psych 10-16

Physiological Changes

Growing older brings with it several inevitable physiological changes. Like Frank, whom we met in the vignette, older adults find that their endurance has declined relative to what it was 20 or 30 years earlier and that their hearing has declined. In this section, we consider some of the most important physiological changes that occur in neurons, the cardiovascular and respiratory systems, the motor system, and the sensory systems. We also consider general health issues such as sleep, nutrition, and cancer. Throughout this discussion, you should keep in mind that although the changes we consider happen to everyone, the rate and the amount of change varies a great deal among individuals. Changes in the Neurons Neuroscience research indicates that the most important normative changes with age involve structural changes in the neurons, the basic cells in the brain, and in how they communicate (Juraska & Lowery, 2012). Recall the basic structures of the neuron we encountered in Chapter 3, shown again here in Figure 14.5. Two structures in neurons are most important in understanding aging: the dendrites, which pick up information from other neurons, and the axon, which transmits information inside a neuron from the dendrites to the terminal branches. Each of the changes we consider in this section impairs the neurons' ability to transmit information, which ultimately affects how well the person functions. Three structural changes are most important in normal aging: neurofibrillary tangles, dendritic changes, and neuritic plaques. Figure 14.5. © Cengage Learning® Basic structure of the neuron. For reasons that are not understood, fibers that compose the axon sometimes become twisted together to form spiral-shaped masses called neurofibrillary tangles. These tangles interfere with the neuron's ability to transmit information down the axon. Some degree of tangling occurs normally with age, but large numbers of neurofibrillary tangles are associated with Alzheimer's disease and other forms of dementia (Scheff, Neltner, & Nelson, 2014). Changes in the dendrites are more complicated. Some dendrites shrivel up and die, making it more difficult for neurons to communicate with each other and transmit information (Voss et al., 2013). However, research indicates that dendrites continue to grow in some areas of the brain, and embryonic stem cell research indicates that inducing growth may be a future way to treat brain disease and injury (West, 2010). This may help explain why older adults continue to improve in some areas, as we will discover later in this chapter. Why some dendrites degenerate and others do not is poorly understood; it may reflect the existence of two different families of neurons. Damaged and dying neurons sometimes collect around a core of protein and produce neuritic plaques. Plaques likely interfere with normal functioning of healthy neurons. Although large numbers of plaques are considered a defining criteria of dementia (e.g., Alzheimer's disease), researchers have not established a specific number of plaques that indicate a healthy aging brain (Scheff et al., 2014). As we will see later in the chapter, the current focus of many researchers is on understanding how plaques can be prevented or eliminated as ways to treat dementia. Because neurons do not physically touch each other, they must communicate via chemicals called neurotransmitters. With age, the levels of these neurotransmitters decline (Behl & Ziegler, 2014). These declines are believed to be responsible for numerous age-related behavioral changes, including those in memory and sleep, and perhaps for afflictions such as Parkinson's disease (Nyberg et al., 2012). These changes in neurons are a normal part of aging. However, when these changes occur at a much greater rate, they cause considerable problems and are associated with Alzheimer's or related diseases, conditions we discuss in more detail on pages 502-507. This point is important because it means that serious behavioral changes (e.g., severe memory impairment) are not a result of normative age changes in the brain; rather, they are indicators of disease. Through technological advances in noninvasive imaging and in assessing psychological functioning, we are learning a great deal about the relations between changes in the brain and changes in behavior (Blanchard-Fields, 2010; Chavarria-Siles et al., 2014). Neuroimaging is an important tool for understanding both normal and abnormal cognitive aging. Two neuroimaging techniques are used most often: Structural neuroimaging provides highly detailed images of anatomical features in the brain. The most commonly used are X-rays, computerized tomography (CT) scans, and magnetic resonance imaging (MRI). Images from structural neuroimaging techniques are like photographs in that they document what a specific brain structure looks like at a specific point in time. Structural neuroimaging is usually effective at identifying such things as bone fractures, tumors, and other conditions that cause structural damage in the brain, such as strokes. Functional neuroimaging provides an indication of brain activity but not high anatomical detail. The most commonly used are single photon emission computerized tomography (SPECT), positron emission tomography (PET), functional magnetic resonance imaging (fMRI), magnetoencephalograpy (or multichannel encephalograpy), and near infrared spectroscopic imaging (NIRSI). In general, fMRI is the most commonly used technique in cognitive neuroscience research (Poldrack, 2012). Functional neuroimaging provides researchers with information about what parts of the brain are active when people are doing specific tasks. A typical image will show different levels of brain activity as different colors; for example, red on an image might indicate high levels of brain activity in that region, whereas blue might indicate low levels of activity. These noninvasive imaging techniques coupled with sensitive tests of cognitive processing have shown quite convincingly that age-related changes in the brain are, at least in part, responsible for the age-related declines in cognition that we will consider later (Blanchard-Fields, 2010; Chavarria-Siles et al., 2014). Why these declines occur has yet to be discovered, although fMRI offers considerable promise in helping researchers unlock this mystery. Cardiovascular and Respiratory Systems Having a healthy heart and circulatory system, as well as healthy lungs are two key factors for people to enjoy high quality of life as they grow older. Let's take a closer look at the changes that occur to us all, as well as problems that can develop. Cardiovascular System Changes. You may already know that cardiovascular disease is the most common cause of death in the United States. The incidence of cardiovascular diseases such as heart attack, irregular heartbeat, stroke, and hypertension increases dramatically with age and is much higher among African Americans (Go et al., (2014). For example, only about 10% of adults aged 25 to 44 have hypertension compared with more than 50% of adults over age 65. However, the overall death rates from these diseases have been declining over recent decades, mainly because fewer adults smoke cigarettes and many people have reduced the amount of fat in their diets. Normative changes in the cardiovascular system that contribute to disease begin by young adulthood. Fat deposits are found in and around the heart and in the arteries (National Institute on Aging, 2013). Eventually, the amount of blood that the heart can pump per minute will decline roughly 30%, on average, by the late seventies to eighties. The amount of muscle tissue in the heart also declines as it is replaced by connective tissue. A general stiffening of the arteries also occurs due to calcification. These changes appear irrespective of lifestyle, but they occur more slowly in people who exercise, eat low-fat diets, and manage to lower stress effectively (see Chapter 13). As people grow older, their chances of having a stroke increase. Strokes, or cerebral vascular accidents (CVAs), are caused by interruptions in the blood flow in the brain due to blockage or a hemorrhage in a cerebral artery. Blockages of arteries may be caused by clots or by deposits of fatty substances due to the disease atherosclerosis. Hemorrhages are caused by ruptures of the artery. CVAs are the leading cause of disability (and fourth leading cause of death) in the United States. Treatment of CVA has advanced significantly. The most important advance is use of the clot-dissolving drug tissue plasminogen activator (tPA) to treat CVAs (del Zoppo, 2013). Currently, tPA is the only approved treatment for CVAs caused by blood clots, which constitute 80% of all CVAs. Not every patient should receive tPA treatment, and tPA is effective only if given promptly, which is vitally important. So if you or a person you know thinks they are experiencing a CVA, get medical attention immediately because to be most effective, tPA therapy must be started within three hours after the onset of a stroke. Recovery from CVA depends on the severity of the stroke, area and extent of the brain affected, and patient age. Older adults often experience transient ischemic attacks (TIAs), which involve an interruption of blood flow to the brain and are often early warning signs of stroke. A single, large cerebral vascular accident may produce serious cognitive impairment, such as the loss of the ability to speak, or physical problems, such as the inability to move one's arm. The nature and severity of the impairment in functioning that a person experiences are usually determined by which specific area of the brain is affected. Recovery from a single stroke depends on many factors, including the extent and type of the loss, the ability of other areas in the brain to assume the functions that were lost, and personal motivation. Numerous small cerebral vascular accidents can result in a disease termed vascular dementia. Unlike Alzheimer's disease, another form of dementia discussed later in this chapter, vascular dementia can have a sudden onset and may progress slowly (Leys, Murao, & Pasquier, 2014). Typical symptoms include hypertension, specific and extensive alterations on an MRI, and differential impairment on neuropsychological tests, although we still have a great deal to learn about precise diagnosis (Shim, 2014). The differential impairment refers to a pattern of scores showing some functions intact and others significantly below average. Individuals' specific symptom patterns may vary a great deal depending on which specific areas of the brain are damaged. In some cases, vascular dementia has a much faster course than Alzheimer's disease, resulting in death an average of two to three years after onset; in other cases, the disease may progress more slowly with idiosyncratic symptom patterns. Single cerebral vascular accidents and vascular dementia are diagnosed similarly. Evidence of damage may be obtained from diagnostic structural imaging (e.g., CT scan or MRI), which provides pictures such as the one shown in Figure 14.6, that is then confirmed by neuropsychological tests. Known risk factors for both conditions include hypertension and a family history of the disorders. Figure 14.6. Scott Camazine/Science Source Neuroimaging is especially helpful in diagnosing a cerebrovascular accident (shown in red). Respiratory System Changes. Although the size of the lungs does not change with age, the maximum amount of air in one breath drops 40% from age 25 to age 85, due mostly to stiffening of the rib cage and air passages with age and to destruction of the air sacs in the lungs by pollution and smoking (Guenette & Jensen, 2014). This decline is the main cause of shortness of breath after physical exertion in later life. Because of the cumulative effects of breathing polluted air over a lifetime, it is hard to say how much of these changes is strictly age-related. The most common form of incapacitating respiratory disease among older adults is chronic obstructive pulmonary disease (COPD). COPD can be a debilitating condition and may result in depression, anxiety, and the need to be continually connected to oxygen (Frederick, 2014). Emphysema is the most common form of COPD; although most cases of emphysema are due to smoking, some forms are genetic. Asthma is another common type of COPD. Sensory Changes Growing older brings with it several normative changes in sensory abilities. These changes can affect people's ability to enjoy life but in most cases can be adequately compensated for through various types of interventions. Vision. Age-related changes in vision are fairly obvious—just watch as middle-aged and older adults' arms become too short for them to see things clearly close up. This change is due to age-related changes in the lens's ability to adjust, and focus declines as the muscles around it stiffen (Andersen, 2012; Charman, 2008). This is what causes difficulty in seeing close objects clearly (called presbyopia), necessitating either longer arms or corrective lenses. To complicate matters further, the time our eyes need to change focus from near to far (or vice versa) increases. This also poses a major problem in driving. Because drivers are constantly changing their focus from the instrument panel to other autos and signs on the highway, older drivers may miss important information because of their slower refocusing time. In addition, as we grow older, the lens becomes more yellow, causing poorer color discrimination in the green-blue-violet end of the spectrum. Other changes also occur that affect how well we see in later life. One is a decrease in the amount of light that passes through the eye, resulting in the need for more light to do tasks such as reading. As you might suspect, this change is one reason older adults do not see as well in the dark, which may account in part for their reluctance to go places at night. One logical response to the need for more light would be to increase illumination levels in general. However, this solution does not work in all situations because we also become increasingly sensitive to glare (Sanford, 2014). Another major change is that our ability to adjust to changes in illumination, called adaptation, declines. Going from outside into a darkened movie theater involves dark adaptation; going back outside involves light adaptation. Research indicates that the time it takes for both types of adaptation increases with age (Andersen, 2012). These changes are especially important for older drivers, who have more difficulty seeing after being confronted with the headlights of an oncoming car. A third structural change affects the ability to see detail and to discriminate different visual patterns, called acuity. Acuity declines steadily between ages 20 and 60, with a more rapid decline thereafter. Loss of acuity is especially noticeable at low light levels (Andersen, 2012). Besides these normative structural changes, some people experience diseases caused by abnormal structural changes. First, opaque spots called cataracts may develop on the lens, which limits the amount of light transmitted. Cataracts often are treated by surgical removal and use of corrective lenses. Second, the fluid in the eye may not drain properly, causing very high internal pressure; this condition, called glaucoma, can cause internal damage and loss of vision. Glaucoma is a fairly common disease in middle and late adulthood and is usually treated with eye drops. The second major family of changes in vision results from changes in the retina. The retina lines approximately two-thirds of the interior of the eye. The specialized receptor cells for vision, the rods and cones, are contained in the retina. They are most densely packed toward the rear, especially at the focal point of vision, a region called the macula. At the center of the macula is the fovea, where incoming light is focused for maximum acuity, as when one is reading. With increasing age, the probability of degeneration of the macula increases (Lighthouse International, 2014). Age-related macular degeneration involves the progressive and irreversible destruction of receptors from any of a number of causes. This disease results in the loss of the ability to see details; for example, reading becomes extremely difficult and television is often reduced to a blur. Roughly one in five people over age 75, especially smokers and European American women, have macular degeneration, making it the leading cause of functional blindness in older adults. A second age-related retinal disease is a by-product of diabetes. Diabetes is accompanied by accelerated aging of the arteries, with blindness being one of the more serious side effects. Diabetic retinopathy, as this condition is called, can involve fluid retention in the macula, detachment of the retina, hemorrhage, and aneurysms (National Eye Institute, 2012). Because it takes many years to develop, diabetic retinopathy is more common among people who developed diabetes early in life. Hearing. The age-related changes in vision we have considered can significantly affect people's ability to function in their environment. Similarly, age-related changes in hearing can also have this effect and interfere with people's ability to communicate with others. Hearing loss, especially for high-pitched tones, is one of the well-known normative changes associated with aging (Li-Korotky, 2012). A visit to any housing complex for older adults will easily verify this point; you will quickly notice that television sets and radios are turned up fairly loud in most of the apartments. But you don't have to be old to experience significant hearing problems. iStockphoto.com / webphotographeer Exercising while wearing headphones or earbuds and listening to loud music when you are young can result in serious hearing loss in later life. Loud noise is the enemy of hearing at any age. You probably have seen people who work in noisy environments (such as factories and airports) wearing protective gear on their ears so that they are not exposed to loud noise over extended periods of time. However, you can do serious damage to your hearing with short exposure, too. But you don't need to be at a loud rock concert or next to a jet engine to damage your hearing either. Using headphones or earbuds, especially at high volume, can cause the same serious damage and should be avoided. It is especially easy to cause hearing loss with headphones or earbuds if you wear them while exercising; the increased blood flow to the ear during exercise makes hearing receptors more vulnerable to damage. Because young adults do not see their music listening behavior as a risk (Gilliver et al., 2012), hearing loss from this and other sources of loud noise is on the rise. The worst news is that hearing loss is likely to increase among older adults in the future (Agrawal, Platz, & Niparko, 2008). The cumulative effects of noise and normative age-related changes create the most common age-related hearing problem: reduced sensitivity to high-pitched tones or presbycusis, which occurs earlier and more severely than the loss of sensitivity to low-pitched tones. Research indicates that by their late seventies, roughly half of older adults have presbycusis. Men typically have greater loss than women, but this may be due to differential exposure to noisy environments. Hearing loss usually is gradual at first, but accelerates during the forties, a pattern seen clearly in Figure 14.7. Figure 14.7. Based on Ordy, J. M., Brizzee, K. R., Beavers, T., and Medart, P. (1979). Age differences in the functional and structural organization of the auditory system in man. In J. M. Ordy and K. R. Brizzee (Eds.), Sensory systems and communication in the elderly. Hearing loss occurs in all adults but is greatest for high-pitched tones and greater for men than for women. As a reference, the highest note on a piano is 4,186 Hz; normal human hearing ranges from 27 Hz to 20,000 Hz. Presbycusis results from four types of changes in the inner ear (Yamasoba et al., 2013): sensory, consisting of atrophy and degeneration of receptor cells; neural, consisting of a loss of neurons in the auditory pathway in the brain; metabolic, consisting of a diminished supply of nutrients to the cells in the receptor area; and mechanical, consisting of atrophy and stiffening of the vibrating structures in the receptor area. Knowing the cause of a person's presbycusis is important because the different causes have different implications for other aspects of hearing (Punnoose, Lynm, & Golub, 2012). Sensory presbycusis has little effect on other hearing abilities. Neural presbycusis seriously affects the ability to understand speech. Metabolic presbycusis produces severe loss of sensitivity to all pitches. Finally, mechanical presbycusis also produces loss across all pitches, but the loss is greatest for high pitches. Because hearing plays a major role in social communication, its progressive loss can have an equally important effect on social adjustment and quality of life (Heyl & Wahl, 2012). Loss of hearing in later life may cause numerous adverse emotional reactions, such as loss of independence, social isolation, irritation, paranoia, and depression. Much research indicates that hearing loss per se does not cause social maladjustment or emotional disturbance. However, friends and relatives of an older person with hearing loss often attribute emotional changes to hearing loss, which strains the quality of interpersonal relationships, and the older person's emotional well-being can be negatively affected (Sprinzl & Riechelmann, 2010). In fact, such problems often start with family and friends becoming impatient at having to repeat everything to the person with hearing loss. Thus, while hearing loss may not directly affect older adults' self-concept or emotions, it may negatively affect how they feel about interpersonal communication. By understanding hearing-loss problems and ways to overcome them, those without hearing loss can play a large part in minimizing the effects of hearing loss on the older people in their lives. Think About It How might changes in hearing affect people's cognitive performance? Fortunately, many people with hearing loss can be helped through two types of amplification systems and cochlear implants. Analog hearing aids are the most common and least expensive, but they provide the lowest-quality sound. Digital hearing aids include microchips that can be programmed for different hearing situations. Cochlear implants do not amplify sound; rather, a microphone transmits sound to a receiver, which stimulates auditory nerve fibers directly. Although technology continues to improve, none of these devices can duplicate our original equipment; so be kind to your ears.

Coping with Unemployment

Losing one's job can have enormous personal impact that can last a very long time (Blau et al., 2013; Gabriel, Gray, & Goregaokar, 2013; Waters et al., 2014), as Jo Ann's case in the Real People feature illustrates. Real People Applying Human Development Experiencing Layoff When Jo Ann graduated from college, she thought she had hit the jackpot by getting a great job with a major technology company. She was a rising star for her first 16 years with the company, being named to all-company lists of the best systems marketing employees, exceeding her sales goals every year, and being promoted quickly up the ranks. So when the rumors of layoffs began circulating through the company, she thought she had little to worry about. She was wrong. To Jo Ann's shock, she was laid off. The entire division of the company was eliminated and outsourced. She was totally devastated. The severance package the company provided was no consolation. Unemployment benefits did not pay the mortgage. Her savings would soon be gone. She felt as if someone had punched her hard right in the gut. She had lost much of her identity. She felt ashamed. She felt at fault. She became depressed. She realized it was going to be a difficult process finding a new job with so many other people like herself out of work. When U.S. unemployment rates hit 10.6% in January 2010, millions of people could relate to these feelings. When unemployment lasts and reemployment does not occur soon, unemployed people commonly experience a variety of negative effects (Blau et al., 2013; Gabriel et al., 2013) that range from a decline in immune system functioning (Cohen et al., 2007) to decreases in well-being (Gabriel et al., 2013). The complex interconnections of these effects are shown in Figure 12.7. Figure 12.7. From McKee-Ryan et al., 2005, p. 56. Psychological and physical well-being after losing one's job is affected by many variables. Coping with unemployment involves both financial and personal issues. The financial support people receive varies across states and situations. Unemployment compensation is typically much reduced from one's original salary, resulting in financial hardship and difficult choices for individuals. The effects of job loss vary with age, gender, and education. In the United States, middle-aged men are more vulnerable to negative effects than are older or younger men—largely because they have greater financial responsibilities than the other two groups—but women report more negative effects over time (Bambra, 2010). Research in Spain indicates that gender differences in responding to job loss are complexly related to family responsibilities and social class (Artazcoz et al., Benach, Borrell, & Cortès, 2004). Specifically, to the extent that work is viewed as one's expected contribution to the family, losing a job has a more substantial negative effect. Because this tends to apply more to men than to women, it helps explain the gender differences. However, financial pressures are often more severe for women who are single mothers. The higher one's education level, the less stress one typically feels immediately after losing a job, probably because higher education level usually results in faster reemployment (Mandemakers & Monden, 2013). Because unemployment rates for many ethnic minority groups are substantially higher than for European Americans (Bureau of Labor Statistics, 2013b), the effects of unemployment are experienced by a greater proportion of people in these groups. Cultural differences need to be considered in understanding the effects of unemployment (Grosso & Smith, 2012). Compared with European Americans, however, it usually takes minority workers longer to find another job. How long you are unemployed also affects how people react. People who are unemployed for at least a year perceive their mental health significantly more negatively than either employed people or those who have removed themselves from the labor force (e.g., have stopped looking for work) (Pharr, Moonie, & Bungum, 2012). Those who lost their jobs involuntarily feel a loss of control over their "work" environment and feel less demand placed on them. Importantly, a reasonable amount of "demand" is critical to maintaining good health, whereas too little demand has a negative effect on one's health. Research also offers some advice for adults who are trying to manage occupational transitions (Ebberwein, 2001): Approach job loss with a healthy sense of urgency. Consider your next career move and what you must do to achieve it, even if there are no prospects for it in sight. Acknowledge and react to change as soon as it is evident. Be cautious of stopgap employment. Identify a realistic goal and then list the steps you must take to achieve it. Think About It What are some of the broader effects of unemployment on an individual's personal and family life? In addition, the U.S. Department of Labor offers tips for job seekers, as do online services such as LinkedIn, which also provides networking groups. These steps may not guarantee that you will find a new job quickly, but they will give you a better sense that you are in control. What appears to make a difference is maintaining a positive attitude before and after job loss (Waters et al., 2014). Test Yourself 12.3 Recall One response to the pressures of a global economy and an aging workforce is to provide . SOLUTION ↓ Two factors that may cause involuntary occupational change are economic trends and . SOLUTION ↓ Fear of job loss is often a more important determinant of stress than is . SOLUTION ↓ The age group that is most at risk for negative effects of job loss is . SOLUTION ↓ Interpret The trend toward multiple careers is likely to continue and become the norm. What implications will this have for theories of career development? Apply You have been asked to design a program to help employees cope with losing their job. What key components would you include in this program?

Lifelong Learning

Many people work in occupations in which information and technology change rapidly. To keep up with these changes, many organizations and professions now emphasize the importance of learning how to learn, rather than learning specific content that may become outdated in a couple of years. Workers in many professions—such as medicine, nursing, social work, psychology, auto mechanics, and teaching—are now required to obtain continuing education credits to stay current in their fields. Helen King/Comet/Corbis Most occupations require the acquisition of new information over time through lifelong learning so that workers can do their job well and stay up to date on the latest information. Lifelong learning is gaining acceptance as the best way to approach the need for continuing education and for retraining displaced workers. But should lifelong learning be approached as merely an extension of earlier educational experiences? Knowles, Swanson, and Holton (2005) argue that teaching aimed at children and youth differs from teaching aimed at adults. Adult learners differ from their younger counterparts in several ways: Adults have a higher need to know why they should learn something before undertaking it. Adults enter a learning situation with more and different experience on which to build. Adults are most willing to learn those things they believe are necessary to deal with real-world problems rather than abstract, hypothetical situations. Most adults are more motivated to learn by internal factors (such as self-esteem or personal satisfaction) than by external factors (such as a job promotion or pay raise). Lifelong learning is becoming increasingly important, but educators need to keep in mind that learning styles change as people age. Effective lifelong learning requires smart decisions about how to keep knowledge updated and which approach will work best among the many different learning options available (Janssen et al., 2007). Nowhere is this more apparent than in people's experiences when they are faced with upgrading their smartphone or the software or apps on their computer or tablet. As described in the Spotlight on Research feature, software companies would do well to take into account differences in expertise and in learning when designing updated versions of familiar programs and apps. Spotlight on Research Designing Software for Middle-Aged and Older Nonexperts Who were the investigators, and what was the aim of the study? Ali Darejeh and Dalbir Singh (2014) observed that software companies such as Microsoft periodically make significant changes to their core products. Such changes are often well-founded and greatly enhance the functionality of the program or app. However, the changes may be difficult for some people to adapt to, thereby impairing their ability to use the program or app effectively and efficiently. Darejeh and Singh were especially interested in how well middle-aged adults could learn how to use the Ribbon interface in Microsoft (MS) Office Outlook, as the introduction of the Ribbon was a major design change. How did the investigators measure the topic of interest? Darejeh and Singh observed participants' actions while they were using MS Outlook. Participants also completed several evaluation forms, and they were interviewed. Who were the participants in the study? The participants were four men and six women staff or students of Apple English Institute in Kuala Lumpur, Malaysia, between the ages of 52 and 66. None of the participants had significant background knowledge about computers, worked on computers daily, were very familiar with programming languages, or were proficient with Microsoft Outlook. What was the design of the study? The design was a longitudinal design that lasted 62 days during which tasks to be completed on MS Office were assigned (e.g., create a new e-mail and attach a file to it; create a new meeting). Sessions lasted 45 minutes each. Were there ethical concerns with the study? There were no ethical concerns as participants were appropriately informed about the study. What were the results? Darejeh and Singh found that only two of the nine tasks could be completed by more than half the participants using MS Outlook as designed by Microsoft. However, based on interviews and other assessments, Darejeh and Singh redesigned the MS Outlook interface to include such changes as using more meaningful icons, showing only those tools that were useful for the tasks at hand, and providing more complete descriptions of how tools are used. When this redesigned interface was provided, all but one of the tasks was completed by at least 80% of the participants. What did the investigators conclude? Darejeh and Singh concluded that users who are not experts learn better when provided more appropriately designed interfaces with embedded help. The redesigned interface greatly improved self-learning as measured by a decrease in the time and in the number of steps needed as well as much improved performance. In sum, upgrades to software need to take learner differences into account. What converging evidence would strengthen their conclusions? Future research should include people at different levels of expertise with the target software or app, and participants should be of a wider age range.

divorce

Most couples enter marriage with the idea that their relationship will be permanent. Unfortunately, fewer and fewer couples experience this permanence. Rather than growing together, many couples grow apart. Who Gets Divorced and Why? You or someone you know has experienced divorce. No wonder. Divorce in the United States is common—couples who marry in the United States today have about a 50-50 chance of divorce (National Center for Health Statistics, 2013a). The odds are even worse if you marry young: For couples between 20 and 24 at the time of marriage, the odds are about 60% for divorce. But there is good news. The divorce rate has been slowly declining in the United States since it peaked in the late 1970s and early 1980s. In part, that's due to people being more serious about marriage and waiting longer to marry and in part to a greater social acceptance of cohabitation as an alternative. What about other countries? As you can see in Figure 11.7, the divorce rate in nearly every other country is lower than that of the United States (National Center for Health Statistics, 2013a; United Nations, 2010). However, divorce rates in nearly every developed country have increased over the past several decades (United Nations, 2010). Figure 11.7. National Center for Health Statistics. (2010b). Marriage and divorce. Retrieved October 17, 2010, from http://www.cdc.gov/nchs/fastats/divorce.htm. United Nations. (2010). Divorces and crude divorce rates by urban/rural residence: 2004-2008. Retrieved October 17, 2010, from http//www.unstats.un.org/unsd/demographic/products/dyb/dyb2008/Table25.pdf. Divorces and crude divorce rates by urban/rural residence: 2008-2012. Retrieved May 13, 2014 from http://unstats.un.org/unsd/demographic/products/dyb/dyb2012/Table24.pdf The United States has one of the highest divorce rates in the world. Of those marriages ending in divorce, African American and Asian American couples tended to be married longer at the time of divorce than do European American couples, and ethnically mixed marriages are at greater risk (National Center for Health Statistics, 2013a). People with higher levels of education tend to have lower rates of divorce (Cherlin, 2013). Research indicates that men and women tend to agree on the reasons for divorce (Braver & Lamb, 2013). Infidelity is the most commonly reported cause, followed by incompatibility, drinking or drug use, and growing apart. An individual couple's specific reasons for divorcing vary with gender, social class, and life-course variables. Former husbands and wives are more likely to blame their ex-spouses than themselves for the problems that led to the divorce. Former husbands and wives agree, however, that the women were more likely to have initiated the divorce. Why people divorce has been the focus of much research. A great deal of attention has been devoted to the notion that success or failure depends critically on how couples handle conflict. Although conflict management is important, it has become clear from research in couples therapy that the reasons couples split are complex (Kayser, 2010). Gottman and Levenson (2004) proposed a bold framework for understanding divorce. They developed two models that predict divorce early (within the first seven years of marriage) and later (when the first child reaches age 14) with 93% accuracy over the 14-year period of their study. Negative emotions displayed during conflict between the couple predict early divorce but not later divorce. Longitudinal research with European and African American couples over a 16-year period demonstrates that how couples deal with conflict changes over time (Birditt et al., 2012). In general, European American wives and African American couples use more accommodating and fewer destructive and quiet withdrawal behaviors over time, indicating that they are looking for ways to defuse conflict and are working through difficult issues more effectively. European American husbands tend to remain consistent in their behaviors, perhaps because they use less withdrawal early in the marriage. These findings explain why the odds for divorce are higher earlier in marriage: Couples married for shorter times are less able to deal effectively with conflict. Gottman's framework and the research it has generated is important because it clearly shows that the way couples express emotion is critical to marital success. Couples who divorce earlier typically do so because of high levels of negative feelings (e.g., contempt, criticism, defensiveness, stonewalling) experienced as a result of intense marital conflict. But for many couples, such intense conflict is generally absent. Although this makes it easier to stay in a marriage longer, the absence of positive emotions eventually takes its toll and results in later divorce. For a marriage to last, people need to be told that they are loved and that what they do and feel really matters to their partner. But we must be cautious about applying Gottman's model to all married couples. Kim, Capaldi, and Crosby (2007) reported that Gottman's variables predicting early divorce did not hold in a sample of lower-income, high-risk couples. However, Coan and Gottman (2007) point out that sample differences among the various studies means that, as noted in Chapter 1, conclusions about the predictive model must be drawn carefully. The high divorce rate in the United States has led to many approaches to increase the likelihood that marriages will last. One approach to keeping couples together, termed covenant marriage, makes divorce much harder to obtain. Covenant marriage expands the marriage contract to a lifelong commitment between the partners within a supportive community. This approach is a religious-centered view founded on the idea that if getting married and getting divorced were grounded in religious and cultural values and divorce was made more difficult, couples would be more likely to stay together. The couple wanting to celebrate a covenant marriage agrees to participate in mandatory premarital counseling, and should problems arise later, the grounds for divorce become very limited (White, 2010). Other approaches to decreasing the likelihood of divorce focus on teaching couples the skills necessary for maintaining strong relationships, such as good communication skills and joint problem-solving strategies. Research related to these initiatives has focused on the positive aspects of marriage and on the need to do a better job with marriage education (Fincham & Beach, 2010). Will they succeed in helping couples stay married longer? That remains to be seen. What Do You Think? Does Marriage Education Work? The Healthy Marriage Initiative really focused a great deal of attention on ways to lower the divorce rate (Fincham & Beach, 2010). One approach endorsed by many groups, called marriage education, is based on the idea that the more couples are prepared for marriage, the better the relationship will survive over the long run. More than 40 states have initiated some type of education program. Do they work? Most education programs focus on communication between the couple; the programs provide general advice, not specific ways to deal with a couple's issues. Because only a minority of couples currently attend a marriage education program, there is plenty of room for improvement. Several religious denominations have their own version of marriage education programs; the Catholic's Pre-Cana program is one example. There are numerous challenges to more extensive community-based marriage education programs. For example, in some cases, the education programs were originally developed to address poverty (Administration for Children and Families, 2010). Many couples cohabit and are less likely to attend marriage education programs even though there is little evidence that cohabitation improves communication skills between the couple (Fincham & Beach, 2010). As a result, versions of marriage education programs are being adapted for younger adults (who, if they marry while young, have a much higher risk for divorce) and for single adults (to teach them about communication skills). In addition, programs timed at key transition points (e.g., engagement) have also been developed (Halford, Markman, & Stanley, 2008). Rather than intervene with couples before they marry, some programs target already-married couples (O'Halloran et al., 2013). One of the best known of these programs is Worldwide Marriage Encounter. Research to date shows that these skills-based education programs have modest but consistently positive effects on marital quality and communication (Cowan, Cowan, & Knox, 2010; O'Halloran et al., 2013). Perhaps not surprisingly, couples who report more problems at the beginning of the program appear to benefit most. These positive outcomes are resulting in a broadening of the approaches used by marriage educators to topics beyond communication. How these programs develop and whether more couples will participate remain to be seen. What does appear to be the case is that if couples agree to participate in a marriage education program, they may lower their risk for problems later on. What do you think? Would you be willing to participate in a marriage education program? Effects of Divorce on the Couple Although changes in attitudes toward divorce have eased the social trauma associated with it, divorce still takes a high toll on the psyche of the couple. Research in the United States and Spain shows great similarity in how both partners in a failed marriage feel: deeply disappointed, misunderstood, and rejected (Doohan, Carrère, & Riggs, 2010; Yárnoz-Yaben, 2010). Unlike the situation of a spouse dying, divorce often means that one's ex-spouse is present to provide a reminder of the unpleasant aspects of the relationship and, in some cases, feelings of personal failure. Divorced people suffer negative health consequences as well (Lamela, Figueiredo, & Bastos, 2014). As a result, divorced people are typically unhappy in general, at least for a while (Doohan et al., 2010). The effects of a divorce can even be traced to generations not yet born because of the long-term negative consequences on education and parent-child relations in future generations (Amato & Cheadle, 2005). Divorced people sometimes find the transition difficult; researchers refer to these problems as "divorce hangover" (Walther, 1991). Divorce hangover reflects divorced partners' inability to let go of the former marriage or partner, develop new friendships, or reorient themselves as single parents (if there are children). Indeed, ex-spouses who are preoccupied with thoughts of—and who have high feelings of hostility toward—their former partner have significantly poorer emotional well-being than ex-spouses who are not so preoccupied or who have feelings of friendship toward the former partner (Braver & Lamb, 2013). Both low preoccupation and forgiveness may be indicators that ex-spouses are able to move on with their lives. Divorce in middle age has some special characteristics. If women initiate the divorce, they report self-focused growth and optimism; if they did not initiate the divorce, they tend to ruminate and feel vulnerable (Sakraida, 2005). However, in both cases, they report changes in their social networks. Middle-aged women are at a significant disadvantage for remarriage—an especially traumatic situation for women who obtained much of their identity from their roles as wife and mother. We must not overlook the financial problems that many divorced women face (Braver & Lamb, 2013). These problems are especially keen for the middle-aged divorcee who may have spent years as a homemaker and has few marketable job skills. For her, divorce presents an especially difficult financial hardship, which is intensified if she has children in college and the father provides little support. Relationships with Young Children When it involves children, divorce becomes a complicated matter, especially when viewed from a global perspective (Amato & Boyd, 2014). In most countries, mothers tend to obtain custody but often do not obtain sufficient financial resources to support the children. This puts an extreme financial burden on divorced mothers, whose standard of living is typically reduced. In contrast, divorced fathers often pay a higher psychological price. Although many would like to remain active in their children's lives, few actually do. Child support laws in some states also may limit fathers' contact with their children (Wadlington, 2005). When mothers who have custody remarry, visits from noncustodial fathers usually decline (Anderson & Greene, 2013). One hopeful direction that addresses the usually difficult custody situations following divorce is the Collaborative Divorce Project, based on collaborative law (Mosten, 2009; Pruett, Insabella, & Gustafson, 2005). Collaborative divorce is a voluntary, contractually based alternative dispute resolution process for couples who want to negotiate a resolution of their situation rather than have a ruling imposed on them by a court or an arbitrator (Ballard et al., 2014). Collaborative divorce is an intervention designed to assist the parents of children 6 years and younger as they begin the separation/divorce process. Early results from this approach are positive (DeLucia-Waack, 2010). In addition to positive evaluations from both parents, couples benefited in terms of less conflict, greater father involvement, and better outcomes for children than in the control group. Attorneys and court records indicate that intervention families were more cooperative and were less likely to need custody evaluations and other costly services. The Collaborative Divorce Project is evidence that programs can be designed and implemented to benefit all members of the family. Divorce and Relationships with Adult Children We saw in Chapter 5 that young children can be seriously affected by their parents' divorce. But what happens when the parents of adult children divorce? Are adult children affected, too? It certainly looks that way. Young adults whose parents divorce experience a great deal of emotional vulnerability and stress (Cooney & Uhlenberg, 1990). One young man put it this way: The difficult thing was that it was a time where, you know, [you're] making the transition from high school to college . . . your high school friends are dispersed . . . they're all over the place. . . . It's normally a very difficult transition [college], new atmosphere, new workload, meeting new people. You've got to start deciding what you want to do, you've got to sort of start getting more independent, and so forth. And then at the same time you find out about a divorce. You know, it's just that much more adjustment you have to make. (Cooney et al., 1986) Think About It Given the serious impact of divorce, what changes in mate selection might lower the divorce rate? The effects of experiencing the divorce of one's parents while growing up can be quite long-lasting. College-age students report poorer relations with their parents if their parents are divorced (Yu et al., 2010). Parental divorce also affects young adults' views on intimate relationships and marriage, often having negative effects on them (Ottaway, 2010). Wallerstein and Lewis (2004) report the findings from a 25-year follow-up study of individuals whose parents divorced when they were between 3 and 18 years old. Results show an unexpected gulf between growing up in intact versus divorced families as well as the difficulties that children of divorce encounter in achieving love, sexual intimacy, and commitment to marriage and parenthood. Even when the length of time spent in the intact two-parent family was taken into account, negative effects of divorce on adult children were still found in a large Dutch study (Kalmijn, 2013). The "marriage protection" factor outweighed biological relatedness, especially for fathers. There is no doubt that divorce has significant effects regardless of when it occurs in a child's life.

