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GERONTOLOGY STUDY NOTES
1
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Theories and Methods

3
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Personal Health and Well-Being

5
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Race and Ethnicity

7
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Finances and Economics

9
...
Housing and Transportation
11
...
Family Life and Relationships
13
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Death and Dying
15
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Ageism
Goals And Impact Of Gerontology
Goals of Gerontology
•
•
•
•

Gerontology aims to study aging systematically
...

The field focuses on understanding the diverse experiences of older individuals
...


•

Educational programs and social policies are utilized to moderate ageism
...

Stereotyping can lead to misjudgments and inappropriate treatment of older
individuals
...

Gerontologists aim to address ageism through research and advocacy
...


Emergence of 'Third Age' and 'Fourth Age'
•
•
•
•
•

The concept of the 'Third Age' refers to a period of active retirement and personal
fulfillment
...

These terms highlight the evolving nature of aging and the need for tailored support
systems
...

Social changes and advancements in healthcare contribute to the delineation of
these age categories
...

Prejudice leads to negative attitudes towards older individuals, affecting their social
interactions
...

Gerontology aims to challenge stereotypes and promote a more nuanced
understanding of aging
...


Benefits of Studying Aging
•
•
•
•
•

Understanding aging helps in addressing social issues related to an aging
population
...

Active participation in recreation programs and community services enhances the
quality of life for older individuals
...

Knowledge of aging contributes to informed decision-making in public policy and
resource allocation
...

Contrary to common myths, many older individuals report good health and
emotional well-being
...

Understanding the diverse needs of older individuals is essential for developing
tailored social services
...


Importance of Studying Aging
Career Relevance
•
•
•

Studying aging is crucial for professionals in fields like nursing, social work,
physiotherapy, recreation studies, architecture, family studies, and business
...

Understanding aging provides a better grasp of clients' needs and enhances service
delivery
...

Knowledge of aging can help individuals support their parents and grandparents
through the challenges of later life
...


Satisfaction and Well-being
•
•
•

Research indicates that satisfaction with life tends to increase in older age groups,
even when considering factors like health and marital status
...

Contrary to negative stereotypes, aging can bring about a sense of fulfillment and
improved well-being
...


•
•

Ageism reflects societal unease with aging, disease, disability, and mortality
...


Prevalence and Impact
•
•
•

Studies show a prevalence of ageism globally, with older individuals often
experiencing disrespect and assumptions about their health
...

Ageism can lead to biased behavior towards older individuals, even within the older
age group itself
...

Older individuals may internalize negative age stereotypes, influencing their selfperception and behavior
...


Impact on Self-perception
•
•
•

Older individuals may distance themselves from their age in daily life to avoid
negative stereotypes
...

Ageism can lead to unpleasant and challenging experiences for older individuals,
affecting their quality of life
...

These jokes can imply a lack of control over bodily functions, perpetuating negative
perceptions
...


•
•

Society's ingrained stereotypes of older individuals contribute to the prevalence of
ageism
...


Impact of Early Exposure on Ageism
•
•
•
•
•

Psychological learning theory suggests that early exposure to age-related
stereotypes influences perceptions of aging
...

Realistic understanding of aging from a young age can lead to more informed
decisions throughout life
...
(2014) discovered implicit negative attitudes towards sexuality in
older adults among young students
...


Media Representation of Ageism
•
•
•
•
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Historical literature and media often depict older individuals in negative or
stereotypical roles
...

The media, including shows like 'The Simpsons,' frequently perpetuates ageist
stereotypes through characters like Grandpa Simpson
...

Screen Actors Guild (SAG) reports highlight the limited and often negative roles
available for older actors in the entertainment industry
...


•
•

These programs aimed to improve the lives of older people but also inadvertently
led to scapegoating and questioning of their entitlements
...


Key Terms
•
•
•

Social Institution: Stable social organizations like family, government, or education
systems
...

Compassionate Stereotype: Aims to evoke sympathy for older people but may not
present a true picture of aging
...

• A national study in the United States revealed that older individuals perceive
serious issues among their peers, despite not experiencing the same problems
themselves
...

"Even older people continue to believe the negative stereotype that most old people are
weak, sick, or senile" - Palmore (2015)
•
•

Some older individuals resist using senior discounts, preferring to pay full price to
avoid acknowledging their age
...


New Ageism and Compassionate Stereotypes
•

Kalish (1979) and Estes (1979) introduced the concept of 'new ageism,' which
involves providing special treatment to older individuals due to health issues,
poverty, or lack of social support
...

Estes identified that the 'aging enterprise,' a federal bureaucracy to support older
individuals, emerged from compassionate stereotyping, portraying seniors as poor,
frail, and dependent
...
Reality
•

Younger adults often hold more negative views about aging compared to seniors
...

The study revealed that older individuals reported lower levels of memory loss,
inability to drive, serious illness, lack of sexual activity, sadness, feeling unneeded,
loneliness, financial struggles, and burden than what younger adults anticipated
...

Pew Research Center's survey of 1,332 older adults revealed a generally positive
outlook on old age, emphasizing the advantages of retirement and increased time
for personal interests and family
...


Age Awareness and Culture
Quiz: Are You Age Aware?
•

•
•

A quiz by Revera (2015) assesses individuals' attitudes towards aging and older
adults through questions about interactions, perceptions, and responses to agingrelated scenarios
...

The quiz aims to highlight age awareness and potential ageist attitudes in
individuals
...

The use of humor in age-related contexts may inadvertently reinforce negative
stereotypes about aging
...

Various proposed terms like 'Gruppies' and 'OPALs' aim to present older individuals
positively but lack widespread acceptance
...

Different regions and cultures may have varying preferences for age-related
terminology
...


Ageism in Entertainment Industry
•
•
•
•
•

Levitt and Dubner's study on game show contestants revealed age-based
discrimination, with elderly players being disproportionately eliminated
...

Studies show underrepresentation of older individuals in prime-time television,
commercials, and children's shows
...

Concerns raised by older individuals regarding the portrayal of aging in media
reflect the impact of negative stereotypes
...

Levitt and Dubner (2005) in 'Freakonomics' discussed ageism on TV, citing 'The
Weakest Link' as an example
...


•
•

Bowd (2003) identified eight categories of negative stereotypes related to age,
including the impotent male and the forgetful older person
...


Impact of Elderspeak
•
•
•
•
•

Definition: Elderspeak is a specialized speech resembling baby talk, affecting older
people's self-esteem and communication abilities
...

Examples: The use of terms like 'dearie' and 'cutie' contribute to elderspeak,
reinforcing stereotypes of low mental ability in older individuals
...

Case Study: Ruth Reichl's experience at a restaurant revealed how elderspeak
influenced service quality based on perceived age
...

Impact: The experiment shed light on societal perceptions and treatment of older
individuals
...

Case Study: Ruth Reichl's disguised experiment at a restaurant exposed biases and
stereotypes faced by older individuals
...

Facts on Aging Quiz: Palmore's quiz aimed to challenge misconceptions and test
knowledge about aging
...


•
•

Research: Studies link ageism to lower vitality, poor health, and negative impacts
on older individuals
...


QUICK REFERENCE
...

Philip Zimbardo: Conducted the Stanford Prison Experiment to explore the effects of
perceived power in a simulated prison environment
...


Seminal Studies
•
•
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Facts on Aging Quiz (FAQ): Created by Erdman Palmore to test knowledge about aging
and common misconceptions
...

Ageism in America Study: Explored ageism in various aspects of society, including
television shows and commercials
...

Conduct of the Stanford Prison Experiment: Philip Zimbardo's study on the effects of
perceived power in a simulated prison environment
...


Key Themes
•
•
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Ageism: Negative attitudes and stereotypes toward aging individuals
...

Elderspeak: Specialized speech used with older people, resembling baby talk
...

Ageism is biased attitudes against older people based on their age
...

Prejudice is a negative attitude toward a person based on their social characteristic
such as age, gender, ethnicity, or race
...


Reference Information
•
•
•
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The Federal Interagency Forum reported that between 2008 and 2010, 76% of
people age 65 and over rated their health as good, very good, or excellent
...

Studies have shown that older cohorts report higher levels of subjective well-being
compared to younger cohorts
...


Key Terms/Concepts
•
•
•
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Stereotyping: To believe unfairly that all people with a particular characteristic are the
same
...

Discrimination: Unfair treatment based on a prejudice rather than merit
...


CHAPTER 2
...

Subfields of Gerontology and Theory Importance
Subfields of Gerontology
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Gerontology encompasses various subfields that contribute uniquely to the study of
aging
...

Each subfield focuses on different aspects of aging, such as social interactions,
biological processes, and cognitive changes
...

Research in gerontology often involves interdisciplinary collaboration to address
the complexity of aging
...

Gerontologists utilize theories to explain and predict phenomena related to aging
...

Theories help researchers interpret data, formulate hypotheses, and understand
the relationships between different variables
...


Perspectives and Categories of Change in Gerontology
Major Perspectives in Gerontology
•

Gerontologists employ three major perspectives in their research: functionalism,
conflict theory, and symbolic interactionism
...

Conflict theory examines power dynamics and inequalities among different age
groups in society
...

Each perspective offers a unique lens through which gerontologists analyze agingrelated issues
...


Categories of Change Studied by Gerontologists
•
•
•
•
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Gerontologists study three main categories of change: biological, psychological,
and social
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Psychological changes involve cognitive processes, emotional well-being, and
mental health in older adults
...

Disentangling these effects helps researchers understand the multifaceted nature
of aging
...


Research Designs and Methods in Gerontology
Cross-Sectional and Longitudinal Research
•
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•
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Cross-sectional research involves collecting data from a diverse group of
individuals at a single point in time
...

Pros of cross-sectional studies include efficiency in data collection and immediate
results
...


•

Combining both designs provides a comprehensive understanding of aging
processes
...

Qualitative methods focus on in-depth exploration of experiences, perceptions, and
meanings related to aging
...

Qualitative research allows for rich, detailed insights into the subjective
experiences of older adults
...


Information Literacy and Ethical Considerations
•
•
•
•
•

Information literacy is vital in the digital age to critically evaluate online sources and
ensure research validity
...

Researchers navigate ethical dilemmas by following established guidelines and
ethical principles
...

Applying research outcomes to improve the lives of older individuals reflects the
ethical responsibility of researchers
...

Sir Edmund Halley and Benjamin Rush made significant early contributions to
understanding life expectancy and aging processes
...

Elie Metchnikoff coined the term 'gerontology' in 1905, marking the formalization of
aging studies as a distinct field
...
Stanley Hall's work in the early 20th century laid the foundation for scientific
research on aging in the United States
...

Researchers employ various methods such as surveys, controlled studies,
historical analysis, and field research to investigate aging
...

Ongoing research in gerontology focuses on addressing the challenges and
opportunities associated with an aging population
...


Historical Development of Gerontology
Early Studies on Aging
•

Stanley Hall's Contribution: Published 'Senescence, the Last Half of Life' in 1922,
pioneering scientific studies on aging in the US
...

Pre-17th Century: Authors relied on personal experiences, reflecting fears and
biases of the time
...

Mathematical Techniques: By the 18th century, researchers in natural sciences
and medicine began using mathematical tools
...

Growth of Journals: Major US journals like Journal of Gerontology emerged after
1946, with numerous global academic journals focusing on aging
...

Bibliographic Expansion: A bibliography from 1954-1974 listed 50,000 sources,
surpassing all previous writings on aging
...


Gerontology as a Discipline
Defining Gerontology
•
•
•
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Discipline or Subfield?: Debate on whether gerontology is a distinct discipline or a
subfield within existing disciplines like sociology or biology
...

Academic Units: Proposal for gerontology departments with dedicated faculty and
administrative status
...


Core Areas of Aging Studies
•
•
•

Biomedical Studies: Focus on bodily changes with age, including DNA, cells,
systems, stress, and dementia
...

Socioeconomic-Environmental Studies: Examine aging's impact on social
institutions like the economy, family, and healthcare system
...

Biomedical Focus: Emphasizes social effects of physical aging, such as changes in
mobility and healthcare needs
...

Life Course Changes: Studies transitions in family dynamics, relationships, and
activities over a lifetime
...

Theory: Defined as a conceptual model of some aspect of life
...
Scientific Theories: Contrast between common beliefs and
scientifically tested theories
...


The Importance of Theories in Gerontology
Role of Theories in Research
•

Psychologists and researchers study memory decline with age, producing literature
to test theories
...

• Theories help researchers organize their work and provide different perspectives on
phenomena
...
" - Bengtson, Gans, Putney, and Silverstein (2009)

•
•

Theories aid in organizing and focusing research efforts, offering different
explanations and descriptions
...


Levels of Theories in Gerontology
•
•
•
•
•

Micro-level theories focus on individuals and relationships, studying small-scale
events like interactions in nursing homes and changes in personality with age
...

Macro-level theories examine social institutions, systems, and whole societies,
analyzing how they shape experiences and behavior
...

Modernization theory is an example of a macro-level theory
...

Macro-level theories: Focus on social institutions, systems, and whole societies
...

Theories include social constructionism, social exchange theory, symbolicinteractionist perspective, social phenomenology, and ethnomethodology
...

"People learn to read and respond to the symbols around them
...


Functionalism and Conflict Perspectives
•
•
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Functionalism: Focuses on how society works together to maintain stability and
order
...

These perspectives provide different lenses to analyze gerontological phenomena
...
I
...

The study involved 40 older couples to understand how they adjusted to daily life
after one partner received an MCI diagnosis
...

The research highlighted how partners with MCI began relying on their spouses for
care and support
...

Close collaboration between researchers and subjects is crucial in this type of
research to capture the subject's story and perspective
...

Researchers adopting this perspective aim to understand how individuals create
and maintain meaning in specific social contexts
...

This approach allows researchers to see the world through the eyes of the subjects,
fostering a deeper understanding of their experiences
...


Critique of Interpretive Perspective
Limitations of the Interactionist Perspective
•

The interactionist perspective may overlook the impact of larger social institutions
on individual experiences
...

Power dynamics and conflicts between social groups are not extensively addressed
within the interactionist perspective
...

Critics argue that the interactionist perspective lacks a comprehensive analysis of
structural influences on individual behaviors and experiences
...

Emile Durkheim and Talcott Parsons are key figures associated with the
development of functionalist theory
...

Functionalism emphasizes consensus, social stability, and the positive evolution of
society
...


Application of Functionalism in Gerontology
•
•
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•
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Early gerontological theories like disengagement theory and activity theory were
influenced by functionalist principles
...

