to higher levels of life satisfaction in elderly people (Havighurst, 1968). If they can, individuals stay active and involved and carry on as many activities of middle adulthood as possible. There is growing evidence that physical activity is associated with postponing functional limitation and disability (Benjamin et al., 2005). Activity theory has received some criticism, however, for not addressing relatively high levels of satisfaction for individuals like Ms. Johnson, whose level of activity is declining, arguing that the theory satisfies U.S. society's view of how people should age (Moody & Sasser, 2015). It also does not address the choice made by many older individuals to adopt a more relaxed lifestyle.
3. Continuity theory. Continuity theory was developed in response to critiques of the disengagement and activity theories. According to continuity theory, individuals adapt to changes by using the same coping styles they have used throughout the life course, and they adopt new roles that substitute for roles lost because of age (Neugarten et al., 1968). Individual personality differences are seen as a major influence in adaptation to old age.
4. Social construction theory. Social construction theory aims to understand and explain the influence of social definitions, social interactions, and social structures on the individual elderly person. This theoretical framework suggests that ways of understanding aging are shaped by the cultural, social, historical, political, and economic conditions in which knowledge is developed (Dean, 1993). The recent conceptualization of gerotranscendence is an example of the application of social constructionist theory to aging. The idea of gerotranscendence holds that human development extends into old age and does not simply end or diminish with aging (Hooyman et al., 2018; Tornstam, 2005). According to this theory, aging persons evaluate their lives in terms of the time they have ahead and try to derive a sense of identity, self, and place in the world (Degges-White, 2005; Tornstam, 2005).
5. Feminist theories. Proponents of feminist theories of aging suggest that gender is a key factor in understanding a person's aging experience. They contend that because gender is a critical social stratification factor with attendant power, privilege, and status that produces inequalities and disparities throughout the life course, we can only understand aging by taking gender into account (Arber & Ginn, 1995). Gender is viewed as influencing the life course trajectory by impacting access and opportunity, health disparities, and disparities in socioeconomic opportunities and by creating a lifelong condition of "constrained choice" (Rieker & Bird, 2005). Spector-Mersel (2006) argues that in Western societies, older persons have been portrayed as "ungendered." Older men are in a paradoxical position because the metaphors for old age are the opposite of the metaphors for masculinity in these societies. Think of Pete Mullin as he considers how he will manage to live alone. Also, consider Ms. Johnson's experience as a single older woman. How might her personal situation differ if she were a man?
6. Social exchange theory. Social exchange theory is built on the notion that an exchange of resources takes place in all interpersonal interactions (Blau, 1964; Homans, 1961). Individuals will only engage in an exchange if they perceive a favorable cost-benefit ratio or if they see no better alternatives (Hendricks, 1987). As individuals become older, the resources they are able to bring to the exchange begin to shift. Social exchange theory bases its explanation of the realignment of roles, values, and contributions of older adults on this assumption. As social workers, then, it is important to explore how older couples are dealing with the shift in resources within their relationships. Several studies indicate that maintaining reciprocity is important for older individuals (Fiori et al., 2008). For example, a recent study of reciprocity among residents of assisted living looked at the positive contributions of aging care recipients to their social relationships, including their interactions with caregivers (Beel-Bates et al., 2007).
[Page 566]7. Life course perspective. From the life course perspective, the conceptual framework used in this section of the book, aging is a dynamic, lifelong process (Greve & Staudinger, 2006). Individuals go through many transitions over their life course (Hendricks & Hatch, 2006). The era they live in, the cohort they belong to, and personal and environmental factors influence individuals during these transitions. "Life course capital" is a contemporary addition to the life course perspective. The theory states that people, over the course of their life, accumulate human capital-resources that they can use to address their needs. This capital can take on various forms; it may be social, biological, psychological, or developmental human capital (Hooyman et al., 2018). This accumulation of life course capital has an impact on a person's aging; for instance, on health (e.g., morbidity, mortality) or wealth (e.g., standard of living in retirement).
8. Age stratification perspective. The framework of age stratification falls into the tradition of the life course perspective (Foner, 1995; Riley, 1971). Stratification is a sociological concept that describes a given hierarchy that exists in a given society. Social stratification is both multidimensional and interactive in that individuals occupy multiple social locations with varying amounts of power, privilege, and status. The age stratification perspective suggests that similar to the way society is structured by socioeconomic class, it is also stratified by age. Roles and rights of individuals are assigned based on their membership in an age group or cohort. The experience of aging differs across cohorts because cohorts differ in size, composition, and experience with an ever-changing society.
9. Productive aging. Productive aging theory focuses on the positive changes that have occurred to the older adult population. A new generation of older adults is more independent and better off than previous cohorts in many areas, including health, economic status, mobility, and education (Kaye, 2005). This approach maintains that the focus of aging theories has been too much on the losses, crises, and problems of aging while neglecting the positive side of becoming older.
10. Environmental gerontology. Central to environmental gerontology is the concept of place (Gubrium, 1978) and the ecological model of aging first presented by Lawton (1986). Environmental gerontology focuses on the interplay among system, person, place, and time throughout the life course (Moore, 2014). Differing from the life course perspective's focus on life capital, place and environment play a key role in environmental gerontology. Although older adults may want to continue assuming certain roles or carrying out certain actions, their physical or cognitive losses in combination with environmental factors may hinder their possibilities to do so. This in turn may impact the person's social roles and statuses. For example, when older adults live in environments that present them with opportunities for more physical activity and social interaction, they tend to stay more mobile and engaged.