Depression

Most people feel down or sad from time to time, perhaps in reaction to a problem at work or in one's relationships. But does this mean that most people are depressed? How is depression diagnosed? Are there age-related differences in the symptoms examined in diagnosis? How is depression treated? First of all, let's dispense with a myth. Contrary to the popular belief that most older adults are depressed, for healthy people, the rate of severe depression declines from young adulthood to old age as shown in Figure 14.11; the average age of onset is one's early thirties (National Institute of Mental Health, 2013). However, this downward age trend does not hold in all cultures; for example, depressive symptoms among Chinese older adults rose over a 24-year period (1987-2010, inclusive) (Shao et al., 2013). Rates for depression tend to be equivalent for Latino and European American older adults, while rates for African American and Asian older adults are lower (Jimenez et al., 2010). For those people who do experience depression, let's examine its diagnosis and treatment. Figure 14.11. Source: National Institute of Mental Health. (2013). Major depressive disorder among adults. Retrieved from www.nimh.nih.gov/statistics/1mdd_adult.shtml. 12-month Prevalence of Depression Among All U.S. Adults by Age. How Is Depression Diagnosed in Older Adults? Depression in later life is usually diagnosed on the basis of two clusters of symptoms that must be present for at least two weeks: feelings and physical changes. As with younger people, the most prominent symptom of depression in older adults is feeling sad or down, termed dysphoria. But whereas younger people are likely to label these feelings directly as "feeling depressed," older adults may refer to them as "feeling helpless" or in terms of physical health such as "feeling tired" (Segal, Qualls, & Smyer, 2011). Older adults are also more likely than younger people to appear apathetic and expressionless, to confine themselves to bed, to neglect themselves, and to make derogatory statements about themselves. The second cluster of symptoms includes physical changes such as loss of appetite, insomnia, and trouble breathing (Segal et al., 2011). In young people, these symptoms usually indicate an underlying psychological problem, but in older adults, they may simply reflect normal, age-related changes. Thus, older adults' physical symptoms of depression must be evaluated very carefully (Whitbourne & Spiro, 2010; Wiebe, Cassoff, & Gruber, 2012). A third cluster of symptoms concerns memory problems, which are also a common long-term feature of depression in older adults (González, Bowen, & Fisher, 2008). An important step in diagnosis is ruling out other possible causes of the symptoms. For example, other physical health problems, neurological disorders, side effects of medication, metabolic conditions, and substance abuse can cause behaviors that resemble depression (Segal et al., 2011; Whitbourne & Spiro, 2010). For many minorities, immigration status and degree of acculturation and assimilation are key factors to consider (Jimenez et al., 2010), as is the stress from multiple roles. For example, Native American custodial grandparents show more symptoms of depression than do their European American counterparts (Letiecq, Bailey, & Kurtz, 2008). Finally, it is important to establish whether the symptoms interfere with daily life. Can the person carry out normal responsibilities at home? How well does he or she interact with others? There must be clear evidence that daily life is affected. What Causes Depression? There are two main schools of thought about the causes of depression. One focuses on biological and physiological processes, particularly on imbalances of specific neurotransmitters, genetic predisposition, and brain changes (McKinney & Sibille, 2013). Research evidence indicates that the most likely cause of severe depression in later life is an imbalance in neurotransmitters such as low levels of serotonin and the action of brain-derived neurotrophic factor (Hashimoto, 2013). The general view that severe depression has a biochemical basis underlies current approaches to drug therapies, discussed a little later in the chapter. The second view focuses on psychosocial factors, such as loss and internal belief systems. Although several types of loss or negative events have been associated with depression—including loss of a spouse, a job, or one's health—it is how a person interprets a loss, rather than the event itself, that causes depression (Segal et al., 2011). In this approach, internal belief systems, or what one tells oneself about why certain things are happening, are emphasized as the cause of depression. For example, experiencing an unpredictable and uncontrollable event such as the death of a spouse may cause depression if you believe it happened because you are a bad person (Beck, 1967). People who are depressed tend to believe that they are personally responsible for all the bad things that happen to them, that things are unlikely to get better, and that their whole life is a shambles. How Is Depression Treated in Older Adults? Regardless of how severe depression is, people benefit from treatment, often through a combination of medication and psychotherapy (Segal et al., 2011). Most medications used to treat depression work by altering the balance of specific neurotransmitters in the brain (Jainer et al. 2013). For very severe cases of depression, medications such as selective serotonin reuptake inhibitors (SSRIs), heterocyclic antidepressants (HCAs), or monoamine oxidase (MAO) inhibitors can be administered. SSRIs are the medication of first choice because they have the lowest overall side effects of any antidepressant. SSRIs work by boosting the level of serotonin, which is a neurotransmitter involved in regulating moods. If SSRIs are not effective, the HCAs are the next family of medications. However, HCAs cannot be used if the person is also taking medications to control hypertension or has certain metabolic conditions. As a last resort, MAO inhibitors may be used. But MAO inhibitors cause dangerous, potentially fatal interactions with foods—such as cheddar cheese, wine, and chicken liver—containing tyramine or dopamine. Either as an alternative to medication or in conjunction with it, psychotherapy is also a popular approach to treating depression. Two forms of psychotherapy have been shown to be effective with older adults. The basic idea in behavior therapy is that depressed people experience too few rewards or reinforcements from their environment. Thus, the goal of behavior therapy is to increase the good things that happen and minimize the negative things (Lewinsohn, 1975). This is often accomplished by having people increase their activities; simply by doing more, the likelihood that something nice will happen is increased. In addition, behavior therapy seeks to get people to reduce the negative things that happen by learning how to avoid them. The net increase in positive events and net decrease in negative events comes about through practice and homework assignments during the course of therapy, such as going out more or joining a club to meet new people. A second effective approach is cognitive therapy, which is based on the idea that maladaptive beliefs or cognitions about oneself are responsible for depression. From this perspective, those who are depressed view themselves as unworthy and inadequate, the world as insensitive and ungratifying, and the future as bleak and unpromising (Beck et al., 1979). In a cognitive therapy session, a person is taught how to recognize these thoughts and to reevaluate the self, the world, and the future more positively, resulting in a change in the underlying beliefs. Cognitive therapy is especially effective with older adults (Jeste & Palmer, 2013). The most important fact to keep in mind about depression is that it is treatable. Thus, if an older person behaves in ways that indicate depression, it is a good idea to have him or her examined by a mental health professional. Even if the malady turns out not to be depression, another underlying and possibly treatable condition may be uncovered. A major health care problem in the United States is that less than 40% of adults of all ages receive minimally adequate treatment for depression (National Institute of Mental Health, 2013)

primary control

behavior aimed at affecting the individual's external world

social norms approach

behavior is considered abnormal if it deviates greatly from accepted social standards, values, or norms: changing the culture of drinking in college to something college students do not do

what happens to intelligences as you age

fluid intelligence declines throughout adulthood, whereas crystallized intelligence improves

cohort effects

occur when differences between age groups are due to the groups growing up in different time periods

rites of passage

rituals marking initiation into adulthood, often among the most important ones in a culture

social clock

tagging future events with a particular time or age by which they are to be completed

what increases likeliness of drinking in college students

-alcohol is readily available -member of fraternity or sorority -feel positively about what they're doing -being a women

how does the way men and women deal with intense emotions when faced with real danger differ

-men: tend go be highly confident in their ability to extract themselves from tough positions and do nit feel the need to rehearse just in case -women: more likely to have qualms, ease them by rehearsing

neuroscience and intelligences as brain ages

-neuroscience research indicates that white matter integrity in the brain during adulthood and late life is related in complex ways to reasoning, flexibility in thinking, and speed of processing -increase in crystallized intelligence (at least until late life) indicates that people continue to add knowledge every day, which may be reflected in the continual development of cognitive networks

ethical issues

An ambulance screeches to a halt, and emergency personnel rush a woman into the emergency room. As a result of an accident at a swimming pool, she has no pulse and no respiration. Working rapidly, the trauma team reestablishes a heartbeat through electric shock. A respirator is connected. An EEG and other tests reveal extensive and irreversible brain damage—she is in a persistent vegetative state. What should be done? This is an example of the kinds of problems faced in the field of bioethics , the study of the interface between human values and technological advances in health and life sciences. Bioethics grew from two bases: respect for individual freedom and the impossibility of establishing any single version of morality by rational argument or common sense. Both of these factors are increasingly based on empirical evidence and cultural contexts (Priaulx, 2013; Sherwin, 2011). In practice, bioethics emphasizes the importance of individual choice and the minimization of harm over the maximization of good. That is, bioethics requires people to weigh how much the patient will benefit from a treatment relative to the amount of suffering he or she will endure as a result of the treatment. Examples of the tough choices required are those facing cancer patients about aggressive treatment that is likely to be fatal in any case and those facing family members about whether to turn off a life-support machine that is attached to their loved one. In the arena of death and dying, the most important bioethical issue is euthanasia —the practice of ending life for reasons of mercy. The moral dilemma posed by euthanasia becomes apparent when we try to decide the circumstances under which a person's life should be ended, which implicitly forces one to place a value on the life of another (Bedir & Aksoy, 2011; Munoz & Fox, 2013; Verheijde, 2010). It also makes us think about the difference between "killing" and "letting die" at the end of life (Dickens, Boyle, & Ganzini, 2008). In our society, this dilemma occurs most often when a person is being kept alive by machines or when someone is suffering from a terminal illness. This is the situation confronting Ernesto and Paulina in the opening vignette. Euthanasia Euthanasia can be carried out in two different ways: actively and passively (Moeller, Lewis, & Werth, 2010). Active euthanasia involves the deliberate ending of someone's life, which may be based on a clear statement of the person's wishes or be a decision made by someone else who has the legal authority to do so. Usually, this involves situations in which people are in a persistent vegetative state or suffer from the end stages of a terminal disease. Examples of active euthanasia would be administering a drug overdose or ending a person's life through so-called mercy killing. A second form of euthanasia, passive euthanasia , involves allowing a person to die by withholding available treatment. For example, a ventilator might be disconnected, chemotherapy might be withheld from a patient with terminal cancer, a surgical procedure might not be performed, or food might be withdrawn. Some ethicists and medical professionals do not differentiate active and passive euthanasia. For example, the European Association of Palliative Care (EAPC, 2011) established an ethics task force that opposes euthanasia and claims that the expression "passive euthanasia" is a contradiction in terms because any ending of a life is by definition active. Despite these concerns, Garrard and Wilkinson (2005) conclude that there really is no reason to abandon the category provided it is properly and narrowly understood and provided "euthanasia reasons" for withdrawing or withholding life-prolonging treatment are carefully distinguished from other reasons, such as family members not wanting to wait to divide the patient's estate. Still, whether there is a difference between active and passive euthanasia remains controversial (Busch & Rodogno, 2011). Most Americans favor such actions as disconnecting life support in situations involving patients in a persistent vegetative state, withholding treatment if the person agrees or is already in the later stages of another terminal illness, and even involving the concept of assisted death. But feelings also run strongly against such actions for religious and other reasons (Bedir & Aksoy, 2011; Meilaender, 2013; Verheijde, 2010). Even political debates can incorporate the issue, as demonstrated in the United States when opponents of President Obama's health care reform falsely claimed that "death panels" would make decisions about terminating life support if the reform measure passed. Think About It How do sociocultural forces shape attitudes about euthanasia? Globally, opinions about euthanasia vary (Bosshard & Materstvedt, 2011). A systematic survey of laypersons and health care professionals in the Netherlands and Belgium found that most said that they would support euthanasia under certain specific conditions (Teisseyre, Mullet, & Sorum, 2005). Respondents assigned most importance to patients' specific requests for euthanasia and supported these requests, but they did not view patients' willingness to donate organs—without another compelling reason—as an acceptable reason to request euthanasia. However, Greek physicians and nurses oppose euthanasia while supporting the legalization of hastening the death of an advanced cancer patient (e.g., not reviving a terminal cancer patient) (Parpa et al., 2010). Other analyses show that opinions are often related to religious or political beliefs (Swinton & Payne, 2009). For example, Western Europeans tend to view active euthanasia more positively due to a lesser influence of religion and more social welfare services than do residents of Eastern European and Islamic countries, who tend to be more influenced by religious beliefs that argue against such practices (Baumann et al., 2011; Góra & Mach, 2010; Hains & Hulbert-Williams, 2013; Nayernouri, 2011). Disconnecting a life support system is one thing; withholding nourishment from a terminally ill person is quite another for many people. Indeed, such cases often end up in court. The first high-profile legal case involving passive euthanasia in the United States was brought to the courts in 1990; the U.S. Supreme Court took up the case of Nancy Cruzan, whose family wanted to end her forced feeding. The court ruled that unless clear and incontrovertible evidence is presented that an individual desires to have nourishment stopped, such as through a health care power of attorney or living will, a third party (such as a parent or partner) cannot decide to end it. A widely publicized and politicized case of disconnecting Marlise Muñoz from life support occurred in late 2013 and early 2014. This controversial case involved the termination of life support from a pregnant Marlise who had been declared brain dead. The debate involved a hospital's interpretation of Texas law, the woman's and her family's desire for life support to be terminated, and the courts. As discussed in the What Do You Think? feature, such cases reveal the difficult legal, medical, and ethical issues as well as the high degree of emotion surrounding the topic of death with dignity. What Do YOU Think? The Marlise Muñoz Case On November 26, 2013, Erick Muñoz, a firefighter in a town near Dallas, came home to find his wife, 33-year-old Marlise, lying on the kitchen floor after experiencing a blood clot in her lungs. She was rushed to John Peter Hospital in Fort Worth, where she arrived alive but not breathing. Within two days, she was declared brain dead. She had made it clear that she did not wish to be left on life support; so her husband and parents informed the physicians in the intensive care unit of their desire to act on those views and asked the physicians to disconnect her from the machine. The physicians refused. Why? Marlise was 14 weeks pregnant, and the physicians believed that a Texas law prohibiting the removal of life support from a pregnant patient trumped the patient's and family's clear wishes. What followed was a legal battle pitting an individual's and her family's wishes not to have life prolonged by machine in the case of brain death and the belief that Texas law makes those desires irrelevant in certain cases, essentially requiring that such patients be kept alive on machines. At the core of the debate was the law, initially passed in 1989 and amended in 1999, that states that a person may not withdraw or withhold "life-sustaining treatment" from a pregnant patient. People agreed that the law was aimed at situations in which the pregnant woman was in a coma or persistent vegetative state and "alive" under the laws pertaining to the definition of death. At issue was whether the law also applied to women who were declared brain dead. The hospital decided that it did; Marlise's family argued that it did not. Laws such as the one in Texas are common; at least 31 states have laws restricting the ability of physicians to terminate life support for terminally ill pregnant women, irrespective of what those women or their families want. The Texas law requires that life support be maintained no matter how far into the pregnancy the woman is. Marlise's case raised several issues for medical ethicists. Many pointed out that if she is brain dead, then she cannot be a patient, and physicians cannot be compelled to treat a deceased person. Others pointed out that because Marlise was dead and the fetus had not reached the point of being viable outside the womb, then there was no hope for the fetus. Still others argued that even if the chances for the fetus to survive to viability were remote, the fetus's rights to that chance supersede the dead mother's and her family's. On January 24, 2014, Texas state judge R. H. Wallace, Jr., ruled that Marlise, by then 22 weeks pregnant, could be disconnected from life support. The judge agreed with the family's argument that the hospital had erred in its application of the Texas law. Medical records also indicated that the fetus was "distinctly abnormal" and suffered from hydrocephalus (an accumulation of fluid in the brain) as well as a likely cardiac problem. Because the hospital decided not to appeal the ruling, Marlise was taken off the machine on January 26. Marlise's case raises numerous issues about the rights of individual patients, their families, and the unborn. Whose rights are more important? What happens if there is a conflict? Can a state overrule end-of-life decisions that reflect deep personal and religious convictions? How do medical personnel respond if they are required to keep all pregnant women on life support? Are there public obligations to cover the medical expenses in such cases? What do you think? Should Marlise Muñoz have been removed from life support? Discuss your thoughts in class. Physician-Assisted Suicide Taking one's own life through suicide has never been popular in the United States because of religious and other prohibitions. In other cultures, such as Japan, suicide is viewed as an honorable way to die under certain circumstances (Joiner, 2010). But attitudes regarding suicide in certain situations is changing. Much of this change concerns the topic of physician-assisted suicide , in which physicians provide dying patients with a fatal dose of medication that the patient self-administers. A Harris Poll released in 2011 indicated that 70% of all adult respondents (and 62% of those over age 65) agreed that people who are terminally ill, are in great pain, and have no chance of recovery should have the right to choose to end their lives. Only 17% of the respondents disagreed. By a margin of 58% to 20%, respondents supported physician-assisted suicide for such patients (Harris Interactive, 2011). A similar poll in 2012 by NPR-Truven Health Analytics showed that 55% of Americans favored physician-assisted suicide for those with less than six months to live (Hensley, 2012). Clearly, most Americans favor having a choice. Several countries—including Switzerland, Belgium, and Colombia—tolerate physician-assisted suicide. In 1984, the Dutch Supreme Court eliminated prosecution of physicians who assist in suicide if five criteria are met: The patient's condition is intolerable with no hope for improvement. No relief is available. The patient is competent. The patient makes a request repeatedly over time. Two physicians have reviewed the case and agree with the patient's request. The Dutch Parliament approved the policy in April 2001, making the Netherlands the first country to have an official policy legalizing physician-assisted suicide (Deutsch, 2001). Voters in Oregon passed the Death With Dignity Act in 1994, the first physician-assisted suicide law in the United States. Laws passed in Washington State in 2008 and Vermont in 2013 (and that are pending in several other states) are modeled after the Oregon law (Death With Dignity National Center, 2014). These laws make it legal for people to request a lethal dose of medication if they have a terminal disease and make the request voluntarily. Although the U.S. Supreme Court ruled in two cases in 1997 (Vacco v. Quill and Washington v. Glucksberg) that there is no right to assisted suicide, the Court decided in 1998 not to overturn the Oregon law. The Oregon and Washington laws are more restrictive than the law in the Netherlands (Deutsch, 2001). Both laws provide for people to obtain and use prescriptions for self-administered lethal doses of medication. The law requires that a physician inform the person that he or she is terminally ill and to describe alternative options (e.g., hospice care, pain control). The person must be mentally competent and make two oral requests and one written request, with at least 15 days between each oral request. Such provisions are included to ensure that people making the request fully understand the issues and that the request is not made hastily. Several studies have examined the impact of the Oregon law. The numbers of patients who received prescriptions and who died between 1998 and early 2011 are shown in Figure 16.1. Over the period, a total of 525 patients died under the terms of the law (Oregon Department of Human Services, 2014). Comprehensive reviews of the implementation of the Oregon law soon after its passage concluded that all safeguards worked and that such things as depression, coercion, and misunderstanding of the law were carefully screened (Orentlicher, 2000). Available data also indicate that laws such as Oregon's has psychological benefits for patients who value having autonomy in death as in life, especially in situations involving unbearable suffering (Hendry et al., 2013). Figure 16.1. Oregon Department of Human Services. (2014). Oregon's Death with Dignity Act—2013. Number of Oregon Death with Dignity Act (DWDA) prescription recipients and deaths, 1998-2013. There is no question that the debate over physician-assisted suicide will continue. As the technology to keep people alive continues to improve, the ethical issues about active euthanasia in general and physician-assisted suicide in particular will continue to become more complex and will likely focus increasingly on quality of life

Types of Leisure Activities

Leisure can include virtually any activity. To organize the options, researchers have classified leisure activities into several categories. Jopp and Hertzog (2010) developed an empirically based set of categories that includes a wide variety of activities: physical (e.g., lifting weights, backpacking, jogging), crafts (e.g., woodworking, household repairs), games (e.g., board/online games, puzzles, card games), watching TV, social-private (e.g., going out with a friend, visiting relatives, going out to dinner), social-public (e.g., attending a club meeting, volunteering), religious (e.g., attending a religious service, praying), travel (e.g., travel abroad, travel out of town), experiential (e.g., collect stamps, read for leisure, garden, knit), developmental (e.g., read as part of a job, study a foreign language, attend a public lecture), and technology use (e.g., taking pictures, using computer software, playing an instrument). © Olga Danylenko/Shutterstock.com Adults engage in many different types of leisure activities, including backpacking. More complete measures of leisure activities not only provide a better understanding of how adults spend their time but also help in clinical settings. For example, a decline in the frequency of leisure activities is associated with depression (Schwerdtfeger & Friedrich-Mei, 2009) and with a later diagnosis of dementia (Hertzog et al., 2009). Monitoring changes in levels of leisure activity during and after intervention programs can provide better outcome assessments of these interventions. Given the wide range of options, how do people pick their leisure activities? Apparently, each of us has a leisure repertoire, a personal library of intrinsically motivated activities that we do regularly and that are important for successful aging (Kleiber, 2013). The activities in our repertoire are determined by two things: perceived competence (how good we think we are at the activity compared with other people our age) and psychological comfort (how well we meet our personal goals for performance). A study of French adults revealed that as for occupations, personality factors are related to one's choice of leisure activities (Gaudron & Vautier, 2007). Other factors are important as well: income, interest, health, abilities, transportation, education, and social characteristics. For example, some leisure activities, such as downhill skiing, are relatively expensive and require transportation and reasonably good health and physical coordination for maximum enjoyment. In contrast, reading requires minimal finances (if one uses a public library) and is far less physically demanding. The use of technology in leisure activities has increased dramatically (Kuo & Tang, 2014). Facebook, Twitter, and other social networking tools for such activities as keeping in touch with family and friends, pursuing hobbies, and partaking in lifelong learning are increasingly popular. Computer gaming on the Web has also increased among adult players.

Dealing with One's Own Death

Many authors have tried to describe the dying process, often using the metaphor of a trajectory that captures the duration of time beginning with the onset of dying (e.g., from the diagnosis of a fatal disease) as well as death and the course of the dying process (Field & Cassel, 2010; Kheirbek et al., 2013). These dying trajectories vary a great deal among diseases. Some diseases, such as lung cancer, have a clear and rapid period of decline; this "terminal phase" is often used to determine eligibility for certain services (e.g., hospice, which is discussed later). Other diseases, such as congestive heart failure, have no clear terminal phase. The two approaches of describing the dying process that we will consider try to account for both types of trajectories. Kübler-Ross's Work Elisabeth Kübler-Ross changed the way we approach dying. When she began her investigations into the dying process in the 1960s, such research was controversial; her physician colleagues initially were outraged, and some even denied that their patients were terminally ill. Still, she persisted. More than 200 interviews with terminally ill people convinced her that most people experienced several emotional reactions. Using her experiences, she described five reactions that represented the ways in which people dealt with death: denial, anger, bargaining, depression, and acceptance (Kübler-Ross, 1969). Although they were first presented as a sequence, it was subsequently realized that the emotions can overlap and can be experienced in different order. Although she believed that these five stages represent the typical range of emotional development in the dying, Kübler-Ross (1974) cautioned that not everyone experiences all of them or progresses through them at the same rate or in the same order. Research supports the view that her "stages" should not be viewed as a sequence (Charlton & Verghese, 2010; Parkes, 2013). In fact, we could harm dying people by considering these stages as fixed and universal. Individual differences are great. Emotional responses may vary in intensity throughout the dying process. Thus, the goal in applying Kübler-Ross's ideas to real-world settings would be to help people achieve an appropriate death—one that meets the needs of the dying person, allowing him or her to work out each problem as it comes. A Contextual Theory of Dying Describing the process of dying is very difficult. One reason for these problems is the realization that there is no one right way to die, although there may be better or worse ways of coping (Corr, 2010a, 2010b; Corr & Corr, 2013; Corr, Corr, & Nabe, 2008). Corr identified four dimensions of the issues or tasks a dying person faces from his or her perspective: bodily needs, psychological security, interpersonal attachments, and spiritual energy and hope. This holistic approach acknowledges individual differences and rejects broad generalizations. Corr's task work approach also recognizes the importance of the coping efforts of family members, friends, and caregivers as well as those of the dying person. Kastenbaum and Thuell (1995) argue that what is needed is an even broader contextual approach that takes a more inclusive view of the dying process. They point out that theories must be able to handle people who have a wide variety of terminal illnesses and be sensitive to dying people's own perspectives and values related to death. The socio-environmental context within which dying occurs, which often changes over time, must be recognized. For example, a person may begin the dying process living independently but end up in a long-term care facility. Such moves may have profound implications for how the person copes with dying. A contextual approach would provide guidance for health care professionals and families in discussing how to protect the quality of life, provide better care, and prepare caregivers for dealing with the end of life. Such an approach would also provide research questions—for example, how does one's acceptance of dying change across various stages? Although we do not yet have a comprehensive theory of dying, we examine people's experiences as a narrative that can be written from many points of view (e.g., the patient, family members, caregivers). What emerges would be a rich description of a dynamically changing process

Employment and Volunteering

Retirement is an important life transition, one that is best understood through a life-course perspective that takes into account other aspects of one's life, such as one's marital relationship (Wickrama, O'Neal, & Lorenz, 2013). This life change means that retirees must look for ways to adapt to new routines and patterns while maintaining social integration and being active in various ways (e.g., friendship networks, community engagement). Working in Late Life For an increasing number of people, especially those whose retirement savings either took a significant drop or disappeared during the Great Recession, "retirement" involves working at least part time. Employment for them is a financial necessity to make ends meet, especially those whose entire income would consist only of Social Security benefits. For others, the need to stay employed at least part time represents a way to stay involved and serves as an income supplement. As you can see in Figure 15.6, the number of adults aged 65 and over who are in the labor force increased a great deal between 2004 and 2014. Note also that the trend has been consistently upward, indicating that the forces keeping older adults in the labor force have been acting for many years (Bureau of Labor Statistics, 2014). Figure 15.6. Bureau of Labor Statistics. (2014a). Labor Force Statistics from the Current Population Survey. Retrieved from http://data.bls.gov/timeseries/LNU02000097. Number of adults aged 65 and over in the U.S. labor force. Overall, labor force participation of older adults in the United States and other developed countries has been increasing most rapidly among women (Sterns & Chang, 2010). For the most part, this is due to more women being in the labor force during adulthood than in decades past and more older women being single and needing the income. Most older adults are employed part time, and this proportion is increasing due to the loss of full-time jobs in the Great Recession. Older workers face many challenges, not the least of which are ageism and discrimination (Jackson, 2013). Employers may believe that older workers are less capable, and there is some evidence that this translates into less likelihood of getting a job interview compared with younger or middle-aged workers, all other things being equal. Despite the fact that age discrimination laws in the United States protect people over age 40, such barriers are still widespread. The relationship between age and job performance is complex (Sterns & Chang, 2010) because it depends a great deal on the kind of job a person is considering, such as a job that involves a great deal of physical exertion or one that involves a great deal of expertise and experience. In general, older workers show more reliability (e.g., showing up on time for work), organizational loyalty, and safety-related behavior. How have companies adapted to having more older workers? One example is BMW, which has made a number of changes in its automobile assembly plants to meet the needs of older workers (de Pommereau, 2012). BMW provides physical trainers on the factory floor; laid new, softer floors; provides chairs that can be raised up and down to make tasks easier; uses larger print fonts on computer screens, and provides special shoes. The trend for companies to employ older workers, especially on a part-time basis, is likely to continue because it is a good option for companies (Beck, 2013). Some companies find that they need the expertise of older workers, and the flexibility of older workers in terms of hours and the type of benefits they need (or do not need) often make it less expensive. Consequently, "retirement" is likely to continue to evolve as a concept and is likely to include some aspect of employment well into late life. Volunteering The past few decades have witnessed a rapid growth of organizations devoted to offering opportunities to retirees. Groups at the local community level, including senior centers and clubs, promote the notion of lifelong learning and help keep older adults cognitively active. Many organizations also offer travel opportunities specifically designed for active older adults. Healthy, active retired adults also maintain community ties by volunteering (Kleiber, 2013). Older adults report that they volunteer for many reasons that benefit their well-being (Greenfield & Marks, 2005): to provide service to others, to maintain social interactions and improve their communities, and to keep active. Why do so many people volunteer? © Mike Greenlar / The Image Works Some retired adults volunteer as a way to stay active. Several factors are responsible (Tang, Morrow-Howell, & Choi, 2010): developing a new aspect of the self, finding a personal sense of purpose, wanting to share one's skills and expertise, redefining the nature and merits of volunteer work, making use of a more highly educated and healthy population of older adults, and taking advantage of expanded opportunities for people to become involved in volunteer work that they enjoy. Research in New Zealand documents that older adults find that volunteering enables them to give back to their local communities (Wiles & Jayasinha, 2013). Brown et al. (2011) maintain that volunteerism offers a way for society to tap into the vast resources that older adults offer.