Age stratification theory explores the dynamic interplay between individual aging
processes and broader social changes
...

Functionalism in gerontology historically focused on social order, consensus, and
the role of social institutions in shaping aging experiences
...

Social Exchange Theory: Describes the give-and-take relationships between
individuals
...

Social Phenomenology: Examines the social construction of reality and everyday
interactions
...


Key Perspectives
•
•
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Interpretive Perspective: Focuses on how individuals interpret their social world and
create social order
...

Conflict Perspective: Emphasizes social conflict and power dynamics between
different groups
...

Study on Sexual Identity in Later Life: Explored the experience of transgender
individuals contemplating gender transition
...

Study on Caregivers of Spouses with Mild Cognitive Impairment: Investigated how
couples adjusted to daily life after a diagnosis of MCI
...

The Social System (1951) by Talcott Parsons: Further developed the structuralfunctionalism theory
...


Facts to Memorize
•
•
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Transitions: Changes in social status or social roles include marriage, divorce,
remarriage, widowhood, and parenthood
...

Key Terms: Homeostasis, Thomas theorem, cohort flow, age cohort
...

Social Gerontology: Study of aging that includes psychosocial, socioeconomicenvironmental, and practice-related aspects
...

Homeostasis: Tendency of an organism to maintain equilibrium
...


CHAPTER 3
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Population Aging and Demographic Forces
Developed, Less Developed, and Least Developed Nations
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•

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Developed Nations: Countries like Western Europe, North America, Australia, and
Japan fall under this category
...

Less Developed Nations: Examples include China, Vietnam, and India
...

Least Developed Nations: Parts of Latin America, Africa, and Oceania are
classified as least developed nations
...

Examples: Japan experienced rapid population aging in recent years, transitioning
from a relatively young population to one with a high proportion of older individuals
...

Median Age of the Population: The age that divides the population into two
numerically equal groups
...


•

Significance: These measures help demographers compare aging trends across
societies and over time
...


Demographic Transition
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Definition: Refers to the process of population aging in different societies
...

Comparison: Allows for comparisons within and between societies at different
time points
...


Impact of Population Aging
Impact of Baby Boom on U
...
Population
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Definition: Refers to the significant increase in birth rates post-World War II
...
S
...


•

Example: The Baby Boom generation significantly influenced American culture,
economy, and social structures
...

Importance: Signifies a significant demographic shift with implications for
healthcare, social services, and economic policies
...


Racial, Ethnic, and Regional Differences
•

Overview: Examines variations in the older population based on race, ethnicity, and
geographical location
...


•

Example: Different regions may face unique challenges in addressing the needs of
their aging populations
...
S
...

Implications: Understanding these forces is essential for predicting future
population trends and planning social services
...
S
...
S
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Trends: Migration patterns among the older population can impact regional
demographics and resource distribution
...


Dependency Ratios and Cost of Aging Society
Critique of Dependency Ratios
•
•
•

Definition: Dependency ratios are used to measure the economic burden of an
aging population
...

Example: Dependency ratios may not fully capture the contributions of older
individuals to society or consider factors like healthcare advancements
...

Median Age: Divides a population into two equal parts, with half younger and half
older than the median age
...

Societies can have many older people but a small proportion of the population in
old age, as seen in less developed nations
...


Demographic Transition
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•
•
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Describes the population change pattern in Western nations over the past 250
years
...

Developing nations are expected to go through this transition, with some already in
progress
...

The middle of the transition sees an increase in the working-age population, leading
to a demographic dividend
...

Results in high economic productivity and relatively low costs for dependents
...

Low birth rates eventually lead to a decrease in the working-age population and
societal aging
...

Shift in perspective on the life cycle, with more people living to old age and beyond
...

Expectation of a significant increase in the proportion of older people in the
population
...

Stage II: High fertility with declining mortality, population growth as more children
survives
...

Stage IV: Low fertility and mortality, low population growth, large proportion of
older people
...

Speed of transition differs between developing and developed nations
...

Developing nations like China will see a rapid increase in the proportion of older
people
...

China, despite a relatively low proportion of older people, has a large number of
older individuals
...

Developing nations like Brazil and China have smaller proportions of older people,
which may change with declining birth rates and increased life expectancy
...

More developed regions include Europe, Japan, North America, Australia, and New
Zealand
...

Projections indicate significant growth in the older population globally, with varying
rates across regions
...

It shows that the older population is expected to grow significantly, with faster rates
in less developed countries compared to more developed ones
...

Projections indicate that the Asian older population will increase at a faster rate due
to rising life expectancies
...


•

The distribution of older people worldwide, as shown in Figure 3
...


Implications of Population Aging
•
•
•
•
•

Rapid population aging poses economic, political, and social challenges for
countries
...
(2012) highlight the increased need for elder care and support due
to population aging
...

Countries like China are experiencing significant population aging, leading to
profound demographic changes
...


Population Pyramids
•
•
•
•
•

Population pyramids visually represent the age and gender distribution of a
population
...
3 compare less developed and more developed regions
over time (1970, 2013, 2050)
...

Both regions are transitioning towards a more rectangular shape, reflecting aging
populations and declining birth rates
...


Case Study: China's Population Aging
Population Decline and Aging in China
•
•

China's population is expected to slightly decrease by 2050, with a significant
growth in the older population
...


•
•
•
•

Experts predict that China will age faster than other developing nations due to its
low fertility rate
...

China faces the task of balancing the needs of an aging population with economic
growth and industrialization
...


Implications of Aging Population in China
•
•
•
•
•

China is projected to have the largest population of older people globally, including
a substantial number of the oldest-old (age 80+)
...

The challenges include providing adequate healthcare, social support, and pension
systems for the elderly
...

The demographic changes in China highlight the importance of adapting policies to
address the implications of population aging
...

These nations typically have young populations with a small percentage of older
individuals, some with as low as 2% of the population aged 65 and over
...

Developed nations are expected to have up to 32% of their populations aged 60 and
over by 2050
...


Impact on Developing Nations
•
•
•
•
•

Over two-thirds of the world's older population will reside in developing countries by
2050
...

The rapid growth of the older population in developing nations is attributed to high
fertility rates in the past and improved survival rates
...

Developing nations, like China, need to enhance their information and planning for
an aging society, adapting social programs and pension plans to cater to a larger
older population
...

The country introduced its first pension system in 1997, offering relatively low
pensions, especially in rural areas
...

The high cost of establishing and operating long-term care institutions limits the
growth of nursing homes in China
...


Social Implications and Family Dynamics
•
•
•
•

The increased number of older individuals in China will lead to significant social
changes, potentially altering the social and economic fabric of the country
...

Caregiver burden and burnout are common in urban centers due to the traditional
responsibility of family members for elder care
...


•

Family breakdowns may occur in rural areas as younger individuals move to cities
for work, reducing support for older relatives
...

If the only child dies before their parents, there may be no one left to support the
older family members, resulting in fewer workers to support the growing older
population
...

The traditional model of co-residence with grown children has been disrupted by
factors like strict family planning policies, shrinking family sizes, increased mobility,
and changing perceptions of filial piety
...


Legal and Social Responses
•
•
•
•

Chinese law updated in 2012 reinforces adult children's obligations to meet their
older parents' financial and emotional needs
...

The ruling Communist Party emphasized the implementation of the 'one couple,
two children' policy to address the issue of an aging population
...


Societal Implications
•
•

Gustafson and Baofeng (2014) noted that the growing elderly population in China
has impacted the traditional model of co-residence with grown children
...


•
•

Economic and social shifts have influenced the dynamics of intergenerational
relationships and the traditional roles within families
...


Aging Population in Least Developed Nations
Challenges in African Nations
•
•
•
•

Older people in Africa face challenges due to urbanization, wage labor, and political
movements that have altered traditional support systems
...

Lack of basic services like running water and sanitation affects the quality of life for
older individuals in African nations
...


Family Support Dynamics
•

•
•
•

Older people in African countries often rely on family support for their well-being,
but factors like lower fertility rates and youth migration impact the availability of
such support
...

The increase in the older population in African nations poses challenges for
intergenerational relationships and family dynamics
...


Economic and Social Implications
•
•
•

African nations lack comprehensive social security programs for older individuals,
placing the burden of care on families
...

Changes in social policies aim to support older individuals in African nations,
emphasizing traditional family values and community care
...


Key People
•

Ida Keeling: A centenarian who set a world record for the 100-meter dash at the age of
100, emphasizing the importance of nutrition, exercise, and self-love for a robust old
age
...


Key Places
•

China: A developing nation facing rapid population aging due to the one-child policy,
leading to the '4-2-1 problem' where one child must care for two parents and
potentially four grandparents
...


Facts to Memorize
1
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2
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3
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4
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5
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Reference Information
6
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7
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8
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9
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Problem-Solving Steps
Population Aging in China:
o Describe the impact of China's one-child policy on population aging
...

o Evaluate the effectiveness of the two-child policy in addressing population aging
...

o Examine the impact of the HIV/AIDS epidemic on rapid demographic aging
...


Key Terms/Concepts
•

Life Expectancy: The average number of years a person is expected to live, based on
the year of their birth, their current age, and other demographic factors such as sex
...

Aging, Health, and Chronic Illness
...

Intrinsic Aging: Involves internal processes like decreased lung capacity, loss of
brain cells, and hardened arteries
...

Key Terms:

Term

Description

Life Span

The maximum lifespan scientists believe a human can reach,
currently estimated at around 120 years

Intrinsic
Aging

Changes in the body due to internal processes like decreased
lung capacity and loss of brain cells

Extrinsic
Aging

Changes in the body due to external factors like sunlight,
smoking, or noise

Longevity Examples
•

Jeanne Calment lived to 122 years and 164 days, attributing her long life to an active
lifestyle
...

• Various centenarians attribute their longevity to factors like regular sex, specific
diets, or physical activity
...
Calment's longevity was also attributed to her active lifestyle, living independently
until 110 and engaging in physical activities
...


Intrinsic Aging Criteria
•

Universal: True aging affects all members of a species if they live long enough
...

Progressive: Accumulation of debris in cells over time leads to dysfunction
...


Models of Successful Aging and Controversies
Models of Successful Aging
•
•
•

Definition: Different models exist to define successful aging, each with its pros and
cons
...

Income Inequality: Explore how income disparities impact health in later life
...

The compression of morbidity hypothesis suggests that the onset of illness can be
postponed, leading to a shorter period of morbidity before death
...

Environmental Improvements: Discuss how environmental enhancements
contribute to a better quality of life in old age
...

Longevity Research: Biologists and physiologists aim to extend life expectancy,
leading to an increase in centenarians
...

• Senescence: Normal functional decline over time, exemplified by changes in skin
elasticity
...

Weight training has been shown to increase muscle mass and strength even in the oldestold individuals
...

• Reserve Capacity: All body systems decline with age, impacting overall health and
functionality
...

Physical Changes with Aging
Muscle Strength and Exercise
•
•
•

Regular exercise can significantly improve muscle strength in older individuals
...
(2010) conducted a study on men aged 70 to 80 who exercised on a
bike, resulting in a 21% increase in muscle strength
...


Skeletal System Changes
•
•

Bones replace about 10% of their content annually, reaching peak density between
ages 25 and 35
...


•
•
•

This bone mass loss increases the risk of fractures in older individuals
...

Osteoporosis prevalence increases with age, affecting 9% of individuals over 50 in
2005-2008
...

Women over 80 have a high prevalence of low bone mass and osteoporosis
...

The risk of fractures due to osteoporosis is a significant concern, leading to
hospitalization and further health complications
...


Sensory Changes with Aging
Smell, Taste, and Touch
•
•
•
•
•

Aging affects all five senses, with some showing more pronounced changes than
others
...

The sense of touch declines, affecting temperature and pain perception
...

Adding herbs and spices to food can enhance taste enjoyment and promote better
eating habits
...

Older individuals may experience dry eyes, reduced pupil size, and weakened eye
muscles
...

Older people may struggle with contrast, color sensitivity, and peripheral vision
...


Taste and Smell
Relationship between Taste and Smell
•
•
•

Aldwin and Gilmer (2004) noted that taste is heavily influenced by smell, with most
taste perceptions being a function of smell
...

Sensitivity to different smells varies, with some declining earlier than others (e
...
,
natural gas vs
...


Impacts of Aging on Taste and Smell
•
•
•

Aging can lead to a decrease in taste and smell perception
...

Understanding the relationship between taste and smell is crucial for maintaining
overall sensory health
...

Surgical interventions can address severe vision problems like cataracts, while drug
therapy is used for conditions like glaucoma
...


Hearing Loss and Management
•
•
•

Types of age-related hearing loss include presbycusis, tinnitus, and conductive
hearing loss
...

Hearing loss can lead to social isolation, misunderstandings, and emotional
challenges
...

The prevalence of hearing loss increases with age, affecting social interactions and
emotional well-being
...


Social and Cultural Aspects of Aging
Menopause and Social Constructs
•
•
•

Menopause is often viewed through a medical lens, leading to various treatments
and perceptions
...

Coping strategies for menopausal symptoms include lifestyle adjustments and
cultural considerations
...

Understanding the social construction of menopause can help in providing better
support and care for women
...


Menopause and Society
Menopause as a Social Phenomenon
•
•
•

Menopause is viewed differently in society, with some considering it liberating as it
marks the end of childbearing years
...

Historical mythologies surrounding menopause have often instilled fear and shame,
but modern writers present a more balanced view
...

Menopause, characterized by the end of menstrual bleeding due to decreased
estrogen levels, typically occurs around the age of 50
...

Hormone replacement therapy, involving estrogen and progesterone, is used to
alleviate menopausal symptoms
...

Menopause is a natural biological process, not a medical illness, according to the
Mayo Clinic
...


Health Status and Aging
Epidemiological Transition
•
•
•
•
•

The epidemiological transition refers to the shift from high rates of infectious
diseases to high rates of chronic illnesses in society
...

Chronic diseases like heart disease, cancer, diabetes, and stroke account for a
significant portion of deaths and healthcare spending
...

The epidemiological transition poses challenges to healthcare systems worldwide
as populations age
...


•
•
•
•

Heart disease and cancer together constitute a significant percentage of deaths in
the United States
...

The shift from acute childhood illnesses to chronic diseases in old age reflects
changes in societal health patterns
...


Impact of Chronic Diseases on Older Adults
Death Rates and Chronic Diseases
•
•
•
•
•
•

Alzheimer's disease ranks fourth among people aged 85 and over
...

Death rates for leading causes of death increase significantly with age
...

African Americans aged 65 and over have different rates of certain illnesses
compared to whites
...


