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II. Aging: Changes in Physical, Mental, and Social Status Physical Status. Contrary to popular belief, 72% of those aged 65 and older reported being in good health, and several studies have shown that older Americans are healthier and better able to live independently than recent generations. Disability rates and nursing home use have declined. That said, physical decline is normal. Eighty percent of folks aged 65+ experience one or more physical conditions such as heart disease, arthritis, respiratory or digestive problems. Some exercise physiologists attribute 50% of physical decline to a sedentary lifestyle.

As we know already, there are huge healthcare disparities across racial-ethnic groups, and because socioeconomic status is an overlapping factor, across SES. For example, African Americans are much less likely to get poor healthcare than whites, and this may be attributable to both racial discrimination and SES. Mental Health. With regard to mental health and aging, the two most common ailments are depression and dementia. Symptoms of depression are listed on p. 486. A multiplicity of factors are considered to play a role in depression, including genetics, personal history, and contextual (environmental) factors. Consider the potential life-changes that may occur for the elderly: loss of loved ones and spouses, decreased ability to fend for oneself, decreased autonomy, US discrimination against the old, chronic physical ailments, and perhaps going fomr an authority role in one's own family to the role of an invalid as health declines. It's no wonder depression hits hard in older groups!

VI. Grandparents and Divorce, Relatinoships Between Aging Parents and Adule Children Know pp. 499-501. VII. Dying, Death, Bereavement We are not a culture that talks about death, or thinks about it in an accepting way. Know Kubler-Ross' stages of death (denial, anger, bargaining, depression, and acceptance), as well as criticisms of her model (pp. 502-503).

Chapter 18: The Family in the 21st Century Some statistics: The number of families with children under 18 will decrease. Families with single mothers under the age of 25 are predicted to increase by 44%. Single fathers will also increase in number. The number of folks between the ages of 45 - 54 is expected to increase from 17 million to 25 million (by 45%). We will talk about predictions about the family from 6 different perspectives: structure, racial-ethnic diversity, children's rights, health-related issues, economic concerns, and global aging.

V. Grandparents as Surrogate Parents Contrary to stereotypes, white grandparents constitute the largest proportion of this group. They tend to raise their grandchildren due to substance abuse problems, usually in the mother, mental/physical illness, divorce, death of a parent, and abuse and neglect. There are three broad categories of this group:

Custodial: These g'parents have a legal relationship with their grandkids through adoption, guardianship, or custody. Living-With: These g'parents keep their grandchildren in their own homes, usually because parents could not provide a loving safe environment Day-Care: These g'parents assume responsibility for daycare of their grandkids.

Some random statistics: Older people (defined as those 65 and above) are increasing in numbers in the US population, due to advances in contemporary medicine. Life expectance has also increased over the years. For example, in 1900, the average life expectance was 47 years. In 2001, it was 79.8 for women and 74.4 for men. People aged 85 and older made up 0.6 percent of the US population in 1900, but in 2000, they make up 1.6 percent. This has implications for the structure (and function) of families as we know them.

I. Multigenerational Families Gerontologists are scientists who study the biological, social, and psychological aspects of aging. They divide older populations into 3 groups: Young-old: ages 65-74 Old-old: 75-84 Oldest-old: 85 and up. This is one of the fastest growing groups, and by the year 2030, it is expected to constitute about 3% of the US population. As older populations increase, the proportion of younger people in US society is decreasing. In 2000, whites made up 84% of the population aged 65 and older. However, people of color (including African American, American Indian, Asian/Pacific Islander, and Latino groups) are projected to make up 36% of this population by the year 2050. This is largely because fertility rates tend to be greater in minority groups. Gerontology research has indicated that many of the elderly are healthy, and are living longer and longer lives. This contributes to the increased number of multigenerational families. For example, approximately 5.6 million kids (8% of all kids) live in homes with a grandparent present. Some sociologists suggest that multigenerational family bonds are growing stronger, and are more important than nuclear family bonds.

I. Family Structure Some predicted changes: more multigenerational families, and due to the number of divorces, elderly people may depend on the care of "stepkin." There may also be a greater number of gay and lesbian parents as society becomes more accepting. People will still marry - it doesn't seem like the institution of marriage will go "out of style." 93% of folks will marry at least once.

II. Racial-Ethnic Diversity The growth of ethnically diverse families will continue, given immigration and higher fertility rates in minority groups. Minority groups will comprise 30% of the population by the year 2030. Eventually, non-Hispanic whites are expected to become a minority. The political capital of Hispanic and Latino groups will continue to grow. It is expected that as the US population ages, minority youth will work to support a largely older, white population - this is predicted to lead to increased racial-ethnic discrimination across generations.

III. Retirement and Family Life Retirement is exit from the paid labor force. Social Security benefits, a public retirement pension system, pays 90% of the elderly, but the amount depends on how long folks have been in the labor force. Of those aged 65 and older, men are more likely to still be working than women (18% compared to 10%, respectively), although health often impacts retirement decisions. Due to greater life expectance, 1/3 of life may be spent in retirement. As folks age, income tends to decline. Women tend to make less than men, and may continue to work beyond age 65 because SS benefits are low due to years taken off to raise children. Whites make more than other ethnic groups (see Table 17.4 on page 494).