Juggling Multiple Roles

When both members of a heterosexual couple with dependents are employed, who cleans the house, cooks the meals, and takes care of the children when they are ill? This question goes to the heart of the core dilemma of modern, dual-earner couples: How are household chores divided? How are work and family role conflicts handled? Dividing Household Chores Despite much media attention and claims of increased sharing in the duties, women still perform the lion's share of housework, regardless of employment status. As shown in Figure 12.8, this is true globally (Ruppanner, 2010). This unequal division of labor causes the most arguments and the most unhappiness for dual-earner couples. This is the case with Jennifer and Bill, the couple in the vignette; Jennifer does most of the housework. Figure 12.8. Source: Data from Ruppanner, L. E. (2010). Cross-national reports of housework: An investigation of the gender empowerment measure. Social Science Research, 19, 963-975. Table 1 p. 968. Women spend more time on household chores than men do, even after the children have left (empty nest). Although women still do most of the household chores, things are getting a bit better. Women have reduced the amount of time they spend on housework (especially when they are employed), and men have increased the amount of time they spend on such tasks (Saginak & Saginak, 2005). The increased participation of men in these tasks is not all that it seems, however. Most of the increase is on weekends, involves specific tasks that they agree to perform, and is largely unrelated to women's employment status. In short, the increase in men's participation has not done much to lower women's burdens around the house. Men and women view the division of labor differently. Men are often most satisfied with an equitable division of labor based on the number of hours spent, especially if the amount of time needed to perform household tasks is relatively small. Women are often most satisfied when men are willing to perform women's traditional chores (Saginak & Saginak, 2005). When ethnic minorities are studied, much the same is true concerning satisfaction. Ethnic differences in the division of household labor are also apparent. In Mexican American families with husbands born in Mexico, men help more when family income is lower and their wives contribute a proportionately higher share of the household income (Pinto & Coltrane, 2009). Comparisons of Latino, African American, and European American men consistently show that European American men help with the chores less than Latino or African American men (Omori & Smith, 2009). Work-Family Conflict When people have both occupations and children, they must figure out how to balance the demands of each. These competing demands cause work-family conflict , which is the feeling of being pulled in multiple directions by incompatible demands from one's job and one's family. Dual-earner couples must find a balance between their occupational and family roles. Because nearly 60% of married couples with children consist of dual-earner households (Bureau of Labor Statistics, 2013b), how to divide the household chores and how to care for the children have become increasingly important questions. Many people believe that in such cases, work and family roles influence each other: When things go badly at work, the family suffers, and when there are troubles at home, work suffers. That's true, but the influence is not the same in each direction (Andreassi, 2007). Whether work influences family or vice versa is a complex function of support resources, type of job, and a host of other issues (Saginak & Saginak, 2005). One key but often overlooked factor is whether the work schedules of both partners allow them to coordinate activities such as child care (van Klaveren, van den Brink, & van Praag, 2013). Left Lane Productions/Flirt/Corbis Dual-earner couples must learn how to grapple with work-family conflict in balancing job and family demands. Of course, it is important that the partners negotiate agreeable arrangements of household and child-care tasks, but we've noted that truly equitable divisions of labor are clearly the exception. Most U.S. households with heterosexual dual-worker couples still operate under a gender-segregated system: There are traditional chores for men and for women. These important tasks must be performed to keep homes safe, clean, and sanitary; these tasks also take time. The important point for women is not how much time is spent performing household chores so much as which tasks are performed. What bothers wives the most is when their husbands are unwilling to do "women's work." Men may mow the lawn, wash the car, and even cook, but they are less likely to vacuum, scrub the toilet, or change the baby's diaper. So how and when will things change? An important step is to talk about these issues with your partner. Keep communication lines open all the time and let your partner know if something is bothering you. Teaching your children that men and women are equally responsible for household chores will also help end the problem. Only by creating true gender equality—without differentiating among household tasks—will this unfair division of labor be ended. Understanding work-family conflict requires taking a life-stage approach to the issue (Blanchard-Fields, Baldi, & Constantin, 2004). For example, several studies have found that the most conflict between the competing demands of work and family occurs during the peak parenting years, when there are at least two preschool children in the home. Interrole conflict diminishes in later life stages, especially when the quality of the marriage is high. A comprehensive review of the research on the experience of employed mothers supports this conclusion (Edwards, 2012). How juggling the demands of housework and child care affect women depends on the complex interplay among the age of the children, the point in career development and advancement the woman is, and her own developmental phase. The combination of challenges that any one of these reflects changes over time. Because all of these factors are dynamic, how they help or hinder a woman in her career changes over time. In addition to the impacts on each individual, dual-earner couples often have difficulty finding time for each other, especially when both work long hours. The amount of time together is not necessarily the most important issue; as long as the time is spent in shared activities such as eating, playing, and conversing, couples tend to be happy (Ochs & Kremer-Sadlik, 2013). Especially when both partners are employed, getting all of the schedules to work together smoothly can be a major challenge. However, these joint activities are important for creating and sustaining strong relations among family members. Unfortunately, many couples find themselves in the same position as Hi and Lois; by the time they have an opportunity to be alone together, they are too tired to make the most of it. Reprinted with special permission of King Features Syndicate. The issues faced by dual-earner couples are global: for example, burnout from the dual demands of work and parenting is more likely to affect women across many cultures (Aryee et al., 2013; van Klaveren et al., 2013; Spector et al., 2005). Job satisfaction of Japanese career women declines (and turnover becomes more likely) to the extent that they have high work-family conflict (Honda-Howard & Homma, 2001). Research comparing sources of work-family conflict in the United States and China reveals that when work demands do not differ, the work pressure is a significant source of work-family conflict in both countries (Yang et al., 2000). So what effects do family matters have on work performance and vice versa? Evidence suggests that work-family conflict is a major source of stress in couples' lives. In general, women feel the work-to-family spillover to a greater extent than men, but both men and women feel the pressure (Edwards, 2012; Saginak & Saginak, 2005). The work-family conflict described here is worse for couples in the United States because Americans work more hours and have fewer vacation days compared with other developed country (Frase & Gornick, 2013). Couples can work together to help mitigate the stress, though. Most important, they can negotiate schedules around work commitments throughout their careers, taking other factors such as child care and additional time demands into account (van Wanrooy, 2013). These negotiations also should include discussion of joint activities such as meals and family activities (Ochs and Kremer-Sadlik, 2013). Test Yourself 12.4 Recall Parents report lower work-family conflict and have lower absenteeism when supervisors are sympathetic and supportive regarding . SOLUTION ↓ Men are satisfied with an equitable division of labor based on , whereas women are satisfied . SOLUTION ↓ Interpret What can organizations do to help ease work-family conflict? Apply Suppose you are the vice president for human resources and you are thinking about creating a way to help employees who face dependent care issues. What factors will you need to consider before implanting a plan?

Plasticity

concept that intellectual abilities are not fixed but can be modified under the right conditions at just about any point in adulthood

what does alcohol do to neurotransmitters

disrupts balance of neurotransmitters such as GABA (inhibits impulsiveness), glutamate (excites nervous system), norepinephrine (response to stress), dopamine, serotonin, and opioid peptides (responsible for pleasurable feelings)

when are people in the best physical shape of their lives

early twenties: the best years for strenuous work, trouble-free reproduction, and peak athletic performance

McAdam's Life Story Model

identity is based on a story of how one came into being, where they have been, where they are going, and who he/she will become (revised over time) -begin forming it late adolescence and early adulthood

role transitions

movement into the next stage of development marked by assumption of new responsibilities and duties

Baltes three concepts that are vital to intellectual development in adults

multidirectionality, interindividual variability, and plasticity

Body Mass Index (BMI)

ratio of body weight and height related to total body fat

personal control beliefs

the degree to which you believe your performance in a situation depends on something you do

Why Do People Retire?

Provided that they have good health, more workers retire by choice than for any other reason (Ekerdt, 2010; McClinton, 2010; Sterns & Chang, 2010), although economic conditions with regard to personal as well as societal matters also have powerful effects (Hairault, Langot, & Zylberberg, 2012). Individuals usually retire when they feel financially secure after considering projected income from Social Security, pensions and other structured retirement programs, and personal savings. Of course, some people are forced to retire because of health problems or because they lose their jobs. As corporations downsize during economic downturns or after corporate mergers, some older workers accept buyout packages involving supplemental payments if they retire. Others are permanently furloughed, laid off, or dismissed. The decision to retire is influenced by one's occupational history and goal expectations (Ekerdt, 2010; Hairault et al., 2012; McClinton, 2010; Sargent et al., 2013). Whether people perceive that they will achieve their personal goals through work or retirement influences the decision to retire and its connection with health and disability. The rude awakening many people received during the Great Recession was that the best made plans are only as good as external factors allow them to be, especially when it comes to financial savings and pensions. Many people lost much (and sometimes all) of these financial packages as the value of stocks plummeted and companies eliminated pension plans. Consequently, many people were forced to delay their retirement until they had the financial resources to do so or to continue working part time to supplement their income when they had not planned to do so. For example, research shows that 44% of people over age 55 in 2013 now think that they will retire beyond age 66, compared with 29% in 2003 (Employee Benefits Research Institute, 2013). In addition, many people do not have adequate savings for retirement. As you can see in Table 15.1, most people have not saved anything close to what they will need (Employee Benefits Research Institute, 2013). There has also been a decline in people's confidence that that their savings will be adequate. Those feelings get even stronger when retirement plans, such as employer pension plans, are less than promised or have been eliminated when people try and collect them. Table 15.1. Reported Total Savings and Investments Among Those Providing a Response (not including value of primary residence or defined be nefit plans) All Workers Ages 25-34 Ages 35-44 Ages 45-54 Ages 55+ Less than $10,000 46% 60% 46% 40% 36% $10,000-$24,999 11 15 12 11 7 $25,000-$49,999 9 9 11 6 9 $50,000-$99,999 10 8 10 13 8 $100,000-$249,999 12 7 13 14 18 $250,000 or more 12 2 8 16 24 SOURCE: Employee Benefit Research Institute and Mathew Greenwald & Associates, Inc., 2013 Retirement Confidence Survey. How much savings do you need to be comfortable in retirement? A decent rule of thumb is to plan for between 65% and 75% of your current income, which usually means having savings equal to about 11 times your final salary in addition to expected income from Social Security (Aon, 2013). That figure takes into account typical medical expenses. The bottom line is that longer life expectancies have added to the amount of money people will need in retirement—and that amount is usually much greater than they think. Gender and Ethnic Differences Women's experience of retiring can be quite different from men's (Everingham et al., 2007; Frye, 2008; Loretto & Vickerstaff, 2013). For example, women may enter the workforce after they have stayed home and raised children and in general have more discontinuous work histories; also, having fewer financial resources may affect women's decisions to retire. Women also tend to spend less time planning their retirement (Jacobs-Lawson, Hershey, & Neukam, 2004). For women who were never employed outside the home, the process of retirement is especially unclear (Gardiner, Stuart, Forde, Greenwood, MacKenzie, & Perrett et al., 2007; Loretto & Vickerstaff, 2013). Because they most likely were not paid for their work raising children and caring for the home, it is rare for them to have their own pensions or other sources of income in retirement. In addition, their work in caring for the home continues, often nearly uninterrupted. Not much research examines the process of retirement as a function of ethnicity. African American older adults are likely to continue working beyond age 65 (Troutman et al., 2011). However, there are no ethnic-based differences in health outcomes between African American women and men following retirement (Curl, 2007). Blend Images / Alamy We know less about the experiences of older adults of color in retirement than we do about European Americans.

Sociocultural Definitions of death

What comes to mind when you hear the word death? A driver killed in a traffic accident? A transition to an eternal reward? Flags at half-staff? A cemetery? A car battery that doesn't work anymore? Each of these possibilities represents a way in which death can be considered in Western culture, which has its own set of specific rituals (Bustos, 2007; Penson, 2004). All cultures have their own views. Some cultures pull their hair (Lewis, 2013). Melanesians have a term, mate, that includes the very sick, the very old, and the dead; the term toa refers to all other living people (Counts & Counts, 1985). Other South Pacific cultures believe that the life force leaves the body during sleep or illness; sleep, illness, and death are considered together. Thus people "die" many times before experiencing "final death." In Ghana, people are said to have a "peaceful" or "good" death if the dying person finished all business and made peace with others before death, which implies being at peace with his or her own death (van der Geest, 2004). A good and peaceful death comes "naturally" after a long and well-spent life. Such a death preferably takes place at home, which is the epitome of peacefulness, surrounded by children and grandchildren. Finally, a good death is a death that is accepted by the relatives. Max Milligan/AWL Images/Getty Image The symbols we use when people die, such as these caskets from Ghana, provide insights into how cultures think about death. Mourning rituals and states of bereavement also vary in different cultures (Lee, 2010; Norton & Gino, 2014). There is great variability across cultures in the meaning of death and in the rituals or other behaviors that are used to express grief. Some cultures have formalized periods of time during which certain prayers or rituals are performed. For example, after the death of a close relative, Orthodox Jews recite ritual prayers and cover all the mirrors in the house. The men slash their ties as a symbol of loss. In Papua New Guinea, there are accepted time periods for phases of grief (Hemer, 2010). The rituals of the Muscogee Creek tribe include digging the grave by hand and giving a "farewell handshake" by throwing a handful of dirt into the grave before covering it (Walker & Balk, 2007). Ancestor worship, a deep, respectful feeling toward individuals from whom a family is descended or who are important to the family, is an important part of customs of death in many Asian cultures (Roszko, 2010). We must keep in mind that the experiences of our culture or particular group may not generalize to other cultures or groups. Death can be a truly cross-cultural experience. The international outpouring of grief over the death of world leaders such Nelson Mandela in 2013, the thousands killed in the terrorist attacks against the United States in September 2001, and the hundreds of thousands killed in natural disasters such as the earthquake in Haiti in 2010 drew much attention to the ways in which the deaths of people we do not know personally can still affect us. It is at these times that we realize that death happens to us all and that death can simultaneously be personal and public. The many ways of viewing death can be seen in various customs involving funerals. You may have experienced a range of different types of funeral customs, from very small, private services to elaborate rituals. Variations in the customs surrounding death are reflected in some of the most iconic structures on earth, such as the pyramids in Egypt, and some of the most beautiful, such as the Taj Mahal in India. Nerissa D'Alton/Gallo images/Alamy The large international public displays of grief at the death of Nelson Mandela show that death can bring together people from around the world

Consequences of Leisure Activities

What do people gain from participating in leisure activities? Researchers have long known that involvement in leisure activities is related to well-being (Warr, Butcher, & Robertson, 2004). This relation holds in other countries, such as China, as well (Dai, Zhang, & Li, 2013). Research shows that participating in leisure activities helps promote better mental health in women, such as when they use family-based leisure as a means to help cope during their partner's military deployment (Werner & Shannon, 2013), and buffers the effects of stress and negative life events. It even helps lower the risk of mortality (Talbot et al., 2007). © Mauro Rodrigues/Shutterstock.com Participating in leisure activities improves one's well-being. Studies show that leisure activities provide an excellent forum for the interaction of biological, psychological, and sociocultural forces (Kleiber, 2013). Leisure activities are a good way to deal with stress, which—as we have seen—has significant biological effects. This is especially true for unforeseen negative events (Janoff-Bulman & Berger, 2000). Psychologically, leisure activities have been well documented as one of the primary coping mechanisms that people use (Patry, Blanchard, & Mask, 2007). How people cope using leisure varies across cultures depending on the various types of activities that are permissible and available. Likewise, leisure activities vary across social class; basketball is one activity that cuts across class because it is inexpensive, whereas downhill skiing is associated more with people who can afford to travel to ski resorts and pay the fees. How do leisure activities provide protection against stress? Kleiber (2013) summarizes four ways that leisure activities serve as a buffer against negative life events: Leisure activities distract us from negative life events. Leisure activities generate optimism about the future because they are pleasant. Leisure activities connect us to our personal past by allowing us to participate in the same activities over much of our lives. Leisure activities can be used as vehicles for personal transformation. Whether the negative life events we experience are personal, such as the loss of a loved one, or societal, such as a terrorist attack, leisure activities are a common and effective way to deal with them. They represent the confluence of biopsychosocial forces and are effective at any point in the life cycle. Participating with others in leisure activities may also strengthen feelings of attachment to one's partner, friends, and family (Otway & Carnelley, 2013). Adults use leisure as a way to explore interpersonal relationships or to seek social approval. In fact, research indicates that marital satisfaction is linked with leisure time; marital satisfaction is even helped when couples spend leisure time with others in addition to spending it just as a couple (Zabriskie & Kay, 2013). But there's no doubt that couples who play together are happier (Johnson, Zabriskie, & Hill, 2006). But what if leisure activities are pursued very seriously? In some cases, people create leisure-family conflict by engaging in leisure activities to extremes (Heo et al., 2010). Individuals who are very serious about participating in specific leisure activities may experience "flow" or being in the "zone." When things get serious, though, problems may occur. Only when there is support from others for such extreme involvement are problems avoided. For example, professional quilters felt more valued when family members were supportive (Stalp & Conti, 2011). As in most things, moderation in leisure activities is probably best, unless you know you have strong support. You have probably heard the saying that "no vacation goes unpunished." It appears to be true, and the trouble is not just afterward. Research shows that prevacation workload is associated with lower health and well-being for both men and women and that pre-vacation homeload (extra work that needs to be done at home) has the same negative effect for women (Nawijn, de Bloom, & Geurts, 2013). Once on vacation, it matters what you do. If you detach from work, enjoy the activities during vacation, and engage in conversation with your partner, the vacation can improve health and well-being, even after you return home (de Bloom, Geurts, & Kompier, 2012). However, workers report that high postvacation workloads eliminate most of the positive effects of a vacation within about a week (de Bloom et al., 2010). Restful vacations do not prevent declines in mood or in sleep due to one's postvacation workload. Think About It What effect does leisure have on adult development and aging? Test Yourself 12.5 Recall Activities in which people engage for relaxation or, enjoyment or as creative pursuits are considered activities. SOLUTION ↓ Compared with younger adults, middle-aged adults prefer leisure activities that are more family- and home-centered and . SOLUTION ↓ Being involved in leisure activities is related to . SOLUTION ↓ Interpret How are choices of leisure activities related to physical, cognitive, and social development? Apply Workers in the United States tend to take fewer vacation days compared with workers in European countries. What might the consequences of this be for U.S. workers? One frequently overlooked outcome of leisure activity is social acceptance. For persons with disabilities, this is a particularly important consideration (Choi, Johnson, & Kriewitz, 2013). There is a positive connection between frequency of leisure activities and positive identity, social acceptance, friendship development, and acceptance of differences. These findings highlight the importance of designing inclusive leisure activity programs.

Retraining Workers

When you are hired into a specific job, you are selected because your employer believes that you offer the best fit between the abilities you already have and those needed to perform the job. As most people can attest, though, the skills needed to perform a job usually change over time. Such changes may be due to the introduction of new technology, additional responsibilities, or promotion. © Pavel L Photo and Video/Shutterstock.com Each year thousands of workers around the world take seminars such as this as part of worker training and retraining programs. Unless a person's skills are kept up-to-date, the outcome is likely to be either job loss or a career plateau (McCleese & Eby, 2006; Rose & Gordon, 2010). Career plateauing occurs when there is a lack of challenge in one's job or promotional opportunity in the organization or when a person decides not to seek advancement. Research in Canada (Foster, Lonial, & Shastri, 2011), Asia (Lee, 2003), and Australia (Rose & Gordon, 2010) shows that believing one's career has plateaued usually results in less organizational commitment, lower job satisfaction, and a greater tendency to leave. But attitudes can remain positive if it is only the lack of challenge and not a lack of promotion opportunity that is responsible for the plateauing (Conner, 2014). In cases of job loss or a career plateau, retraining may be an appropriate response. Around the world, large numbers of employees participate each year in programs and courses that are offered by their employer or by a college or university and are aimed at improving existing skills or adding new job skills. For midcareer employees, retraining might focus on how to advance in one's occupation or how to find new career opportunities—for example, through résumé preparation and career counseling. Increasingly, such programs are offered online to make them easier and more convenient for people to access (Githens & Sauer, 2010). Many corporations as well as community and technical colleges offer retraining programs in a variety of fields. Organizations that promote employee development typically promote in-house courses to improve employee skills. They also may offer tuition reimbursement programs for individuals who successfully complete courses at colleges or universities. The retraining of midcareer and older workers highlights the need for lifelong learning (Agola & Awange, 2014; Sterns & Spokus, 2013). If corporations are to meet the challenges of a global economy, they must include retraining in their employee development programs. Such programs will help improve people's chances of advancing in their chosen occupations and can assist people in making successful transitions from one occupation to another. This fact is supported through history; research shows that as innovation changed the nature of work, retraining workers helped companies keep up and society to reduce poverty (Agola & Awange, 2014).

what else happens to adult thinking

people may not always purchase the product that has the least impact on the environment, such as a fully electric car, even though philosophically they are strong environmentalists because recharging stations are currently not widely available -The integration of emotion with logic that happens in adulthood provides the basis for decision making in the very personal and sometimes difficult arenas of love and work

Becoming an Expert

One day John Cavanaugh was driving along when his car suddenly began coughing and sputtering. As deftly as possible, he pulled over to the side of the road, turned off the engine, opened the hood, and proceeded to look inside. It was hopeless; to him, it looked like a jumble of unknown parts. After the car was towed to a garage, a middle-aged mechanic set about fixing it. Within a few minutes, the car was running like new. How? We saw in Chapter 10 that aspects of intelligence grounded in experience (crystallized intelligence) tend to improve throughout most of adulthood. In a real-world experiential perspective, each of us becomes an expert at something that is important to us, such as our work, interpersonal relationships, cooking, sports, or auto repair. In this sense, an expert (such as the mechanic or Kesha, the social worker in the vignette) is someone who is much better at a task than people who have not put much effort into it (such as John Cavanaugh in terms of auto repair). We tend to become selective experts in some areas while remaining rank amateurs or novices in others. What makes experts better than novices? It's how experts handle the problem (Ericsson, 2014). For novices, the goal of accomplishing the activity is to reach as rapidly as possible a satisfactory performance level that is stable and "autonomous." In contrast, experts build up a wealth of knowledge about alternative ways of solving problems or making decisions. These well-developed knowledge structures are the major difference between experts and novices, and they enable experts to bypass steps needed by novices (Chi, 2006). Experts don't always follow the rules as novices do; experts are more flexible, creative, and curious; and they have superior strategies grounded on superior knowledge for accomplishing a task (Ericsson, 2014). Even though experts may be slower in terms of raw speed because they spend more time planning, their ability to skip steps puts them at a decided advantage. In a way, this represents "the triumph of knowledge over reasoning" (Charness & Bosman, 1990). One of the outcomes of expertise appears to be a decrease in the ability to explain how one arrives at a particular answer (Boshuizen & van de Wiel, 2014). It seems that the increased efficiency that comes through merging the process with the product of thinking comes at the cost of being able to explain to others what one is doing. This could be why some instructors have a difficult time explaining the various steps involved in solving a problem to novice students but an easier time explaining it to graduate students who have more background and experience. Because these instructors may skip steps, it's harder for those with less elaborated knowledge to fill in the missing steps.

A Life-Course Approach to Dying

Suppose you learned today that you had only a few months to live. How would you feel about dying? That's what Randy Pausch, a professor at Carnegie Mellon University, faced when he was told he had had three to six months to live after his pancreatic cancer came back. What happened next, describe in the Real People feature, touched millions of people around the world. Real People Applying Human Development Randy Pausch's Last Lecture Randy Pausch was a famous computer scientist on the faculty at Carnegie Mellon University. He cofounded the Entertainment Technology Center there and invented a highly innovative way to teach computer programming, called Alice. But that's not what made him world-famous. He was a pioneer of virtual reality. Pittsburgh Post-Gazette/ZUMA Press/Newscom Randy Pausch At the age of 46, Randy was told that his pancreatic cancer had recurred and that he had between three and six months to live. So instead of just getting depressed about it, he decided to give a lecture a month later about achieving one's childhood dreams. His lecture is both moving and funny. Rather than talking about dying, Randy focused on overcoming obstacles and seizing every moment of one's life because, as he put it, "Time is all you have ... and you may find one day that you have less than you think." He spoke of his love for his wife and three children. He had a birthday cake brought onto the stage for his wife. Randy lived several more months after his lecture, dying in July 2008 at age 47. You can see Randy's lecture by searching YouTube. It was also published as a book. In a strange twist, the coauthor of the book, Jeff Zaslow, was himself killed in an automobile accident at age 53. One never knows when one's life will end; it is said that the end comes like a thief in the night. But people such as Randy Pausch help us put our own death into perspective by reminding us what is important. It probably doesn't surprise you to learn that feelings about dying vary across adulthood. For example, adults of various ages who live with a person who has a life-threatening illness come to terms with death in an individual and family-based way, and together they cocreate ways the patient meets his or her goals (Bergdahl et al., 2013; Carlander et al., 2011). Although not specifically addressed in research, the shift from formal operational thinking to postformal thinking (see Chapter 7) could be important in young adults' contemplation of death. Presumably, this shift in cognitive development is accompanied by a lessening of the feeling of immortality in adolescence to one that integrates personal feelings and emotions with their thinking. Midlife is the time when most people in developed countries confront the death of their parents. Until that point, people tend not to think much about their own death; the fact that their parents are still alive buffers them from reality. After all, in the normal course of events, our parents are supposed to die before we do. Once their parents have died, though, people realize that they are now the oldest generation of their family—the next in line to die. Reading the obituary pages, they are reminded of this, as the ages of many of the people who have died get closer and closer to their own. Probably as a result of this growing realization of their own mortality, middle-aged adults' sense of time undergoes a subtle yet profound change. It changes from an emphasis on how long they have lived to how long they have left to live, a shift that increases into late life (Cicirelli, 2006; Maxfield et al., 2010). This may lead to occupational change or some other redirection, such as improving relationships that had deteriorated over the years. In general, older adults are less anxious about death and more accepting of it compared with any other age group. Still, because the discrepancy between desired and expected number of years left to live is greater for young-old than for mid-old adults, anxiety is higher for young-old adults (Cicirelli, 2006). In part, the greater overall acceptance of death results from the achievement of ego integrity, as described in Chapter 9. For other older adults, the joy of living is diminishing. More than any other group, they have experienced loss of family and friends and have come to terms with their own mortality. Older adults have more chronic diseases (see Chapters 3 and 4), which are not likely to go away. They may feel that their most important life tasks have been completed (Kastenbaum, 1999). Understanding how adults deal with death and their consequent feelings of grief is best approached from the perspective of attachment theory (Mercer, 2011; Stroebe, Schut, & Stroebe, 2005). In this view, a person's reactions are a natural consequence of forming attachments and then losing them. We consider adult grief a little later in the chapter

Competence and Environmental Press

Understanding psychosocial aging requires paying attention to individuals' needs rather than treating all older adults alike. One way of doing this is to focus on the relation between the person and the environment (Wahl, Iwarsson, & Oswald, 2012). As discussed in Chapter 1, the competence-environmental press approach is a good example of a theory that incorporates elements of the biopsychosocial model into the person-environment relation (Lawton & Nahemow, 1973; Nahemow, 2000; Wahl et al., 2012). Competence is defined as the upper limit of a person's ability to function in five domains: physical health, sensory-perceptual skills, motor skills, cognitive skills, and ego strength. We discussed age-related changes for most of these domains in Chapter 14; ego strength, which is related to Erikson's concept of integrity, is discussed later in this chapter. These domains are viewed as underlying all other abilities and reflect biological and psychological forces. Environmental press refers to the physical, interpersonal, or social demands that environments put on people. Physical demands might include having to walk up three flights of stairs to your apartment. Interpersonal demands include having to adjust your behavior patterns to different types of people. Social demands include dealing with laws or customs that place certain expectations on people. These aspects of the theory reflect biological, psychological, and social forces. Both competence and environmental press change as people move through the life span; what you are capable of doing as a 5-year-old differs from what you are capable of doing as a 25-, 45-, 65-, or 85-year-old. Similarly, the demands put on you by the environment change as you age. Thus, the competence-environmental press framework reflects life-cycle factors as well. The competence-environmental press model, depicted in Figure 15.1, shows how the two are related. Low to high competence is represented on the vertical axis, and weak to strong environmental press is represented on the horizontal axis. Points in the figure represent various combinations of the two. Most important, the shaded areas show that adaptive behavior and positive affect (emotion) can result from many different combinations of competence and environmental press levels. Adaptation level is the area where press level is average for a particular level of competence; this is where behavior and affect are normal. Slight increases in press tend to improve performance; this area on the figure is labeled the zone of maximum performance potential . Slight decreases in press create the zone of maximum comfort , in which people are able to live happily without worrying about environmental demands. Combinations of competence and environmental press that fall within either of these two zones result in adaptive behavior and positive effect, which translate into a high quality of life. Figure 15.1. From "Ecology and the Aging Process," by M. P. Lawton and L. Nahemow. In C. Eisdorfer and M. P. Lawton (Eds.), The Psychology of Adult Development and Aging, pp. 619-674. Copyright © 1973 American Psychological Association. The competence-environmental press model. As one moves away from these areas, behavior becomes increasingly maladaptive and affect becomes negative. Notice that these outcomes, too, can result from several different combinations and for different reasons. For example, too many environmental demands on a person with low competence and too few demands on a person with high competence both result in maladaptive behaviors and negative effect. What does this mean with regard to late life? Is aging merely an equation relating certain variables? The important thing to realize about the competence-environmental press model is that each person has the potential of being well adapted to some but not all living situations. Whether people are functioning well depends on whether their abilities fit the demands of their environment. When their abilities match these demands, people adapt; when there is a mismatch, they don't. In this view, aging is more than an equation, as the best fit must be determined on an individual basis. How do people deal with changes in their particular combinations of environmental press (such as adjusting to a new living situation) and competence (perhaps due to illness)? People respond in two basic ways (Lawton, 1989; Nahemow, 2000). When people choose new behaviors to meet new desires or needs, they exhibit proactivity and exert control over their lives. In contrast, when people allow the situation to dictate their options, they demonstrate docility and have little control. Lawton (1989) argues that proactivity is more likely to occur in people with relatively high competence and docility in people with relatively low competence. This model has considerable research support. For example, it explains why people choose the activities they do (Lawton, 1982), how well people adhere to medication regimens (Morrow & Wilson, 2010), and how people adapt to changing housing needs over time (Oswald & Wahl, 2013; Pynoos, Caraviello, & Cicero, 2010) and the need to exert some degree of control over their lives (Langer & Rodin, 1976). It also helps us understand how well people adapt to various care situations, such as adult day care and residential facilities (Golant, 2012). In short, there is considerable merit to the view that aging is a complex interaction, mediated by choice, between a person's competence level and environmental press. This model can be applied in many different settings. Think About It How does the competence-environmental press approach help explain which coping strategies might work best in a particular situation? Understanding how people age usually entails taking a broader perspective than any single theory can offer. The Real People feature about Pete Seeger, folk singer and social and environmental activist, shows that both successful aging and competence-environmental press theory are important. Real People Applying Human Development Pete Seeger When Pete Seeger died on January 27, 2014, tributes to him came from a wide cross section of Americans from President Barack Obama to Bruce Springsteen to Dave Matthews. His influence on music was wide, having written or cowritten such hits as "Turn, Turn, Turn," "We Shall Overcome," and "If I Had a Hammer." He helped found the Newport Folk Festival, where Bob Dylan became famous for using an electric guitar. For his efforts at mentoring young musicians, Seeger was inducted into the Rock and Roll Hall of Fame in 1996. © Sandra A. Dunlap / Shutterstock.com Pete Seeger But Seeger's influence was not just in music. He worked his entire life on behalf of social justice for workers, for civil rights, and for environmental action and reform (especially regarding the cleanup of the Hudson River). He was investigated for his actions by the House Un-American Activities Committee, which held hearings in the 1950s. But Seeger stayed true to his beliefs, even at the detriment of his career. Seeger remained active his whole life, even winning a Grammy Award in 2009 for his album "At 89." He performed at a concert with Bruce Springsteen before Barack Obama's first inauguration. But despite his fame, Seeger never enriched himself, preferring to donate much of his income to various causes in which he believed passionately. Seeger is an excellent example of successful aging, remaining professionally active into his nineties and staying true to his values of social justice and environmental sustainability. He was able to find balance between his competence and the environmental presses he experienced, even as normative age-related changes caught up with him. He is also an excellent example of a person who remained relevant as an influence and a mentor across many generations of musicians and social activists. By using his music to send social messages, he became a force for social change. Perhaps no other person in the second half of the 20th century had such an impact using only a 5-string banjo and a 12-string guitar.