Gender Disparities in Chronic Illness
•
•
•
•
•
•

Older women have higher rates of hypertension, arthritis, and osteoporosis
...

Differences in illness rates are influenced by income, work-related stress, and
lifestyle habits
...

Women have higher rates for most chronic illnesses compared to men
...


Chronic Health Conditions Among Older Adults
•

Chronic health conditions increase with age
...

Activity limitations increase with age, leading to the need for health care support
...

Chronic conditions can lead to functional loss, disability, and activity limitations in
older adults
...

Chronic lower respiratory diseases rank fifth after Alzheimer's disease in this age
group
...

Rates of chronic illnesses vary by race and gender
...

Older women have higher rates of hypertension and arthritis compared to older
men
...

Older men have higher rates of diabetes, cancer, and heart disease
...

Exercise, diet, and lifestyle modifications can reduce the severity of chronic
diseases
...

Men have higher rates of heart disease, stroke, cancer, and diabetes
...


•

Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) are
essential for daily functioning
...

Spouses often provide practical and social support for individuals with activity
limitations
...


•
•
•

QUICK REFERENCE
...

Walter Breuning: Claimed the title of the world's oldest man at 114 years old in 2010
...

Heart Disease: Leading cause of death for women in the United States
...

Diabetes: Affects more than one-quarter of women over 65
...


Symptoms
•
•
•

Presbycusis: Age-related hearing loss, making it hard to hear conversations or callers
on the phone
...

Conductive Hearing Loss: Hearing loss from a blockage in the ear canal, such as wax
buildup
...

Intrinsic aging: Changes in the body due to internal processes such as decreased
lung capacity, loss of brain cells, and hardened arteries
...


Reference Information
•
•
•

Jeanne Calment of Arles, France, died in 1997 at the age of 122 years and 164 days,
living the longest reliably documented life in human history
...

Strehler's four criteria for intrinsic aging: universal, basic to the organism,
progressive, and deleterious
...

Intrinsic Aging: Changes in the body due to internal processes such as decreases in
lung capacity, loss of brain cells, and hardened arteries
...

Life Span: The longest life that scientists think a human can live, thought to be about
120 years today
...

Senescence: Normal functional decline that takes place in the human body over time
...

Memory and Mental Function in Later
Life
...

Research has focused on understanding memory changes and cognitive abilities in
older individuals
...

The traditional approach has laid the foundation for further research on memory
and aging
...

Research highlights the role of memory in everyday life activities
...

Understanding the changes in intelligence with age is a key focus of recent
research
...


Wisdom and Developmental Intelligence
•
•
•
•
•

Research has explored wisdom and developmental intelligence in later stages of
life
...

Understanding the concept of wisdom and its implications for aging is a significant
area of study
...

Developmental intelligence plays a crucial role in shaping individuals' responses to
aging
...

Studies have shown the effectiveness of mental exercises in improving cognitive
functions
...

Case studies like Pasquale Ianni's leadership program demonstrate the impact of
new roles on mental potential
...


Self-Development and Life Course Perspective
•
•
•
•
•

Exploring self-development opportunities in later stages of life is crucial for
personal growth
...

The life course perspective offers insights into the significance of aging experiences
...

Case studies and research outcomes provide valuable insights into selfdevelopment and aging challenges
...


•

Research indicates both declines and improvements in memory functions with
aging
...

Case studies like Ruth and Ray's ballroom dance lessons illustrate memory
concerns in older age
...


•
•
•

Research on Memory Stability
•
•
•
•
•

Recent research challenges the notion of drastic memory decline with age
...

Studies suggest that memory problems in older age may not be as severe as
perceived
...

The study of memory in aging individuals is a significant area of research in
psychology
...


•
•

Neurons have a long lifespan, living through the entire duration of a person's life
...


•

Understanding neuroplasticity and neuronal longevity is crucial for studying
memory and cognitive functions
...


•

Changes in Memory and Brain Function with Age
Memory Processes and Aging
•
•
•
•
•
•

Changes in the brain occur gradually throughout life
...

Age-related declines in memory are not uniform, with variations in different memory
domains
...

Diversity exists within the older population, with some individuals showing no
decline until late in life
...


Types of Memory
•
•
•
•

Short-term memory: Information stored temporarily during processing
...

Prospective memory: Remembering to do something in the future
...


Memory Processes
•
•
•

Memory is broken down into steps in an information-processing model
...

Laboratory studies often use a cross-sectional design to compare memory
performance across age groups
...

Different parts of the memory model may show varying results with age
...

Episodic memory: Declines in memory acquired at specific times and places
...


Episodic Memory Decline
•
•
•

Psychologists debate the onset of episodic memory decline, with some suggesting
it starts in the twenties or thirties
...

Working memory decline in older individuals is influenced by the interference of
irrelevant information
...

Older individuals may struggle with working memory when irrelevant information
interferes
...


Neural Activity and Memory Performance
Effect of Age on Neural Activity
•

Older individuals may show less activation in certain brain regions during memory
tasks
...

Declines in mental performance are linked to specific regions of the brain
...


Memory Encoding and Retrieval
•
•

Studies suggest that encoding, rather than retrieval, may explain memory
performance differences between age groups
...


Memory Performance in Older Adults
Encoding Speed Discrepancy
•
•
•
•
•

Older adults exhibit slower speed of encoding compared to younger adults
...

Effective encoding methods include creating stories from words, relating words to
past experiences, and forming sentences with words
...

Item recognition relying on the posterior cortex shows minimal decline with age,
while semantic memory remains stable and can even increase in later life
...


•

Older adults showing higher activation in these brain regions tend to perform better
on memory tasks
...

Encoding involves learning new information and linking it to existing knowledge
...


•

•
•

Age-Related Differences in Speeded Tasks
•
•
•
•

Speeded tasks exacerbate the gap in mental performance between young and old
individuals
...

Older individuals may struggle with retrieval, taking longer to access information
...


Long-Term Memory and Processing Speed
Age-Related Decline in Mental Ability
•
•
•
•
•

Decreased processing speed underlies much of the age-related decline in mental
ability
...

Slower processing speed can inhibit decision-making and lead to information loss
during tasks
...

Breakdowns in the central nervous system with age contribute to the slowing of
mental functioning
...

Disruption in chemical pathways, particularly catecholamines like norepinephrine
and dopamine, can lead to declines in memory functions
...

Changes in brain structure, such as atrophy, predict declines in cognitive
performance over time
...


Compensatory Mechanisms in Older Adults
•
•
•
•
•

Older individuals compensate for brain volume loss by recruiting specialized
networks in the prefrontal cortex
...

Utilizing compensatory networks helps overcome neural challenges and functional
deterioration associated with aging
...

Specialized networks in the prefrontal cortex aid in overcoming the effects of
biological and environmental factors on cognitive performance
...

Symptoms may include memory loss, as well as difficulties in planning and
scheduling
...

Schaie (2016) referred to this group as displaying 'unsuccessful aging
...


Dementia
•
•
•

Individuals in this group exhibit a significant decline in mental function, often with a
physical cause such as brain lesions or diseases like Alzheimer's
...

Example: Patients with dementia may struggle with basic daily activities, experience
memory loss, and exhibit personality changes
...


•
•
•

They continue to develop through mid-life and reach a peak in late middle age
...

Example: Successful agers may remain active, engaged in social activities, and
continue to learn new skills well into old age
...

They show modest decline through their early eighties, with more significant decline
closer to death
...

Example: Normal agers may experience slight memory lapses but can still perform
daily tasks independently
...

Studies show that older adults use both sides of their brains for tasks, while
younger adults use only one side
...

Example: Older adults may take longer to complete tasks but can still perform them
accurately by utilizing additional brain regions
...

This reserve capacity protects individuals from cognitive decline and brain
diseases
...


Flexibility in Brain Function
•
•
•

Older adults demonstrate mental reserve capacity, allowing them to adapt to agerelated changes
...

Example: Older adults may develop new memory techniques to overcome agerelated memory decline
...

Long-term problems, such as relationships with grandchildren, require emotional
and social skills
...


Memory Strategies in Older Adults
•
•
•

Older individuals tend to remember positive information more than negative
information to maintain a positive mood
...

Example: Older adults may recall pleasant memories more easily than negative
ones to enhance their emotional well-being
...

Automatic processing, related to familiar information, is preserved with age due to
repetition and experience
...


Memory Studies and Ecological Validity
Everyday Problems and Memory Performance
•
•

•

•

•

•

Memory studies often lack ecological validity, struggling to translate from laboratory
settings to real-life situations
...
(2006) conducted a study comparing the performance of two age
groups on different tasks, highlighting age-related differences in abstract planning
versus real-life errand planning
...

Studies by Craik (2000) and Hoyer & Verhaeghen (2006) suggest that semantic
memory and vocabulary tasks show little decline with age, with older adults
potentially having an advantage due to accumulated knowledge
...

Ackerman (2008) reported that older adults with a bachelor's degree performed
better in humanities and civics knowledge tests, showcasing the retention of
accumulated knowledge in later life
...

Environmental supports, such as multiple-choice tests with displayed answers,
reduce mental processing and improve recall in older individuals
...

Research suggests that older individuals consistently outperform young adults
when provided with aids like notes, indicating the importance of external support in
memory tasks
...


•

Studies by Cerella et al
...
(2007) demonstrate the benefits of
physical exercise, sensory-motor training, and social engagement in improving
mental function in older adults
...

Charness found that older chess players had difficulty recalling positions
accurately due to retrieval issues, but their overall game-playing performance was
determined by skill level rather than age
...

Expert performance in problem-solving relies on organized knowledge structures in
long-term memory, enabling abstract problem-solving abilities
...

In real-world scenarios, individuals use various techniques like chaining activities to
routines to enhance memory and task performance, as seen in studies by Park and
Meade (2006) and Liu and Park (2003)
...


Key Terms
Term

Definition

Short-term
Memory

Information stored temporarily while being processed or shortly
afterward
...


Prospective
Memory

Remembering to do something in the future
...


Non-Episodic
Memory

Information with no reference to the time acquired
...


Working Memory

Selects, manipulates, and stores recent information temporarily
...

Minority Aging Theories
Definition of Minority Group
•

Social scientists define a minority group as a culturally, ethnically, or racially
distinct group within a larger society
...

• Includes women and gays in the broader sociological definition, but focuses on
race, ethnicity, and national origin in this context
...
S
...
"
Impact of Cultural and Economic Barriers
•
•

Cultural and economic barriers can hinder a minority of older people from living a
satisfying old age
...


•

Study of minority aging enhances understanding of aging and suggests ways to
improve the lives of older minority members
...

Explores the aging experience as a minority group member
...


Minority Elderly in the United States
Dominant Group vs
...
S
...

Minority groups are culturally, ethnically, or racially distinct groups within the larger
society, often facing prejudice and discrimination
...


Melting Pot Concept
•
•
•

The U
...
is often viewed as a melting pot, assimilating people from diverse
backgrounds into American culture
...

Recent immigrants maintain strong ties to their original language and culture
...
4%) of the U
...
population
...

Minority groups are projected to grow and proportion, necessitating new policies
and programs to address their needs
...

Individuals can occupy different points on this continuum for various aspects of
their lives
...

Examples include Jewish, Asian American, African American, and Hispanic
American communities preserving cultural identities through religious practices,
festivals, and food
...


Pluralistic Society
•
•
•
•
•

Defined as a society where multiple racial and ethnic groups exist alongside each
other
...

Modern immigrants come from various regions such as Asia, Africa, Mexico, the
Caribbean, and Central America, contributing to the nation's diversity
...

Immigrants retain aspects of their original culture, enriching American society with
new beliefs, foods, and customs
...

An African American individual demonstrates high assimilation at work but
maintains ties to his roots by owning property in a rural area
...


•

Minority aging is influenced by ethnic and racial identities, with older individuals
belonging to various minority groups
...

Older population reflects the pluralism of U
...
society, with elderly individuals from
diverse ethnic and racial backgrounds
...

Research indicates significant diversity within minority groups, impacting
education, income levels, and living conditions
...


Growth and Projections of Minority Older Population
•

•
•
•

The number of minority older people in the U
...
is projected to increase
significantly, with Hispanic and Asian older populations expected to grow
substantially
...

The proportion of non-Hispanic white older population is expected to decrease,
while Hispanic Americans will nearly triple their representation
...


Demographic Characteristics of Dominant and Minority Group Elders
Educational Disparities
•
•

The older white population in the United States, predominantly of European origin,
has higher levels of formal education compared to minority group elders
...


•

•

•

Asian/Pacific Islander elderly have lower high school graduation rates than whites
but higher university graduation rates, reflecting the educational levels of recent
Asian immigrants
...

Educational disparities are mirrored in poverty rates, with older non-Hispanic
whites having lower poverty rates compared to older blacks and Hispanics
...

Older blacks have more than double the poverty rate of older whites, while Asians
have almost double the poverty rate of older whites
...

New immigrant seniors may lack access to Social Security, relying solely on work or
family support
...


Cultural Contributions and Challenges
•
•
•
•
•

Minority elders experience aging differently, with unique challenges such as limited
financial resources in retirement
...

Minority groups demonstrate strength and resourcefulness, offering valuable
lessons on aging
...
S
...

African American, Native American, and Japanese American elders exemplify
resilience and cultural preservation
...
S
...

Hispanic Americans are expected to significantly increase their proportion in the
older population, while Asian Americans will also see growth
...

Access to formal support systems, including government programs and health care
services, may vary among different racial and ethnic groups
...


Income Disparities Among Racial and Ethnic Groups
Social Security and Pension Distribution
•
•
•
•
•

The Asian group, with many recent immigrants, has the lowest proportion of Social
Security recipients
...

Asians have the highest poverty rates, relying heavily on Supplemental Security
Income (SSI)
...

Figure 6
...


Minority Population Diversity
•
•

Minority groups differ from the white population in mortality, fertility, and migration
...


•

Subgroups within Hispanic minority groups vary in demography and cultural
background
...


•
•

Mexican Americans form a significant portion of the older Hispanic population
...
4 displays median income for different racial and ethnic groups across age
categories
...

Social Security plays a crucial role in preventing poverty among minority groups in
later life
...

Income disparities lessen between whites and blacks in older age groups
...

Various Asian subgroups have unique cultures, demographic structures, and
histories in the U
...

African American group also consists of diverse subgroups with varied cultural
backgrounds and lifestyles
...

Figure 6
...


Health Disparities and Aging
Disparities in Health Reporting
•

Non-Hispanic whites report better health due to lifetime advantages in income and
healthcare resources
...