IV. Grandparenting There are several styles of grandparenting, including: Remote/Detached: g'parents live far away and see g'kids infrequently. Ritualistic relationship without depth. Only 3% of g'parents never see or write to grandkids. Factors in this include poor health, or g'kids busy schedules. Companionate/Supportive: Most common. 8 of 10 grandparents spoke with g'kids on the phone in the previous month. This relationship emphasizes emotional/instrumental support, but g'parents have no authority. Involved/Influential: G'parents are playful and loving, but have greast authority over g'kids. More common in single-mom families, urban families, or African American families. Advisory/Authoritative: g'parent serves as an advisor and may even financially support the family. Cultural transmitters: G'parents pass along cultural norms and rituals in the family.

III. Children's Rights 12% of children live in poverty. Children have been "neglected" in terms of social policy. However, there are areas in which family policy has helped. 1984 law about child support enforcement, including funding to support 75% of state's enforcement costs. Require states to withhold pay of delinquent parents. 1988 this law was strengthened - judges required to provide a written document if they decided to depart from protocol - stipulates review every 3 years. This reflects the general trend for courts to be more aware of children's rights.

Impoverished families cannot afford quality child care. Because women are most likely to take care of the kids, they are behind men in pay, benefits, and seniority. 23% of moms between 21 and 29 don't work because they can't afford childcare. In comparison with other countries, the US record on child-care provisions is ridiculous. Deductions for children are minimal. 60% of childcare in Japan is government-funded, and many companies offer subsidies to families with children. Many countries have paid infant-care leave. We only have unpaid leave via the family medical leave act. In Sweden, families have 18 months of paid leave, and additional unpaid leave - the first 18 months, families get 80 of wages, the next 3 they get a flat rate, and the final 3 are unpaid. These can be shared between either parent, and prorated.

V. Economic Concerns 1 of 5 US children lives in poverty, some believe because the government has not developed a strong policy on poverty. Good policy (according to Danziger and Danziger, 1993) would include better education/training, subsidies to the working poor, greater access to health care/child care, better housing, ending discrimination against women and minorities, and better employment opportunities. Minimum wage needs to be much higher (8.60 compared to 5.15 per hour). 1996 Welfare Reform Act: Personal Responsibility and Work Opportunity Reconciliation Act - this converts AFDC (Aid to Families with Dependent Children) to a block grant for states called TANF (Temporary Assistance to Needy Families), with a 5-year limit to welfare benefits. States decide how to spend the block grants. After 2 years, folks are required to work, do vocational training, or community service. Unmarried mothers under age 18 are required to live with an adult and attend school in order to get welfare. The purpose of the change is to get folks off welfare through requiring them to work. This is based on the assumption that welfare causes single parenthood/laziness.

Since 1996, 43% of welfare rolls have declined. However, many argue that it increases child poverty. There is no evidence that welfare causes out-of-wedlock births. There's also no evidence that those who leave the welfare rolls are successful in lifting themselves out of poverty. Know what corporate welfare is (p. 523) Men and women should receive equal pay for equal work (principle of "comparable wealth"), but don't. VI. Global Aging Because the global population is aging at an unprecedented rate, right-to-die issues will become more prevalent. In the Netherlands, there is right to die legislation, and 19% of all deaths are assisted suicides. In Oregon, voters supported a referendum for assisted suicide for adults who were terminally ill and of sound mind. Living wills allow folks to specify what life saving measures will be used.

Dementia, on the other hand, is the loss of mental abilities that most commonly occurs in later life. Prevalence increases with age: for example, 8% of folks over 65 have it, and 50% over age 85 have it. Alzheimer's is the most common form. It is a progressive, degenerative disorder that attacks the brain and impairs memory, thinking and behavior. Researchers have linked Alzheimer's with genes that leave protein deposits and debris called "neurofibrillary tangles" that kill neurons in the brain. 10% of those aged 65+ and 40% of those over 85 have it. There is no cure. Alzheimer's groups predict that it will bankrupt the healthcare system.

Social Status. The status of the elderly has generally declined since 1900. Many societies (other than ours) view the elderly as a source of wisdom. In particular, those societies that do not overvalue independence and self-reliance are more likely to view the elderly as powerful and privileged. Many of us dread growing old. - consider the popularity of plastic surgery. There are many stereotypes of the elderly, including the "myth of senility." If an elderly person forgets where the car keys are, he/she is assumed to be "feeble-minded." In contrast, a younger person doing the same thing would be considered "forgetful." Such stereotypes are often supported by the media, for example, films tend to underrepresent older Americans, or present them negatively.

IV. Health-Related Issues Overall health has improved - smoking and alcohol use is in decline, but rates are still high. HIV/AIDs is a major concern. Still, folks, especially heterosexual folks, still engage in risky sexual behaviors. In a recent survey, 40% of HIV positive individuals did not tell their partners, fearing rejection. Most didn't use condoms.

We don't have nationalized healthcare, and we do not consider health care a right. About 16% of the population have no health insurance. Women are more likely to have insurance (Medicaid) because they are more likely to be below the poverty line. Young adults are the least likely to have health insurance (low paid, part-time jobs). There are drawbacks to socialized medicine though - it works best for minor problems, and may not have resources to treat complicated medical needs.


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