Caring for a partner

When couples pledge their love to each other "in sickness and in health," most of them envision the sickness part to be no worse than an illness lasting a few weeks. That may be the case for many couples, but for others, the illness they experience severely tests their pledge. Francine and Ron are one such couple. After 51 years of mostly good times together, Ron was diagnosed with Alzheimer's disease. When she was first contacted by researchers, Francine had been caring for Ron for six years. "At times, it's very hard, especially when he looks at me and doesn't have any idea who I am. Imagine after all these years not to recognize me. But I love him, and I know that he would do the same for me. But to be perfectly honest, we're not the same couple we once were. We're not as close; I guess we really can't be." Francine and Ron are typical of couples in which one partner cares for the other. Caring for a chronically ill partner presents different challenges from caring for a chronically ill parent. The partner caregiver assumes the new role after decades of shared responsibilities. Often without warning, the division of labor that had worked for years must be readjusted. Such change inevitably puts stress on the relationship (Haley, 2013). This is especially true when one's spouse/partner has a debilitating chronic disease. Studies of partner caregivers of persons with Alzheimer's disease show that satisfaction with the relationship is much lower than for healthy couples (Cavanaugh & Kinney, 1994; Cohen, 2013; Haley, 2013). Spousal and gay and lesbian partner caregivers report a loss of companionship and intimacy over the course of caregiving, but also more rewards compared with adult child caregivers (Croghan, Moone, & Olson, 2014; Kimmel, 2014; Raschick & Ingersoll-Dayton, 2004). Marital satisfaction is also an important predictor of spousal caregivers' reports of depressive symptoms; the better the perceived quality of the marriage, the fewer symptoms caregivers report (Kinney & Cavanaugh, 1993), a finding that holds across European American and African American spousal caregivers (Parker, 2008). Most partner caregivers adopt the caregiver role out of necessity. Although evidence about the mediating role of caregivers' appraisal of stressors is unclear, interventions that help improve the functional level of the ill partner generally improve the caregiving partner's situation (Van Den Wijngaart, Vernooij-Dassen, & Felling, 2007). daj/amana images inc./Alamy Caring for a spouse can be both extremely stressful and highly rewarding. The importance of feeling competent as a partner caregiver fits with the docility component of the competence-environmental press model presented earlier in this chapter. Caregivers attempt to balance their perceived competence with the environmental demands of caregiving. Perceived competence allows them to be proactive rather than merely reactive (and docile), which gives them a better chance to optimize their situation. Even in the best of committed relationships, providing full-time care for a partner is both stressful and rewarding in terms of the relationship (Baek, 2005; Croghan et al., 2014; Haley, 2013; Kimmel, 2014). For example, coping with a wife who may not remember her husband's name, who may act strangely, and who has a chronic and fatal disease presents serious challenges even to the happiest of couples. Yet even in that situation, the caregiving husband may experience no change in marital happiness despite the changes in his wife due to the disease

reflective judgment

way in which adults reason through real-life dilemmas

Dementia

Arguably the most serious age-related condition is dementia, a family of diseases involving serious impairment of behavioral and cognitive functioning and some form of permanent damage to the brain. Of these disorders, Alzheimer's disease is the most common. Alzheimer's Disease Alzheimer's disease causes people to change from thinking, communicative human beings to confused, bedridden victims unable to recognize their family members and close friends. Because these symptoms can be so life-changing, the fear of Alzheimer's disease among healthy older adults—especially those who are married to or related to a person with Alzheimer's disease—is often a significant concern (Kaiser & Panegyres, 2007). Millions of people are afflicted with and die from Alzheimer's disease, including such notable individuals as former U.S. President Ronald Reagan, civil rights leader Rosa Parks, and former British Prime Minister Margaret Thatcher. About 5.2 million Americans have Alzheimer's disease, which cuts across ethnic, racial, and socioeconomic groups (Alzheimer's Association, 2014). The prevalence increases with age, rising from extremely low rates in the fifties to about half of all people aged 85 and older. As the number of older adults increases rapidly over the next several decades, the number of cases is expected to roughly triple. Alan Oddie/PhotoEdit Alzheimer's disease involves memory loss to an extent that may include forgetting the names of family members. What Are the Symptoms of Alzheimer's Disease? The key symptoms of Alzheimer's disease are gradual declines in memory, learning, attention, and judgment; confusion as to time and place; difficulties in communicating and finding the right words; decline in personal hygiene and self-care skills; inappropriate social behavior; and changes in personality. These classic symptoms may be vague and may occur only occasionally in the beginning with little behavioral impact, but as the disease progresses, the symptoms become more pronounced and are exhibited more regularly (Gaugler et al., 2014). Wandering away from home and not being able to remember how to return increases. Delusions, hallucinations, and other related behaviors develop and get worse over time. Spouses become strangers. Patients may not even recognize themselves in a mirror; they wonder who is looking back at them. In its advanced stages, Alzheimer's disease often causes incontinence, the loss of control of bladder or bowels. It may also result in a total loss of mobility. Victims eventually become completely dependent on others for care. At this point, many caregivers seek facilities such as adult day-care centers and other sources of help, such as family and friends, to provide a safe environment for the Alzheimer's patient while the primary caregiver is at work or needs to run basic errands. The rate of deterioration in Alzheimer's disease varies widely from one patient to another but averages around 12 years from onset of symptoms, although progression usually is faster when onset occurs earlier in adulthood (Gandy & DeKosky, 2013; Zerr, 2013). It is very difficult to predict how long a specific patient will survive, which only adds to the caregiver's stress (Cavanaugh & Nocera, 1994). Think About It How do the memory problems in Alzheimer's disease differ from those in normal aging? How Is Alzheimer's Disease Diagnosed? Given that the behavioral symptoms of Alzheimer's disease eventually become quite obvious, one would assume that diagnosis would be straightforward. Quite the contrary. In fact, despite intensive research to find specific indicators, absolute certainty that a person has Alzheimer's disease cannot be achieved while the individual is alive (Gaugler et al., 2014). Definitive diagnosis must be based on an autopsy of the brain after death because the defining criteria for diagnosing Alzheimer's disease involve documenting large numbers of amyloid plaques and neurofibrillary tangles, structural changes in neurons that occur normally with age but in very large numbers and much earlier in Alzheimer's disease. Of course, one is still left with the issue of figuring out whether a person probably has Alzheimer's disease while he or she is still alive. Although not definitive, the number and severity of behavioral changes lead clinicians to make fairly accurate diagnoses of probable Alzheimer's disease (Gaugler et al., 2014). Several brief screening measures have been developed, with some, such as the 7-Minute Screen (Ijuin et al., 2008), showing about 90% accuracy. Greater accuracy depends on a broad-based and thorough series of medical and psychological tests, including complete blood tests, metabolic and neurological tests, and neuropsychological tests (Reitz & Mayeux, 2014). A great deal of diagnostic work goes into ruling out virtually all other possible causes of the observed symptoms. This effort is essential. Because Alzheimer's disease is an incurable, fatal disease, every treatable cause of the symptoms must be explored first. In essence, Alzheimer's disease is diagnosed by excluding all other possible explanations. A model plan for making sure the diagnosis is correct is shown in Figure 14.12. Figure 14.12. Alzheimer's Association online document, developed and endorsed by the TriAD Advisory Board. Copyright 1996 Pfizer Inc. and Esai Inc. with special thanks to J. L. Cummings. Algorithm reprinted from TriAD, Three for the Management of Alzheimer's Disease. Diagnosing Alzheimer's disease requires a thorough process of ruling out other possibilities. In an attempt to be as thorough as possible, clinicians usually interview family members about their perceptions of the observed behavioral symptoms. Most clinicians view this information as critical to understanding the history of the difficulties the person is experiencing. However, research indicates that spouses are often inaccurate in their assessments of the level of their partner's impairment (McGuire & Cavanaugh, 1992). In part, this inaccuracy is due to lack of knowledge about the disease; if people do not understand or know what to look for, they will be less accurate in reporting changes in their spouse's behavior. Also, to give the appearance that they are coping well in a difficult situation, spouses may want to portray themselves as being in control either by denying that the symptoms are severe or by exaggerating the severity. Some spouses describe their partner's symptoms accurately, but family reports should not be the only source of information about the person's ability to function. A great deal of attention has been given to the development of more definitive tests for Alzheimer's disease while the person is still alive. Much of this work has focused on beta amyloid, a protein that is produced in abnormally high levels in persons with Alzheimer's disease, perhaps causing the neurofibrillary tangles and neuritic plaques described earlier. Considerable recent research has focused on beta-amyloid as a major factor in Alzheimer's disease in terms of potential diagnosis as well as a possible cause and avenue for treatment. The role of beta-amyloid is controversial, though. Some researchers view concentration of beta-amyloid as a biomarker of Alzheimer's disease (Jack et al., 2013; Krut et al., 2013). Others consider it an early warning of potential cognitive decline, even in the absence of any behavioral symptoms (Gandy & DeKosky, 2013). Think About It If an accurate diagnostic test for Alzheimer's disease is developed and there is no treatment for the disease, should the test be made available? What Causes Alzheimer's Disease? We do not know for sure what causes Alzheimer's disease (Scheff et al., 2014). Currently, most research concentrates on identifying genetic links and biomarkers (e.g., Gandy & DeKosky, 2013; Krut et al., 2013; Reitz & Mayeux, 2014). To understand the evidence better, we need to think about two general types of Alzheimer's disease: early onset (before age 60) and later onset (after age 60). The early onset version tends to run in families. It has an autosomal dominant inheritance in that the presence of certain genes means that there is a 100% chance of the person eventually getting the disease. Familial Alzheimer's disease is linked to three causative genes: APP, PSEN1, and PSEN2 (Gandy & DeKosky, 2013). If you have one of these genes, symptoms always appear before age 60 and sometimes as early as the thirties or forties. These genes are the ones most often included in studies regarding cerebrospinal fluid indicators of Alzheimer's disease. Later onset Alzheimer's disease may be linked to risk genes, that is, genes that increase one's risk of getting the disease. Several sites on various chromosomes have been tentatively identified as being risk factors for Alzheimer's disease, including chromosomes 12, 14, 19, and 21. The most promising work has noted links between the genetic markers and the production of amyloid protein, the major component of neuritic plaques (Liu et al., 2013). Much of this research focuses on apolipoprotein E4 (apo E4), associated with chromosome 19, which may play a central role in creating neuritic plaques. People with the apo E4 trait are more likely to get Alzheimer's disease than those with the more common apo E3 trait. In addition, a related mutation (TREM2) may be involved with apo E4 as well by interfering with the brain's ability to contain inflammation (Jonsson et al., 2013). Interestingly, another version, apo E2, seems to have the reverse effect from that of apo E4: It decreases the risk of Alzheimer's disease (Liu et al., 2013). Despite the relation between apo E4 and neuritic plaques and between apo E4 and beta-amyloid buildup, researchers have yet to establish strong relations directly between apolipoprotein E and general cognitive functioning (Liu et al., 2013). Neuroimaging studies of persons with Alzheimer's disease are providing supportive evidence of the structural changes caused by the genes identified so far (Risacher, Wishart, & Saykin, 2012). An important opportunity in this regard is the Alzheimer's Disease Neuroimaging Initiative (ADNI) that is following over 800 people with various levels of cognitive impairment. All of the data discovered in the ADNI are made public. Although the mechanisms of specific genes in causing Alzheimer's disease are being studied extensively, exactly how they work is still unclear, suggesting that other associated genes or environmental triggers remain to be identified. Perhaps additional advances in the area of genetics will give us insights into what we can do to prevent this devastating disease. What Can Be Done for Victims of Alzheimer's Disease? Currently there is no effective treatment for Alzheimer's disease and no way to prevent it. The best we can do today is alleviate some of the symptoms. Most of the research is focused on drugs aimed at improving cognitive functioning. Unfortunately, most medications approved by the Food and Drug Administration to date provide little relief over the long run, and few medications in development show promising results. However, some effective behavioral and educational interventions have been developed. One behavioral intervention, grounded in the E-I-E-I-O model discussed earlier, involves using the implicit-internal memory intervention called spaced retrieval. Adapted by Camp and colleagues (Camp, 2005; Camp et al., 2012), spaced retrieval involves teaching persons with Alzheimer's disease to remember new information by gradually increasing the time between retrieval attempts. This easy, almost magical technique has been used to teach names of staff members and other information, and it holds considerable potential for broad application. Research shows that spaced retrieval is superior to other techniques (Haslam, Hodder, & Yates, 2011) and that combining spaced retrieval with additional memory encoding aids helps even more (Kinsella et al., 2007). In designing interventions for those with Alzheimer's disease, the guiding principle should be optimizing the person's functioning. Regardless of the level of impairment, attempts should be made to help the person cope as well as possible with the symptoms. The key is helping all individuals maintain their dignity as human beings. This can be achieved in some very creative ways, such as adapting the principles of Montessori methods of education to bring older adults with Alzheimer's disease together with preschool children so that they can perform tasks together (Malone & Camp, 2007; Materne, Luszcz, & Goodwin-Smith, 2014). One example of this approach is discussed in the Spotlight on Research feature. Spotlight on Research Training Persons with Dementia to Be Group Activity Leaders Who were the investigators, and what was the aim of the study? Dementia is marked by progressive and severe cognitive decline. But despite these losses, can people with dementia be trained to be group leaders? Most people might think the answer is no, but Cameron Camp and Michael Skrajner (2004) decided to find out by using a training technique based on the Montessori method. How did the investigators measure the topic of interest? The Montessori method is based on self-paced learning and developmentally appropriate activities. As Camp and Skrajner point out, many techniques used in rehabilitation (e.g., task breakdown, guided repetition, moving from simple to complex and concrete to abstract) and in intervention programs for people with dementia (e.g., use of external cues and implicit memory) are consistent with the Montessori method. For this study, a program was developed to train group leaders for memory bingo (see Camp, 1999a and 1999b, for details about this game). Group leaders had to learn which cards to pick for the game, where the answers were located on the card, where to "discard" the used (but not the winning) cards, and where to put the winning cards. Success in the program was measured by research staff raters, who made ratings of the type and quality of engagement in the task shown by the group leader. Who were the participants in the study? Camp and colleagues tested four people who had been diagnosed as probably having dementia who were also residents of a special care unit of a nursing home. What was the design of the study? The study used a longitudinal design so that Camp and Skrajner could track participants' performance over several weeks. Were there ethical concerns with the study? Having persons with dementia as research participants raises important issues regarding informed consent. Because of their serious cognitive impairments, these individuals may not fully understand the procedures. Thus, family members such as a spouse or adult child caregiver are also asked to give informed consent. Additionally, researchers must pay careful attention to participants' emotions; if participants become agitated or frustrated, the training or testing session must be stopped. Camp and Skrajner took all these precautions. What were the results? Results showed that at least partial adherence to the established game protocols was achieved at a very high rate. Indeed, staff assistance was not required at all for most of the game sessions for any leader. All of the leaders said that they enjoyed their role, and one recruited another resident to become a leader in the next phase of the project. What did the investigators conclude? It appears that persons with dementia can be taught to be group activity leaders through a procedure based on the Montessori method. This is important because it provides a way for such individuals to become more engaged in an activity and to be more productive. Although more work is needed to continue refining the technique, applications of the Montessori method offer a promising intervention approach for people with cognitive impairments. What converging evidence would strengthen these conclusions? Camp and Skrajner studied only four residents; more evidence that the approach works with different types of people would bolster their conclusions. Although the Montessori method is effective for training persons with dementia, the approach has not yet been demonstrated to be effective with other diseases that cause serious memory loss. Parkinson's Disease Parkinson's disease is known primarily for its characteristic motor symptoms: very slow walking, difficulty getting into and out of chairs, and a slow hand tremor, but it can develop into a form of dementia. These problems are caused by a deterioration of neurons in the midbrain that produce the neurotransmitter dopamine. Former boxing champion Muhammad Ali and actor Michael J. Fox are some of the more famous individuals who have Parkinson's disease. Over 1 million people in the United States (over 4 million globally) have Parkinson's disease (National Parkinson Foundation, 2014). Symptoms of Parkinson's disease are treated effectively with two primary approaches: medication and surgery (Bhidayasiri & Brenden, 2011). The most common medications are levodopa, which raises the functional level of dopamine in the brain; Sinemet (a combination of levodopa and carbidopa), which gets more levodopa to the brain; and Stalevo (a combination of Sinemet and entacapone), which extends the effective dosage time of Sinemet. Surgical intervention involves using a device called a neurostimulator, which acts like a brain pacemaker by regulating brain activity when implanted deep inside the brain. Research indicates that a neurostimulator may prove effective in significantly reducing tremors, shaking, rigidity, stiffness, and walking problems when medications fail (Schuepbach et al. 2013). For reasons we do not yet understand, some people with Parkinson's disease also develop severe cognitive impairment and eventually dementia (Zheng et al., 2014). As with Alzheimer's disease, attention is focused on beta-amyloid protein levels as a possible cause, but much work remains to be done (Beyer et al., 2013). Chronic Traumatic Encephalopathy An issue of growing concern is the long-term effects of experiencing brain concussions (Gardner, Iverson, & McCrory, 2014). A brain autopsy following the suicide at age 50 of former NFL player Dave Duerson in 2011 brought major attention to the problem. It was revealed that he suffered from chronic traumatic encephalopathy (CTE), a form of dementia caused by repeated head trauma such as concussions. Duerson had suffered ten known concussions and reported symptoms well after he had retired from football. Other former players who died relatively young also may have had the disease. Researchers at the Boston University School of Medicine Center for the Study of Traumatic Encephalopathy reported that 14 of 15 brains of former NFL players they examined showed evidence of CTE (Smith, 2011). CTE can occur as the result of repeated brain trauma not only in sports but also through other causes such as military combat (Sorg et al., 2014). Emerging evidence shows that irrespective of the cause, there is structural damage to various parts of the brain that have to do with executive functions and memory. Although there is evidence of severe cognitive problems in some people who experienced repeated brain trauma, at this point, there is controversy regarding whether CTE is a separate disease or a variation of other diseases (Randolph, 2014). Further research is necessary to decide which is the case. Meanwhile, the increased attention being paid to head trauma in general and the need for protection against it is a good thing.

Elder Abuse and Neglect

Arletta, an 82-year-old woman in relatively poor health, has been living with her 60-year-old daughter, Sally, for the past two years. Recently, neighbors became concerned because for several months, they had not seen Arletta very often. When they did, she looked rather worn, thin, and unkempt. Finally, the neighbors decided that they should do something; so they called the local office of the Department of Human Services. Upon hearing the details of the situation, a caseworker immediately investigated. The caseworker found that Arletta was severely malnourished, had not bathed in weeks, and appeared disoriented. Based on these findings, the agency concluded that Arletta was a victim of neglect. She was moved temporarily to a county nursing home. Although elder abuse, neglect, and exploitation are difficult to define precisely, the following categories are commonly used (National Center on Elder Abuse, 2013): Physical abuse: use of physical force that may result in bodily injury, physical pain, or impairment Sexual abuse: nonconsensual sexual contact of any kind Emotional or psychological abuse: infliction of anguish, pain, or distress Financial or material exploitation: illegal or improper use of an older adult's funds, property, or assets Abandonment: desertion of an older adult by an individual who had physical custody or otherwise had assumed responsibility for providing care for the older adult Neglect: refusal or failure to fulfill any part of a person's obligation or duties to an older adult Self-neglect: behaviors of an older person that threaten his or her health or safety, excluding those conscious and voluntary decisions made by a mentally competent and healthy adult Researchers estimate that perhaps one in four vulnerable older adults are at risk for some type of abuse, neglect, or exploitation (Nerenberg, 2010; Wong & Rothenhaus, 2014). Unfortunately, only a small proportion of these cases are reported to authorities; of those that are, neglect is the most common type. Elder abuse is often noted by physicians first, either through routine examinations or in emergency departments in hospitals (Linden & Olshaker, 2014). Current approaches to elder abuse, especially by adult children, conceptualize it not as an outcome of a caregiving situation, but as a development from the longer ongoing relationship between parent and child (Pickering & Phillips, 2014). Similarly, abuse by intimate partners may also be tied to former existing relationship issues even if abuse had not been present previously (Roberto, McPherson, & Brossoie, in press). Understanding, detecting, and addressing elder abuse requires culturally sensitive approaches that reflect the values of older adults in different societies (Teaster, Harley, & Kettaneh, 2014). Although certain characteristics, such as a correlation with disability, occur across cultures, how those characteristics are manifest differ. Likewise, prevention and intervention strategies must take cultural differences into account. As with abuse at other points in the life span, identifying and reporting it is everyone's concern. If you suspect that an older adult is a victim of elder abuse, neglect, or exploitation, the best thing you can do is contact your local adult protective services office and report it.

occupational choice and career development

As adults, people do not make their first decisions about what they want to do in the world of work, as we saw in Chapter 9. Even by adolescence, there is evidence that occupational preferences are related to people's personalities. But what are people preparing for? Much has been written about the rapidly changing nature of work and the fact that people cannot prepare for a stable career in which they will work for the same organization their entire working life (Savickas, 2013). Currently, it is more appropriate to consider careers as something people construct themselves rather than enter (Savickas, 2013). Career construction theory posits that people build careers through their own actions that result from the interface of their personal characteristics and the social context. What people "do" in the world of work, then, results from how they adapt to their environment, which in turn is a result of biopsychosocial processes grounded in the collection of experiences they have during life. Let's see how these ideas play out in people's occupations and careers. Holland's Theory Revisited. Holland's (1997) personality-type theory proposes that people choose occupations to optimize the fit between their individual traits (such as personality, intelligence, skills, and abilities) and their occupational interests. Recall from Table 9.x that Holland categorizes occupations by the interpersonal settings in which people must function and by their associated lifestyles. He identifies six personality types that combine these factors: investigative, social, realistic, artistic, conventional, and enterprising, which he believes are optimally related to occupations. How does Holland's theory help us understand the continued development of occupational interests in adulthood? Monique, the college senior in the vignette, found a good match between her outgoing nature and her major, communications. Indeed, college students of all ages tend to like best the courses and majors that fit well with their personalities. You are likely to be one of them. Later on, that translates to the tendency of people to choose occupations and careers that they like. Social Cognitive Career Theory Complementarily, social cognitive career theory (SCCT) proposes that career choice is a result of the application of Bandura's social cognitive theory, especially the concept of self-efficacy. Thus, SCCT proposes that people's career choices are heavily influenced by their personal interests (Lent, 2013; Sheu et al., 2010). As depicted in Figure 12.1, SCCT has two versions. The simplest includes four main factors: Self-Efficacy (your belief in your ability), Outcome Expectations (what you think will happen in a specific situation), Interests (what you like), and Choice Goals (what you want to achieve). The more complex version also includes Supports (environmental things that help you) and Barriers (environmental things that block or frustrate you). Several studies show support for the six-variable version of the model (Sheu et al., 2010). Figure 12.1. © Cengage Learning® The four-variable (paths 1-6) and six-variable (paths 1-13) versions of the Social Cognitive Career Theory interest/choice models. Occupational selection is a complex developmental process involving interactions among personal beliefs, ethnic, gender, and economic factors. As research continues to document how these factors interrelate, we will continue to understand better how people choose what they want to do for a living. Of course, life does not always play out according to people's plans, as millions discovered in the Great Recession. We will see how this happens as we consider occupational development and occupational changes in this chapter. Super's Theory For most of us, getting a job is not enough; we also want to move "up the ladder." Promotion is a measure of how well one is doing in one's career. How quickly occupational advancement does (or does not) occur may lead to a label such as "fast-tracker" or "dead-ender." Barack Obama, who was elected president of the United States at age 47, is an example of a fast-tracker. People who want to advance quickly learn how long they should stay at one level and how to seize opportunities when they arise, but others may experience the frustration of remaining in the same job with no chance for promotion. © spirit of america/Shutterstock.com Barack Obama is an example of a "fast-tracker." How a person advances in a career may depend on professional socialization, which occurs when people learn the unwritten rules of an organization. These rules include several factors other than those that are important in choosing an occupation, including expectations, support from coworkers, priorities, and job satisfaction. Before we consider these aspects, let's look at a general scheme of career and occupational development. Over four decades, Donald Super (1957, 1980; Super, Savickas, & Super, 1996) developed a theory of occupational development based on self-concept, first introduced in Chapter 9. He proposed a progression through five distinct stages during adulthood as a result of changes in individuals' self-concept and adaptation to an occupational role: implementation, establishment, maintenance, deceleration, and retirement (see Figure 12.2). People are located along a continuum of vocational maturity through their working years; the more congruent their occupational behaviors are with what is expected of them at different ages, the more vocationally mature they are. Figure 12.2. © Cengage Learning® Super's occupational stages during adulthood. Super proposed five developmental tasks, the first two (crystallization and specification) occurring primarily in adolescence. The remaining three (implementation, stabilization, and consolidation) occur over the course of adulthood. Each of the tasks in adulthood has distinctive characteristics, as follows. The implementation task begins in the early twenties, when people take a series of temporary jobs to learn firsthand about work roles and to try out possible career choices. Summer internships that many students use to gain experience are one example. The stabilization task begins in the mid-twenties with selecting a specific occupation during young adulthood. It continues until the mid-thirties as the person confirms the occupational choice that was made. The consolidation task begins in the mid-thirties and continues throughout the rest of the person's working life as he or she advances up the career ladder. Taking a position in a law firm and working one's way up to partner or beginning as a salesclerk in a store at a mall and moving up to store manager are two examples. These adult tasks overlap a sequence of developmental stages, beginning at birth, that continues during adulthood: exploratory (age 15 to24), establishment (age 24 to 44), maintenance (age 45 to 64), and decline (age 65 and beyond). These stages reflect the overall occupational cycle from choosing what one wants to do through achieving the maximum possible in a career to the reduction in work in late adulthood. Super's theory applies to people who enter and stay in a particular career their entire adult lives and to those who change occupations. Because it is now typical for Americans to have a series of careers, Super's notion is that we cycle and recycle through the tasks and stages as we adapt to changes in ourselves and the workplace (Super et al., 1996). Super may be right. A longitudinal study of 7,649 individuals born in the United Kingdom showed that occupational aspirations at age 16 in science and health fields predicted actual occupational attainments in science, health professions, or engineering at age 33 (Schoon, 2001). Adult occupational attainment was also related to belief in one's ability, mathematical test performance, several personality characteristics, sociocultural background, and gender. These results point to the importance of viewing occupational development as a true developmental process, as Super claimed, as well as the importance of personal characteristics, as proposed in occupational selection theories. Perspectives on Occupational Choice and Career Development How well do these theories work in actual practice, particularly in the rapidly changing world in which we live and in which people's careers are no longer stable? Super's theory can be placed into context with Holland's theory and social cognitive career theory to form a more comprehensive view of occupational selection and career development (Walker, 2010). This more comprehensive view emphasizes that people's occupations evolve in response to changes in their self-concept and self-efficacy (Walker, 2010) and reflect an individual's personal view of occupation and career related to each task and stage (Hurley-Hanson, 2006). So, for example, a high-level executive could, as a volunteer or the result of losing her job, decide to take a lower-ranking position if her sense of self changed from a high need to be in charge to one with a lower need for that responsibility. Consequently, how a person's occupation and career unfolds is part of a developmental process that reflects and explains important life changes. Certainly, the relations among occupation, personality, and demographic variables are complex (e.g., Barrick et al., 2013). However, even given the lack of stable careers and the real need to change jobs frequently, there is still a strong tendency on people's part to find occupations in which they feel comfortable and that they like (Lent, 2013). As we will see later, loss of self-efficacy through job loss and long-term unemployment supports the fact that the self-statements that underlie self-efficacy and SCCT are key. SCCT has also been used as a framework for career counselors and coaches to help people identify and select initial occupations and navigate later occupational changes. The goal is for people to understand that the work world changes rapidly and that they need to develop coping and compensatory strategies to deal with that fact. Think About It How does one's level of cognitive development relate to one's choice of occupation? Although people may have underlying tendencies that relate to certain types of occupations, unless they believe they could be successful in those occupations and careers, they are unlikely to choose them. These beliefs can be influenced by external factors. For example, occupational prestige and gender-related factors need to be taken into account (Deng, Armstrong, & Rounds, 2007).

Adulthood

Dealing with the loss of a loved one is never easy. How we deal with such losses as adults depends somewhat on the nature of the loss and our age and experience with death. Special Challenges in Young Adulthood Because young adults are just beginning to pursue the family, career, and personal goals they have set, they tend to be more intense in their feelings toward death. When asked how they feel about death, young adults report a strong sense that those who die at this point in their lives would be cheated out of their future (Attig, 1996). Complicated grief is relatively common (Mash, Fullerton, & Ursano, 2013). Wrenn (1999) relates that one of the challenges faced by bereaved college students is learning "how to respond to people who ignore their grief, or who tell them that they need to get on with life, that it's not good for them to continue to grieve" (p. 134). Because college students have a need to express their grief in the same way that other bereaved people do, providing them the opportunity to do so is crucial (Fajgenbaum, Chesson, & Lanzl, 2012; Servaty-Seib & Taub, 2010). © Jeff Mitchells/Reuters/Landov Becoming a widow as a young adult can be especially traumatic. Experiencing the loss of one's partner in young adulthood can be traumatic not only because of the loss itself but also because such loss is unexpected. As Trish Straine, a 32-year-old widow whose husband was killed in the World Trade Center attack, put it: "I suddenly thought, 'I'm a widow.' Then I said to myself, 'A widow? That's an older woman, who's dressed in black. It's certainly not a 32-year-old like me'" (Lieber, 2001). One of the most difficult aspects for young widows and widowers is that they must deal with both their own and their young children's grief and provide the support their children need. But that can be extremely difficult. "Every time I look at my children, I'm reminded of Mark," said Stacey, a 35-year-old widow whose husband died of bone cancer. "And people don't want to hear you say that you don't feel like moving on, even though there is great pressure from them to do that." Think About It How might young adults' thoughts about death change with each level of reflective judgment? Stacey is a good example of what research shows: Young adult widows report that their level of grief does not typically diminish significantly until five to ten years after the loss, and they maintain strong attachments to their deceased husbands for at least that long (Derman, 2000). Young Canadian widows also report intense feelings and a desire to stay connected through memories (Lowe & McClement (2010-2011). Death of One's Child The death of one's child, for most parents, brings unimaginable grief (Stroebe et al., 2013). Because children are not supposed to die before their parents, it is as if the natural order of things has been violated, shaking parents to their core (Rubin & Malkinson, 2001). Mourning is intense, and some parents never recover or reconcile themselves to the death of their child and may terminate their relationship with each other (Rosenbaum, Smith, & Zollfrank, 2011). The intensity of feelings is due to the strong parent-child bond that begins before birth and lasts a lifetime (Maple et al., 2013; Rosenbaum et al., 2011). Young parents who lose a child unexpectedly report high anxiety, a more negative view of the world, and much guilt, which results in a devastating experience (Seyda & Fitzsimons, 2010). The most overlooked losses of a child are those that happen through stillbirth, miscarriage, abortion, or neonatal death (Earle, Komaromy, & Layne, 2012; Nikcˇevic´ & Nicolaides, 2014). Attachment to the child begins before birth, especially for mothers; so the loss hurts deeply. For this reason, ritual is extremely important to acknowledge the death and validate parents' feelings of grief (Kobler, Limbo, & Kavanaugh, 2007). Also important is finding a reason for the miscarriage (Nikcˇevic´ & Nicolaides, 2014). Yet parents who experience this type of loss are expected to recover quickly. The lived experience of parents tells a different story (Seyda & Fitzsimons, 2010). These parents talk about a life-changing event and report a deep sense of loss and hurt, especially when others do not understand their feelings. Worst of all, if societal expectations for quick recovery are not met, the parents may be subjected to unfeeling comments. As one mother notes, parents often just wish somebody would acknowledge the loss (Okonski, 1996). The loss of a young adult child for a middle-aged parent is experienced differently but is equally devastating (Maple et al., 2013; Schneider, 2013). For example, parents who lost sons in wars (Rubin, Malkinson, & Witztum, 2012) and in traffic accidents (Shalev, 1999) still report strong feelings of anxiety, problems in functioning, and difficulties in relationships with both surviving siblings and the deceased as long as 13 years after the loss. Death of One's Parent Most parents die after their children are grown. But whenever parental death occurs, it hurts. Losing a parent in adulthood is a rite of passage as one is transformed from being a "son" or "daughter" to being "without parents" (Abrams, 2013). We, the children, are now next in line. The loss of a parent is significant. For young adult women transitioning to motherhood, losing their mother during adolescence raises many feelings, such as deep loss at not being able to share their pregnancies with their mothers and fear of dying young themselves (Franceschi, 2005). Middle-aged women who lose a parent report feeling a complex set of emotions (Westbrook, 2002): They have intense emotional feelings of both loss and freedom, they remember both positive and negative aspects of their parent, and they experience shifts in their own sense of self. The feelings accompanying the loss of an older parent reflect a sense of letting go, loss of a buffer against death, better acceptance of one's own eventual death, and a sense of relief that the parent's suffering is over (Abrams, 2013; Igarashi et al., 2013). Yet if the parent dies from a cause such as Alzheimer's disease that involves the loss of the parent-child relationship along the way, then bodily death can feel like the second time the parent died (Shaw, 2007). Whether the adult child now tries to separate from the deceased parent's expectations or finds comfort in the memories, the impact of the loss is great