Aging of the minority population is significant, with projections showing a
substantial increase in older minority individuals by 2050
...

Recent immigrants bring diverse cultural values, impacting the experiences of aging
within minority communities
...

Different subgroups of older minority Americans have varying healthcare and social
service needs
...

Unique histories and cultural heritages influence the aging experiences within each
minority community
...


Theories on Minority Group Aging
•
•
•
•
•

Gerontologists explore how a person's lifelong experiences as a minority impact
their aging process
...

Multiple jeopardy theory suggests that individuals facing multiple disadvantages
(age, race, ethnicity, gender) are at increased risk of adverse health outcomes
...

Minority older women, for example, face unique challenges due to the intersection
of minority, age, and gender identities
...


•

Minority groups will experience a doubling or more in the proportion of seniors
within their populations
...

Research demonstrates that older African American and Hispanic groups report
more physically unhealthy days compared to whites
...


Critique of Multiple Jeopardy Theory
•
•
•
•
•

Multiple jeopardy theory posits a compounding of disadvantages associated with
age, race, ethnicity, and gender
...

Research on multiple jeopardy examines the widening gap in health outcomes
between minority and white populations as they age
...

Precise definitions of multiple jeopardy emphasize the worsening health and wellbeing differentials between minority and dominant groups with age
...


Fundamental Theories
•
•

Multiple Jeopardy: The compounding of disadvantages associated with age, race,
ethnicity, and gender, leading to increased risks of death and illness
...


Key Demographics
•
•

Population Growth: Minority older populations are projected to grow significantly,
with Hispanic and Asian groups showing the most substantial increases
...


Key Health Disparities
•
•

Health Disparities: Older minority groups often have lower incomes, poorer health,
and shorter lives than other older populations
...


Concept Comparisons
Concept
Definition
Focus
Example

Multiple Jeopardy
Compounding disadvantages
associated with age, race,
ethnicity, and gender
...

Older African Americans facing
increased risk of death and
illness due to compounding
disadvantages
...

Studies the intersection of social
identities to reveal the compound
effect of social categories
...


Cause and Effect
Event

Impact

Older African Americans and Hispanics
report more unhealthy days compared to
whites as they age
...


Minority group members experience
poorer health and lower income than the
dominant group
...


Age and minority membership combined
create multiple jeopardy
...


Key Terms
•
•
•
•

Dominant Group: A group that holds the most power and controls the majority of
social and economic resources in a society
...

Melting Pot: An image of the United States as a country that assimilates people from
diverse backgrounds into Americans
...


CHAPTER 7
...

Health Care Models and Financing
Comparison of Health Care Models
•
•
•
•
•

Fee-for-Service Model: Traditional model where providers are paid for each service
rendered
...

Single-Payer System: Government-funded model where a single entity covers
healthcare costs
...

Managed Care emphasizes preventive care and cost control
...

Health Promotion Model: Emphasizes preventive measures and healthy lifestyle
choices
...

Social support and preventive care can improve the quality of life for seniors
...


Financing of Medicare and Medicaid
•
•
•
•
•

Medicare: Federal program for individuals aged 65 and older, and those with
specific medical needs
...

Both programs face financial challenges due to increasing healthcare costs
...

Medicaid's original mandate has expanded to cover various healthcare needs
...

Increased administrative expenses, technological advancements, and
pharmaceutical costs play a role
...

Comparison with other countries' healthcare systems can provide insights into
cost-effective measures
...


Long-Term Care and Community Support
•
•
•
•
•

Importance of long-term care for seniors and limitations of private insurance
...

Community-based care offers a more personalized and cost-effective alternative
...

Managed care can help coordinate medical services and control costs for seniors
...


•
•
•
•

Public health programs and environmental quality contribute to a healthy aging
population
...

Collaborative efforts between healthcare providers and public health agencies are
essential
...


Overview of the U
...
Health Care System
The Affordable Care Act (ACA)
•
•
•

The ACA guarantees health insurance for all Americans, reducing the uninsured
population from 20
...
7% between 2013 and 2015
...


•

Encourages experimentation with new payment methods, best practices studies,
and treatment development
...

Older individuals primarily rely on Medicare and Medicaid for health insurance
...


•

The Medical Model
•
•
•
•
•

Focuses on diagnosing and curing illnesses, defining healthcare as sickness
treatment
...

Physicians control treatment within this model, with limited training in alternative
treatments like health promotion
...

Public funds for long-term care often favor institutional options over community
care services
...

Includes services like family counseling, home health care, and adult day care,
often provided in the community
...

Aims to keep older individuals in the community by coordinating various services
and supports
...


Models of Health Care
The Medical Model
•
•
•
•
•

Focuses on diagnosing and curing illnesses, using drugs, surgery, and
rehabilitation
...

Physicians play a central role in treatment decisions within this model
...

Emphasizes technical criteria and disease-specific treatments
...

Includes services like family counseling, home health care, and adult day care,
often provided in the community
...

Aims to keep older individuals in the community by coordinating various services
and supports
...


Health Care Expenditure
•

Hospital care comprises the largest portion (38%) of U
...
health care spending
...

Prescription drugs make up 12% of the total health care spending
...

Rising Medicare costs have led to policy changes and increased support for
alternative care models
...

Includes formal and informal care, case management, and multidisciplinary
assessment of needs and outcomes
...

Rising Medicare costs, growing from 3
...

Long-term care costs, such as home health care and hospice care, are expected to
rise with the aging population
...

Emphasis on functional capacity over illness presence for well-being
...

Aging population's needs are driving the shift towards the social model of health
care
...


Health Promotion Model
•

Introduces new treatment and management strategies to restore lost abilities
...

Aims to keep older people healthy and fit through health promotion and disease
prevention initiatives
...


•
•

The U
...
Health Care System Today
Dominance of the Medical Model
•
•
•
•
•

Hospital care and physician/clinical services account for over half of the $3
...

Only 3% of the total expenditure is allocated to home health care
...

High costs of hospital care have led to a shift towards more community-based care
...


Medicare and Health Care Costs
•
•
•
•

Medicare spending as a share of the federal budget increased significantly over the
years
...

Medicaid funded community-based programs with a focus on reducing nursing
home costs
...


Evolution of Health Care Models
•

Shift from the medical model to the social model due to high institutional care costs
and aging population needs
...

Exploration of health promotion models to prevent disease and promote overall
health
...


Historical Context and Establishment of Medicare
Importance of Medicare Establishment
•

Medicare was established due to the unaffordability of private insurance for older
people and the denial of coverage based on preexisting conditions
...

"Medicare became Title XVIII and Title IX of the Social Security Act, signed into law by
President Lyndon Johnson on July 30, 1965
...

• Advocacy for Medicare was bolstered by alliances with organizations like the AFLCIO and a growing sympathy for the needs of older individuals
...
"
Opposition and Passage of Medicare
•

The American Medical Association (AMA) opposed Medicare, citing concerns about
government control over fees
...

"Despite opposition, Medicare was eventually passed due to strong advocacy and
strategic alliances
...
3 million by 2015
...

"In 2015, Medicare paid out $638
...
"
Medicare Part D and Prescription Drug Coverage
•
•

Medicare Part D, introduced in 2006, covers prescription drugs for enrollees
...

"Critics highlight complexities, high administrative costs, and limited coverage of Part D
...

• Enrollees can choose from various plans that coordinate care and may include
prescription drug benefits
...
5 million people enrolled in Part C plans, enhancing coverage options
for beneficiaries
...
45% of
their income
...

"The Federal Hospital Insurance Trust Fund supports all hospital insurance expenses
...

• Services covered include hospital care, physician payments, prescription drugs,
and home health care
...
"
Criticisms and Evaluations of Medicare Programs
•

Critics point out complexities, high administrative costs, and limited coverage of
certain Medicare programs
...

"Policy makers face challenges in balancing public costs with the financial benefits for
Medicare beneficiaries
...
3 million people aged 65 and over were enrolled in Medicare Part A and
Part B, with total payments reaching $351 billion
...

Future Medicare costs may rise due to factors like increasing prescription prices,
higher enrollment, provider payments, and medical care prices
...

Rising costs and increasing enrollment, especially with the aging Baby Boomer
population, indicate a potential financial crisis for Medicare, necessitating system
changes
...


•
•
•
•

The number of Medicare beneficiaries has been increasing over the years, with a
projected significant rise in enrollment by 2060
...

Medicare spending is expected to double between 2015 and 2026, partly due to the
aging Baby Boomer population entering old age
...


Medicare Key Terms and Physician Participation
•
•
•
•
•

Deductible: An amount paid by individuals for healthcare services before insurance
coverage begins
...

Medicare coverage has decreased over time, leading to higher out-of-pocket
expenses for beneficiaries
...

In 2012, 685,000 doctors participated in Medicare, while 9,539 opted out of the
program, impacting access to care for Medicare beneficiaries
...

In October 2015, Medicaid enrolled 58
...

Medicaid services in 2014 totaled $476 billion, with significant disparities in usage
among different demographic groups
...

Widowed, divorced, and never-married seniors, particularly women, exhibit higher
Medicaid usage compared to married seniors
...
8% of African American seniors
received Medicaid payments, highlighting income disparities
...

The graph illustrating Medicare costs as a percentage of GDP demonstrates a rising
trend in costs over the years
...

Medicaid expenditure reflects the diverse healthcare needs of the population, with
variations in service utilization among different demographic groups
...

1 in 5 Hispanic seniors and 17
...
9% of white seniors
...

Moon (2006) highlights that federal deficits and the wider economy will impact
future Medicare support
...

Policy makers are concerned about the rising cost of Medicaid in relation to GDP
...

Individuals aged 85 and above, as well as those in poor mental and physical health,
form a significant portion of Medicaid users
...

Compared to private insurance holders, Medicaid recipients exhibit higher rates of
various chronic diseases
...

Spouses of Medicaid patients in institutions historically had to deplete their assets
...
61% of GDP in 2015 to 5
...

Factors contributing to rising Medicare costs include the large Baby Boom
generation, longer life expectancies, and increased healthcare needs in old age
...

Medicaid also covers long-term care services for eligible individuals, with costs
expected to rise as the disabled older population grows
...

Medicaid patients' spouses in institutions were historically required to exhaust their
assets
...

For hospitalization, Medicare covers different periods with varying payment
structures
...

• Hospice care is covered by Medicare with certain copayments and conditions
...
1 outlines Medicare payments for selected services in the Original Medicare
Plan for 2016
...


Key People
•

Lyndon Johnson: President who signed the Health Insurance for the Aged (Medicare)
Act into law on July 30, 1965
...


Key Dates
•

July 30, 1965: President Lyndon Johnson signed the Health Insurance for the Aged
(Medicare) Act into law
...


Facts to Memorize
•
•
•
•
•

Medicare and Medicaid are two key programs in the U
...
health care system
...

Medicaid serves low-income Americans of all ages
...

Medicaid funds long-term care for eligible individuals
...

Medicare Part D provides prescription drug coverage
...

The Affordable Care Act (ACA) expanded Medicaid to provide health insurance to
millions of low-income Americans
...
S
...
No coinsurance for the first 60 days
...
Enrollees pay a premium for this coverage
...


CHAPTER 8
...

Without public pensions, the poverty rate among older people would be
significantly higher
...

Example: Marianne's reliance on her husband's benefits and spousal Social
Security benefits highlights the importance of these programs in providing financial
stability in old age
...


Historical Development of the U
...
Pension System
•
•
•
•
•

The U
...
pension system has a three-tiered structure today, reflecting its historical
evolution
...

Example: The reforms and changes in the U
...
pension system over time have
aimed to enhance retirement income security
...

Case study: Comparing the current U
...
pension system with historical models
sheds light on its effectiveness and areas for improvement
...
Defined Contribution Pension Plans
•

Defined Benefit (DB) and Defined Contribution (DC) pension plans have different
implications for workers and retirees
...

Analyzing the reasons for poverty among specific groups of older individuals
provides insights into the effectiveness of pension plans
...

Understanding the benefits and limitations of each pension plan type is crucial for
retirement planning and financial security
...

Financial struggles can lead to limited access to healthcare, proper nutrition, and
social activities
...

Reforms in the U
...
healthcare system is necessary to address the specific needs of
older populations living in poverty
...


Role of Social Security in Income Security
•
•
•
•
•

Social Security plays a significant role in providing income security for older
individuals in the U
...

Nearly all older people in the U
...
receive some form of Social Security benefits
...

Example: Marianne's reliance on Social Security benefits and her husband's
pension illustrates the common scenario of dual-income sources in retirement
...
S
...


Criticisms and Reforms in Pension Systems
•
•
•
•
•

Critics question the sustainability and fairness of public pension plans, labeling
affluent seniors as 'greedy geezers
...

Reforms in pension systems are essential to ensure equitable distribution of
resources and address income disparities among different age groups
...

Historical perspective: Government programs have played a vital role in shaping the
financial well-being of older populations, necessitating ongoing reforms for
sustainability
...

41
...

Without Social Security, 59
...


•

Data from the Kaiser Family Foundation (2016b) highlights the impact of Social
Security on poverty levels
...


•

Vulnerable Groups
•
•
•
•
•

Very old individuals, minorities, and disabled older people face a higher risk of
poverty
...
1% in 2010
...
, 2014)
...

Addressing poverty among these groups requires better pension funding rather than
cutbacks
...

Questions arise about potential future reductions in funding for pension programs
...

The Center on Budget and Policy Priorities (2016) provides insights into Social
Security's impact on poverty levels
...


Historical Development of U
...
Pension System
Transition from Agricultural to Industrial Society
•
•
•
•
•

In the 19th century, a significant portion of the U
...
workforce lived an agricultural
lifestyle
...

The move to cities created new risks for workers and reduced traditional sources of
support
...

The shift highlighted the need for social insurance programs to support the elderly
and unemployed
...

State and federal governments introduced social insurance programs to provide
income to the neediest individuals
...

Charities and religious groups offered limited assistance, emphasizing food and
shelter over cash benefits
...


Global Influence on Pension Systems
•
•
•
•
•

Otto von Bismarck implemented Germany's national pension plan in 1889 to
address social discontent
...

By the early 1900s, several countries, including Denmark, New Zealand, and Britain,
had established old-age security programs
...
S
...

The delay in implementing a pension system in the U
...
was influenced by factors
such as industrialization
...

General labor strikes in cities like San Francisco and Minneapolis raised alarms
about social order
...