Reproductive Changes

If you watched any television recently, you undoubtedly saw programs and advertisements showing middle-aged and older couples who clearly have active sex lives. Belsky (2007) reports that couples can and often do have sexual relationships that are very much alive and may be based on a newfound or re-found respect and love for each other. A major national survey by AARP (Fisher, 2010) found that middle-aged adults not only tend to continue to enjoy active sex lives but also enjoy romantic weekends, and about six of every ten middle-aged men and women report that a satisfying sex life is important for their quality of life. Still, middle age brings changes to the reproductive systems of men and women. These changes are more significant for women, but men also experience certain changes. Let's see what they are and how people learn to cope with them. The Climacteric and Menopause As women enter midlife, they experience a major biological process called the climacteric, during which they pass from their reproductive to nonreproductive years. Menopause is the point at which menstruation stops. Men do not endure such sweeping biological changes but experience several gradual changes. These changes have important psychological implications because midlife is thought by many to be a key time for people to redefine themselves, an issue we will examine later in this chapter. For example, some women view climacteric as the loss of the ability to have children, whereas others view it as a liberating change because they no longer need to worry about getting pregnant. The major reproductive change in women during adulthood is the loss of the ability to bear children. This change begins in the forties as menstrual cycles become irregular, and by age 50 to 55, it is usually complete (Vorvick, 2010). This time of transition from regular menstruation to menopause is called perimenopause, and how long it lasts varies considerably. The gradual loss and eventual end of monthly periods is accompanied by decreases in estrogen and progesterone levels, changes in the reproductive organs, and changes in sexual functioning. A variety of physical and psychological symptoms may accompany perimenopause and menopause with decreases in hormonal levels (WomensHealth.gov, 2010): hot flashes, night sweats, headaches, sleep problems, mood changes, more urinary infections, pain during sex, difficulty concentrating, vaginal dryness, less interest in sex, and an increase in body fat around the waist. Many women report no symptoms at all, but most women experience at least some, and there are large differences across social, ethnic, and cultural groups in how they are expressed (Nosek, Kennedy, & Gudmundsdottir, 2012; Utian, 2005). For example, women in the Mayan culture of Mexico and Central America welcome menopause and its changes as a natural phenomenon and do not attach any stigma to aging (Mahady et al., 2008). In the United States, Latinas and African Americans, especially working-class women, tend to view menopause more positively, whereas European American women describe it more negatively (Dillaway et al., 2008). Women in South American countries report a variety of symptoms that impair quality of life, many of which persisted five years beyond menopause (Blümel et al., 2012). Big Cheese Special/Big Cheese Photo LLC/Alamy Despite physical changes associated with middle age, women and men continue to enjoy sexual activity. The decline in estrogen that women experience after menopause is related to increased risk of osteoporosis, cardiovascular disease, stress urinary incontinence (involuntary loss of urine during physical stress, as when exercising, sneezing, or laughing), weight gain, and memory loss (Dumas et al., 2010; Mayo Clinic, 2012). In the case of cardiovascular disease, at age 50 (prior to menopause) women have 3 times less risk of heart attacks compared with men on average. Ten years after menopause, when women are about 60, their risk equals that of men. In response to these increased risks and to the estrogen-related symptoms that women experience, one approach is the use of menopausal hormone therapy (MHT) : Women take low doses of estrogen, which is often combined with progestin (a synthetic form of progesterone). Hormone therapy is controversial and has been the focus of many research studies with conflicting results (Bach, 2010; O'Brien et al., 2014). There appear to be both benefits and risks with MHT, as discussed in the What Do You Think? feature. What Do You Think? Menopausal Hormone Therapy For many years, women have had the opportunity to take medications to replace the female hormones that are not produced naturally by the body after menopause. Hormone therapy may involve taking estrogen alone or in combination with progesterone (or progestin in its synthetic form). Research on the effects of menopause hormone therapy has helped clarify the appropriate use of such medications. Until about 2003, it was thought that menopausal hormone therapy (MHT) was beneficial for most women, and results from several studies were positive. But results from research by the Women's Health Initiative (WHI) in the United States and from the Million Women Study in the United Kingdom indicated that for some types of MHT, there were several potentially serious side effects. As a result, physicians are now more cautious in recommending MHT. The WHI, begun in the United States in 1991, was a very large study (National Heart, Lung, and Blood Institute, 2003). The estrogen plus progestin trial used 0.625 milligram of estrogens taken daily in addition to 2.5 milligrams of medroxyprogesterone acetate (Prempro) taken daily. This combination was chosen because it is the mostly commonly prescribed form of the combined hormone therapy in the United States and it had appeared to benefit women's health in several observational studies. The women in the WHI estrogen plus progestin study were aged 50 to 79 when they enrolled in the study between 1993 and 1998. The health of study participants was carefully monitored by an independent panel called the Data and Safety Monitoring Board (DSMB). The study was stopped in July 2002 because investigators discovered a significant increased risk for breast cancer and because overall the risks outnumbered the benefits. However, in addition to the increased risk of breast cancer, heart attack, stroke, and blood clots, MHT resulted in fewer hip fractures and lower rates of colorectal cancer. The Million Women Study began in 1996 and included 1 in 4 women over age 50 in the United Kingdom, the largest study of its kind ever conducted (Million Women Study, 2013). Like the Women's Health Initiative, the study examined how MHT (both estrogen/progestin combinations and estrogen alone) affects breast cancer, cardiovascular disease, and other aspects of women's health. Results from this study confirmed the Women's Health Initiative outcome of increased risk for breast cancer associated with MHT. The combined results from the WHI and the Million Women Study led physicians to recommend that women over age 60 should not begin MHT to relieve menopausal symptoms or protect their health. In fact, women over age 60 who begin MHT are at increased risk for certain cancers. In sum, women face difficult choices when deciding whether to use MHT as a means of combatting certain menopausal symptoms and protecting themselves against other diseases. For example, MHT can help reduce hot flashes and night sweats, help reduce vaginal dryness and discomfort during sexual intercourse, slow bone loss, and perhaps ease mood swings. On the other hand, MHT can increase a woman's risk of blood clots, heart attack, stroke, breast cancer, and gallbladder disease. The best course of action for a woman is to consult closely with her physician to weigh the benefits and risks. She also should keep in mind several key points (WomensHealth.gov, 2010): Once a woman reaches menopause, MHT is recommended only as a short-term treatment. Doctors rarely recommend MHT to prevent certain chronic diseases such as osteoporosis. Women who have gone through menopause should not take MHT to prevent heart disease. MHT should not be used to prevent memory loss, dementia, or Alzheimer's disease. Women's genital organs undergo progressive change after menopause. The vaginal walls shrink and become thinner, the size of the vagina decreases, vaginal lubrication is reduced and delayed, and the external genitalia shrink somewhat. These changes have important effects on sexual activity, such as the increased possibility of painful intercourse and more time and stimulation needed to reach orgasm. Failure to achieve orgasm is more common in midlife and beyond than in a woman's younger years. However, maintaining an active sex life throughout adulthood lowers the degree to which problems are encountered. Despite these changes, there is no physiological reason not to continue having an active and enjoyable sex life from middle age through late life. The vaginal dryness that occurs, for example, can be countered by using personal lubricants such as K-Y or Astroglide. Whether women continue to have an active sex life has more to do with lack of a willing or appropriate partner, not a lack of physical ability or desire (Fisher, 2010). Reproductive Changes in Men Unlike women, men do not have a clear physiological (or cultural) event to mark reproductive changes, although there is a gradual decline in testosterone levels (Bribiescas, 2010) that can occur to a greater extent in men who are obese or have diabetes (Nigro & Christ-Crain, 2012). Men do not experience a complete loss of the ability to father children, as this varies widely from individual to individual, but men do experience a normative decline in the quantity of sperm (MedlinePlus, 2012). However, even at age 80, a man is still half as fertile as he was at age 25 and is quite capable of fathering a child. With increasing age, the prostate gland enlarges, becomes stiffer, and may obstruct the urinary tract. Prostate cancer becomes a real threat during middle age, and its diagnosis and treatment are controversial (Heidenreich et al., 2014). Following an extensive review of research and clinical evidence in 2009, the American Cancer Society, along with other major medical organizations (e.g., European Association of Urology), now recommends that men with average risk of developing prostate cancer be informed at age 50 of the benefits and risks of the available diagnostic tests (e.g., digital rectal exam, prostate-specific antigen [PSA] blood test). The PSA test, although potentially useful, has a high error rate in that even though many men with elevated PSA levels do have prostate cancer, a majority of men with elevated PSA levels do not. Men over age50 should discuss with their physician the best course of action for diagnosis. Testosterone levels decline about 1% per year after age 40, and about 20% of men over age 60 have levels below the lower limit of the normal range (Gupta & Agarwal, 2010). Afew men who experience an abnormally rapid decline in testosterone production during midlife or early old age report symptoms similar to those experienced by some menopausal women, such as hot flashes, chills, rapid heart rate, and nervousness (Pines, 2011). Men experience some physiological changes in sexual performance (Corona etal., (2013). By old age, men report less perceived demand to ejaculate, a need for more time and stimulation to achieve erection and orgasm, and a much longer resolution phase during which erection is impossible. Older men also report more frequent failures to achieve orgasm and loss of erection during intercourse (Fisher, 2010). However, the advent of Viagra and other medications, as well as highly effective lifestyle changes (e.g., weight control, exercise) to treat erectile dysfunction has provided easy-to-use medical treatments and the possibility of an active sex life well into later life (Moyad, 2014). Think About It Why does sexual desire remain largely unchanged despite the biological changes that are occurring? As with women, as long as men enjoy sex and have a willing partner, sexual activity is a lifelong option. Like women, the most important ingredient of sexual intimacy for men is a strong relationship with a partner (Fisher, 2010).

Social security and medicare

Without doubt, the most important societal changes in the United States regarding older adults during the 20th century were the creation of retirement income plans such as Social Security and other pension plans as well as universal basic health care plans such as Medicare (Polivka, 2010). Similar programs also were initiated in other developed countries. Even though the costs of such programs continue to rise dramatically, Social Security and Medicare are so strongly supported that elected officials are often afraid to discuss and implement much-needed reforms. Such programs have reduced the number of older adults who live below the poverty line; for example, the median income of adults born in the 1930s and 1940s is significantly higher than it was for adults born earlier (Emmons & Noeth, 2013). However, projections indicate that baby boomers and Generation X members will have lower incomes in old age due to fundamental changes in pension availability and lower savings rates. In analyzing the financial well-being of older adults, economists argue that older adults should be evaluated by different standards compared with younger or middle-aged adults (Johnson & Wilson, 2010). Economists often argue that older adults need 200% of the federal poverty limit to make ends meet, especially with respect to health care costs. By this measure, women and minorities are especially at risk financially. To capture these issues, the Wider Opportunities for Women and the Gerontology Institute at the University of Massachusetts Boston developed the Elder Economic Security StandardTM Index. The Elder Index is a measure of the income that older adults need to meet their basic housing, health care, transportation, food, and other essential costs and to age in place. Separate indices are available for cities and counties in the United States. The aging of the baby boomers presents difficult and expensive problems (Office of Management and Budget, 2014). In fiscal year 2015, federal spending on the various parts of Social Security and Medicare alone was expected to be roughly $1.2 trillion in a total budget of $6.4 trillion. (When all government pension and health programs are considered, spending for them tops $2.4 trillion.) If spending patterns do not change, by 2039 (when most baby boomers will have reached old age), the expenditures for Social Security and Medicare alone are projected to consume nearly 12% of the U.S. gross domestic product (GDP), a 50% increase over rates in 2010 (Social Security and Medicare Boards of Trustees, 2013). Without major reforms in these programs, such growth will force extremely difficult choices in how to pay for them. Social Security. Social Security began in 1935 as an initiative by President Franklin D. Roosevelt to "frame a law which will give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age" (Roosevelt, 1935). Thus, Social Security was originally intended to provide a supplement to savings and other means of financial support. Over the years, revisions to the original law have changed Social Security to the point that it now represents the primary source of financial support after retirement for most U.S. citizens and the only source for many (Polivka, 2010). However, increasing numbers of workers have been included in employer-sponsored retirement plans such as 401(k), 403(b), and 457 plans, as well as mutual funds and various types of individual retirement accounts (IRAs) (McGill et al., 2010; Polivka, 2010). These various retirement plans, especially savings options, in addition to financial pressure to reform Social Security may force future retirees to use Social Security as the supplemental financial source for which it was intended, thereby shifting responsibility for retirement financial planning to the individual (Polivka, 2010). The primary challenge facing Social Security is the aging of the baby boomers and the much smaller generation that follows. Because Social Security is not a savings account but is funded by current workers' payroll taxes, the amount of money each worker must pay depends on the ratio of the number of people paying Social Security taxes to the number of people collecting benefits. When it was created, 150 workers were paying into the Social Security system for every person collecting benefits (Taylor, 2014). By 2030, this ratio will be down to two workers paying in for every person collecting benefits. As Taylor (2014) points out, this shift sets the stage for generational conflict over scarce national financial resources between the baby boomers and the Millennials. Despite numerous plans having been proposed since the 1970s to address this issue, Congress has not yet taken the actions necessary to ensure the long-term financial stability of the system (Social Security Administration, 2013). As discussed later in the What Do You Think? feature, the suggestions for doing this present difficult choices. Medicare. Roughly 50 million U.S. citizens depend on Medicare for their medical insurance (Kaiser Family Foundation, 2014a). The most common way to become eligible for Medicare is to meet several criteria (AARP, 2014): You are aged 65 or older You are a U.S. citizen or a permanent legal resident; and You or your spouse has worked long enough to be eligible for Social Security or railroad retirement benefits—usually having earned 40 credits from about 10 years of work—even if you are not yet receiving these benefits; or You or your spouse is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working. Medicare consists of four parts (Medicare.gov, 2014): Part A, which covers inpatient hospital services, skilled nursing facilities, home health services, and hospice care; Part B, which covers the cost of physician services, outpatient hospital services, medical equipment and supplies, and other health services and supplies; and Part D, which provides some coverage for prescription medications. Part C, also called "Medicare Advantage," is offered by private companies approved by Medicare. It includes all of the benefits of Parts A and B as well as additional coverage (e.g., vision, dental) and usually Part D. Expenses relating to most long-term care needs are funded by Medicaid, another major health care program funded by the U.S. government and targeted to people who are poor. Out-of-pocket expenses associated with co-payments and other charges are often paid by supplemental insurance policies, sometimes referred to as "Medigap" policies (Medicare.gov, 2014). Like Social Security, Medicare is funded by a payroll tax. However, whereas the Social Security payroll tax has an upper limit on the salary used to compute how much people pay (the upper limit of salary increases each year), the Medicare payroll tax is applied to one's entire salary. Still, the funding problems facing Medicare are similar to those facing Social Security and are greatly exacerbated by the aging of the baby boomers. In addition, Medicare costs have increased dramatically as a result of the rapidly increasing costs of health care. Cost containment of health care remains a major political concern, and the issue has been caught in the overall debate about health care reform in the United States. Also, because Medicare is a government-run health care program, it continues to be controversial among those who oppose such approaches to health care. But unlike Social Security, Medicare has already been subjected to significant cuts in expenditures, typically through reduced payouts to health care providers. President Obama proposed reductions to the Medicare Advantage (Part C) program in his budgets as part of his overall strategy to control increase in health care costs. Whether this practice will continue is unclear, especially when baby boomers find out that their coverage could be significantly reduced or limited to certain health conditions and that their out-of-pocket expenditures will increase significantly. Clearly, the political and social issues concerning benefits to older adults are quite complex. The first baby boomers became eligible for Medicare benefits in 2011 and full Social Security benefits in 2012, so the need for action to ensure that these programs remain solvent for future generations is urgent (Taylor, 2014). The implementation of the Patient Protection and Affordable Care Act in 2014 may lower the growth of some costs in Medicare, but some of that reduction is likely to be the result of reductions in reimbursement to care providers. The What Do You Think? feature takes a closer look at the financial pressures facing Social Security and Medicare. What Do You Think? Reforming Social Security and Medicare Few political issues have been around as long and are as politically sensitive as those that concern making Social Security and Medicare fiscally sound for the long term. The basic issues have been well known for decades: The present method for raising and distributing revenues in Social Security and Medicare are not sustainable (Social Security and Medicare Boards of Trustees, 2013). Because Social Security and Medicare are based on current workers paying a tax to support current retirees, the looming funding problems depend critically on the worker-to-retiree ratio. This declining ratio places an increasing financial burden on workers to provide the level of benefits to retirees that people have come to expect. Because of this declining ratio, unless major structural changes are made, the Social Security and Medicare systems are headed toward bankruptcy in the foreseeable future, requiring significant reductions in benefits to match expenditures with revenues (Social Security and Medicare Board of Trustees, 2013). So it's no wonder that young and middle-aged adults have little faith that Social Security or Medicare will be there for them. Potential solutions to these problems differ. Because Social Security is essentially an income assurance program, there appear to be more options with it. Among the possibilities proposed over the years are: Privatization: Various proposals have been made for allowing or requiring workers to invest at least part of their money in personal retirement accounts managed by either the federal government or private investment companies. Another option would be to allow individuals to create personal accounts with a portion of the funds paid in payroll taxes. Means-test benefits: This proposal would reduce or eliminate benefits to people with high incomes. Increase the number of years used to compute the benefit: Currently, benefits are based on one's history of contributions over a 35-year period. This proposal would increase that period to perhaps 40 years. Increase the retirement age: The age of eligibility for full Social Security benefits is increasing slowly to age 67 in 2027. Various proposals have been made to speed up the increase, to increase the age to 70, or to connect the age at which a person becomes fully eligible to average longevity statistics. Adjust cost-of-living increases downward: Some proposals have been made to lower those increases given to beneficiaries that result from increases in the cost of living. Increase the payroll tax rate: One direct way to address the coming funding shortfall is to increase revenues through a higher tax rate. Increase the earnings cap for payroll tax purposes: This proposal would either raise or remove the cap on income subject to the Social Security payroll tax (the maximum taxable earnings for Social Security was $117,000 in 2014). Make across-the-board reductions in Social Security pension benefits: A reduction in benefits of 3% to 5% would resolve most of the funding problem. None of these proposals for Social Security has universal support. Many proposed solutions would significantly disadvantage certain people—especially minorities and older widows—who depend almost entirely on Social Security for their retirement income (Polivka, 2010). Nevertheless, a range of options continues to be discussed. In contrast, fixing Medicare is more difficult (Davis, 2013). As a health care entitlement program, Medicare must pay for all medically necessary covered benefits for enrollees; except for constraints placed on the program by the health insurance financing mechanism, there are no limits on overall Medicare spending. That leaves the only viable approaches based on (1) further restructuring of the health care system to manage costs better, (2) restructuring of the funding mechanisms including both the Medicare taxes on wages and the premiums and co-pays, or (3) some combination of both. Solving the funding problems facing Social Security and Medicare will become increasingly important in the next few years. What do you think should be done to stabilize them? Taken together, the challenges facing society concerning older adults' financial security and health will continue to be major political issues throughout the first few decades of the 21st century. There are no easy answers, but open discussion of the various arguments will be essential for creating the optimal solution

what is the single biggest contributor to health problems

smoking

quasi-reflective thinking

-likely to say that nothing can be known for certain and to change their conclusions based on the situation and the evidence -knowledge is subjective -less persuasive with their positions on controversial issues -"Each person is entitled to his or her own view; I cannot force my opinions on anyone else."

Exercise

Ever since the time of Hippocrates, physicians and researchers have known that exercise significantly slows the aging process. Indeed, evidence suggests that a program of regular exercise, in conjunction with the healthy lifestyles discussed in Chapter 10, can slow the physiological aging process (Rogers, 2010). Being sedentary is hazardous to your health. Adults benefit from aerobic exercise, which places moderate stress on the heart by maintaining a pulse rate between 60% and 90% of a person's maximum heart rate. You can calculate your maximum heart rate by subtracting your age from 220. Thus, if you are 40 years old, your target range would be 108 to 162 beats per minute. Examples of aerobic exercise include jogging, step aerobics, swimming, and cross-country skiing. How much exercise is ideal? The U.S. Department of Health and Human Services (2008) established the first-ever guidelines for physical activity in 2008. Adults should average 150 minutes per week of moderate-intensity aerobic exercise, 75 minutes of vigorous-intensity aerobic activity, or a combination of the two. Strengthening exercises are recommended at least twice per week. What happens when a person exercises aerobically (besides becoming tired and sweaty)? Physiologically, adults of all ages show improved cardiovascular functioning and maximum oxygen consumption; lower blood pressure; and better strength, endurance, flexibility, and coordination (Mayo Clinic, 2011). Psychologically, people who exercise aerobically report lower levels of stress, better moods, and better cognitive functioning. The best way to gain the benefits of aerobic exercise is to maintain physical fitness throughout the life span, beginning at least in middle age. The benefits of various forms of exercise are numerous and include lowering the risk of cardiovascular disease, osteoporosis (if the exercise is weight-bearing), and a host of other conditions. The Mayo Clinic's Healthy Living Program (Mayo Clinic, 2014), which combines exercise with proper nutrition and other wellness behaviors, provides an excellent place to start. In planning an exercise program, you should remember three points. First, check with a physician before beginning an aerobic exercise program. Second, bear in mind that moderation is important. Third, just because you intend to exercise doesn't mean you will; you must take the necessary steps to turn your intention into action (Schwarzer, 2008). If you do (and stick with it), you may feel much younger (Joyner & Barnes, 2013). Without question, regular exercise is one of the two most important behaviors one can do to promote healthy living and good aging (not smoking is the other). In addition to the variety of positive effects on health (e.g., lower risk of cardiovascular disease, diabetes, hypertension), there is also substantial evidence that exercise is connected to less cortical atrophy, better brain function, and enhanced cognitive performance (Erickson, Gildengers, & Butters, 2013). Specifically, exercise has a positive effect on the prefrontal and hippocampal areas, which, as we have seen, are closely associated with memory and other cognitive functions. Whether exercise can delay or prevent diseases associated with these brain structures, such as Alzheimer's disease, remains to be seen. But the evidence to date points to such outcomes as a reason to promote exercise as a way to a healthy, better-functioning brain in later life. And a better-functioning brain may well be related to the mood improvements seen as another positive benefit of exercise, as shown in Figure 13.4.

Information Processing

In Chapter 1, we saw that one theoretical framework for studying cognition is information-processing theory. This framework provides a way to identify and study the basic mechanisms by which people take in, store, and remember information. Innovations and discoveries in neuroscience have resulted in major advances in our understanding of how people process information across the life span. Neuroscience has guided investigators as they examine age-related differences in basic processes such as attention and reaction time, particularly through the use of neuroimaging (Blanchard-Fields, 2010; Borghesani et al., 2013). Earlier in this chapter, we considered ways of investigating brain processes through neuroimaging; such research is essential for understanding age-related changes in cognition. Psychomotor Speed You are driving home from a friend's house when all of a sudden a car pulls out of a driveway directly into your path. If you don't hit the brakes as fast as possible, you will have an accident. How quickly can you move your foot from the accelerator to the brake? This real-life situation is an example of psychomotor speed, the speed with which a person can make a specific response. Psychomotor speed (also called reaction time) is one of the most studied phenomena of aging, and hundreds of studies point to the same conclusion: People slow down as they get older. In fact, the slowing-with-age finding is so well documented that many researchers accept it as the only universal behavioral change in aging discovered so far (Salthouse, 2014a, 2014b). As the cartoon shows, even Garfield feels the effects but blames faster spiders. For people, though, it's not that the world really speeds up; we slow down in general. However, data suggest that the rate at which cognitive processes slow down from young adulthood to late life varies a great deal depending on the task (Salthouse, 2014, 2014a, 2014b). © Paws, Inc. Reprinted with permission of UNIVERSAL PRESS SYNDICATE. All rights Psychomotor Speed The most important reason reaction times slow down is that older adults take longer to decide that they need to respond, especially when the situation involves ambiguous information (Salthouse, 2014a, 2014b). Even when the information presented indicates that a response will be needed, there is an orderly slowing of responding with age. As the uncertainty of whether a response is needed increases, older adults become differentially slower; the difference in reaction time between older adults and middle-aged adults increases as the uncertainty level increases. Although response slowing is inevitable, the amount of the decline can be reduced if older adults are allowed to practice making quick responses or if they are experienced in the task. In a classic study, Salthouse (1984) showed that although older secretaries' reaction times (measured by how fast they could tap their finger) were slower than those of younger secretaries, their computed typing speed was no slower than that of their younger counterparts. Why? Typing speed is calculated on the basis of words typed, including those corrected for errors; because older typists are more accurate, their final speeds were just as good as those of younger secretaries, whose work tended to include more errors. Also, older secretaries are better at anticipating what letters come next (Kail & Salthouse, 1994). Because psychomotor slowing is a universal phenomenon, researchers have argued that it may explain a great deal of the age differences in cognition (e.g., Salthouse, 2014a, 2014b). Indeed, psychomotor slowing is a very good predictor of cognitive performance, but research has shown that there's a catch. The prediction is best when the task requires little effort. If the task requires more effort and is more difficult, then working memory (which we consider later) is a better predictor of performance. Also, exercise can mediate the effects of normative aging on cognitive slowing (Spirduso, Poon, & Chodzko-Zajko, 2008). Neuroscience has shed light on the brain changes that may underlie the decline in psychomotor speed. Cohen (2014) and Kennedy and Raz (2009) summarize neuroimaging research that documents age-related declines in brain white matter (which aids in neural transmission), which in turn has been associated with measures of processing speed, among other things. Practical Aspects of Information Processing: Driving a Car Research documenting age-related changes in attention, psychomotor speed, vision, and hearing has sparked considerable controversy concerning whether older adults should be allowed to drive. As you can see in Figure 14.9, statistics compiled by the National Highway Traffic Safety Administration (2013) show that although the fatality rate for older drivers over age 75 has declined, it is still higher than that for middle-aged adults. Changes in sensory and cognitive abilities appear to underlie this higher rate. Figure 14.9. U.S. Department of Transportation, National Highway Traffic Administration, Traffic Safety Facts: 2011 Data. National fatal passenger vehicle driver crash involvements per 100,000 licensed drivers by driver age group. Because individual differences in the amount of age-related changes that occur are large, experts agree that decisions about whether "at-risk" drivers should be allowed to continue driving must be based on performance measures rather than age or medical diagnosis alone. One approach measures the useful field of view (UFOV), the area from which one can extract visual information in a single glance without turning one's head or moving one's eyes (Rebok et al. 2014), which can easily be assessed via a personal desktop computer. A prototype assessment that can be used during normal driving has also been developed (Danno, Kutila, & Kortelainen, 2010). Thesize of the UFOV is important; it may mean the difference between "seeing" a car running a stop sign or a child running out between two parked cars and "not seeing" such information, which may mean the difference between having an accident and avoiding one. The UFOV test simulates driving in that it demands quick processing of information, simultaneous monitoring of central and peripheral stimuli, and the extraction of relevant target stimuli from irrelevant background information while performing a task. Performance on the UFOV predicts driving performance (e.g., Danno et al., 2011). People can be trained to improve the cognitive processes that underlie their UFOV (Rebok et al., 2014). To assist states in adopting more uniform standards, the American Automobile Association Foundation for Traffic Safety provides the AAA Roadwise Review Online: A Tool to Help Seniors Drive Safely Longer. The Roadwise Review is a screening tool developed by AAA and transportation safety researchers and validated in research. Designed to be administered online, the Roadwise Review assesses eight key functional areas: leg strength and general mobility, head and neck flexibility, high-contrast visual acuity, low visual acuity, working memory, visualization of missing information, visual search, and visual information processing speed. Drivers with a significant loss in the functional capabilities tested by Roadwise Review are 2 to 5 times more likely to cause a motor vehicle crash than drivers without such loss.

Complicated or Prolonged Grief

Not everyone is able to cope with grief well and to begin rebuilding a life. Sometimes the feelings of hurt, loneliness, and guilt are so overwhelming that they become the focus of the survivor's life to such an extent that there is never any closure and the grief interferes indefinitely with the survivor's ability to function. When this occurs, individuals are viewed as having complicated or prolonged grief disorder , which is distinguished from depression and from normal grief in terms of separation distress and traumatic distress (Stroebe, Schut, van den Bout, 2012). Symptoms of separation distress include being preoccupied with the deceased to the point that it interferes with everyday functioning, having upsetting memories of the deceased, longing and searching for the deceased, and feeling isolated following the loss. Symptoms of traumatic distress include feeling disbelief about the death, mistrusting others, feeling anger, and being detached from others as a result of the death, feeling shocked by the death, and experiencing the physical presence of the deceased. Complicated grief forms a separate set of symptoms from depression (Stroebe et al., 2012). Individuals experiencing complicated grief report high levels of separation distress (such as yearning, pining, or longing for the deceased person), along with specific cognitive, emotional, or behavioral indicators (such as avoiding reminders of the deceased, experiencing a diminished sense of self, having difficulty in accepting the loss, feeling bitter or angry), as well as increased morbidity, increased smoking and substance abuse, and difficulties with family and other social relationships. Similar distinctions have been made between complicated or prolonged grief disorder and anxiety disorders. Some researchers believe that complicated grief may be more likely with certain types of loss (such as the death of a child). In addition, some also speculate that whether a person has a supportive social network may make a difference. However, too little research has been conducted for clear conclusions to be drawn. The Spotlight on Research feature explores grief work regarding a common but under-researched topic: the degree to which partners influence each other's grieving process (Stroebe et al., 2013). As you read it, note how grief, which is typically thought of in an individual context, is experienced in a social context. Spotlight on Research The Costs of Holding in Grief for the Sake of One's Partner Who were the investigators, and what was the aim of the study? When parents experience the loss of a child, they must cope with two main things: how to deal with the worst thing imaginable with the death of the child and how do deal with each other. Surprisingly, little research has been done to examine how partners work through the grieving process alone and together. Stroebe and colleagues wanted to know how each partner regulates or tries to protect the other from the pain of the loss and from his or her own grief. How did the investigators measure the topic of interest? The researchers administered the Dutch version of the Inventory of Complicated Grief, items that measured Partner-Oriented Self-Regulation (POSR, such as "I stay strong for my partner") and items that assessed expressions of concern for one's partner. Who were the participants in the study? Participants were 463 Dutch couples who had lost a child and were invited to participate. Parents who also were grandparents and single parents were excluded. A total of 219 couple agreed to participate. Their age range was 26-68 years, the causes of death of the children were varied, and roughly two-thirds of the children were males. What was the design of the study? The study used a longitudinal design with three times of measurement (6, 13, and 20 months after the death of the child). Were there ethical concerns in the study? There were no ethical concerns, as participants were carefully screened, were provided detailed information about the nature of the project, and were given the opportunity to stop their participation at any time. What were the results? Several findings are noteworthy. First, grief lessened over time for both partners, with a recognition that grief was always greater for women than for men. Higher levels of POSR mattered; individuals whose partner reported more POSR experienced more grief themselves, as did their partner. These relations held over time. Expressions of concern for the partner showed the opposite—more expressions of concern were related to lower levels of grief in the partner being targeted by those expressions. What did the investigators conclude? The researchers argued that behaviors intended to show that one is strong for one's partner are actually unhelpful in lowering the experience of grief. On the other hand, one partner who expresses grief and concern about his or her partner can be helpful in the couple's and the individuals' coping with grief. What converging evidence would strengthen these conclusions? Because the study included only Dutch couples, more diverse samples would be beneficial. Also, more analyses on the cause of death and the age of the child at death may provide additional insightful information

Creativity and Wisdom

Two aspects of cognition that have been examined for age-related differences are creativity and wisdom. Each has been the focus of stereotypes: Creativity is assumed to be a function of young people, whereas wisdom is assumed to be the province of older adults. Let's see whether these views are accurate. Creativity What makes a person creative? Is it exceptional productivity? Does creativity mean having a career marked by precocity and longevity? Researchers define creativity in adults as the ability to produce work that is novel, high in demand, and task-appropriate (Sternberg & Lubart, 2001). Creative output, in terms of the number of creative ideas a person has or the major contributions a person makes, varies across the adult life span and across disciplines (Jones, 2010; Kozbelt & Durmysheva, 2007; Simonton, 2012). For example, most people consider Diego Rivera, a famous painter who created hundreds of pieces, and Thomas Edison, who still holds the record for the number of patents by an individual with 1,093, as creative. But people also consider Lao-tzu, whose only known work is the classic Tao Te Ching, creative as well. When considered as a function of age, the overall number of creative contributions a person has tends to increase through one's thirties, peak in the early forties, and decline thereafter. The age-related decline does not mean that people stop being creative altogether, just that they produce fewer creative ideas than when they were younger (Simonton, 2012). In fact, the age at which people made major creative contributions, such as research that resulted in winning the Nobel Prize, increased throughout the 20th century (Jones, 2010). The point is that one is never too old to be creative, a point explored in the Real People feature about Susan Perlstein. Real People Applying Human Development Creativity Never Stops Susan Perlstein never believed that creativity stopped at a certain age. She believes that no matter how old you are, you need to be striving to reach your potential. For her, being creative is one of those potentials. To help older adults reach their creative potential, Susan founded the National Center for Creative Aging (NCCA). The NCCA showcases the creative work of older adults through its blog, which includes works by older artists and photographers, among others, and personal stories of ways in which older adults are creative. Examples of people who found their creative expression through Susan's efforts abound. Among them are numerous older military veterans who started painting in later life. The NCCA also showcases active, creative people, such as women who returned to complete their education. In one case, at age 52, a young widow returned to school to complete her degree and worked to educate the military about human sexuality. She was reelected to her city council at age 78 (for a fifth term); works out with her Wii; and enjoys living with her daughter, son-in-law, and grandchildren. Susan Perlstein's efforts to promote creative aging remind us that although the quantity of creative output may decrease, the fact of creative output never ends. So no matter how old you are, you can—and should—be creative in some way. Exciting neuroimaging research is supporting the point that one's most innovative contribution tends to happen most often during the thirties or forties, as well as showing that creative people's brains work differently. This new research shows that white matter brain structures that connect distant brain regions (and coordinate the cognitive control of information among them) are related to creativity or insight and are more apparent in creative people (Jung et al., 2010; Kounios & Beeman, 2014; Takeuchi et al. 2010). Additional neuroimaging research shows that different areas of the prefrontal and parietal areas are responsible for different aspects of creative thinking (Abraham et al. 2012). This research supports the belief that creativity involves connecting disparate ideas in new ways, as different areas of the brain are responsible for processing different kinds of information. Because white matter tends to change with age, this finding also suggests that there are underlying brain maturation reasons why innovative thinking tends to occur most often during late young adulthood and early middle age. Wisdom For thousands of years, cultures around the world have greatly admired people who were wise. Based on years of research using in-depth think-aloud interviews with young, middle-aged, and older adults about normal and unusual problems that people face, Baltes and colleagues (Ardelt, 2010; Baltes & Staudinger, 2000; Scheibe, Kunzmann, & Baltes, 2007) describe four characteristics of wisdom: Wisdom deals with important or difficult matters of life and the human condition. Wisdom is truly "superior" knowledge, judgment, and advice. Wisdom is knowledge with extraordinary scope, depth, and balance that is applicable to specific situations. Wisdom, when used, is well intended and combines mind and virtue (character). Researchers have used this framework to discover that people who are wise are experts in the basic issues in life (Ardelt, 2010; Baltes & Staudinger, 2000). Wise people know a great deal about how to conduct life, how to interpret life events, and what life means. Kunz (2007) refers to this as the strengths, knowledge, and understanding learned only by living through the earlier stages of life. Research studies indicate that, contrary to what many people expect, there is no association between age and wisdom (Ardelt, 2010; Baltes & Staudinger, 2000). As envisioned by Baltes and colleagues, whether a person is wise depends on whether he or she has extensive life experience with the type of problem given and has the requisite cognitive abilities and personality. Thus, wisdom could be related to crystallized intelligence, knowledge that builds over time and through experience (Ardelt, 2010). Culture matters, though, in understanding wisdom. For example, younger and middle-aged Japanese adults use more wisdom-related reasoning strategies (e.g., recognition of multiple perspectives, the limits of personal knowledge, and the importance of compromise) in resolving social conflicts than do younger or middle-aged Americans (Grossman et al., 2012). However, older adults in both cultures used similar wisdom-related strategies. So what specific factors help one become wise? Baltes (1993) identified three factors: (1) general personal conditions, such as mental ability; (2) specific expertise conditions, such as mentoring or practice; and (3) facilitative life contexts, such as education or leadership experience. Personal growth during adulthood, reflecting Erikson's concepts of generativity and integrity, also helps foster the process, as do facing and dealing with life crises (Ardelt, 2010). All of these factors take time. Thus, although growing old is no guarantee of wisdom, it does provide the time that, if used well, creates a supportive context for developing wisdom. Becoming wise is one thing; having one's wisdom recognized is another. Interestingly, peer ratings of wisdom are better indicators of wisdom than are self-ratings (Redzanowski & Glück, 2013). It appears that people are better at recognizing wisdom in others than they are in themselves. Perhaps it is better that way. Interestingly, there is a debate over whether with wisdom comes happiness. Some research evidence shows that wise people are happier (Bergsma & Ardelt, 2012; Etezadi & Pushkar, 2013). Wise people tend to have higher levels of perceived control over their lives and use problem-focused and positive reappraisal coping strategies more often than people who are not wise. On the other hand, some evidence indicates that the attainment of wisdom brings increased distress (Staudinger & Glück, 2011). Perhaps that is because with the experience that brings wisdom comes an understanding that life does not always work out the way one would like.