The Act aimed to protect workers from unemployment and poverty in retirement,
like programs in other countries like Germany
...
Roosevelt emphasized the importance of the legislation in
providing a measure of protection against life's uncertainties
...

Retirement age in the U
...
was set at 65, different from the German model, based
on practical considerations and existing pension programs
...

The Act also included provisions to support the neediest older individuals and laid
the foundation for federal-state benefit partnerships
...


Evolution and Expansion of Social Security
•
•
•
•

•

Initially, the program covered 56% of workers but excluded certain groups like the
self-employed and railroad workers
...
S
...

The program evolved to include support for the disabled, widows, orphans, and the
very poor, under the title of Old-Age, Survivors, and Disability Insurance (OASDI)
...

By 2015, Social Security covered over 90% of the U
...
labor force, demonstrating its
widespread impact and importance
...
65% of covered earnings towards Social
Security, totaling 15
...

Self-employed individuals were responsible for the full 15
...

These contributions were withheld from workers' pay and channeled into a trust
fund dedicated to Social Security programs
...

Social Security and Medicare accounted for a significant portion of federal program
expenditures, highlighting their financial impact
...
S
...

For many older Americans, Social Security constitutes the primary or sole source of
income, emphasizing its critical role in retirement planning
...

The three-legged stool concept, comprising public pensions, work and assets, and
private pensions, underscores the importance of diversified income sources for
retirees
...


Program Impact and Beneficiaries
•
•
•

•
•

Social Security benefits have been vital in supporting retirees, disabled workers,
and surviving spouses who have contributed to the program
...

The program caters to retired workers, survivors of deceased workers, disabled
workers, and their dependents, making it the largest income maintenance program
in the U
...

Social Security has been lauded as a popular and essential social program,
providing stability and financial support to millions of Americans
...


Overview of the Social Security Program
Social Security Program Components
•

•

•
•
•

The Social Security program is the largest children's program, providing monthly
wage-related benefits to dependent children of deceased, disabled, or retired
workers until their late teens
...

Social Security benefits individuals of all ages, with one-third of all beneficiaries
being under the age of 65
...

Social Security is funded through payroll taxes and serves as a safety net for
workers and their families
...

No means test: Benefits are received regardless of other income sources, although
there is a retirement test for high-income individuals
...

Compulsory coverage: Almost all-American workers are required to pay into the
program, spreading the risk of social insurance
...


Social Security's Benefit to Individuals and Society
•
•
•
•
•

Adjusts benefits to the cost of living, providing protection against inflation
...

Offers a guaranteed pension for spouses of beneficiaries upon death
...

Provides more support to lower-income earners, replacing a larger proportion of
their income
...
4 trillion, with projected payments
covering only 74% of expected benefits
...
8 trillion surplus in 2015, the program faces a growing shortfall over
the long term
...

Increasing life expectancy, earnings inequality, and legacy debt contribute to the
financial challenges faced by the program
...


Future Sustainability and Recommendations
•
•
•
•
•

Lawmakers are urged to address the growing shortfalls to allow for phased changes
and public preparation
...

Workers can begin receiving benefits as early as age 62, with reduced benefits for
early retirement and increased payments for delayed retirement
...

Social Security coverage extends to nearly all-American workers, offering security
for individuals and families
...

Example: A person born after 1929 needs at least 40 quarters of earnings to qualify
for benefits
...

This system provides proportionately higher benefits to the poorest individuals
...


Spousal Benefits and Medicare
•

Homemakers or individuals with no Social Security payments can receive 50% of
their spouse's benefits
...

Individuals entitled to Social Security benefits also receive Medicare (Part A)
hospital insurance and can opt for Medicare (Part B) medical insurance
...

Context: Social Security extends benefits to spouses and provides healthcare
coverage
...

The government started taxing Social Security benefits in 1984 to reduce program
costs
...

Higher income individuals pay more back into the system
...


Privatized Retirement Income System
Proposal and Support
•
•
•
•

President George W
...

Supporters proposed investing Social Security taxes in personal accounts,
including treasury notes or stocks
...

Context: Privatization aimed to provide individuals more control over their
retirement funds
...
'
Drawbacks included administrative costs, potential benefit cuts, and lack of
disability insurance
...

Context: Privatization could lead to financial insecurity and exacerbate income
inequalities
...


QUICK REFERENCE
...
Bush: Initiated a campaign to privatize Social Security, claiming
the system was headed for disaster
...
Moynihan: Stated that Social Security put an end to the great terror
of growing old without income
...


Key Events
•
•
•

Great Depression (1930s): Led to the creation of the first U
...
social insurance
programs to address economic distress
...

Increase in Retirement Age (2003): The age for full Social Security benefits began to
increase to 67 by 2027
...

Concord Coalition: Advocated for moving Social Security towards a fully funded
system
...

Three-Legged Stool Model: Refers to the retirement income system's three
components: public pensions, employment income, and private savings
...
A person's contributions during their working years
determine the amount of their pension
...

Social Security benefits account for 39 percent of all older persons' aggregate
income in the United States
...

Social Security and Medicare accounted for 41 percent of federal program
expenditures in 2015
...

Social Security benefits account for the sharp decrease in poverty rates for older
people since the 1950s
...

Social Security provides a variety of benefits including life insurance, disability
insurance, and survivor benefits for spouses and children
...


Contributions are made into an individual account, and the
retirement benefit depends on the contributions and
investment performance
...


Employees bear the investment risk
...


Common in 401(k) plans
...


Benefits are not fixed and depend on contributions and
market performance
...
Contributions during working years determine the pension
amount
...


•

Near Poverty: Income within 200% of the poverty line, indicating hardship even if not
below the poverty line
...

Retirement Trends and Challenges
...

• Unions advocated for seniority systems to provide job security, leading to the
acceptance of retirement as a graceful exit for older workers
...

"Retirement gave them a graceful way out of work
...

Impact of Social Policies on Retirement Age
•
•
•

The Social Security program in the United States, starting in 1935, played a
significant role in shaping retirement norms
...

The retirement principle proposed a fixed retirement age regardless of physical or
mental ability
...


Citizen's
Wage

Social Security program in the United States that began
in 1935, replacing part of income
...


•
•

Analyze the reasons behind these differences, considering societal norms and
economic factors
...


Unique Challenges for Minority Workers
•
•
•

Identify and describe the unique issues faced by minority group workers in the
context of retirement
...

Discuss the impact of social structures and economic inequality on retirement
options for minority workers
...

Explain the motivations behind choosing these alternatives, considering financial,
personal, and professional factors
...


Employer Strategies and Future Trends
Attracting and Retaining Older Workers
•
•
•

Propose actions that employers can take to attract and retain older workers in the
workforce
...

Provide examples of successful initiatives or programs implemented by companies
to support older employees
...


•
•

Consider demographic shifts, technological advancements, and economic factors
influencing retirement
...


Historical Development of Retirement
Factors Influencing Retirement
•
•
•
•
•

Industrial societies introduced the 'retirement principle' which suggested leaving
work at a fixed age, irrespective of physical or mental ability
...

Bismarck's national pension plan in Germany in the 1880s established a fixed
retirement age, initially at 70 years and later lowered to 65
...

The concept of retirement at age 65 or earlier was linked to the availability of a
retirement wage, supported by rising entitlements from the state
...

By 1980, retirement had become institutionalized, defining old age as a period
sustained by the welfare state
...

Social Security benefits post-WWII provided significant protection against poverty in
old age, leading to increased early retirement
...


Impact of Economic Events on Retirement
Effects of the Great Recession
•
•
•
•
•

The Great Recession, lasting from 2007 to 2009, had a profound impact on older
workers' retirement decisions
...

The U
...
economy lost 8
...

Older workers faced job losses and saw a substantial decrease in the value of their
savings and investments, impacting retirement plans
...


Shifts in Retirement Trends
•
•
•
•
•

Many older workers chose to remain in their jobs or rejoin the workforce to
compensate for financial losses during the recession
...

Older men were disproportionately affected by job losses during the recession
compared to women
...

Low-income workers faced challenges during the recession, with higher rates of
disability and illness impacting their ability to find work
...

Example: A worker retiring at 62 instead of 66 loses $403 in Social Security benefits
per month for life
...


•
•
•

Challenges faced by older boomers include declining home equity and lower stock
market returns
...

Case study: Jan Gissel, a 63-year-old small business owner, faced financial
struggles and had to retire early due to the recession
...

Taking a reverse mortgage at an early age poses a risk of financial instability later in
life
...

Expert insight: Nyce emphasizes the importance of working longer for retirement
security
...

Average retirement age may continue to rise as Baby Boomers age
...

Factors influencing retirement age include changes in Social Security policies and
pension plans
...

Various reasons for delayed retirement include financial insecurity, changes in
employment, and stock market losses
...

Workforce participation among older individuals has shown significant increases
over the years
...

Census projections indicate a significant increase in labor force participation for
older women
...

MetLife survey findings suggest a trend of older Boomers planning to work longer
...

Economic necessity compels individuals with inadequate savings to extend their
working years
...

Men and women aged 65 and over have shown notable increases in workforce
participation
...

Non-retirees have adjusted their expected retirement age in response to economic
conditions
...

Census projections suggest a significant shift in labor force dynamics over the
coming years
...

Rix (2009b) finds this trend exciting, marking a significant labor force development
...


•
•

Case study: Census Bureau projects further increase in labor force participation for
older men in 2024
...


Factors Influencing Retirement Decisions
•

Shift from defined benefit to defined contribution pension plans
...

Personal reasons like health and social aspects influencing retirement choices
...
g
...

Economic factors such as stock market fluctuations and pension availability affect
retirement decisions
...


•
•

Gender Disparities in Retirement
•
•
•
•
•
•

Women's increasing labor force participation: 57% of the total labor force in 2015
(U
...
Department of Labor, Women’s Bureau, 2007)
...

Influence of life cycle experiences, including workforce history and marital status,
on retirement planning (Szinovacz, 2006)
...

Impact of financial resources on retirement planning and daily living (Denton et al
...

Bridge jobs as a strategy for women to extend their work careers post-retirement
(Cahill et al
...


Challenges Faced by Older Workers
Employability Concerns
•
•
•

Older workers expressing concerns about job prospects and employability (Ng &
Law, 2014)
...

Case study: Women expressing doubts about reentering the workforce due to agerelated stereotypes
...

Study by McMullin and Berger (2006) highlighting fears and challenges faced by
older job seekers
...


Family Responsibilities and Retirement
•
•
•
•
•
•

Influence of family caregiving responsibilities on retirement decisions
...

Impact of caregiving on labor force participation for women compared to men
...

Gender discrimination and its long-term effects on retirement choices
...


Gender Disparities in Retirement
Impact of Gender Differences in Retirement
•
•
•
•
•

Women often retire to care for a spouse, influenced by a lifetime of workplace
discrimination
...

Moen and Spencer (2006) highlight how a person's work career shapes retirement
opportunities
...

Increasing numbers of women now have long, continuous work records, improving
their retirement resources
...

Research should focus on resource disparities, coping strategies, and retirement
outcomes
...

McDonald (2006) advocates for a life course perspective in retirement definitions to
reflect gender, family, and work dynamics
...

Higher-income minority workers are more likely to have workplace pension plans
...

Social surveys like Prudential Research (2015-16) provide insights into retirement
trends among African Americans
...


•

Economic Policy Institute data shows disparities in retirement plan access among
different racial groups
...

Urban Institute studies highlight the widening retirement savings gap between
whites and minorities
...

African American women often engage in part-time work to supplement income for
basic expenses
...

Limited pensions and disability issues restrict retirement options for African
Americans
...

Lack of participation in employer-sponsored plans and broken work careers
contribute to poor pension benefits for minorities
...

Full-time Hispanic workers exhibit the lowest participation rates in retirement
plans, leading to inadequate savings for retirement
...

Aging in Place: Home Modifications and
Universal Design

Living Arrangements
Trends in Living Arrangements for Older People
•
•
•
•
•

Many older individuals, like Mrs
...

Studies show that moving to a planned housing complex can improve morale,
increase activity, and enhance social interaction
...

In the United States, older people have a wide range of housing options available,
although challenges exist in certain areas like inner cities and rural settings
...


Lawton-Nahemow Ecological Model of Housing
•
•
•
•

Developed by Lawton and Nahemow, this model emphasizes the interaction
between individuals and their environment
...

The model considers factors such as accessibility, safety, comfort, and social
support within housing environments
...


Continuum of Housing for Older People
•
•
•
•
•

The continuum of housing options for older individuals includes a range of choices
to suit different preferences and needs
...

Understanding the continuum helps seniors and their families make informed
decisions about housing transitions
...

Tailored housing solutions can enhance the overall well-being and satisfaction of
older adults
...

Pros of aging in place include familiarity, independence, and emotional attachment
to one's home
...

Understanding the reasons why seniors prefer to age in place is essential for
developing supportive services and resources
...


Apartment and Supportive Housing Options
•
•
•
•
•

Various types of apartment options are available for older people, ranging from
independent units to assisted living communities
...

These housing choices cater to different levels of care and support, allowing seniors
to maintain independence while accessing necessary amenities
...

Retirement communities provide a range of social activities and amenities to
enhance the overall quality of life for seniors
...

Seniors in good health may enjoy living alone, while frail or mentally challenged
seniors may struggle
...

Trends show an increasing number of older adults living alone due to factors like
divorce rates and personal preferences
...


Impact of Living Alone on Health and Well-being
•
•
•
•
•

A Pew Research Center study revealed that older individuals living alone reported
poorer health and less happiness compared to those living with others
...

Older men living alone reported lower health and happiness levels than women in
similar situations
...

The trend of living alone in old age is associated with a lower quality of life for both
men and women
...

Studies show that the older the age group, the greater the preference for aging in
place
...

Emotional attachment to one's home, memories, and sense of security play a
significant role in the desire to age in place
...


Ecological Model of Housing
Key Concepts of the Ecological Model
•
•
•

The Lawton-Nahemow model describes the interaction between an individual and
their environment
...

Environmental demand (or press) represents the challenges posed by the
environment on an individual
...

The fit between what a person can do and what the environment demands is crucial
for optimal functioning
...

Autonomous individuals have the resources to pursue their goals and enjoy
freedom of choice and action
...

The fit between autonomy and security is essential for person-environment
relations in later life
...


Lawton-Nahemow Ecological Model
Autonomy and Security
Autonomy and security are central to person-environment relations in later life
...

Autonomy is the ability to meet environmental demands and live comfortably, while
security involves trustworthy physical and social resources
...

It shows a comfort zone where individuals can easily function and a challenge zone where
maximum demands are placed
...