Bias and Discrimination

Since the 1960s, organizations in the United States have been sensitized to the issues of bias and discrimination in the workplace. Hiring, promotion, and termination procedures have come under close scrutiny in numerous court cases, resulting in judicial rulings governing these processes. Gender Bias and the Glass Ceiling By the middle of the second decade of the 21st century, women accounted for more than half of all people employed in management, professional, and related occupations (Bureau of Labor Statistics, 2013b). However, women are still underrepresented at the very top; for example, at the beginning of 2014, less than 5% of Fortune 500 companies had women CEOs, and only about 17% of seats on their boards of directors were held by women, a significant increase since the mid-2000s, but still a small number overall. Janice's observation in the vignette, that few women serve in the highest ranks of major corporations, is accurate. In addition, women are underrepresented as members of Congress and as presidents or chancellors of colleges and universities. STAN HONDA/AFP/Getty Images Women CEOs of major corporations, such as Mary Barra at General Motors, are still few in number. Why are there so few women in such positions? The most important reason is gender discrimination : the act of denying a job to someone solely on the basis of whether the person is a man or a woman. Gender discrimination is still pervasive in too many aspects of the workplace (Purcell, MacArthur, & Samblanet, 2010). Women are being kept out of high-status jobs by the men at the top (Sabharwal, 2014). Research in the United States and Britain also confirms that women are forced to work harder than men (Gorman & Kmec, 2007). Neither differences in job characteristics nor family obligations account for this difference; the results clearly point to stricter job performance standards being applied to women. Women themselves refer to a glass ceiling , the level to which they may rise in an organization but beyond which they may not go. The glass ceiling is a major barrier for women (Johns, 2013; Purcell et al., 2010; Sabharwal, 2014), and the greatest barrier facing them is at the boundary between lower-tier and upper-tier grades. Men are largely blind to the existence of the glass ceiling (Heppner, 2007). The glass ceiling is pervasive across higher management and professional workplace settings (Johns, 2013; Sabharwal, 2014). Despite decades of attention to the issue, little overall progress is being made in the number of women who lead major corporations or serve on their boards of directors (Cundiff & Stockdale, 2013). The glass ceiling has also been used to account for why African Americans and Asian Americans do not advance as much in their careers as do European American men (Cundiff & Stockdale, 2013; Hwang, 2007). It also provides a framework for understanding limitations to women's careers in many countries around the world, such as South Africa (Kiaye & Singh, 2013). Women such as Janice tend to move to the top of the lower tier and remain there, whereas men are more readily promoted to the upper tier even when other factors (e.g., personal attributes, qualifications, job performance) are controlled (Lovoy, 2001). Interestingly, a different trend emerges when one examines who is appointed to critical positions in organizations in times of crisis (Sabharwal, 2014). Research shows that at such times, women are more likely to be put into leadership positions. Consequently, women often confront a glass cliff , a situation in which their leadership position is precarious. For example, evidence shows that companies are more likely to appoint a woman to their board of directors if their financial performance had been poor in the recent past, and women are more likely to be political candidates if the seat is a highly contested one (Ryan, Haslam, & Kulich, 2010). This evidence indicates that women's experience of and opportunities for high-level leadership in organizations is different than men's and tends to be much riskier (Sabharwal, 2014). What can be done to eliminate the glass ceiling and the glass cliff? Kolb, Williams, and Frohlinger (2010) argue that women can and must be assertive in getting their rightful place at the table by focusing on five key things: drilling deep into the organization so that they can make informed decisions, getting critical support, getting the necessary resources, getting buy-in, and making a difference. On the organizational side, Mitchell (2000) suggests that companies must begin to value the competencies women develop, such as being more democratic and interpersonally oriented than men, and to assist men in feeling more comfortable with their female colleagues. Mentoring is also an important aspect. Lovoy (2001) adds that companies must be more proactive in promoting diversity, provide better and more detailed feedback about performance and where employees stand regarding promotion, and establish ombuds offices (company offices where employees can complain about working conditions or their supervisor without fear of retribution) that help women deal with difficulties on the job. Much debate has erupted over the issue of women rising to the top. There is no doubt that the glass ceiling and glass cliff exist. The controversy revolves around the extent to which part of the issue also is due to women's decision not to pursue (some say reluctance to purse) the top positions. As discussed in the What Do You Think feature, this debate is likely to rage for years. What Do You Think? Do Women Lean Out When They Should Lean In? Sheryl Sandberg is unquestionably successful. She has held some of the most important, powerful positions in some of the most recognizable technology companies in the world. When she published her book Lean In: Women, Work, and the Will to Lead in 2013, she set off a fierce debate. Sandberg claimed that there is discrimination against women in the corporate word. But she also argued that an important reason women do not rise to the top more often is due to their unintentional behavior that holds them back. She claimed that women do not speak up enough, need to abandon the myth of "having it all," must set boundaries, need to get a mentor, and must not "check out of work" when thinking about starting a family. The national debate around these topics points raised many issues: Sandberg's ability to afford to pay for support may make her points irrelevant for women who do not have those resources; her husband's ability and willingness to share in child rearing and household chores may make her arguments irrelevant for single parents; she was "blaming the victim"; no one ever puts men in these situations of having to choose; and so on. Does Ms. Sandberg have a valid point to make? Do men and women differ in how they approach careers? Are the differences she notes inherent in men and women, or are they learned? What support systems that are currently missing need to be put in place? What do you think? Equal Pay for Equal Work In addition to discrimination in hiring and promotion, women are also subject to pay discrimination. According to the Bureau of Labor Statistics (2013a), women's median income overall is about 81 percent of men's, creating an earnings gap of 19 percent. As you can see in Figure 12.6, the wage gap depends on ethnicity and has been narrowing since the 1980s. Figure 12.6. Source: U.S. Bureau of Labor Statistics. Women's earnings as a percentage of men's. In the United States, the first law regarding pay equity was passed by Congress in 1963. Forty-six years later in 2009, President Obama signed the Lilly Ledbetter Fair Pay Act, showing that the problem of pay inequity still exists. In their comprehensive and insightful analysis of the continuing gap between men's and women's paychecks for the same work, Dey and Hill (2007) make a clear case that much needs to be done—and now. What if women choose a college major that is associated with high-paying jobs, such as those in science, technology, engineering, and mathematics? Will that help reduce the pay differential? No. Choosing a traditionally male-dominated major will not solve the problem. For example, women in mathematics occupations earn only about $0.76 for every $1.00 a male mathematics graduate earns. A woman is also significantly disadvantaged regarding the division of labor at home if she is married to or living with a man, as we will consider later in this chapter. Despite decades of trying to get men to do more of the housework and child care tasks, little has changed in terms of the amount of time men actually spend on these tasks. In effect, this means that women have two careers—one in the workplace and the other at home. In addition, if a college-educated woman stays at home to care for a child or parent and then decides to go back to work, her return to the workforce will be at a lower salary than it would have been otherwise. Sexual Harassment Suppose you have worked very hard on a paper for a course and think you've done a good job. When you receive an A for the paper, you are elated. When you discuss your paper (and your excitement) with your instructor, you receive a big hug. How do you feel? What if this situation involved a major project at work and the hug came from your boss? Your coworker? What if it were a kiss on your lips instead of a hug? Whether such behavior is acceptable or whether it constitutes sexual harassment depends on many situational factors, including the setting and the people involved and the relationship between them. How many people have been sexually harassed? That's a very hard question to answer for several reasons: There is no universal definition of sexual harassment, men and women have different perceptions, and many victims do not report it (The Advocates for Human Rights, 2010). Even given these difficulties, global research indicates that between 40% and 50% of women in the European Union and 30% to 40% of women in Asia Pacific countries experience workplace sexual harassment (International Labour Organization, 2013). Victims are most often single or divorced young adult women (Zippel, 2006), but about 16% of workplace cases that result in formal legal charges involve male victims (Equal Employment Opportunity Commission, 2010). Although the number of formal complaints in the United States is declining, it is unclear whether this is due to increased sensitivity and training by employers, reluctance of victims to report harassment for fear of losing their jobs during economically difficult times, or both. What are the effects of being sexually harassed? As you might expect, research evidence clearly shows negative job-related, psychological, and physical health outcomes (Lim & Cortina, 2005). Cultural differences in labeling behaviors as sexually harassment are also important. Research comparing countries in the European Union reveals differences across these countries in terms of definitions and corrective action (Zippel, 2006). Unfortunately, little research has been done to identify what aspects of organizations foster harassment or to determine the impact of educational programs aimed at addressing the problem. In 1998, the U.S. Supreme Court (in Oncale v. Sundowner Offshore Services) ruled that the relevant laws also protect men. Thus, the standard by which sexual harassment is judged could now be said to be a "reasonable person" standard. Think About It What are the key biological, psychological, sociocultural, and life-cycle factors that should be incorporated into training programs concerning sexual harassment? What can be done to provide people with safe work and learning environments, free from sexual harassment? Training in gender awareness is a common approach that often works, especially given that gender differences exist in perceptions of behavior (Lindgren, 2007). Age Discrimination Another structural barrier to occupational development is age discrimination , which involves denying a job or promotion to someone solely on the basis of age. The U.S. Age Discrimination in Employment Act of 1986 protects workers over age 40. A law that brought together all of the anti-discrimination legislation in the United Kingdom, the Equality Act of 2010, includes a prohibition against age discrimination, and more European countries are protecting middle-aged and older workers (Government Equalities Office, 2013; Lahey, 2010). These laws stipulate that people must be hired based on their ability, not their age, and cannot segregate or classify workers or otherwise denote their status on the basis of age. Dennis Wise/Digital Vision/Getty Images Employers cannot make a decision not to hire this woman solely on the basis of her age. Employment prospects for middle-aged people around the world are lower than for their younger counterparts (Lahey, 2010). For example, age discrimination toward those over age 45 is common in Hong Kong (Cheung, Kam, & Ngan, 2011), resulting in longer periods of unemployment. Such practices may save companies money in the short run, but the loss of expertise and knowledge comes at a high price. Indeed, an emerging model of employment is boomerang employees , individuals who terminate employment at one point in time but return to work in the same organization at a future time. Boomerang employees sometimes return as employees on the company's payroll, but increasingly are returning as contract workers who are not eligible for benefits, thereby meeting the company's needs for both expertise and lower costs (Shipp et al., 2014). Age discrimination usually happens before or after interaction with professional human resources staff by other employees making the hiring decisions, and it can be covert (Lahey, 2010; Pillay, Kelly, & Tones, 2006). For example, employers can make certain types of physical or mental performance a job requirement and argue that older workers cannot meet the standard prior to an interview. Or they can attempt to get rid of older workers by using retirement incentives. Supervisors' stereotyped beliefs sometimes factor in performance evaluations for raises or promotions or in decisions about which employees are eligible for additional training (Sterns & Spokus, 2013). Test Yourself 12.2 Recall Women who choose nontraditional occupations are viewed by their peers. SOLUTION ↓ Among the reasons women in well-paid occupations leave, are most important for part-time workers. SOLUTION ↓ Ethnic minority workers are more satisfied with and committed to organizations that are responsive and provide . SOLUTION ↓ Three barriers to women's occupational development are sex discrimination, the glass ceiling, and . SOLUTION ↓ Interpret What steps need to be taken to eliminate gender, ethnic, and age bias in the workplace? Apply Suppose you are the CEO of a large organization and you need to make personnel reductions through layoffs. Many of your most expensive employees are over age 40. How can you accomplish this without being accused of age discrimination?

job satisfaction

What does it mean to be satisfied with one's job or occupation? Job satisfaction is the positive feeling that results from an appraisal of one's work. Research indicates that job satisfaction is a multifaceted concept but that certain characteristics—including hope, resilience, optimism, and self-efficacy—predict both job performance and job satisfaction. This research has resulted in the creation of psychological capital theory , the notion that having a positive outlook improves processes and outcomes (Youssef-Morgan & Luthans, 2013). Satisfaction with some aspects of one's job tends to increase gradually with age (Besen et al., 2013). Why? Is it because people sort themselves out and end up in occupations they like? Is it that they simply learn to like the occupation they are in? What other factors matter? For starters, the factors that predict job satisfaction differ somewhat across cultures (Klassen, Usher, & Bong, 2010). This is explored in more detail in the Spotlight on Research feature. Spotlight on Research Cross-Cultural Aspects of Teachers' Job Satisfaction Who were the investigators, and what was the aim of the study? Robert Klassen, Ellen Usher, and Mimi Bong wondered about the similarities and differences in teachers' job satisfaction, self-efficacy, and job stress. To find out, they studied teachers in the United States, Korea, and Canada. Their main question was whether teachers' cultural values, self-efficacy, and job stress would predict job satisfaction across the three countries. How did the investigators measure the topic of interest? The researchers measured self-efficacy by assessing teachers' individual perceptions about their school's collective capabilities to influence student achievement. Job satisfaction was measured through four questions: (1) "I am satisfied with my job," (2) "I am happy with the way my colleagues and superiors treat me," (3) "I am satisfied with what I achieve at work," and (4) "I feel good at work." Job stress was measured using a single item ("I find teaching to be very stressful"). Collectivism, a cultural value, was measured with a six-item scale in which the first part of the question was "In your opinion, how important is it that you and your family . . .," with the conclusion of the items including the following: (1) "take responsibility for caring for older family members?" (2) "turn to each other in times of trouble?" (3) "raise each other's children whenever there is a need?" (4) "do everything you can to help each other move ahead in life?" (5) "take responsibility for caring for older family members?" and (6) "call, write, or see each other often?" The Korean version of the scales was created using a translation-back-translation process to ensure that the meaning of the items was preserved. Who were the participants in the study? A total of 500 elementary and middle school teachers from the United States (n = 137), Canada (n = 210), and Korea (n = 153) participated. The sample from the United States was included to connect this study to other research on teachers' job satisfaction. Canadian teachers were included to determine the degree to which findings from the United States could be generalized to a country holding similar (but not identical) cultural values. The Korean teachers represented a group with a different geographic and demographic profile (East Asian, Confucian, collectivist). Careful analyses showed no significant differences in age, teaching experience, job satisfaction, collective efficacy, job stress, or cultural values across the three countries. What was the design of the study? The study used a cross-sectional design. Were there ethical concerns with the study? Because the study involved voluntary completion of a survey, there were no ethical concerns. What were the results? The analyses revealed that compared with the Korean teachers, North American teachers scored higher on all the variables. However, there were no differences across countries regarding the efficacy of the teachers and either the strength or direction of its relation to job satisfaction. In contrast, analyses also revealed that job stress had a bigger impact for North American teachers, whereas the cultural value of collectivism was more important for Korean teachers. What did the investigators conclude? The most important finding from the study is the similarity across countries in the connection between the efficacy that teachers believe they have and their job satisfaction—the less efficacy there is, the lower a teacher's satisfaction is likely to be. Second, the higher importance of the cultural value of collectivism for Korean teachers probably reflects a cultural norm of avoiding conflict and working for the betterment of the group. Finally, the finding that job stress was a negative predictor of job satisfaction for North American teachers (the higher the stress, the lower the satisfaction) but a positive predictor for Korean teachers (higher job stress predicted higher satisfaction) indicates that job stress may have different components as a function of culture. For Korean teachers, feeling stressed by the presence of more competent teachers may create an urge to improve rather than a feeling of defeat. In sum, some predictors of job satisfaction transcend countries; others do not. What converging evidence would strengthen these conclusions? Because Klassen and colleagues' study examined only a few countries and cultures, it needs to be repeated with others. Also, more types of teachers (high school, college/university) need to be included. So how does job satisfaction evolve over young and middle adulthood? You may be pleased to learn that research shows that given sufficient time, most people find a job with which they are reasonably happy (Hom & Kinicki, 2001). Optimistically, this indicates that there is a job out there, somewhere, in which you will be happy. That's good because research grounded in positive psychology theory indicates that happiness fuels success (Achor, 2010; Youssef-Morgan & Luthans, 2013). It's also true that job satisfaction does not increase in all areas and job types with age. White-collar professionals show an increase in job satisfaction with age, whereas those in blue-collar positions generally do not, and these findings hold with both men and women (Aasland, Rosta, & Nylenna, 2010). This is also true across cultures. A study of Filipino and Taiwanese workers in the long-term health care industry in Taiwan showed that workers with four or five years' experience had lower job satisfaction than workers with less experience, but job satisfaction among older physicians in Norway increased over time (Aasland et al., 2010; Tu, 2007). In addition, the strength of the positive relationship between job satisfaction and various aspects of jobs and coworkers change in different ways, ultimately resulting in increased job satisfaction over time (Besen et al., 2013). However, the changes in the labor market in terms of fewer prospects of having a long career with one organization have begun to change the notion of job satisfaction (Bidwell, 2012; Böckerman et al., 2013). Specifically, the fact that companies may eliminate jobs and workers not based on performance, making it more difficult for employees to develop a sense of organizational commitment, has made the relationship between worker age and job satisfaction more complicated. Also complicating traditional relations between job satisfaction and age is the fact that the type of job one has and the kinds of family responsibilities one has at different career stages—as well as the flexibility of work options such as telecommuting and family leave benefits to accommodate those responsibilities—influence the relationship between age and job satisfaction (Marsh & Musson, 2008). This suggests that the accumulation of experience, changing context, and the stage of one's career development may contribute to the increase in job satisfaction over time, as does the availability of options such as telecommuting. Alienation and Burnout All jobs create a certain level of stress. For most workers, such negatives are merely annoyances. But for others, extremely stressful situations on the job may result in alienation and burnout. ERproductions Ltd/Blend Images/Getty Images High-stress jobs such as intensive care nursing often result in burnout. When workers believe that what they are doing is meaningless and that their efforts are devalued or when they do not see the connection between what they do and the final product, a sense of alienation is likely to result. Terkel (1974) reported that employees are most likely to feel alienated when they perform routine, repetitive actions. But other workers can become alienated, too. The Great Recession that began in 2008 and resulted in record levels of job loss is only the most recent example of even high-level managerial employees feeling abandoned by their employers. It is essential for companies to provide positive work environments to ensure that the workforce remains stable and committed (Griffin et al., 2010). How can employers avoid alienating workers and improve organizational commitment? Research indicates that trust is key (Chen, Aryee, & Lee, 2005; Sousa-Lima, Michel, & Caetano, 2013), as is a perception among employees that the employer deals with people fairly and impartially (Howard & Cordes, 2010). It is also helpful to involve employees in the decision-making process, create flexible work schedules, and institute employee development and enhancement programs. Employees in organizations that foster trust are also more likely to want to stay (Sousa-Lima et al., 2013). Sometimes the pace and pressure of the occupation becomes more than a person can bear, resulting in burnout , a depletion of a person's energy and motivation, the loss of occupational idealism, and the feeling that one is being exploited. Burnout is a state of physical, emotional, and mental exhaustion as a result of job stress (Malach-Pines, 2005). Burnout is most common among people in the helping professions, such as police (McCarty & Skogan, 2013). The tendency of companies to keep employee numbers smaller during times of economic uncertainty adds to the workload for people on the job, increasing the risk of burnout (Bosco, di Masi, & Manuti, 2013). People in these professions and situations must deal with other people's complex problems, usually under difficult time constraints. Dealing with these pressures every day, along with handling bureaucratic paperwork, may become too much for the worker to bear. Frustration builds and disillusionment and exhaustion set in—burnout. And burnout can negatively affect the people who are supposed to receive services from the burned-out employee (Rowe & Sherlock, 2005). But we know that burnout does not affect everyone in a particular profession. Why? Vallerand (2008, 2012; Carbonneau & Vallerand, 2012) proposes that the difference relates to people feeling different types of passion (obsessive and harmonious) toward their jobs. A passion is a strong inclination toward an activity that individuals like (or even love), that they value (and thus find important), and in which they invest time and energy (Vallerand et al., 2010). Vallerand's (2008, 2012) Passion Model proposes that people develop a passion toward enjoyable activities that are incorporated into identity. Vallerand's model differentiates between two kinds of passion: obsessive and harmonious. A critical aspect of obsessive passion is that the internal urge to engage in the passionate activity makes it very difficult for the person to disengage fully from thoughts about the activity, leading to conflict with other activities in the person's life (Carbonneau & Vallerand, 2012; Vallerand et al., 2010). In contrast, harmonious passion results when individuals do not feel compelled to engage in the enjoyable activity; rather, they freely choose to do so, and it is in harmony with other aspects of the person's life (Carbonneau & Vallerand, 2012; Vallerand et al., 2010). Research in France and Canada indicate that the Passion Model accurately predicts employees' feelings of burnout (Vallerand, 2008, 2012; Vallerand et al., 2010). As shown in Figure 12.3, obsessive passion predicts higher levels of conflict, which in turn predicts higher levels of burnout. In contrast, harmonious passion predicts higher levels of satisfaction at work, which in turn predicts lower levels of burnout. Figure 12.3. Source: Vallerand, R. J., Paquet, Y., Philippe, F. L., & Charest, J. (2010). On the role of passion for work in burnout: A process model. Journal of Personality, 78, 289-312. Figure 1 (p. 300). Path analytic model of the relationships among passion, satisfaction at work, conflict, and burnout. Harmonious passion predicts higher satisfaction at work, which predicts lower levels of burnout. In contrast, obsessive passion predicts higher levels of conflict, which in turn predicts higher levels of burnout. The best ways to lower burnout are through intervention programs that focus on both the organization and the employee (Awa, Plaumann, & Walter, 2010) and foster passion (Vallerand, 2008, 2012). At the organizational level, job restructuring and employee-provided programs are important. For employees, using stress-reduction techniques, lowering other people's expectations, incorporating cognitive restructuring of the work situation, and finding alternative ways to enhance personal growth and identity are most effective (van Dierendonck, Garssen, & Visser, 2005). Test Yourself 12.1 Recall For most people, the main reason to work is . SOLUTION ↓ Holland's theory deals with the relationship between occupation and . SOLUTION ↓ says that occupational selection is based in part on a person's self-efficacy regarding his or her occupation. SOLUTION ↓ The role of a mentor is part teacher, part sponsor, part model, and part . SOLUTION ↓ For many workers, job satisfaction tends to in midlife. SOLUTION ↓ Two salient aspects of job dissatisfaction are alienation and . SOLUTION ↓ Interpret What is the relation between occupational development and job satisfaction? Would these relations be different in the case of a person with a good match between personality and occupation versus a person with a poor match? How could interventions that help people avoid alienation be made culturally sensitive? Apply If you were the director of the campus career services office, what would you do to provide students with realistic and accurate information about potential careers? If you were a company's director of human resources, how would you design a new employee orientation program?

Singlehood

When Sharon graduated from college with a degree in accounting, she took a job at a consulting firm. For the first several years in her job, she spent more time traveling than she did at home. During this time, she had a series of love relationships, but none resulted in commitment even though she had marriage as a goal. By the time she was in her mid-thirties, Susan had decided that she no longer wanted to get married. "I'm now a partner in my firm, I enjoy traveling, and I'm flexible in terms of moving if something better comes along," she stated to her friend Michele. "But I do miss being with someone to share my day or to just hang around with." Like Susan, most men and women during early adulthood are single—defined as not living with an intimate partner. Estimates are that approximately 80% of men and 70% of women between ages 20 and 24 are unmarried, with increasing numbers deciding to stay that way (U.S. Census Bureau, 2013a). What's it like to be single in the United States? It's tougher than you might think. DePaulo (2014) points out numerous stereotypes and biases against single people. Her research found that young adults characterized married people as caring, kind, and giving about 50% of the time compared with only 2% for single people. And single people receive less compensation at work than married people do, even when age and experience are equivalent. DePaulo also found that rental agents preferred married couples 60% of the time (Morris, Sinclair, & DePaulo, 2007). Can you think of reasons why people might hold these biases against single people? Many women and men remain single as young adults to focus on establishing their careers rather than marriage or relationships, which most do later. Others report that they simply did not meet "the right person" or prefer singlehood (Ibrahim & Hassan, 2009). However, the pressure to marry is especially strong for women; frequent questions such as "Any good prospects yet?" may leave women feeling conspicuous or left out as many of their friends marry. Men tend to remain single longer in young adulthood because they tend to marry at a later age than women do (U.S. Census Bureau, 2013b). Fewer men than women remain unmarried throughout adulthood, though, mainly because men find partners more easily as they select from a larger age range of unmarried women. Ethnic differences in singlehood reflect differences in age at marriage, as well as social factors. For example, nearly twice as many African Americans are single during young adulthood as European Americans, and more are choosing to remain so(U.S.Census Bureau, 2013b). Singlehood is also increasing among Latinos, in part because the average age of Latinos in the United States is lower than that of other ethnic groups and in part because of poor economic opportunities for many Latinos (Lamanna, Riedmann, & Stewart, 2014). However, Latino men expect to marry (even if they do not) because it indicates achievement. Globally, the meanings and implications of remaining single are often tied to strongly held cultural and religious beliefs. For example, Muslim women who remain single in Malaysia speak in terms of jodoh (the soul mate one finds through fate at a time appointed by God) as a reason; they believe that God simply has not decided to have them meet their mate at this time (Ibrahim & Hassan, 2009). But because the role of Malaysian women is to marry, they also understand their marginalized position in society through their singlehood. In Hong Kong and Taiwan, for instance, the number of single women has increased steadily as educational levels have risen over the past several decades, resulting in significant postponement, and even avoidance of, marriage (Yang & Yen, 2014). However, family systems in these cultures have not yet fully adapted to these changing lifestyle patterns, which will likely result in dramatically lower fertility rates (Jones, 2010; Yang & Yen, 2014). An important distinction is between adults who are temporarily single (i.e., those who are single only until they find a suitable marriage partner) and those who choose to remain single. Results from an in-depth interview study with never-married women in their thirties revealed three distinct groups: some suffer with acute distress about being single and long to be married with children, others describe experiencing the emotional continuum of desiring to be married and desiring to remain single, and others say that they are quite happy with a healthy self-image and high quality of life (Cole, 2000). For most singles, the decision to never marry is a gradual one. This transition is represented by a change in self-attributed status that occurs over time and is associated with a cultural timetable for marriage. It marks the experience of "becoming single" that occurs when an individual identifies more with singlehood than with marriage (Davies, 2003; DePaulo, 2014). As we will see later when we consider marriage education, it may be a good idea to think about what you prefer to be—single or part of a committed relationship. Numerous self-help books are on the market to guide people through this discernment (e.g., Outcalt, 2014). However it is done, think about what you really want.

secondary control

behavior or cognition aimed at affecting the individual's internal world

what has diet been linked to

cancer, cardiovascular disease, diabetes, anemia, and digestive disorders

scenario

manifestation of the life-span construct through expectations about the future -plan for the future

intimacy versus isolation

sixth stage in Erikson's theory and the major psychosocial task for young adults -if clear identity established, ready to share identity with others (intimacy), if no identity, young adults will be afraid of committing to a long-term relationship or might become overly dependent on the partner for his or her identity

most popular medications to control cholesterol

statins (Lipitor, Zocor), lower LDL and modertaely increase HDL

emerging adulthood

the period between late teens and mid to late 20s when individuals are not adolescents but are not yet fully adults

when do people reach financial independence

-college-bound students do this later than those who don't go to college -increasingly common for college graduates to return home to live with their parents prior to establishing financial independence

consequences of binge drinking

-driving under influence -alcohol-related date rape -assault -dying from drinking too much

late adulthood

In general, older adults are less anxious about death and more accepting of it than any other age group (Kastenbaum, 1999). They may believe that their most important life tasks have been completed. However, that is not to say that older adults are unaffected by loss. Far from it. Death of One's Child or Grandchild in Late Life The loss of a child can happen at any point over the adult life span. Older bereaved parents tend to reevaluate their grief as experienced shortly after the loss and years and decades later. Even more than 30 years after the death of a child, older adults still feel a keen sense of loss and have continued difficulty coming to terms with it (Malkinson & Bar-Tur, 2004-2005). The long-lasting effects of the loss of a child are often accompanied by a sense of guilt that the pain affected the parents' relationships with the surviving children. Loss of a child in young adulthood may also result in lower cognitive functioning in late life (Greene et al., in press). The loss of a grandchild results in similar feelings: intense emotional upset, survivor guilt, regrets about the relationship with the deceased grandchild, and a need to restructure relationships with the surviving family. However, bereaved grandparents tend to control and hide their grief behavior in an attempt to shield their child (the bereaved parent) from the level of pain being felt. In cases in which older adults were the primary caregivers for grandchildren, feelings can be especially difficult. For example, custodial grandparents in South Africa whose grandchildren in their care died from AIDS go through emotionally difficult times due to the loss and to the social stigma regarding the disease (Boon et al., 2010). Death of One's Partner Experiencing the loss of one's partner is the type of loss in late life we know most about. The death of a partner differs from other losses. It clearly represents a deep personal loss, especially when the couple has had a long and close relationship (Lee, 2014). In a very real way, when our partner dies, a part of ourself dies, too. There is pressure from society to mourn the loss of one's partner for a period of time and then to "move on" (Jenkins, 2003). Typically, this pressure is manifested if the survivor begins to show interest in finding another partner before an "acceptable" period of mourning has passed. Although Americans no longer specify the length of the mourning period, many believe that about a year is appropriate. The fact that such pressure and negative commentary usually do not accompany other losses is another indication of the seriousness with which most people take the death of a partner. ©Cris Kelly/Shutterstock.com The loss of a spouse or partner can be especially traumatic after a long relationship. Older bereaved spouses may grieve a great deal for a long time (Lee, 2014); research has shown that grief can sometimes last for years (Naef et al., 2013). Given that, you might wonder whether having a supportive social network can help people cope. Research findings on this topic are mixed, however. Some studies find that social support plays a significant role in the outcome of the grieving process. For example, some data show that during the first two years after the death of a partner, the quality of the support system—rather than simply the number of friends—is especially important for the grieving partner. Survivors who have confidants are better off than survivors who have many acquaintances (Hansson & Stroebe, 2007). In contrast, other studies find that having a supportive social network plays little role in helping people cope (DiGiacomo et al., 2013). Issues may include whether there is a complex relationship involving the bereaved person, whether he or she wants to have contact with others, who in the social network is willing to provide support, and whether that support is of high quality. When one's partner dies, how he or she felt about the relationship can play a role in coping with bereavement. For instance, widowed older adults who felt worsening regret about unfinished aspects of their marriages over time had the hardest time dealing with grief (Holland et al., 2014). Several studies of widows document a tendency for some older widows to "sanctify" their husbands (Lopata, 1996). Sanctification involves describing a deceased spouse in idealized terms, and it serves several functions: validating that the widow had a strong marriage, is a good and worthy person, and is capable of rebuilding her life. European American women who view being a wife as above all other roles a woman can perform are somewhat more likely to sanctify their husbands (Lopata, 1996). In fact, the higher the quality of the relationship, the more bereaved spouses yearn for their lost spouse (Stroebe, Abakoumkin, & Stroebe, 2010). Older bereaved spouses who can talk about their feelings concerning their loss exhibit reduced levels of depression and functional impairment (Pfoff, Zarotney, & Monk, 2014). Cognitive-behavioral therapy is one especially effective intervention to help bereaved people make sense of the loss and deal with their other feelings and thoughts (Lichtenthal & Sweeney, 2014). A key to this process is helping people make meaning from the death (Neimeyer & Wogrin, 2008). Gay and lesbian couples may experience feelings and reactions in addition to typical feelings of grief (Clarke et al., 2010). For example, a partner may feel disenfranchised by family members of the deceased at the funeral, making it hard for the partner to bring closure to the relationship (McNutt & Yakushko, 2013). For gay partners who were also caregivers, the loss affects one's sense of identity in much the same way as the death of a spouse, and making sense of the death becomes the primary issue (Cadell & Marshall, 2007). Lesbian widows report similar feelings (Bent & Magilvy, 2006). As same-sex marriage becomes more accepted, it will be important for researchers to document the experience of same-sex widowed people

The Five-Factor Trait Model

In the past few decades, one of the most important advances in research on adult development and aging has been the emergence of a personality theory aimed specifically at describing adults. Due mostly to the efforts of Robert McCrae and Paul Costa, Jr. (2003), we are now able to describe adults' personality traits using five dimensions: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. These dimensions (the so-called Big Five traits) are strongly grounded in cross-sectional, longitudinal, and sequential research. First, though, let's take a closer look at each dimension. People who are high on the neuroticism dimension tend to be anxious, hostile, self-conscious, depressed, impulsive, and vulnerable. They may show violent or negative emotions that interfere with their ability to get along with others or to handle problems in everyday life. People who are low on this dimension tend to be calm, even-tempered, self-content, comfortable, unemotional, and hardy. Individuals who are high on the extraversion dimension thrive on social interaction, like to talk, take charge easily, readily express their opinions and feelings, like to keep busy, have boundless energy, and prefer stimulating and challenging environments. Such people tend to enjoy people-oriented jobs such as social work and sales, and they often have humanitarian goals. People who are low on this dimension tend to be reserved, quiet, passive, serious, and emotionally unreactive. Being high on the openness to experience dimension tends to have a vivid imagination and dream life, an appreciation of art, and a strong desire to try anything once. These individuals tend to be naturally curious about things and to make decisions based on situational factors rather than absolute rules. People who are readily open to new experiences place a relatively low emphasis on personal economic gain. They tend to choose jobs such as the ministry or counseling, which offer diversity of experience rather than high pay. People who are low on this dimension tend to be down-to-earth, uncreative, conventional, uncurious, and conservative. Scoring high on the agreeableness dimension is associated with being accepting, willing to work with others, and caring. People who score low on this dimension (i.e., demonstrate high levels of antagonism) tend to be ruthless, suspicious, stingy, antagonistic, critical, and irritable. People who show high levels of conscientiousness tend to be hard-working, ambitious, energetic, scrupulous, and persevering. Such people have a strong desire to make something of themselves. People at the opposite end of this scale tend to be negligent, lazy, disorganized, late, aimless, and nonpersistent. The five-factor model has been examined cross-culturally. Research evidence generally shows that the same five factors appear across at least 50 cultures, including rarely studied Arabic and Black African groups (McCrae & Terracciano, 2005). Heine and Buchtel (2009) point out, though, that much of this research has been conducted by Westerners; so it remains to be seen whether similar studies conducted by local researchers will have the same outcomes. What's the Evidence for Trait Stability? Costa and McCrae have investigated whether the general traits that make up their model remain stable across adulthood (e.g., McCrae & Costa, 2003). The data from the Costa and McCrae studies came from the Baltimore Longitudinal Study of Aging for the 114 men who took the Guilford-Zimmerman Temperament Survey (GZTS) on three occasions, with each of the two follow-up testings occurring about six years apart. What Costa and McCrae found was surprising. Even over a 12-year period, the ten traits measured by the GZTS remained highly stable; the correlations ranged from 0.68 to 0.85. In much of personality research, we might expect to find this degree of stability over a week or two, but to see it over 12 years is noteworthy. We would normally be skeptical of such consistency over a long period, but similar findings were obtained in other research. In a study of 684 adults aged 17 to 76, Terracciano, McCrae, and Costa (2010) found that the stability of personality traits plateaus in adulthood. A longitudinal study of 60-, 80-, and 100-year-old men and women by Martin, Long, and Poon (2002) found no significant changes across age groups in overall personality patterns. However, some interesting changes did occur in the very old. There was an increase in suspiciousness and sensitivity. This could be explained by increased wariness of victimization in older adulthood. Stability was also observed in past longitudinal data collected over an 8-year span by Siegler, George, and Okun (1979) at Duke University and over a 30-year span by Leon et al., (1979) in Minnesota, as well as in other longitudinal studies (Schaie & Willis, 1995). Thus, according to this evidence, it appears that individuals change very little in self-reported personality traits over periods of up to 30 years and over the age range of 20 to 90 years of age. And these findings generally hold up across cultures (McCrae, 2013), although in one study, Hmong Americans' personality traits differed from those of European Americans depending on the former's degree of acculturation (Moua, 2007). However, there is growing evidence that both stability and change can be detected in personality trait development across the adult life span (Allemand, Zimprich, & Hendriks, 2008; Mõttus, Johnson, & Deary, 2012). Advances in statistical techniques allowed researchers to see that the way people differ in their personality becomes more pronounced with age (Allemand et al., 2008; Mõttus et al., 2012). For example, studies (e.g., Lucas & Donnellan, 2011) find that extraversion and openness decrease with age whereas agreeableness increases with age. Conscientiousness appears to peak in middle age. Most interestingly, neuroticism often disappears or is much less apparent in late life. Such changes are found in studies that examine larger populations across a larger age range (e.g., 16 to mideighties) and across greater geographical regions (e.g., United States and Great Britain). Ursula Staudinger and colleagues have a perspective that reconciles the seemingly contradictory findings of both stability and change (Mühlig-Versen, Bowen,& Staudinger, 2012; Staudinger & Kunzmann, 2005). They suggest that personality takes on two forms: adjustment and growth. Personality adjustment involves developmental changes in terms of their adaptive value and functionality such as whether one can function effectively within society and how personality contributes to everyday life running smoothly. Personality growth refers to ideal end states such as increased self-transcendence, wisdom, and integrity. Examples of growth will be discussed later in relation to Erikson's theory. Both adjustment and growth interact in that growth cannot occur without adjustment. However, Staudinger argues that although growth in terms of ideal end states does not necessarily occur in everyone, as it is less easily acquired, strategies for adjustment develop across the latter half of the life span. This framework can be used to interpret stability and change in the Big Five personality factors. First, the most current consensus of change in the Big Five with increasing age is the absence of neuroticism and the presence of agreeableness and conscientiousness. These three traits are associated with personality adjustment, especially in terms of becoming emotionally less volatile and more attuned to social demands and social roles (Mühlig-Versen et al., 2012; Staudinger & Kunzmann, 2005). These characteristics allow older adults to maintain and regain levels of well-being in the face of loss, threats, and challenges in life, common occurrences in late life. Studies also show a decrease in openness to new experiences with increasing age (e.g., Graham & Lachman, 2012; Srivastava et al., 2003). Staudinger argues that openness to experience is related to personal maturity in that it is highly correlated with ego development, wisdom, and emotional complexity. Evidence suggests that these three aspects of personality (ego level, wisdom, and emotional complexity) do not increase with age and may show decline (Staudinger, Dörner, & Mickler, 2005; Grühn et al., 2013; Mühlig-Versen et al., 2012). Staudinger concludes that personal growth in adulthood appears to be rare rather than normative. In sum, there appears to be increases in adjustment aspects of personality with increasing age, and it could be normative. At the same time, however, the basic indicators of personality growth tend to show stability or decline. What's going on? Think About It Does evidence of stability in traits support the idea that some aspects of personality are genetic? Why or why not? The most likely answer is that personality growth or change across adulthood does not normally occur unless there are special circumstances and an environmental push for it to occur. Thus, the personality-related adjustment that grows in adulthood does so in response to ever-changing developmental challenges and tasks, such as establishing a career, marriage, and family.

Chronic Disease and Health Issues

Older adults face numerous health challenges that are influenced by both life style and genetics and their interaction. Chronic Disease Nearly half of adults in the United States have a chronic health condition (Centers for Disease Control and Prevention, 2012b). Some of the most common are diabetes mellitus and cancer, discussed here, and arthritis, discussed in Chapter 13. Diabetes Mellitus. The disease diabetes mellitus occurs when the pancreas produces insufficient insulin. The primary characteristic of diabetes mellitus is above-normal sugar (glucose) in the blood and urine caused by problems in metabolizing carbohydrates. People with diabetes mellitus can go into a coma if the level of sugar gets too high, and they may lapse into unconsciousness if it gets too low. There are two general types of diabetes (American Diabetes Association, 2014). Type 1 diabetes usually develops earlier in life and requires the use of insulin; hence, it is sometimes called insulin-dependent diabetes. Type 2 diabetes typically develops in adulthood and is often effectively managed through diet. There are three groups of older adults with diabetes: those who develop diabetes as children, adolescents, or young adults; those who develop diabetes in late middle age and typically develop cardiovascular problems; and those who develop diabetes in late life and usually show mild problems. This last group includes the majority of older adults with diabetes mellitus. In adults, diabetes mellitus often is associated with obesity and is usually diagnosed during other medical procedures, such as eye examinations or hospitalizations for other conditions. Diabetes is more common among older adults and members of minority groups (American Diabetes Association, 2014). The chronic effects of increased glucose levels may result in serious complications, including nerve damage, diabetic retinopathy (discussed earlier), kidney disorders, stroke, cognitive dysfunction, damage to the coronary arteries, skin problems, and poor circulation in the arms and legs, which may lead to gangrene. Although it cannot be cured, diabetes can be managed effectively through a low-carbohydrate and low-calorie diet; exercise; proper care of skin, gums, teeth, and feet; and medication (insulin). For older adults, it is important to address potential memory difficulties with the daily testing and management regimens. Education about diabetes mellitus is included in Medicare coverage, making it easier for older adults to learn how to manage the condition. Cancer. Cancer is the second leading cause of death in the United States, behind cardiovascular disease (Centers for Disease Control and Prevention, 2013c). Over the life span, nearly one in two American men and one in three American women will develop cancer (American Cancer Society, 2013). The risk of getting cancer increases markedly with age. Many current deaths caused by cancer are preventable: Stopping smoking, limiting exposure to the sun's ultraviolet rays, and eating a healthy diet can prevent many cancers. © Max Topchii / Shutterstock.com Using sunscreen is an excellent way to help avoid skin cancer. Why older people have a much higher incidence of cancer is not understood fully. Part of the reason is the cumulative effect of poor health habits over a long period of time, such as cigarette smoking and poor diet. In addition, the cumulative effects of exposure to pollutants and cancer-causing chemicals are partly to blame. Some researchers believe that normative age-related changes in the immune system, resulting in a decreased ability to inhibit the growth of tumors, may also be responsible. Research in molecular biology and microbiology is increasingly pointing to genetic links, likely in combination with environmental factors (Battista et al., 2012). For example, two breast cancer susceptibility genes that have been identified are BRCA1 on chromosome 17 and BRCA2 on chromosome 13. When a woman carries a mutation in either BRCA1 or BRCA2, she is at a greater risk of being diagnosed with breast or ovarian cancer. Similarly, a potential susceptibility locus for prostate cancer has been identified on chromosome 1, called HPC1, which may account for about 1 in 500 cases of prostate cancer. An additional rare mutation of HOXB13, on chromosome 17, has also been identified. Screening for cancer remains controversial in some areas, such as for breast cancer and prostate cancer. For example, a 25-year study of nearly 90,000 Canadian women showed that annual mammography did not reduce deaths from breast cancer (Miller et al., 2014). Other research finds similar results for regular screening for breast and prostate cancer. Despite evidence that routine screening for everyone does not reduce deaths from these cancers—and can even result in unnecessary medical procedures—some physicians still encourage routine screening. Health Issues Two key factors in staying healthy are getting enough good sleep and eating a healthy diet. Let's see how these are accomplished later in life. Sleep. Older adults have more trouble sleeping than do younger adults, which is probably related to a decreased "ability" to sleep (Ancoli-Israel & Alessi, 2005). Compared with younger adults, older adults report that it takes roughly twice as long to fall asleep, that they get less sleep in an average night, and that they feel more negative effects following a night with little sleep. Some of these problems are due to mental health problems such as depression; physical diseases such as heart disease, arthritis, diabetes, lung diseases, stroke, and osteoporosis; and other conditions such as obesity. Sleep problems can disrupt a person's circadian rhythm, or sleep-wake cycle. Circadian rhythm disruptions can cause problems with attention and memory. Research shows that interventions, such as properly timed exposure to bright light, are effective in correcting circadian rhythm sleep disorders (Lucas et al., 2014). Nutrition. Most older adults do not require vitamin or mineral supplements as long as they are eating a well-balanced diet (Stanley, 2014). Even though body metabolism declines with age, older adults need to consume the same amounts of proteins and carbohydrates as young adults because of changes in how readily the body extracts the nutrients from these substances. Because they are typically in poor health, residents of nursing homes (Pauly, Stehle, & Volkert, 2007) and frail older adults (Keller, Østbye, & Goy, 2004) are especially prone to malnutrition or deficiencies of such nutrients as vitamin B12 and folic acid unless their diets are closely monitored. A good nutritional guide for older adults is the MyPlate for Older Adults developed by Tufts University (Tufts University, 2011) as shown in Figure 4.8. Based on the U.S. Department of Agriculture's guidelines, the MyPlate for Older Adults takes into account the changes that occur with age. Figure 14.8. From Tuffs University. Nutritional guidelines for older adults are based on national guidelines for all adults.

secondary mental abilities

broader intellectual skills that subsume and organize the primary abilities

why do students start acting and thinking like adults in college?

-advances in intellectual development and personal and social identity -social interaction: college social experience can either facilitate or frustrate development of one's sense of identity, including ethnic/racial identity

edgework

the desire to live life more on the edge through physically and emotionally threatening situations on the boundary between life and death

when does physical functioning peak

young adulthood: -as tall as you will ever be -Physical strength, coordination, and dexterity in both sexes peaks late 20s early 30s declines slowly after -sensory acuity at its break (visual acuity remains high until middle age, when people become farsighted and need reading glasses, hearing declines in late 20s, especially high-pitched tones)

Cohabitation

Being unmarried does not necessarily mean living alone. People in committed, intimate, sexual relationships but who are not married may decide that living together, or cohabitation, provides a way to share daily life. Cohabitation is becoming an increasingly popular lifestyle choice in the United States as well as in Canada, Europe, and Australia and is considered a growing hallmark of emerging adulthood (Goodwin, Mosher, & Chandra, 2010). Cohabitation in the United States has increased tenfold over the past three decades. In fact, most marriages in the United States begin as cohabiting relationships, and most young adults have or will cohabit at some time in their lives (Rose-Greenland & Smock, 2013). Ethnic groups do not differ significantly in cohabitation rates. Figure 11.3 shows how the rate of cohabitation as the choice for a first living arrangement for a couple has increased since 1995. Figure 11.3. Sources: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006-2010, and Table 1 of this link http://www.cdc.gov/nchs/data/nhsr/nhsr064.pdf. There has been a rapid growth in cohabitation in the United States since 1970. Couples cohabit for several reasons, most often in connection with testing their relationship in the context of potential marriage (Rhoades, Stanley, & Markman, 2009; Rose-Greenland & Smock, 2013). Some couples cohabit for reasons of convenience, such as sharing expenses and sexual accessibility. There is typically no long-term commitment for these couples, and marriage is not usually a goal. Women tend to report convenience as a factor more so than men. Because most marriages begin as cohabiting relationships, the cohabiting couple is actually engaging in a trial marriage. If marriage does not follow, the couple usually separates. Finally, some couples permanently use cohabitation instead of marriage. The global picture differs by culture (Popenoe, 2009; Therborn, 2010). For example, in most European, South American, and Caribbean countries, cohabitation is a common alternative to marriage for young adults. Cohabitation is common in the Netherlands, Norway, and Sweden, where this lifestyle is part of the culture; 99% of married couples in Sweden lived together before they married, and nearly one in four couples are not legally married. Decisions to marry in these countries are typically made to legalize the relationship after children are born—in contrast to Americans, who marry to confirm their love and commitment to each other. Think About It Why might there be large differences in cohabitation rates among countries? Interestingly, having cohabitated does not guarantee that marriages will be better. It depends on several factors (Martin, 2013). That may be because couples are pickier about who they marry than about who they cohabit with (Sahib & Gu, 2013). There is also some evidence that couples who have children while cohabiting, especially European American women (as compared with African American and Latina women; Tach & Halpern-Meekin, 2009), and couples who are using cohabitation to test an already shaky relationship (Rhoades et al., 2009) are most likely to report subsequent problems. Are there differences between couples who cohabit and couples who marry right away? Longitudinal studies find few differences in couples' behavior after having lived together for many years regardless of whether they married without cohabiting, cohabited then married, or simply cohabited (Stafford, Kline, & Rankin, 2004), but married couples tend, on average, to be slightly happier (Stavrova, Fetchenhauer, & Schlösser, 2012). No differences are reported in relationships between parents and adult children of married versus cohabiting couples (Daatland, 2007). In addition, many countries extend the same rights and benefits to cohabiting couples as they do to married couples and have done so for many years.

Letting Go: Middle-Aged Adults and Their Children

Being a parent has a rather strange side when you think about it. After creating children out of love, parents spend considerable time, effort, and money preparing them to become independent and to leave. For most parents, the leaving (and sometimes returning) occurs during midlife. Let's take a closer look. Becoming Friends and the Empty Nest Sometime during middle age, most parents experience two positive developments with regard to their children. Suddenly their children see them in a new light, and the children leave home. John Lund/Sam Diephuis/Blend Images/Alamy Adult children's relationships with their parents often include a friendship dimension. The extent to which parents foster and approve of their children's attempts at being independent matters. Most parents manage the transition successfully (Owen, 2005). That's not to say that parents are heartless. As depicted in the cartoon, when children leave home, emotional bonds are disrupted. Mothers in all ethnic groups report feeling sad at the time children leave, but have more positive feelings about the potential for growth in their relationships with their children (Feldman, 2010). For Better or For Worse, © Lynn Johnston Productions, Inc./ Distributed by United Feature Syndicate, Inc. Still, parents provide considerable emotional support (by staying in touch) and financial help (such as paying college tuition, providing a free place to live until the child finds employment) when possible (Mitchell, 2006; Warner, Henderson-Wilson,& Andrew, 2010). A positive experience with launching children is strongly influenced by the extent to which parents perceive that they've done a good job and that their children have turned out well (Mitchell, 2010). Children are regarded as successes when they meet parents' culturally based developmental expectations, and they are seen as "good kids" when there is agreement between parents and children in basic values. When Children Come Back Parents' adjustment to the empty nest is sometimes short-lived (Mayseless & Keren, in press). Roughly half of young adults in the United States return to their parents' home at least once after moving out. There is evidence that these young adults, called "boomerang kids" (Mitchell, 2006), reflect a less permanent, more mobile contemporary society and the difficulty they have in finding a meaningful life (Mayseless & Keren, in press). Why do children move back? Those that do typically arrive back home about the time they enter the workplace, and a major impetus is the increased costs of living on their own when saddled with college debt, especially if the societal economic situation is bad and jobs are not available. Several demographic and psychological factors influence the decision (Mitchell, 2006; Silva, 2013). Men are more likely to move back than women, as are children who had low college GPAs, a low sense of autonomy, or an expectation that their parents would provide a large portion of their income following graduation. Adult children whose parents were verbally or physically abusive are not likely to move back, and neither are those who have married. The U.S. trend for young adults to move back home differs from the trend in some southern European countries (e.g., Italy) for young adults simply to stay at home until they marry or obtain a full-time job (L'Abate, 2006). In contrast, the trend for adult children to return home in other countries has resulted in terms such as Nesthocker in Germany and KIPPERS (Kids in Parents' Pockets Eroding Retirement Savings) in the United Kingdom (Blatterer, 2005). This trend reflects the changing definition of adulthood we considered in Chapter 10. As the ages at which young people take on the roles of adulthood increase, we are likely to see more children living at home longer or returning to their parents' home after graduating from college.

meaning of work

Studs Terkel, author of the fascinating classic book Working (1974), writes that work is "a search for daily meaning as well as daily bread, for recognition as well as cash, for astonishment rather than torpor; in short, for a sort of life rather than a Monday through Friday sort of dying" (p. xiii). Kahlil Gibran, in his mystical book The Prophet (1923), put it this way: "Work is love made visible." Thinkstock / Getty Images Hassling with our commute makes us think about why we work. For some of us, work is a source of prestige, social recognition, and a sense of worth. For others, the excitement, the creativity, and the opportunity to give something of themselves make work meaningful. But for most people, the main purpose of work is to earn a living. This is not to imply, of course, that money is the only reward in a job; making friends, having the opportunity to exercise power, and feeling useful are also important. The meaning most of us derive from working includes both the money that can be exchanged for life's necessities (and perhaps a few luxuries) and the possibility of personal growth through the interaction of work, higher-order goals, and our personality (Barrick, Mount, & Li, 2013). The specific occupation a person holds appears to have no effect on his or her need to derive meaning from work—those in repetitive jobs manage to find meaning, as do people in cutting-edge industries. Finding meaning in one's work can mean the difference between believing that work is the source of one's life problems or a source of fulfillment and contentment (Grawitch, Barber, & Justice, 2010). What meanings do people derive from their work? Researchers and career coaches seek answers to this question by interviewing people in depth about what meaning they derive from work and whether and how these meanings determine work behavior (Barrick et al., 2013; Hyson, 2013). They tend to find four common meanings: developing self, experiencing union with others, expressing self, and serving others. To the extent that all of these meanings can be achieved, people experience the workplace as an area of personal fulfillment, sometimes describing it as a spiritual experience (Hyson, 2013). This provides a framework for understanding occupational selection and transition as a means to find better balance among the four. Contemporary business theory also supports the idea that meaning matters. The concept called meaning-mission fit explains how corporate executives with a better alignment between their personal intentions and their firm's mission care more about their employees' happiness, job satisfaction, and emotional well-being (Abbott, Gilbert, & Rosinski, 2013; French, 2007). Given the various meanings that people derive from work, occupation is clearly a key element of a person's sense of identity and self-efficacy (Lang & Lee, 2005). This can be readily observed when adults introduce themselves socially. You've probably noticed that when people are asked to tell something about themselves, they usually provide information about what they do for a living. Occupation affects your life in a host of ways and often influences where you live, what friends you make, and even what clothes you wear. In short, the impact of work cuts across all aspects of life. Work, then, is a major social role and influence on adult life. Occupation is an important anchor that complements the other major role of adulthood—love relationships. As we will see, occupation is part of human development. Young children, in their pretend play, are in the midst of the social preparation for work. Adults are always asking them, "What do you want to be when you grow up?" School curricula, especially in high school and college, are geared toward preparing people for particular occupations. Young adult college students as well as older returning students have formulated perspectives on the meanings they believe they will get from work. Hance (2000) organized these beliefs into three main categories: working to achieve social influence; working to achieve personal fulfillment; and working because of economic reality. These categories reflect fairly well the actual meanings that working adults report. Because work plays such a key role in providing meaning for people, an important question is how people select an occupation. Let's turn our attention to two theories explaining how and why people choose the occupations they do.

how do we study intelligence in adults

-administering formal testing: asses wide range of abilities and has tests for overall IQ -assessing practical problem-solving skills: assess ability to apply intellectual skills to everyday situations

stress reducers for retuning adult students

-support from family and employers -positive effects of continuing one's education -some, especially middle-aged women, express a sense of self-discovery

why do people not usually think at very complex levels?

-the environment does not provide the supports necessary for using one's highest-level thinking ex: people may not always purchase the product that has the least impact on the environment, such as a fully electric car, even though philosophically they are strong environmentalists because recharging stations are currently not widely available

Grandparenthood

Becoming a grandparent takes some help. Being a parent yourself, of course, is a prerequisite. But it is your children's decisions and actions that determine whether you will experience the transition to grandparenthood, making this role different from most others you experience throughout life. Most people become grandparents in their forties and fifties, although some are older or perhaps as young as their late twenties or early thirties. For many middle-aged adults, becoming a grandparent is a peak experience (Gonyea, 2013; Hoffman, Kaneshiro, & Compton, 2012). Although most research on grandparenting has been conducted with respect to heterosexual grandparents, attention to lesbian, gay, and transsexual grandparents is increasing as these family forms increase in society (Orel & Fruhauf, 2013). How Do Grandparents Interact with Grandchildren? Grandparents have many different ways of interacting with their grandchildren. Categorizing these styles has been attempted over many decades (e.g., Neugarten & Weinstein, 1964), but none of these attempts has been particularly successful because grandparents use different styles with different grandchildren and styles change as grandparents and grandchildren age (Gonyea, 2013; Hoffman et al., 2012). An alternative approach involves considering the many functions grandparents serve and the changing nature of families (Hills, 2010). The social dimension includes societal needs and expectations of what grandparents are to do, such as passing on family history to grandchildren. The personal dimension includes the personal satisfaction and individual needs that are fulfilled by being a grandparent. Many grandparents pass on skills—as well as religious, social, and vocational values (social dimension)—through storytelling and advice, and they may feel great pride and satisfaction (personal dimension) from working with grandchildren on joint projects. Grandchildren give grandparents a great deal in return. For example, grandchildren keep grandparents in touch with youth and the latest trends. Sharing the excitement of surfing the Web in school may be one way in which grandchildren keep grandparents on the technological forefront. Being a Grandparent Is Meaningful Being a grandparent really matters. Most grandparents derive multiple meanings, and they are linked with generativity (Gonyea, 2013; Thiele & Whelan, 2010). For some, grandparenting is the most important thing in their lives. For others, meaning comes from being seen as wise, from spoiling grandchildren, from recalling the relationship they had with their own grandparents, or from taking pride in the fact that they will be followed by not one, but two generations. Grandchildren also highly value their relationships with grandparents, even when they are young adults (Alley, 2004). Grandparents are valued as role models as well as for their personalities, the activities they share, and the attention they show to grandchildren. Young adult grandchildren (ages 21 to 29) derive both stress and rewards from caring for grandparents, much the same way middle-aged adults do when they care for their aging parents (Orel & Fruhauf, 2013). Ethnic Differences How grandparents and grandchildren interact varies in different ethnic groups. Intergenerational relationships are especially important and have historically been a source of strength in African American families (Waites, 2009) and Latino families (Gladding, 2002). African American grandparents play an important role in many aspects of their grandchildren's lives, such as religious education (King et al., 2006). To a greater degree, African American grandfathers, in particular, tend to perceive grandparenthood as a central role than do European American grandfathers (Kivett, 1991). And Latino American grandparents are more likely to participate in child rearing owing to a cultural core value of family (Burnette, 1999). Native American grandparents appear to have some interactive styles that differ from those of other groups (Weibel-Orlando, 1990). These grandparents provide grandchildren with a way to connect with their cultural heritage, and they are likely to provide a great deal of care for their grandchildren (Mutchler, Baker, & Lee, 2007). Research also indicates that Native American grandparents use their own experiences of cultural disruption to reinvest in their grandchildren to ensure the continuity of culture (Thompson, Cameron, & Fuller-Thompson, 2013). In general, Native American grandmothers take a more active role than do grandfathers and are more likely to pass on traditional rituals (Woodbridge, 2008). Brian Skyum/Alamy How grandparents and grandchildren interact varies across ethnic groups. Asian American grandparents, particularly if they are immigrants, serve as a primary source of traditional culture for their grandchildren (Yoon, 2005). When these grandparents become heavily involved in caring for their grandchildren, they especially want and need services that are culturally and linguistically appropriate. When Grandparents Care for Grandchildren Grandparenthood today is tougher than it used to be. Families are more mobile, which means that grandparents are often separated from their grandchildren by geographical distance. Grandparents are more likely to have independent lives apart from their children and grandchildren. What being a grandparent entails in the 21st century is more ambiguous than it once was (Fuller-Thompson, Hayslip, & Patrick, 2005). Perhaps the biggest change worldwide for grandparents is the increasing number that serve as custodial parents or primary caregivers for their grandchildren (Moorman & Greenfield, 2010). Estimates are that about 7 million U.S. grandparents have grandchildren under age 18 living with them, and 2.7 million of those grandparents provide basic needs (food, shelter, and clothing) for one or more of their grandchildren (U.S. Census Bureau, 2013d). These situations result most often when both parents are employed outside the home (Uhlenberg & Cheuk, 2010); when the parents are deceased, addicted, incarcerated, or unable to raise their children for some other reason (Backhouse, 2006; Moorman & Greenfield, 2010); or when the grandchild has exhibited discipline or behavior problems (Giarrusso et al., 2000). Lack of legal recognition stemming from the grandparents' lack of legal guardianship also poses problems and challenges—for example, in dealing with schools and obtaining records. Typically, social service workers must assist grandparents in navigating the many unresponsive policies and systems they encounter when trying to provide the best possible assistance to their grandchildren (Cox, 2007). Clearly, public policy changes are needed to address these issues, especially concerning grandparents' rights with regard to schools and health care for their grandchildren (Ellis, 2010). Raising grandchildren is not easy. Financial stress, cramped living space, and social isolation are only some of the issues facing custodial grandmothers (Bullock, 2004). The grandchildren's routines, activities, and school-related issues also cause stress (Musil & Standing, 2005). All of these stresses also are reported cross-culturally; for example, full-time custodial grandmothers in Kenya reported higher levels of stress than did part-time caregivers (Oburu & Palmérus, 2005). Even custodial grandparents raising grandchildren without these problems report more stress and role disruption than noncustodial grandparents, although most grandparents are resilient and manage to cope (Hayslip et al., 2013). But most custodial grandparents consider their situation to be better for their grandchild than any other alternative and report surprisingly few negative effects on their marriages.

Changes in Bones and Joints

Changes in Bones and Joints The bones and the joints change with age, sometimes in potentially preventable ways and sometimes because of genetic predisposition or disease. Let's take a closer look. Osteoporosis One physical change that can be potentially serious is loss of bone mass. Skeletal maturity, the point at which bone mass is greatest and the skeleton is at peak development, occurs at around 18 for women and 20 in men (Gilsanz & Ratib, 2012; National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2012a). Bone mass stays about the same until women experience menopause and men reach late life. For women, there is a rapid loss of bone mass in the first few years after menopause, which greatly increases the risk of problems with disease and broken bones. Loss of bone mass makes bones weaker and more brittle, thereby making them easier to break. Because there is less bone mass, bones also take longer to heal in middle-aged and older adults. Severe loss of bone mass results in osteoporosis, a disease in which bones become porous and extremely easy to break (see Figure 13.1). In severe cases, osteoporosis can cause spinal vertebrae to collapse, causing the person to stoop and to become shorter (Bartl, Bartl, & Frisch, 2015; National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2012b; see Figure 13.2). About 40 million Americans either have osteoporosis or are at high risk due to low bone density. Non-Latina white women and Asian women are at highest risk, and osteoporosis is the leading cause of broken bones in older women. Although the severe effects of osteoporosis typically are not observed until later life, this disease can occur in people in their fifties. Figure 13.1. © 2016 Cengage Learning The difference between normal bone (on the right) and osteoporosis (on the left) is easy to see. Figure 13.2. Based on Ebersole, P., & Hess, P. (1998). Toward healthy aging (5th ed., p. 395). Notice how osteoporosis eventually causes a person to stoop and to lose height, owing to compression of the vertebrae. Osteoporosis is caused in part by low bone mass at skeletal maturity, deficiencies of calcium and vitamin D, estrogen depletion, and lack of weight-bearing exercise that builds up bone mass. Other risk factors include smoking; high-protein diets; and excessive intake of alcohol, caffeine, and sodium. Women who are being treated for asthma, cancer, rheumatoid arthritis, thyroid problems, and epilepsy are also at increased risk because the medications used can lead to loss of bone mass (Bartl et al., 2015). The National Institute of Arthritis and Musculoskeletal and Skin Diseases (2012b) recommends getting enough dietary calcium and vitamin D as ways to prevent osteoporosis. There is evidence that taking calcium and vitamin D supplements after menopause may slow the rate of bone loss and delay the onset of osteoporosis. The best prevention occurs in youth, before skeletal maturity is reached, but research shows few children get the minimum daily requirements of calcium and vitamin D. People should consume foods (such as milk and broccoli) that are high in calcium and vitamin D. Recommended calcium and vitamin D intakes for men and women of various ages as determined by the Institute of Medicine (2010) are shown in Table 13.1. Data clearly show that metabolizing vitamin D directly affects rates of osteoporosis; however, whether supplementary dietary vitamin D retards bone loss is less certain (Bartl et al., 2015). Weight-bearing exercise is also recommended. Women who are late middle-aged or over age 65 are encouraged to have their bone mineral density (BMD) tested by having a dual-energy X-ray absorptiometry (DXA) test, which measures bone density at the hip and spine. The DXA test results are usually compared with the ideal or peak bone mineral density of a healthy 30-year-old adult, and you are given a T-score. A score of 0 means that your bone mineral density is equal to the norm for a healthy young adult. Differences between your bone mineral density and that of the healthy young adult are measured in units called standard deviations (SDs). The more standard deviations below 0, indicated as negative numbers, the lower your bone mineral density and the higher your risk of fracture. A T-score between +1 and −1 is considered normal or healthy. A T-score between −1 and −2.5 indicates low bone mass, although not low enough to be diagnosed with osteoporosis. A T-score of −2.5 or lower indicates that you have osteoporosis. The greater the negative number, the more severe the osteoporosis (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2012c). In terms of medication interventions, biophosphonates are most commonly used and are highly effective (Bartl et al., 2015). Fosamax, Actonel, and Boniva are three common examples of this family of medications. Biophosphonates slow the process of bone breakdown by helping to maintain bone density during menopause. Research indicates that using biophosphonates for up to five years appears relatively safe if the medication is then stopped (called a "drug holiday"); there is evidence for protective effects lasting up to five years more. Raloxifene (e.g., Evista) is also approved for the treatment and prevention of osteoporosis. It is one of a relatively new group of drugs known as selective estrogen receptor modulators. Selective estrogen receptor modulators (SERMs) are not estrogens, but are compounds that have estrogen-like effects on some tissues and estrogen-blocking effects on other tissues. Raloxifene mimics the effects of estrogen on bones, but it does not have estrogen's potentially harmful effects on breast tissue and the uterus. Raloxifene has been shown to prevent bone loss, have beneficial effects on bone mass, and reduce the risk of spine fractures (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2012b). The newest classes of medications for osteoporosis are the RANK ligand inhibitors, such as denosumab (Lipton et al., 2014). Related research indicates that romosozumab is effective in stimulating bone growth in postmenopausal women (McClung et al., 2014). Although these medications are very promising, additional research will be needed to ensure that they are effective over the long run and that side effects are minimal. Arthritis Many middle-aged adults complain of aching joints. They have good reason. Beginning in one's twenties, the protective cartilage in joints shows signs of deterioration, such as thinning and becoming cracked and frayed. Over time, the bones underneath the cartilage become damaged, which can result in osteoarthritis, a disease marked by gradual onset of bone damage with progression of pain and disability together with minor signs of inflammation from wear and tear. Osteoarthritis is an example of a wear-and-tear disease, a degenerative disease caused by injury or overuse (Arthritis Foundation, 2014a). This most common form of arthritis usually becomes noticeable in late middle age or early old age, progresses slowly, and is especially common in people whose joints are subjected to routine overuse and injury, such as athletes and manual laborers. Pain typically is worse when the joint is used, but skin redness, heat, and swelling are minimal or absent. Osteoarthritis usually affects the hands, spine, hips, and knees, sparing the wrists, elbows, shoulders, and ankles. Effective management approaches consist mainly of taking certain steroids and anti-inflammatory drugs, getting plenty of rest and doing nonstressful exercises that focus on range of motion, making dietary modifications, and using a variety of homeopathic remedies. A second form of arthritis is rheumatoid arthritis, a more destructive disease of the joints that also develops slowly; it typically affects different joints and causes different types of pain than osteoarthritis does. Most often, a pattern of morning stiffness and aching develops in the fingers, wrists, and ankles on both sides of the body. Joints appear swollen. There is no cure, but there are several treatment approaches (Arthritis Foundation, 2014b). Three general classes of medications are commonly used in the treatment of rheumatoid arthritis: (1) nonsteroidal anti-inflammatory agents (NSAIDs, such as Advil and Aleve); (2) corticosteroids (such as prednisone), and (3) disease-modifying anti-rheumatic drugs (DMARDs, such as methotrexate), which include various biologic response modifiers such as adalimumbab (Humira) and JAK inhibitors such as tofacitinib (Xeljanz) that block specific steps in the inflammation process (Arthritis Foundation, 2014c). Because cartilage and bone damage frequently occur within the first two years of the disease, physicians move quickly to prescribe a DMARD agent early in the course of disease, usually as soon as a diagnosis is confirmed, because although the medications are effective, they take longer to begin working (Bingham & Ruffing, 2013). Rest and passive range-of-motion exercises are also helpful. Contrary to popular belief, rheumatoid arthritis is neither contagious nor self-induced by any known diet, habit, job, or exposure. Interestingly, the symptoms often come and go in repeating patterns (Arthritis Foundation, 2014d). Although it is not directly inherited, family history plays a role because researchers believe that you can inherit a predisposition for the disease (Bingham, 2013). Telling the differences between osteoporosis, osteoarthritis, and rheumatoid arthritis can be tricky. A comparison chart is shown in Table 13.2.