Improvement in person-environmental fit can occur by living in a less demanding
environment, enhancing competence, or both
...


Environmental Press and Adaptation
Lawton's 'environmental docility' hypothesis suggests that individuals with low
competence benefit from decreased environmental demand
...

Professionals should consider both sides of the model to promote better adaptation and
increased competence
...

The model highlights that individuals will lose the ability to adapt at a certain level of
demand, regardless of competence
...

Different housing options range from least to most demanding, requiring various levels of
adaptation
...
S
...

Seniors' Housing Statistics
The U
...
Census Bureau reported that a significant percentage of older adults live in
homes they own
...

Older homeowners in non-metropolitan areas tend to live in older homes with lower
market value, facing maintenance issues
...

Frail older adults may face challenges in maintaining single-family homes requiring
assistance with repairs and modifications
...
major renovations
Flexibility in adding modifications as needed

Importance of Home Modifications
Federal Requirements vs
...

New multiple-unit housing for seniors often includes design support
...

Example: Levered doorknobs, grab bars, levered faucets, handrails, widened doors,
ramps
...


Impact of Home Modifications on Aging in Place
•

People often rearrange homes to cope with disabilities
...

The AARP survey shows 86% of respondents made small changes like adding
nightlights and nonskid strips
...

Health problems increase the likelihood of home modifications
...


•
•

AARP study shows modifications can extend staying at home by at least 10 years
...

Figure showing the percentage of homes with accessibility features in the United
States in 2011
...


•
•

Universal Design and Visitability
Universal Design Principles
•

Universal design supports people of all ages and abilities
...

Example: Flat entryways benefit individuals with temporary injuries or pregnant
women
...

Visitability ensures barrier-free movement within the first floor of a single-family
house
...

Visitability codes aim to provide a welcoming environment for guests with mobility
limitations
...

Developers have built 30,000 visitability homes by 2008
...


Challenges and Solutions in Home Modifications
Barriers to Home Modifications
•
•
•

Resistance to home modifications due to aging implications
...

Example: Richard Duncan's perspective on aging and home modifications
...

Two-thirds of US city governments have home modification or maintenance
programs
...

Examples of smart features like smart mailbox, RFID front door, and sensorequipped bathroom
...

University of Florida's Gator Tech smart house as a model for innovative home
technology
...


QUICK REFERENCE
...
Carrington: An example used to illustrate living arrangements and the challenges
faced by older people
...


Key Events
•
•

Housing Bubble Decline (2008 Recession): Threatened the financial security of many
older homeowners and led to distress for many seniors
...


Seminal Studies
•
•
•

National Health and Aging Trends Study (Meucci & Allen, 2016): Surveyed
Medicare enrollees aged 65 and over about home modifications and assistive devices
...

University of Florida Smart House Research: Utilized computer technologies to
create supportive housing with smart features
...

Interior Doors with Minimum Width of 32 Inches: Allows for wheelchair access
...

Half Bathroom on the First Floor: Provides convenience for those with mobility
limitations
...

Ecological model of housing: Lawton-Nahemow model describes the interaction
between an individual's ability and the demands of the environment
...

Environmental demand (environmental press): The demands of the environment on
a person
...

Visitability: Ensures that an older resident or visitor with a disability can move
barrier-free within the first floor of a single-family house
...


Universal Design

Design that supports people of all ages and
abilities
...


Capability (Competence)

A person's ability to respond to environmental
demands
...


Problem-Solving Steps
•
•
•
•
•

Identify the need for home modifications based on changing abilities
...

Assess the financial feasibility of modifications
...

Consider universal design features for long-term support
...
Peripheral Leisure Activities
•
•

•

•

•

Core Leisure Activities: Require few resources, low cost, and easy access
...

Peripheral Leisure Activities: Demand more resources, take place outside the
home, and involve more effort
...

Age Differences in Leisure Activities: Older individuals tend to engage more in
sedentary core activities as they age, such as reading and watching TV
...

Engagement in Sports: Research indicates a decline in sports engagement with
age, with older individuals preferring fitness sports when participating in sports
activities
...
In contrast,
older individuals spend more time watching television
...
7 hrs

0
...
4 hrs

4
...

Physical Limitations: Frailty and decreased physical ability lead to a reduction in
engagement in strenuous activities like swimming, running, and sports among older
individuals
...

Decrease in Leisure Spending: The Bureau of Labor Statistics Consumer
Expenditure Survey shows a decrease in spending on various leisure categories as
individuals age, with a significant drop observed from age 75 onwards
...


Successful Aging and Active Lifestyle
Benefits of Active Living
•
•
•

•

Active leisure lifestyles, like that of Sarah Bowles, have been shown to directly
benefit health and help mitigate the impact of life events and illness
...

Sarah Bowles' Model Program: Sarah's fitness program for older adults, the Retired
People’s Participation Club, exemplifies active living and has grown significantly
over the years
...


•

Volunteer Opportunities: Sarah volunteers to teach fitness programs to older
individuals in small towns and university students, emphasizing the importance of
giving back to the community
...

Training Initiatives: Sarah trains club members to work as instructors and
university students to run fitness programs for older individuals, promoting
knowledge sharing and community involvement
...

Community Engagement: Sarah travels to small towns to teach older individuals
how to lead fitness programs, fostering community involvement and empowerment
...


Influence of Age on Leisure Activities
Sedentary vs
...

Older individuals spend more time watching television and engaging in sedentary
activities like reading, relaxing, and thinking
...

Despite promotion programs, there has been no significant increase in sport
participation among older individuals
...


Time Use Discrepancies Across Age Groups
•

Older Americans spend more time reading for leisure than those under age 65
...

Television watching constitutes a significant portion of leisure time for older
individuals
...

Maintenance activities like housework and shopping increase for those in assisted
living or living independently
...

Women spend significantly more time on household tasks like cleaning, laundry,
and cooking
...

Gender roles influence leisure activities in retirement, with men preferring sports
and competition, and women favoring dance and aerobics
...


Physical Activity and Leisure Engagement
Physical Activity Trends
•
•
•
•
•

Data from the American Time Use Survey shows variations in housework
engagement between men and women
...

Gender roles extend to retirement activities, with men preferring sports and
competition, and women opting for dance and aerobics
...

Reasons for limiting physical activity include medical and nonmedical factors, with
interventions focusing on nonmedical barriers
...


•
•
•
•

Social support plays a crucial role in promoting physical activity among older
adults
...

Participation in recreation programs with friends increases the likelihood of
physical activity engagement
...


Influence of Minority Status on Leisure
Barriers to Active Leisure Among Minorities
•
•
•
•
•

Cultural and economic barriers can hinder minority members from enjoying active
leisure activities
...

Disparities exist in leisure engagement among minority groups, with potential
implications for health and well-being
...

Tailored interventions and community programs can help overcome barriers and
encourage active leisure participation
...

Increased participation in leisure activities correlated with lower mortality risk
...

The study suggests a positive link between leisure activities and longevity
...


Cultural and Economic Barriers to Leisure
•

Minority groups face barriers to active leisure due to cultural and economic factors
...

Barriers include transportation costs, equipment expenses, and usage fees
...

Example: Peters' study on African American fitness buffs on Martha’s Vineyard
...

African American and Hispanic minorities report lower engagement in leisure-time
physical activities compared to whites and Asians
...

Example: Higher rates of inactivity among non-Hispanic blacks and Hispanics
compared to non-Hispanic whites
...


Strategies for Inclusion and Engagement
Recommendations for Programs Targeting Minority Older Women
•
•
•
•
•
•

Program leaders should come from the African American community to serve as
role models
...

Utilize church recreation halls to create a comfortable environment
...

Incorporate fun and culturally appropriate activities like music and dance
...


Role of Community and Spirituality in Exercise
•
•
•

Spiritual music plays a significant role in the lives of African American older people
...

Community support and shared experiences enhance commitment to exercise
...


Faith-Based Approaches to Exercise
•
•

African Americans have low exercise participation rates among older populations
...


•

Example: Quinn and Guion's proposal for a faith-based and cultural approach to
exercise
...

Personal anecdotes illustrate the significance of music and positive anticipation
during challenging times, such as cancer treatment
...

Challenges in recruitment and retention for exercise programs highlight the need for
community involvement, cultural sensitivity, and group participation
...


Barriers to Walking in African American Communities
•
•
•
•
•

Gallagher and colleagues identified barriers to walking in African American
neighborhoods, including crowds, poor lighting, and criminal activity
...

Morning walks are preferred due to daylight and peaceful surroundings
...

Programs promoting fitness among minority elders should address and mitigate
neighborhood barriers
...

Older African American women view leisure as freedom from work and selfexpression, engaging in activities like church work, crafts, and caregiving
...

Participation in mentoring programs like the Experience Corps can promote
physical activity and active lifestyles among African American seniors
...


Leisure Patterns and Physical Activity
Leisure Patterns Among Older Adults
•
•
•

McGuire, Dottavio, and O’Leary identified two groups of older people based on
leisure patterns: contractors and expanders
...

Expanding leisure activities as life circumstances change is essential for
maintaining an active lifestyle in older age
...


Expanders

Maintain former activities and add new ones as life circumstances
change
...

Observations in Asian cultures show a value for exercise in later life, with activities
like t’ai chi, ballroom dancing, and group exercises
...

Leisure service providers should offer diverse options to cater to the physical
activity preferences of older individuals from minority backgrounds
...

Emphasizes the importance of these activities for older adults and minority groups
within the community
...


Leisure Education and New Activities in Old Age
•
•
•

Older individuals often form their leisure attitudes in childhood, with many
perceiving play in adulthood as wasteful
...

Leisure education programs can help individuals expand their leisure activities, with
contractors learning to add new activities and expanders developing skills in new
pursuits
...
'
Many older adults combine outdoor activities with travel, with a significant
percentage planning domestic and international trips
...


Active Lifestyles and Adventure Activities
Preferences and Trends
•
•
•

Baby Boomers show a keen interest in sports like biking, skiing, water sports, and
mountain climbing, as well as travel and tourism
...

Some seniors combine extreme athletic competition with adventure travel, seeking
unique challenges and experiences
...

Older individuals engage in various physical activities like tennis, paddle tennis,
pickleball, and cycling, fostering an active lifestyle
...


Fitness, Health, and Well-Being in Older Adults
Hypokinetic Disease and Physical Decline
•

Hypokinetic disease, characterized by the disuse of the body in old age, leads to
physical decline
...

Overweight and obese individuals often report low participation in leisure-time
physical activities, putting them at further health risks
...

Activity theory serves as a counterpoint, promoting the value of an active lifestyle
for enhanced life satisfaction
...

QUICK REFERENCE
...

Jay Norman and Peter Spiller: Seniors who engaged in ultra-marathon running,
demonstrating the pursuit of physical challenges in later life
...

Ogden, Carroll, Fryar, and Flegal (2015): Studied obesity rates in people aged 60 and
over, highlighting the risks associated with lack of physical activity
...

Continuity Theory: Suggests that older people maintain the same activity patterns
from middle age into later life
...


Key Events
•

•

Introduction of 'America the Beautiful—National Parks and Federal Recreational
Lands Pass—Senior Pass': Encouraged outdoor recreation among older individuals by
providing lifetime access to national parks and recreational areas
...


Concept Comparisons
Concept
Core Leisure
Activities

Description
Require few resources, low cost, and easy access
...


Peripheral
Leisure Activities

Require more resources, take place outside the home, and need
more effort
...


Important Quotes
"It’s exercise and fellowship that makes you feel good inside
...
Coming to hold hands to exercise in the water, to the rays of the light of the sun
warming you, to have the water soothing you as you exercise
...
So it’s a sharing that fortifies and
lets you know that we are not alone, and we need each other at the end of the day
...
And just know that there’s gonna be a bright side when you
wake up
...

Older African American women have a unique view of leisure activity, combining selfexpression, church work, watching TV, and caregiving
...


Key Terms
•
•

Core Leisure Activities: Activities that need few resources, have a low cost, and easy
access
...

Peripheral Leisure Activities: Activities that require more resources, take place
outside the home, and need more effort
...


CHAPTER 12
...

Gerontologists view social support as part of a person's 'life course capital' or
'social capital
...

'Social support leads to more positive views of aging, predicts good mental health, and
buffers social stress
...


Informal vs
...

• Formal Support: Paid help from professional caregivers like doctors, nurses, and
social workers
...

• Families remain the primary source of support for older individuals
...
'
Role of Social Capital
•
•
•

Social capital is the amount of resources available to an individual throughout their
life
...

Older individuals benefit from support received from family and friends
...

'Values about family care of elderly adults have remained strong despite demographic
changes
...


•

Emotional support, companionship, and practical assistance are common forms of
family support
...

Example: Glenda and Al caring for Mr
...

Generational Support
•

Older family members often support younger generations financially and with
childcare
...

• Grandparents frequently provide financial assistance and childcare to
grandchildren
...
' - Leopold and Raab,
2013
Evolution of Family Support
•
•

Family structures have evolved over the past century in the United States
...

• Families assist older members during illness, provide services, and maintain
regular visits
...

Family Dynamics and Support for Older Adults
Changing Family Structures
•
•
•

Families have become smaller with parents having fewer children, leading to
children moving long distances for job opportunities
...

Support includes help during illness, service exchanges, regular visits, and
communication through various means like letters, phone calls, and the Internet
...

Convoy Model of Support: Describes a dynamic network of close ties with family
and friends, with the strongest relationships in the inner circle
...


Informal Caregiving Statistics
•
•
•

Informal caregivers provide 80% of long-term care in the US, estimated at $522
billion in 2014
...
5 million caregivers support individuals aged 50 and over, with a significant
portion caring for those with Alzheimer's or dementia
...


Models of Informal Support
Task Specificity Model
•
•

Different groups offer specific roles in the older person's support system based on
their abilities and resources
...


Hierarchical Compensatory Model
•

Supporters primarily come from the older person's inner family circle and expand
outward as more help is required
...


Convoy Model of Support
•
•

Describes a dynamic network of close ties with family and friends, with varying
levels of intimacy represented by concentric circles
...


Importance of Social Convoys
Impact on Health and Well-being
•

Social convoys consist of individuals who provide continuous support throughout a
person's life cycle
...


Significance of Social Convoys
Social Convoy: 'A group of people that stay connected to someone throughout the life
cycle
...


Research Findings
•
•

Studies support the hierarchical compensatory model, with spouses and grown
children being primary sources of support for older adults
...


Informal Supports and Caregiving
Support Networks and Care Models
•
•

•
•

•

Feld and colleagues (2004) found that spousal care best matched care receivers'
needs, supporting the task specificity model
...

The convoy model, supported by Sims-Gould and Martin-Matthews (2007),
emphasizes a team of relatives and friends providing support to older individuals
...

Researchers like Sims-Gould, Martin-Matthews, and Rosenthal (2008) advocate for
more sophisticated models to describe the reality of informal supports, especially
for rural, minority, and low-income older people
...

Different socioeconomic conditions impact the dynamics of informal support
networks
...

More research on rural, minority, and low-income older people is essential for
accurate models of social support
...


Role of Formal Supports
•
•
•
•
•

Older individuals often use formal supports in conjunction with informal supports
for various reasons, such as specific needs or high healthcare requirements
...

Formal supports focus on medical care, household tasks, and personal care,
complementing the assistance provided by informal caregivers
...

Ward-Griffin (2002) highlighted the professional knowledge and skills of formal care
providers, emphasizing the blurring boundary between professional and family
caregivers
...

Black care receivers often have higher functional disabilities, leading to unmet
needs for home- and community-based services
...


•
•

Strong minority cultural and communal values contribute to the differences in
caregiving dynamics among ethnic groups
...


Community Care as an Alternative
•
•
•
•
•

Community care offers various services like in-home nursing, adult day care, and
long-term respite programs as an alternative to institutionalization
...

Community-based activities include music, art therapy, exercise, and discussion
groups tailored to individual abilities
...

By 2050, a significant increase in the number of Americans receiving community
care is expected, highlighting the growing importance of these services
...

These barriers prevent caregivers from utilizing available respite services
...
1% of
caregivers used adult day care services
...
8%) and Hispanic (51%)

Concerns about Day Care Staff Competency
•

Caregivers worry about the ability of day care staff to properly care for their loved
ones, especially dementia patients
...

This highlights the need for trained and competent staff in adult day care centers
...
(2012) expressed the need for flexible, reliable,
and personalized services
...

Community care should offer an integrated system providing various services like
transportation and in-home respite
...

Despite limited effects, caregivers highly appreciate such interventions
...


Tailored Support for Dementia Caregivers
•
•
•

Each dementia caregiver faces unique challenges requiring tailored psychosocial
support
...

Research indicates that adult children benefit more from counseling and education
compared to spouses
...

Devices like smoke detectors and GPS trackers provide peace of mind to
caregivers
...


Spousal Caregiving Dynamics
Gender Differences in Caregiving Approaches
•
•

Husbands and wives exhibit different caregiving approaches based on gender roles
...


•

These differences influence coping styles and perceptions of caregiving
responsibilities
...

Marital satisfaction is more negatively affected for wives caring for ill spouses
...


Caregiver Burden and Health Implications
•

Caregivers, especially spouses of institutionalized older adults, experience high
levels of stress and depression
...

Johansson et al
...


•

Caregiver Burden and Institutionalization
Caregiver Burden
•
•
•

Definition: The feeling of being overwhelmed by the demands of care, often
reported by caregivers of people with dementia
...

Case Study: Spouses feeling blocked opportunities for personal growth due to
caregiving focus
...


Institutionalization Impact on Spouses
•
•
•
•
•

Transition to Quasi-Widowhood: Wives of institutionalized husbands experience
feelings of loneliness, guilt, and sadness
...

Study Findings: Ross, Rosenthal, and Dawson (1997a, b) discovered the impact of
frequent visits on wives' mental health
...

Decision Making: Moving a relative into long-term care is a challenging decision
influenced by the care needed, caregiver's ability, and available formal supports
...

Monitoring: Adult children often monitor parents' well-being, which can transition
into caregiving as parents' health declines
...

Challenges: Baby Boomers face dilemmas in managing care for aging parents,
especially when living far away
...


Impact on Caregivers' Well-being
Caregiver Health and Quality of Care
•
•

Stress and Health: Chronic stress from caregiving can lead to high blood pressure
and other stress-related illnesses
...


•
•

Importance of Well-being: Caregiver well-being is essential for the overall care
receiver's well-being
...


Continuing Care in Long-Term Institutions
•
•
•
•

Informal Care: Adult children continue to provide informal care even after a parent
moves to a long-term care institution
...

Case Study: Mike Logan's regular visits to his mother in a nursing home despite her
memory loss
...


QUICK REFERENCE
...


Key People
•

Sam Kelso: Example of a caregiver who monitors and assesses the needs of an aging
parent living in a different state
...

Social capital is the number of resources available to a person throughout his or her life;
this resource changes over time and differs for everyone
...


•

Informal support refers to unpaid help given by friends, neighbors, and family, while
formal support refers to paid help from professional caregivers such as doctors, nurses,
and social workers
...
Each group
has a specific role to play in the older person's support system
...


Convoy Model of
Support

People have a dynamic network of close ties with family and
friends, with the strongest relationships in the closest circle
and weaker relationships in outer circles
...
Gerontologists
refer to the number of resources available to a person, including social support, as their
'life course capital' or 'social capital'
...


Key Terms/Concepts
•
•

Formal Support: Paid help from professional caregivers such as doctors, nurses, and
social workers
...
Informal
support includes advice, affection, companionship, and various forms of assistance
...

Caregiver Burden: The feeling of being overwhelmed by the demands of care,
commonly reported by caregivers of people with dementia
...

Aging, Caregiving, and Family Dynamics
Key Concepts in Aging and Elderly Care
Ageism and Its Implications
•
•
•
•
•
•

Ageism refers to discrimination or prejudice against individuals based on their age
...

Ageism manifests in various forms, including elder abuse and challenges in the
workplace
...

Ageism impacts self-esteem, work opportunities, and societal perceptions of aging
...


Demographics and Social Dynamics of Aging
•
•
•
•
•
•

African Americans face unique challenges in aging, including discrimination and
health disparities
...

Factors such as income, poverty, and discrimination influence the aging
experience
...

Aging populations exhibit diverse religious beliefs, impacting their social
interactions and support systems
...


Health and Well-being in Aging
•
•
•
•
•
•

Activities of Daily Living (ADLs) are essential for assessing an individual's functional
independence
...

The Affordable Care Act (ACA) has significant implications for healthcare access
and affordability for older adults
...

Leisure, recreation, and education contribute to overall well-being and quality of life
in older adults
...


Historical Perspectives and Initiatives
Evolution of Aging Studies
•
•
•
•
•
•

Early studies on aging focused on biological aspects and psychological patterns
...

Federal initiatives aim to address the challenges and opportunities associated with
an aging population
...

Theories such as age stratification theory explore the social implications of aging
...


Community and Social Support for the Elderly
•
•

Age-friendly communities prioritize accessibility and inclusivity for older residents
...


•

The Aging Network comprises organizations and services dedicated to supporting
older adults
...


•

•
•

Initiatives like the Network of Age-Friendly Communities aim to create supportive
environments for aging individuals
...


Key Organizations and Surveys
American Association of Suicidology
•
•
•

A non-profit organization dedicated to the understanding and prevention of suicide
...

Example: AAS hosts an annual conference to discuss the latest research and
interventions in suicide prevention
...
S
...

Data from the survey influences federal funding and planning decisions
...


American Psychological Association
•
•
•

Sets ethical standards for psychologists and provides guidelines for professional
conduct
...

Example: APA's code of ethics addresses issues like confidentiality, informed
consent, and conflicts of interest
...

ASA publishes journals and organizes events to promote knowledge exchange in the
field of gerontology
...


Administration on Aging (AoA)
•
•
•

An agency of the U
...
Department of Health and Human Services dedicated to
supporting older Americans
...

Example: AoA funds services like nutrition programs and caregiver support to
enhance the well-being of seniors
...

His writings on aging and the nature of life have influenced Western thought for
centuries
...


Baltes, M
...

•
•
•

Renowned psychologists known for their work on lifespan development and
successful aging
...

Example: The Baltes' model emphasizes the importance of adapting goals and
strategies to maintain well-being in later life
...

•
•

Sociologist specializing in family studies and intergenerational relationships
...


•

Example: Bengtson's research highlights the complexities of family dynamics and
support across generations
...

•
•
•

Economist focusing on the economics of aging and health care
...

Example: Becker's work sheds light on the economic implications of an aging
population and healthcare expenditures
...

•
•
•

Psychologist known for research on social relations and social support across the
lifespan
...

Example: Antonucci's work emphasizes the role of social connections in promoting
well-being and resilience in old age
...
and his works 'Secrets of Living Longer' and 'The Power Nine: Secrets of
long life from the world’s healthiest humans'
Burns, S
...

Burgess, A
...
, and M
...

Bush, G
...
and his various references

•

Notable Individuals
•
•
•

Black, K
...
and G
...
and R
...

Butler, R
...


Health and Aging
Effects of Aging on Body Systems
•
•
•
•
•

Discuss the impact of aging on body systems
Explore the effects on bone density and body mass index (BMI)
Reference the Baltimore Longitudinal Study of Aging (BLSA)
Consider brain disorders and brain function in aging
Examine the brain reserve hypothesis and brain stimulation

Cognitive Health and Aging
•
•
•
•
•

Cognitive decline and impairment in aging
Cognitive reserve and its importance
Cognitive behavioral therapy for older adults
Discuss controlled processing and studies on cognitive functions
Explore the correlation between cognitive health and aging

Longevity and Aging Theories
•
•
•
•
•

Compression of morbidity hypothesis
Cumulative advantage/disadvantage theory
Continuity theory in aging
Explore the brain reserve hypothesis
Discuss the convoy model of support in aging

Social and Cultural Aspects
Social Support and Community Engagement
•
•
•
•

Community care and its significance
Community service and volunteer work for older adults
Cohousing and its benefits
Discuss the Cohousing Association of the United States

•

Explore the concept of a convenience community

Cultural Influences on Aging
•
•
•

Health literacy and culture
Impact of race, ethnicity, and culture on aging
Ageism and its sources in different cultures

•
•

Self-development and cultural influences
Discuss the role of culture in end-of-life communication

Healthcare and Policy
Healthcare Systems and Policies
•
•
•
•
•

Coordination of health care services
Competitive medical plans (CMPs)
Discuss the Code of Federal Regulations in healthcare
Codes of ethics in healthcare
Consider the role of conductive hearing loss in healthcare

Pension Plans and Retirement
•
•
•
•
•

Defined benefit (DB) and defined contribution (DC) pension plans
Deferred retirement option program (DROP)
Explore the Concord Coalition and retirement options
Discuss the cost of living and retirement planning
Consider the impact of pension plans on financial security

Gerontology and Aging
Delirium and Dementia
•
•
•
•

Delirium and dementia are common cognitive disorders in older adults
...

Dementia is a progressive decline in cognitive function affecting memory, thinking,
and behavior
...


•

Experimental research and informed consent are essential in understanding and
treating these conditions
...

Disability, including developmental disabilities, poses challenges for aging
individuals
...

Disability insurance and discouraged workers are important considerations in the
context of aging
...


Caregiving and Long-Term Care
•

Caregivers play a vital role in supporting older adults, especially those with
conditions like Alzheimer's
...

Care managers and respite care are essential in providing relief to caregivers
...

Rewards for caregivers are crucial for recognizing their contributions
...

Demographic dividends can occur when a country's working-age population is
larger than the dependent population
...

Demographers study population dynamics and trends
...


Aging and Social Constructs
•

Aging is a social construct influenced by cultural perceptions and norms
...

The concept of developmental burden highlights the challenges associated with
aging
...

Civic engagement and the digital divide are important considerations in an aging
society
...

Chronic illnesses, such as cardiovascular disease, are common in older
populations
...

The Centers for Disease Control and Prevention (CDC) provide valuable insights
into elder health
...


Key Concepts in Aging and Gerontology
Epidemiological Transition
•
•

Refers to the shift in disease patterns from infectious and communicable diseases
to chronic, non-communicable diseases
...


Ethical Issues in Aging
•
•

Involves ethical considerations related to death, research, and end-of-life care
...


Family Dynamics and Aging
•
•

Examines the impact of aging on family structures and relationships
...


Exercise and Aging
•
•

Explores the benefits of physical activity on cognitive function, health, and overall
well-being in older adults
...


Financial Aspects of Aging
•
•

Focuses on economic considerations, retirement planning, and financial security in
old age
...


Aging Research and Policies
Employee Retirement Income Security Act (ERISA)
•
•

Legislation that sets minimum standards for pension plans in private industry
...


Ethical Principles in Psychology
•
•

Guidelines established by the American Psychological Association to ensure ethical
conduct in psychological research and practice
...


Federal Government Initiatives on Aging
•
•

Programs and policies implemented by the government to address the needs of
aging populations
...


Family Caregiving
•

Involves the provision of care and support to aging family members or relatives
...


Geriatric Depression Scale (GDS)
•
•

Screening tool used to assess depression in older adults
...


Social and Cultural Aspects of Aging
Ethnicity and Aging
•
•

Examines the influence of cultural background on the aging experience
...


Feminist Perspectives on Aging
•
•

Focuses on gender-related issues and inequalities in the context of aging
...


Generational Equity and Interdependence
•
•

Addresses the fair distribution of resources and opportunities across different age
groups
...


LGBT Aging Issues
•
•

Concerns unique to lesbian, gay, bisexual, and transgender older adults
...


Social Support and Aging
•
•

Examines the role of social networks and relationships in promoting well-being in
old age
...


CHAPTER 14
...

People now face the challenge of dealing with death in late old age
...

Death has become more abstract and distant, with limited direct experiences for
many individuals
...


Meaning of Death and Dying in Old Age
•
•
•
•
•

Attitudes towards death and the location of death are key considerations in old age
...

The process of mourning and coping with grief is essential in dealing with death in
old age
...

Communication among family members, healthcare providers, and the dying
person plays a crucial role in end-of-life care
...

Hospice care plays a significant role in providing comfort and support to dying
patients
...

Advance directives are crucial in ensuring that individuals receive the desired endof-life treatment
...


Attitudes Towards Death and Dying
Social Attitudes Towards Death
•
•
•
•
•

Social attitudes towards death exist on a continuum, ranging from viewing death as
an enemy to seeing it as a transition
...

Different societies have diverse views on death, with some perceiving it as a
mystery or a gateway to an afterlife
...

The portrayal of death in media often desensitizes individuals to the reality of death,
creating a disconnect from the experience
...

Legal systems address complex issues surrounding end-of-life decisions and care
...

Families are faced with decisions regarding the location and manner of death,
including choices between burial, cremation, or other alternatives
...


Cultural Differences and Communication
•
•
•
•
•

Cultural diversity influences attitudes towards death and dying, shaping individual
preferences and rituals
...

Discussions surrounding death preferences, such as burial or cremation,
contribute to a better understanding of individual wishes
...

The contrast between historical death practices, like home deaths, and
contemporary experiences, such as deaths in institutions, highlights societal shifts
in end-of-life care
...

Today, most infants are expected to live to old age
...
2 years for females and 76
...

At age 65, women could expect to live to 85
...

The gap in life expectancy between white and African American women closed over
time, while it increased for men
...


Life Expectancy Statistics
•

Life Expectancy at Age 65, by Race and Sex (1981–2014)

Years of
life

•
•
•

White
women

Black/African
American
women

White men

Black/African
American
men

1981

25

20

15

10


...



...



...



...



...

In 2010, 31% of all deaths in the US occurred among people aged 85 and over
...


Changes in Death Patterns
•
•
•

In the past, people often died young from acute illnesses or accidents, while today,
most deaths occur in old age following a long period of illness and decline
...

Dying in old age presents unique challenges for healthcare providers, family
members, and the elderly themselves
...

These trajectories include a rapid decline from a fatal illness, a slow decline with
periods of crisis, and a long-term decline requiring years of personal care
...


Leading Causes of Death
•

Ten Leading Causes of Death in the US, 2014
Cause

•
•

Percent

Diseases of heart

23
...
5

Chronic lower respiratory diseases

5
...



...
6

Heart disease and cancer accounted for 46% of all deaths in the US in 2014,
remaining major causes of death regardless of demographics
...


Attitudes Toward Death
•
•

•

Older people tend to think about death more than younger individuals
...

Studies show that older people think more about death but are less afraid
compared to younger individuals
...


•

Examples include rapid death from a fatal accident or a prolonged death from
diseases like cancer
...

Each trajectory necessitates specific healthcare, service, and social support
...
Would you want to take
antibiotics to extend your life knowing that it would prolong the dying process?
Scenario 5: Intensive Care Even if No Hope of Recovery
Duffy and colleagues (2006) created a questionnaire to understand attitudes toward death
and dying, exploring responses to hypothetical situations
...

End-of-Life Trade-Off Scenarios
Intensive Care vs
...

Example Scenario: CPR Versus No Chance of Recovery - Decision on resuscitation
with only six months left to live
...

Source: Adapted from Duffy et al
...

Personal Preferences: Individual choices on end-of-life care based on personal
values and family dynamics
...


•
•
•
•

Feeding Tube Dilemma: Choosing between using a feeding tube for life prolongation
or accepting a shorter life expectancy
...

Ethical Considerations: Balancing quality of life and medical interventions in endof-life care
...


Gerontological Theories on Death and Dying
Disengagement Theory
•
•
•
•
•

Theory Overview: Proposes that older individuals disengage from social roles as
they age
...

Erikson's Perspective: Ego integrity theory emphasizing life review and acceptance
of one's life cycle
...

Social Impact: Focuses on societal effects of aging and dying, rather than personal
feelings towards death
...

Attitudes Towards Death: Varied responses including denial, acceptance, and
embracing death
...

Personal Regrets: Insights from palliative care workers on common end-of-life
regrets and unfulfilled desires
...


Attitudes Towards Death
Older Adults' Perspectives
•
•
•
•

•
•

Older adults' express concerns about pain, suffering, institutionalization, loss of
mental ability, and loss of independence
...

Research by Hurd Clarke, Korotchenko, and Bundon (2012) on older adults with
chronic conditions revealed open discussions about death and dying
...

Study on the oldest-old (85 and over) showed an acceptance of death as a natural
part of life, influenced by changes in their social environment
...


Fear of Death Studies
•
•
•
•
•

Ellis and Wahab (2013) reviewed 84 studies on fear of death, indicating that high
religiosity often correlates with decreased fear of death
...

Research suggests that somewhat religious individuals exhibit lower levels of fear of
death
...

Nakashima (2007) found that hospice patients who reported a strong personal
relationship with God had better acceptance of death
...

Dr
...

Parnia (2014) called for more scientific research on near-death experiences to
understand their nature
...

Physiological explanations and differing perspectives exist regarding the source and
meaning of near-death experiences
...

Ardelt and Koenig (2006) found that individuals with a strong personal relationship
with God showed better acceptance of death
...


Institutional Death and Palliative Care
•
•
•
•

Health care professionals may view death as a failure due to their training to
preserve life
...

Training in palliative care is essential for healthcare professionals to provide
adequate support to dying patients
...


Challenges in End-of-Life Care
Difficulty in Distinguishing Patients
•
•
•

Nurses in acute care hospitals struggle to differentiate between acute care and
dying patients
...

Lack of preparedness among nurses results in distress and discomfort in providing
appropriate care
...
, 2013)
...

• Rise of palliative care, hospice care, and legalization of physician-assisted suicide
offer alternatives to aggressive medical interventions
...

Legal scholar Dubler (2007) highlighted the challenge posed by risk-averse healthcare
decision-makers and the shift towards patient-centered care
...

Cultural practices influence where and how individuals expect to die, impacting
their attitudes towards death
...

Different cultures ensure varying death practices, with some still prioritizing home deaths
...

Studies indicate that healthcare professionals often feel uneasy when dealing with
dying patients
...

Medical staff may struggle to meet the unique needs of dying older individuals, focusing on
technology and cure rather than comfort (Ross et al
...

Misunderstandings and Challenges in End-of-Life Care
•

Medical staff may experience guilt or anger towards dying patients, leading to
misunderstandings of their care preferences
...

• Lack of clarity in documenting patients' preferences can result in undesired
treatments being administered
...
(2000) revealed that physicians often misinterpret patients'
preferences regarding resuscitation
...

• Kübler-Ross introduced the concept of five stages of death and dying, emphasizing
emotional responses and coping mechanisms
...

Kübler-Ross's stages of death and dying have influenced how individuals perceive and
cope with terminal illness
...

• These stages may not occur linearly and can vary based on individual experiences
and illnesses
...

Kübler-Ross's model has been critiqued for its rigidity, with scholars highlighting the
diverse emotional responses and trajectories of dying individuals
...


•

Modern hospices, pioneered by Dame Cicely Saunders, focus on meeting the
unique needs of dying patients
...

St
...

Legislative Support for End-of-Life Care
•

Legislation in states like Oregon supports the use of controlled substances for
managing end-of-life pain
...

• Federal laws permit the use of opiates to alleviate intractable pain in terminally ill
patients
...


QUICK REFERENCE
...

Dame Cicely Saunders: Founded the first modern hospice, St
...


Fundamental Theories
•
•
•

Activity Theory: Proposes that individuals want to stay active throughout their lives,
substituting new roles and activities for those lost with age
...

Erikson's Theory of Ego Development: Describes the last stage of life involving a life
review, acceptance of one's life cycle, and ego integrity, where death loses its sting
...

Study by Ardelt and Koenig (2006): Investigated the relationship between spiritual
well-being and acceptance of death among older individuals, particularly those in
hospice care
...


Key Institutions/Organizations
•

St
...


Facts to Memorize
Life expectancy at birth in the United States in 2014 stood at 81
...
4 years for males
...
5 and a man could
expect to live to age 83
...


Reference Information
Hospice care focuses on the quality of the dying person’s life, providing pain relief and
maintaining clear mental awareness
...


Key Terms/Concepts
•
•
•

•

Death and Dying: The process of dying and the experience of death, including changes
in societal attitudes and the institutional experience of death
...

Palliative Care: A comprehensive program to manage a person’s physical,
psychological, and spiritual needs, primarily directed at providing relief to terminally ill
individuals through symptom and pain management
...


•

Ego Integrity: A concept from Erik Erikson's theory of ego development where the
integrated person accepts their biography and culture, leading to acceptance of death
...

Political Influence of Older Americans

Voting and Political Engagement
Role of Older People in Politics
•

Older individuals engage in politics through various means such as listening to
public affairs shows, donating to political parties, and participating in political
campaigns
...

• The Gray Panthers utilized the experience of older individuals and the energy of the
youth to bring about social change
...

•

Gerontologists study older people's involvement in politics from the perspectives of
voting patterns, advocacy, activism, and government policies
...

Older individuals view voting as a significant civic duty and actively participate in
elections
...

In the 2012 mid-term elections, individuals aged 65 and over had the highest voter
registration and turnout percentages
...


Voter Preferences and Political Campaigns
•
•
•

Older voters have varying political preferences based on factors like race and
ethnicity
...

Trump's campaign garnered significant support from elderly voters, challenging
stereotypes about his primary supporter demographics
...

Older voters may feel nostalgia for past times and perceive societal decline,
influencing their political choices
...

• Lobby groups and interest groups advocate for policies that benefit older people
and address their concerns
...

• The AARP, formerly the American Association of Retired Persons, has been
instrumental in defining aging issues and advocating for the older population
...

Social Activism and Political Aims
•
•
•
•

Social activism is a method used to achieve political and social policy goals for
seniors
...

The debate over generational equity highlights potential divisions in society based
on age-related policies
...


Government Policies and Legislation
Impact of Legislation on Older People
•

Major legislation and policies in the United States aim to support the needs of older
individuals
...

Civic engagement opportunities provide avenues for older individuals to participate
in governance and community activities
...


Barriers to Political Engagement
•
•
•
•

Various barriers such as lack of transportation, disability, and voter ID laws can
hinder older people from voting
...

Educational programs on voting procedures and same-day registration initiatives
enhance voter turnout among older individuals
...


Factors Influencing Political Participation of Older Adults
Barriers to Voting
•

Older people face barriers that hinder their participation in elections, such as
mobility issues and lack of required documentation
...

"These and other barriers keep some older people from the polls
...

• Minnesota offers voting machine training and eliminates the need for a birth
certificate for voter registration
...

"Minnesota has an 85 percent turnout rate among people age 65 and over—the highest
rate in the nation
...

• Older adults demonstrated a higher voter turnout compared to younger age groups,
with 69% participation
...

"Sixty-nine percent of people age 65 and over voted in the 2004 election, making up 19
percent of all voters
...

• Their engagement in political participation surpasses that of other age
demographics, influencing policy discussions around programs like Social Security
and Medicare
...
"
Policy Considerations
•

Despite their significant presence in the electorate, the older population may not
directly shape public policy or lead to age-specific policies
...

"Older people pay attention to issues of importance to them, such as Social Security and
Medicare
...

However, politicians cannot take their votes for granted, as older adults exhibit
diverse characteristics and interests
...
"
Factors Influencing Older Voter Participation
Influence of Education and Income
•
•
•
•
•
•

Voting participation increases with education levels among older adults
...
2% of those with grade 9-12 education voted,
compared to 75
...

Higher income levels also correlate with higher voting tendencies
...
5% of those with a family income under $10,000 voted,
while 74
...

Educated and affluent individuals tend to understand the political system better
and see the link between voting and social policies like taxation
...


Racial and Ethnic Disparities in Voter Participation
•

Voter participation rates vary by race and ethnicity among older adults
...

Language, culture, and immigration background influence voting behavior
...

Despite challenges, senior minority group members show higher voter participation
compared to younger minority group members
...


•
•
•
•

Political Ideologies and Voting Patterns
•
•
•
•

Older voters reflect conservative views on economic and social issues
...

Older individuals may hold conservative views on some issues but liberal stances
on others
...


•

Older voters' preferences are influenced by factors like race, life experiences, and
generational influences
...

Baby Boomers, who came of age during Democratic presidencies, tend to have
slightly more liberal tendencies on economic and social issues
...

The political ideologies and voting behaviors of Baby Boomers may shape future
voting patterns as they enter old age
...

Older Boomers lean towards Democratic candidates due to their upbringing during
the Vietnam War and Nixon's presidency
...

Baby Boomers may feel they have become more conservative over time compared
to their radical views in the 1960s
...

Studies show older voters transitioning from Democratic to Republican support
over the years
...

Pew Research Center's findings on the shift towards conservatism with age across
generations
...

Gallup polls reflecting fluctuations in party leanings among Boomers over the years
...

Speculation on whether younger generations will lean towards the Republican party
as they age
...

Comparison of Democratic and Republican leanings across different age groups
...

Shifts in party leanings over time among Baby Boomers
...


Impact of Older Voters on Politics
Older Voters' Influence
•
•
•
•
•
•

Older people's increasing impact on election results and the proportion of votes
cast
...

Critiques of the 'gray peril hypothesis' suggesting older people gaining control of
politics
...

Varied political beliefs among people aged 65 and over
...


Age-Related Voting Patterns
•
•
•
•
•
•

Older people's diverse views on age-related issues and candidate preferences
...

Dependence on Social Security influencing voting decisions
...

Consideration of multiple factors, not just age-related policies, in voting choices
...


Influence of Social Factors on Voting Behavior
Role of Social Class
•
•

Social class has a significant impact on voting behavior, often more than age
...


•

The poorest older people heavily rely on Social Security for income, while the
wealthiest rely less on it
...

Social class disparities can lead to contrasting views on social programs and
policies
...

Generational events like wars and presidencies can shape political views
...
S
...

Voting patterns and party affiliations can vary across different age groups and
generations
...


Political Affiliations and Generational Trends
•
•
•
•
•

Baby Boomers show a diverse range of political affiliations based on their birth
years
...

Voting patterns tend to remain consistent within age groups over time
...

Political views can be shaped by the political climate during a generation's early
adulthood
...


•
•
•

Older Boomers were influenced by Nixon's Republican presidency and the Vietnam
War
...

Generational voting trends can shift over time based on external factors
...


Impact of Social Security on Voting Behavior
•

Social Security plays a crucial role in the income of older individuals
...

Older individuals are more likely to support government programs for seniors
...

Older voters consider the impact of their vote on future generations
...


Key People
•

Maggie Kuhn: Founder of the Gray Panthers, a senior activist group, who advocated for
social change and justice for older people
...


Key Institutions/Organizations
•

AARP (American Association of Retired Persons): Founded in 1958, an interest
group advocating for older people's rights and programs like Social Security and
Medicare
...


•
•

The AARP, formerly the American Association of Retired Persons, is a significant
interest group founded in 1958
...


Reference Information
•

•
•

Older people consider voting an important obligation, with 89% of people ages 40 to
69 and 93% of people aged 70 and over considering voting a very important
obligation
...

Studies show that voting participation increases with education and higher incomes
among older people
...


Educated voters tend
to understand the
political system better
and see a stronger link
between voting and
social policies
...


Income
Level

Higher incomes
are associated
with greater
tendencies to
vote
...

patterns
...

to whites
...




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