Frail Older Adults

In our discussion about aging to this point, we focused on the majority of older adults who are healthy, are cognitively competent, are financially secure, and have secure family relationships. Some older adults are not as fortunate. They are the frail older adults who have physical disabilities, are very ill, and may have cognitive or psychological disorders. These frail older adults constitute a minority of the population over age 65, but it is a proportion that increases with age. Frail older adults are people whose competence (in terms of the competence-environmental press model presented earlier) is declining. They do not have one specific problem that differentiates them from their active, healthy counterparts; instead, they tend to have multiple problems (Wilhelm-Leen, Hall, Horwitz, & Chertow, 2014). Given the rise in the population of older adults, the number of people who could be considered frail is increasing. Figure 15.8. SOURCE: Centers for Medicare and Medicaid Services, Medicare Current Beneficiary Survey. Health Status, Indicator 20 retrieved from http://agingstats.gov/agingstatsdotnet/Main_Site/Data/2012_Documents/docs/HealthStatus.pdf. Limitations in activities of daily living and instrumental activities of daily living. Assessing everyday competence consists of examining how well people can complete activities of daily living and instrumental activities of daily living (Gold, 2012). Activities of daily living (ADLs) are basic self-care tasks such as eating, bathing, toileting, walking, and dressing. A person could be considered frail if he or she needs help with one of these tasks. Other tasks are also deemed important for living independently. These instrumental activities of daily living (IADLs) are actions that require some intellectual competence and planning. Which actions constitute IADLs vary considerably from one culture to another and factor into cross-cultural differences in conceptions of competence (Sternberg & Grigorenko, 2004). For example, for most older adults in Western cultures, IADLs would include shopping for personal items, paying bills, making telephone calls, taking medications appropriately, and keeping appointments. In other cultures, IADLs might include caring for animal herds, making bread, threshing grain, and tending crops. Prevalence of Frailty How common are people such as Rosa, the 82-year-old woman in the vignette who still lives in the same neighborhood in which she grew up? As you can see in Figure 15.2, about 40% of people over age 65 report a functional limitation of some kind (AgingStats.gov, 2012). Figure 15.9. Administration on Aging (2013). A Profile of Older Americans: 2012. Retrieved from http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/2012/16.aspx. Prevalence of disability and the need for assistance by age. As you can see in Figure 15.9, the percentage of people needing assistance with various ADLs increases with age (Administration on Aging, 2013). The percentage of people reporting a disability varies somewhat across ethnic groups, with African Americans over age 65 having the highest rate and European Americans, Latino Americans, and Asian Americans reporting the lowest rate (Brault, 2008). Rates for Native Americans were not reported. Disability rates for complex activities such as living independently, working, and participating in community activities is higher in females (36%) than in males (29%); this difference was found in all ethnic groups studied (National Center for Health Statistics, 2013b). In addition to basic assistance with ADLs and IADLs, frail older adults have other needs. Research shows that these individuals are prone to higher rates of anxiety disorders and depression, especially when they are living in a long-term care facility (Qualls & Layton, 2010). Although frailty becomes more likely with increasing age, especially during the last year of life, there are many ways to provide a supportive environment for frail older adults. We have already seen how many family members provide care. Exercise can also help improve functioning and the quality of life of some frail older adults (Zhang et al., 2014), and "exercise prescriptions" can be created for them (Liu & Fielding, 2011). As more research is done focusing on frail older adults, one thing is becoming clear—where the person lives matters. The key to providing a supportive context for frail older adults is to create an optimal match between the person's competence and the environmental demands

Gay and lesbian couples

Less is known about the developmental course of gay and lesbian relationships than heterosexual relationships, largely because historically, they have not been the focus of research (Rothblum, 2009). To date, gay and lesbian relationships have been studied most often in comparison to married heterosexual couples. What is it like to be in a gay or lesbian relationship? One woman shares her experience in the Real People feature. Real People Applying Human Development Annie's Story I am a 28-year-old woman who came out as a lesbian just before I graduated high school. Although I was disappointed by the reaction of some of my friends and the continued negative comments I hear about gay, lesbian, bisexual, and transgendered people, I wouldn't trade my situation for hiding "in the closet" for anything. I do not recall ever feeling like I was heterosexual. It's just natural for me. I know that I'm so very lucky being born at a time when attitudes toward my lifestyle are changing rapidly. I have many older friends who tell me that it was extremely difficult in past decades to acknowledge to oneself that one was lesbian, for example, let alone say it to others. I am also lucky that my family is very tolerant and open about who I am. I have many friends who struggle with one or more family members who have disowned them. One big difference I have noticed is that I can feel the difference where I work in how people treat me—it has gotten a lot better over the five years I have been in the company. The changes in the law allowing me to have access to benefits for my partner are huge for us and just one of the most visible and hopeful signs that things are changing. But best of all, my partner and I were able to get married this year! Wow! When we got together seven years ago, we never imagined we would have this option in our lifetimes. And now look at us—legally married. We have now started thinking about having children, which will take our relationship to new places. Overall, my life is pretty much like everyone else's that I know, with the exception that I know that the good things that have happened to me are too often specific to the place where I live. I know that other states in the United States and certainly other countries do not see things the same way. My fondest hope is that the changes I have experienced will spread there, too. Like heterosexuals, gay and lesbian couples must deal with issues related to effective communication, power, and household responsibilities. Research indicates that the relationships of gay and lesbian couples are similar to those of heterosexual couples in terms of love and commitment, satisfaction, and trust (Joyner, Manning, & Bogle, 2013). Most gay and lesbian couples are in dual-earner relationships, much like the majority of married heterosexual couples, and are likely to share household chores. However, gay and lesbian couples do differ from heterosexual couples in the degree to which both partners are similar on demographic characteristics such as race, age, and education; gay and lesbian couples tend to be more dissimilar (Schwartz & Graf, 2009). In general, though, the same factors predict long-term success of couples regardless of sexual orientation (Joyner et al., 2013). Gender differences play more of a role in determining relationship styles than do differences in sexual orientation. Gay men, like heterosexual men, tend to separate love and sex and have more short-term relationships (Missildine et al., 2005); both lesbian and heterosexual women are more likely to connect sex and emotional intimacy in fewer, longer-lasting relationships. Lesbians tend to make a commitment and cohabit faster than do heterosexual couples (Ganiron, 2007). Men in any type of relationship tend to want more power if they earn more money. Women in any type of relationship are likely to be more egalitarian and to view money as a way to maintain independence from one's partner. © Galina Barskaya/Shutterstock.com Gay and lesbian couples experience joys and stresses in relationships similar to those of heterosexual couples. Gay and lesbian couples report receiving less support from family members than do either married or cohabiting couples (Strong & Cohen, 2014). The more one's family holds traditional ethnic or religious values, the less likely the family will provide support. At a societal level, attitudes about gay and lesbian relationships are changing rapidly in the United States. In 1996, Congress passed and President Bill Clinton signed the Defense of Marriage Act, allowed states to refuse to recognize same-sex marriage, and imposed limits on the benefits received by legally married same-sex couples. By 2013, merely 17 years later, attitudes had changed dramatically. That year, in two landmark decisions, the U.S. Supreme Court asserted the right of same-sex couples to be married. In so doing, the United States joined 13 other countries where same-sex marriage is legal. By early 2014, 16 states and the District of Columbia had legalized same-sex marriage and 33 states continued to ban it. (New Mexico allows each county to decide.) The major change in attitude toward same-sex marriage means that such couples now have the same rights as heterosexual married couples under federal law (but not necessarily under state law). Such rights go to many basic aspects of living, including visiting loved ones in a hospital and having inheritance rights.

Marriage

Most adults want their love relationships to result in marriage. However, U.S. residents are in less of a hurry to achieve this goal; the median age at first marriage for adults in the United States has been rising for several decades. As you can see in Figure 11.4, since the early 1990s, the age at first marriage has increased in the United States by roughly 2.5 years, to 28.6 for men and 26.6 for women (U.S. Census Bureau, 2013a). This trend has some benefits in that, for women anyway, marrying at a later age lessens the likelihood of divorce: Women under age 20 at the time they are first married are 3 times more likely to end up divorced than women who first marry in their twenties and 6 times more likely to end up divorced than first-time wives in their thirties (U.S. Census Bureau, 2012). Let's explore age and other factors that keep marriages going strong over time. Figure 11.4. From U.S. Census Bureau, Current Population Survey, March and Annual Social and Economic Supplements, 2010 and earlier. Median age at first marriage in the United States has increased more for women than men since 1970. What Is a Successful Marriage, and What Predicts It? You undoubtedly know couples who appear to have a successful marriage. But what does that mean, really? Is success in marriage defined as subjective happiness and contentment, personal fulfillment, or simply the fact that the couple is still married? Minnotte (2010) differentiates marital success, which is an umbrella term referring to any marital outcome (such as divorce rate); marital quality, which is a subjective evaluation of the couple's relationship on a number of different dimensions; marital adjustment, the degree to which a husband and wife accommodate to each other over a certain period of time; and marital satisfaction, which is a global assessment of one's marriage. Each of these provides a unique insight into the workings of a marriage. Marriages, like other relationships, differ from one another, but some important predictors of future success can be identified. One key factor in enduring marriages is the relative maturity of the two partners at the time they are married. In general, the younger the partners are, the lower the odds that the marriage will last—especially when the people are in their teens or early twenties (U.S. Census Bureau, 2013b). In part, the age issue relates to Erikson's (1982) belief that intimacy cannot be achieved until after one's identity is established (see Chapter 10). Other reasons that increase or decrease the likelihood that a marriage will last include financial security (increase) and pregnancy (decrease) at the time of the marriage. A second important predictor of successful marriage is homogamy, or the similarity of values and interests a couple shares. As we saw in relation to choosing a mate, the extent that the partners share similar age, values, goals, attitudes (especially the desire for children), socioeconomic status, certain behaviors (such as drinking alcohol), and ethnic background increases the likelihood that their relationship will succeed (Teachman, Tedrow, & Kim, 2013). A third factor in predicting marital success is a feeling that the relationship is equal. According to exchange theory, marriage is based on each partner contributing something to the relationship that the other would be hard-pressed to provide. Satisfying and happy marriages result when both partners perceive that there is a fair exchange, or equity, in all dimensions of the relationship. Problems achieving such equity can arise because of the competing demands of work and family, an issue we take up again in Chapter 12. Cross-cultural research supports these factors. Couples in the United States and Iran (Asoodeh et al., 2010; Vernon, 2013) say that trusting each other, consulting each other, being honest, making joint decisions, and being committed make the difference between a successful marriage and an unsuccessful marriage. Couples for whom religion is important also point to commonly held faith. Do Married Couples Stay Happy? Few sights are happier than a couple on their wedding day. Newlyweds, like Kevin and Beth in the vignette, are at the peak of marital bliss. But as you may have experienced, feelings change over time, sometimes getting better and stronger, sometimes not. Research shows that for most couples, overall marital satisfaction is highest at the beginning of the marriage, falls until the children begin leaving home, and rises again in later life; this pattern holds for both married and never-married cohabiting couples with children (see Figure 11.5; Hansen, 2012). However, for some couples, satisfaction never rebounds and remains low; in essence, they have become emotionally divorced. Figure 11.5. © Cengage Learning® Marital satisfaction is highest early on and in later life, dropping off during the child-rearing years. Overall, marital satisfaction ebbs and flows over time. The pattern of a particular marriage over the years is determined by the nature of the dependence of each spouse on the other. When dependence is mutual and about equal and both people hold similar values that form the basis for their commitment to each other, the marriage is strong and close (Givertz, Segrin, & Hanzal, 2009). When the dependence of one partner is much higher than that of the other, however, the marriage is likely to be characterized by stress and conflict. Changes in individual lives during adulthood shift the balance of dependence from one partner to the other; for example, one partner may go back to school, become ill, or lose status. Learning how to deal with these changes is the secret to long and happy marriages. The fact that marital satisfaction has a general downward trend but varies widely across couples led Karney and Bradbury (1995) to propose a vulnerability-stress-adaptation model of marriage, depicted in Figure 11.6. The vulnerability-stress-adaptation model sees marital quality as a dynamic process resulting from the couple's ability to handle stressful events in the context of their particular vulnerabilities and resources. For example, as a couple's ability to adapt to stressful situations gets better over time, the quality of the marriage probably will improve. How well couples adapt to various stresses on the relationship determines whether the marriage continues or they get divorced. Let's see how this works over time. Figure 11.6. Source: Karney, B. R. (2010). Keeping marriages healthy, and why it's so difficult. Retrieved from http://www.apa.org/science/about/psa/2010/02/sci-brief.aspx. The vulnerability-stress-adaptation model shows how adapting to vulnerabilities and stress can result in either adaptation or dissolution of the marriage. Setting the Stage: The Early Years of Marriage Marriages are most intense in their early days. Early on, husbands and wives share many activities and are open to new experiences together, so bliss results (Olson & McCubbin, 1983). But bliss doesn't come from avoiding tough issues. Discussing financial matters honestly is a key to bliss, as many newly married couples experience their first serious marital stresses around money issues (Parkman, 2007). How tough issues early in the marriage are handled sets the stage for the years ahead. When there is marital conflict, the intensity of the early phase may create the basis for considerable unhappiness (Faulkner, Davey, & Davey, 2005). Early in a marriage, the couple must learn to adjust to the different perceptions and expectations each person has for the other. Many wives tend to be more concerned than their husbands with keeping close ties with their friends. Research indicates that men and women both recognize and admit when problems occur in their marriage (Moynehan & Adams, 2007). The couple must also learn to handle confrontation. Indeed, learning effective strategies for resolving conflict is an essential component of a strong marriage because these strategies provide ways for couples to discuss their problems maturely. Early in a marriage, couples tend to have global adoration for their spouse regarding the spouse's qualities (Karney, 2010; Neff & Karney, 2005). For wives, but not for husbands, more accurate specific perceptions of what their spouses are really like were associated with more supportive behaviors, feelings of control in the marriage, and a decreased risk of divorce. Thus, for women, love grounded in accurate perceptions of a spouse's qualities appears to be stronger than love that is "blind" to a spouse's true qualities. Still, couples who are happiest in the early stage of their marriage tend to focus on the good aspects, not the annoyances; nit-picking and nagging do not bode well for long-term wedded bliss (Karney, 2010). As time goes on and stresses increase, marital satisfaction tends to decline (Lamanna, Riedmann, & Stewart, 2014). Researchers have shown that for most couples, the primary reason for this drop is having children (Hansen, 2012). But it's not just a matter of having a child. The temperament of the child matters, with fussier babies creating more marital problems (Greving, 2007; Meijer & van den Wittenboer, 2007). Parenthood also means having substantially less time to devote to the marriage. Most couples are ecstatic over having their first child, a tangible product of their love for each other. But soon the reality of child care sets in, with 2 a.m. feedings, diaper changing, and the like—not to mention the long-term financial obligations that will continue at least until the child becomes an adult. Both African American and European American couples report an increase in conflict after the birth of their first child (Crohan, 1996). However, using the birth of a child as the explanation for the drop in marital satisfaction is too simplistic because child-free couples also experience a decline inmarital satisfaction (Hansen, Moum, & Shapiro, 2007). It appears that a decline ingeneral marital satisfaction over time is a common developmental phenomenon, even for couples who choose to remain childless (Clements & Markman, 1996). In addition, couples who have no children as a result of infertility face the stress associated both with the biological inability to have children and the psychological impact on each other's identity, both of which exacerbate existing stresses in the relationship and can lower marital satisfaction (Rosner, 2012). Longitudinal research indicates that disillusionment—as demonstrated by a decline in feeling in love, in demonstrations of affection, and in the feeling that one's spouse is responsive, as well as an increase in feelings of ambivalence—is a key predictor of marital dissatisfaction later in the marriage (Baucom & Atkins, 2013). During the early years of their marriage, many couples may spend significant amounts of time apart. This is especially true of marriages involving individuals in the military (Fincham & Beach, 2010). Recent research has focused on the special types of stress these couples face. Spouses who serve in combat areas on active duty assignment and suffer from post-traumatic stress disorder (PTSD) are particularly vulnerable, as they are at greater risk for other spouse-directed aggression. Sandy Huffaker/Getty Images News/Getty Images Young married military couples face special types of stress on their relationship. What the non-deployed spouse believes turns out to be very important. If the non-deployed spouse believes that the deployment will have negative effects on the marriage, then problems are more likely. In contrast, if the non-deployed spouse believes that such challenges make the relationship stronger, then they typically can do so (Renshaw, Rodrigues, & Jones, 2008). Research indicates that the effects of deployment may be greater on wives than husbands; divorce rates for women service members who are deployed is higher than for their male counterparts (Karney & Crown, 2007). Keeping Marriages Happy Although no two marriages are exactly the same, couples must be flexible and adaptable. Couples who have been happily married for many years show an ability to "roll with the punches" and to adapt to changing circumstances in the relationship. For example, a serious problem of one spouse may not be detrimental to the relationship and may even make the bond stronger if the couple use good stress- and conflict-reduction strategies. Successful couples also find a way to keep the romance in the relationship, a very important determinant of marital satisfaction over the long run. Being motivated to meet a partner's sexual needs seems to be a key factor (Muise et al., 2013). Sharing religious beliefs and spirituality with one's spouse is another good way to ensure higher quality marriages, and that's especially the case among couples in lower socioeconomic groups (Lichter & Carmalt, 2009). It appears that this effect goes beyond merely doing an activity together, as religion and spirituality may provide a framework for conflict resolution and a way to put one's marriage in a bigger, more significant context. But when you get down to basics, it's how well couples communicate their thoughts, actions, and feelings to each other and show intimacy and support each other that largely determines the level of conflict couples experience and, by extension, how happy they are likely to be over the long term (Patrick et al., 2007). This is especially important with regard to high-stress areas such as children and work and after long separations such as military deployments (Wadsworth, Hughes-Kirchubel, & Riggs, 2014). And this evidence of the importance of good communication skills forms the basis of most marriage education programs we will consider a bit later. Think About It What types of interventions would help keep married couples happier? So what are the best ways to "stack the deck" in favor of a long, happy marriage? Based on research, here are the best: Make time for your relationship. Express your love to your spouse. Be there in times of need. Communicate constructively and positively about problems in the relationship. Be interested in your spouse's life. Confide in your spouse. Forgive minor offenses and try to understand major ones.

life story

a personal narrative that organizes past events into a coherent sequence

what happens to risky behavior during young adulthood

there is a significant drop in the frequency of risky behaviors such as driving at high speed, having sex without contraception, engaging in extreme sports, and committing antisocial acts such as vandalism

Childhood

Parents often take their children to funerals of relatives and close friends. But many adults, such as Donna and Carl in the vignette, wonder whether young children really know what death means. Children's understanding of death must be understood in terms of their cultural background and that fact that it changes with their development (Miller, Rosengren, & Gutiérrez, 2014). Preschoolers tend to believe that death is temporary and magical, something dramatic that comes to get you in the middle of the night like a burglar or a ghost. Not until children are 5 to 7 years of age do they realize that death is permanent, that it eventually happens to everyone, and that dead people no longer have any biological functions. Why does this shift occur? There are three major areas of developmental change in children that affect their understanding of death and grief (Miller et al., 2014; Webb, 2010a): cognitive-language ability, emotional/psychosocial development, and coping skills. In terms of cognitive-language ability, think back to Chapters 4 and 6, especially to the discussion of Piaget's theory of cognitive development. Consider Jennie, the 6-year-old daughter of Donna and Carl in the vignette. Where would she be in Piaget's terms? In this perspective, the ages 5 to 7 include the transition from preoperational to concrete-operational thinking. Concrete-operational thinking permits children to know that death is final and permanent. Therefore, Jennie is likely to understand what happened to her grandmother. With this more mature understanding of death comes a lower fear of death, too (Gutiérrez et al., 2014; Rosengren, Gutiérrez, & Schein, 2014). Children's expressions of grief at the loss of a loved one vary with age, too (Webb, 2010b). Several common manifestations of grief among children are shown in Figure 16.4. Typical reactions in early childhood include regression, guilt for causing the death, denial, displacement, repression, and wishful thinking that the deceased will return. In later childhood, common behaviors include problems at school, anger, and physical ailments. As children mature, they acquire more coping skills that permit a shift to problem-focused coping, which provides a better sense of personal control. Children will often flip between grief and normal activity, a pattern they may learn from adults (Stroebe et al., 2005). Sensitivity to these feelings and how they get expressed is essential so that the child can understand what happened and that he or she did not cause the death. Figure 16.4. From Oltjenbruns, K. A. (2001). "Developmental context of childhood: Grief and regrief phenomena." Handbook of Bereavement Research: Consequences, Coping, and Care edited by M. S. Stroebe, R. O. Hansson, W. Stroebe, & H. Schut, Fig. 8-1, p. 177. Copyright © 2001 by the American Psychological Association. Children show their grief in many ways, including physiological (somatic), emotional (intrapsychic), and behavioral. Research shows that bereavement per se during childhood typically does not have long-lasting effects such as depression (Miller et al., 2014; Webb, 2010b). Problems are more likely to occur if the child does not receive adequate care and attention following the death. Understanding death can be particularly difficult for children when adults are not open and honest with them, especially about the meaning of death (Miller & Rosengren, 2014). Most adults believe that it is best to shield their children, especially younger children, from death. The use of euphemisms such as "Grandma has gone away" and "Mommy is only sleeping" reflects this belief, but is unwise. First, young children do not understand the deeper level of meaning in such statements and are likely to take them literally. Second, and more important, adults cannot fully shield children from the reality of death. When explaining death to children, it is best to deal with them on their terms. Keep explanations simple, at a level they can understand. Try to allay their fears and reassure them that whatever reaction they have is okay. Providing loving support for the child will maximize the potential for a successful (albeit painful) introduction to one of life's realities. One male college student recalled how, when he was 9, his father helped him deal with his feelings after his grandfather's death: The day of my grandfather's death my dad came over to my aunt and uncle's house where my brother and I were staying. He took us into one of the bedrooms and sat us down. He told us Grandaddy Doc had died. He explained to us that it was okay if we needed to cry. He told us that he had cried, and that if we did cry we wouldn't be babies, but would just be men showing our emotions. (Dickinson, 1992, pp. 175-176) It is important for children to know that it is okay for them to feel sad, to cry, or to show their feelings in whatever way they want. Reassuring children that it's okay to feel this way helps them deal with their confusion at some adults' explanations of death. Young adults remember feeling uncomfortable as children around dead bodies, often fearing that the deceased person would come after them. Still, researchers believe it is very important for children to attend the funeral of a relative or to have a private viewing (Miller & Rosengren, 2014; Webb, 2010b). They will process the experience in age-appropriate ways, especially if they have understanding adults available to answer questions

practical intelligence

Take a moment to think about the following problems (Denney, 1984; Denney, Pearce, & Palmer, 1982): A middle-aged woman is frying chicken in her home when all of a sudden a grease fire breaks out on top of the stove. Flames begin to shoot up. What should she do? A man finds that the heater in his apartment is not working. He asks his landlord to send someone out to fix it, and the landlord agrees. But after a week of cold weather and several calls to the landlord, the heater is still not fixed. What should the man do? These practical problems are different from the examples of measures of fluid and crystallized intelligence in Chapter 10. They are more realistic; they reflect real-world situations that people routinely face. Many researchers argue that using such problems to assess cognition provides a better assessment of the kinds of skills adults actually use in everyday life (Margrett et al., 2010; Mayer, 2014). Most people spend more time at tasks such as managing their personal finances, dealing with uncooperative people, and juggling busy schedules than they do solving esoteric mazes. The shortcomings of traditional tests of adults' intelligence led to different ways of viewing intelligence that differentiate academic (or traditional) intelligence from other skills (Diehl et al, 2005; Margrett et al., 2010). The broad range of skills related to how individuals shape, select, or adapt to their physical and social environments is termed practical intelligence. The examples at the beginning of this section illustrate how practical intelligence is measured. Such real-life problems differ in three main ways from traditional tests (Diehl et al., 2005): People are more motivated to solve them; personal experience is more relevant; and they have more than one correct answer. Research evidence supports the view that practical intelligence is distinct from general cognitive ability (Margrett et al., 2010). Applications of Practical Intelligence Practical intelligence and postformal thinking (see Chapter 10) across adulthood have been linked. Specifically, the extent to which a practical problem evokes an emotional reaction, in conjunction with experience and one's preferred mode of thinking, determines whether one will use a cognitive analysis (thinking one's way through the problem), a problem-focused action (tackling the problem head-on by doing something about it), passive-dependent behavior (withdrawing from the situation), or avoidant thinking and denial (rationalizing to redefine the problem and so minimize its seriousness). Research indicates that adults tend to blend emotion with cognition in their approach to practical problems, whereas adolescents tend not to because they get hung up in the logic. Summarizing over a decade of her research, Blanchard-Fields (2007) notes that for late middle-aged adults, highly emotional problems (issues with high levels of feelings, such as dealing with unexpected deaths) are associated most with passive-dependent and avoidant-denial approaches. It is interesting, though, that problems concerned more with instrumental issues (issues related to daily living such as grocery shopping, getting from place to place, etc.) and home management (issues related to living in one's household) are dealt with differently. Middle-aged adults use problem-focused strategies more frequently in dealing with instrumental problems than do adolescents or young adults. Clearly, we cannot characterize problem solving in middle age in any one way. Mechanics and Pragmatics of Intelligence When we combine the research on practical intelligence with the research on the components or mechanics of intelligence discussed in Chapter 10, we have a more complete description of cognition in adulthood. The two-component model of life-span intelligence (Baltes et al., 2006) is grounded in the dynamic interplay among the biopsychosocial forces (see Chapter 1). The mechanics of intelligence reflects those aspects of intelligence comprising fluid intelligence (see Chapter 10). The pragmatics of intelligence refers to those aspects of intelligence reflecting crystallized intelligence (see Chapter 10). However, as Baltes and colleagues point out, the biopsychosocial forces differentially influence the mechanics and pragmatics of intelligence. Whereas the mechanics of intelligence is more directly an expression of the neurophysiological architecture of the mind, the pragmatics of intelligence is associated more with the bodies of knowledge that are available from and mediated through one's culture (Baltes et al., 2006). These concepts are illustrated in the left side of Figure 13.6. The mechanics of intelligence in later life is more associated with the fundamental organization of the central nervous system (i.e., biological forces). Thus, it is more closely linked with a gradual loss of brain efficiency with age (Horn & Hofer, 1992), a finding supported by brain imaging studies (Blanchard-Fields, 2010). Figure 13.6. Based on Baltes, P. B. (1993). The aging mind: Potential and limits. The Gerontologist, 33, 580-594. Conceptualization of the mechanics and pragmatics of intelligence across the life span. As described later, the mechanics of intelligence correspond to fluid intelligence and the pragmatics to crystallized intelligence. On the other hand, the pragmatics of intelligence is more closely associated with psychological and sociocultural forces. At the psychological level, knowledge structures change as a function of the accumulated acquisition of knowledge over time. For example, the more you learn about the American Revolution, the more differentiated your knowledge system becomes, going, for example, from a basic knowledge that the Americans declared their independence from Great Britain and won the war to a more elaborate knowledge about the various battles, how the Americans nearly lost the war, and that many people in America sided with the British. At the sociocultural level, knowledge structures are also influenced by how we are socialized given the particular historical period in which we are raised. For example, those of us who grew up in the Cold War era were taught that the people in the former Soviet Union were our enemies; those of us who grew up after the breakup of the former Soviet Union in 1991 were taught that the Russians could be our allies. Such differences reflect the sociocultural and historical contexts of particular points in time. Overall, these knowledge structures influence the way we implement our professional skills, solve everyday problems, and conduct the business of life (Baltes et al., 2006). Finally, as the right portion of Figure 13.6 shows, the developmental pathways the mechanics and pragmatics of intelligence take across the course of adult life differ. Given that biological and genetic forces govern the mechanics more, there is a downward trajectory with age beginning by middle age. However, given that the pragmatics of intelligence is governed more by environmental and cultural factors, there is an upward trajectory that is maintained across the adult life span.

Longevity

The number of years a person can expect to live, termed longevity, is jointly determined by genetic and environmental factors. Researchers distinguish between three types of longevity: average life expectancy, useful life expectancy, and maximum life expectancy. Average life expectancy (or median life expectancy) is the age at which half of the people born in a particular year will have died. As you can see in Figure 14.3, average life expectancy at birth for people in the United States increased steadily during the 20th century. This increase was due in large part to significant declines in infant mortality and in the number of women dying during childbirth, the elimination of major diseases such as smallpox and polio, and improvements in medical technology that prolong the lives of people with chronic disease. Currently, average life expectancy at birth for American women is 81 years; for men, it's 76.2 (National Center for Health Statistics, 2013b). Figure 14.3. Data from Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System (2010). http://www.cdc.gov/nchs/data/hus/hus12.pdf#018 Life expectancy at birth and at 65 years of age in the United States. Countries around the world differ dramatically in how long their populations live on average. As you can see in Figure 14.4, the current range extends from about 45years in Sierra Leone, Africa, to over 83 years in Hong Kong. Such a wide divergence in life expectancy reflects vast discrepancies in genetics, sociocultural and economic conditions, health care, and disease across developed and developing nations. Figure 14.4. From countryeconomy.com/demography/life-expectancy. International data on average life expectancy at birth. Note the differences between developed and developing countries. As important as the sheer length of one's life is, a more important issue is one's useful life expectancy. Useful life expectancy is the number of years that a person is free from debilitating chronic disease and impairment. Ideally, useful life expectancy would match the actual length of a person's life—the person has a long and useful life, then dies quickly. However, medical technology sometimes enables people to live on for years even though they may no longer be able to perform routine daily tasks. Accordingly, when making medical treatment decisions people are now placing greater emphasis on useful life expectancy and less emphasis on the sheer number of years they may live (Eckholm, 2014). We will consider this issue in more detail in Chapter 16. Maximum life expectancy is the oldest age to which any person lives. Currently, scientists estimate that the maximum limit for humans is around 120 years, mostly because the heart and other key organ systems are limited in how long they can last without replacement (Hayflick, 1998). Genetic and Environmental Factors in Longevity We have known for some time that a good way to increase the chances of a long life is to come from a family with a history of long-lived individuals—in other words, have good genes (Hayflick, 1998). The Human Genome Project, which has mapped the basic human genetic code, and its spinoffs in microbiology, behavior genetics, and aging, have confirmed the role of genetic linkages to longevity, as well as with both physical health and disease (Sebastiani et al., 2013). Research is also focusing on treating genetic diseases by implanting "corrected" genes in people in the hopes that the good genes will reproduce and eventually wipe out the defective genes and by designing specialized medications to treat specific forms of diseases such as cancer. The fact that we can identify certain genetic markers of diseases that affect longevity has important implications for families, such as whether they should have children and even whether they want to know their genetic makeup (Henriksen et al., 2014). Payoffs from such research are already helping us understand how increasing numbers of people are living to 100 and older. For example, genomic studies of human aging are advancing our understanding of why longevity tends to run in certain families (Sebastiani et al., 2013). Perls and Terry (2003) showed that genetic factors play a major role in determining how well centenarians (people over age 100) cope with disease. The oldest-old are hardy because they have a high threshold for disease and show slower rates of disease progression than their peers, who develop chronic diseases at younger ages and die earlier. Jack Hollingsworth / Getty Images Coming from a family of long-lived individuals shows the role of genetics in longevity. Although heredity is a major determinant of longevity, environmental factors also affect the life span (Perls & Terry, 2003; Slagboom et al., 2011). Some environmental factors are more obvious; diseases, toxins, lifestyle, and social class are among the most important. Compared with other factors, the impact of social class on longevity is a more recent focus. Social class effects result from reduced access to such important things as healthy food and medical care that characterizes the poor regardless of ethnic group (National Institute on Minority Health and Health Disparities, 2014). Most poor people have inadequate access to health care and cannot afford the cost of a more healthful lifestyle. For example, fresh fruits and vegetables often cost more than less healthy alternatives, and living in large urban areas exposes people to serious problems such as lead poisoning from old water pipes, air pollution, and poor drinking water, but many people simply cannot afford to move. The sad part about most environmental factors is that people are responsible for them. Denying adequate access to health care to everyone, continuing to pollute the environment, and failing to address the underlying causes of poverty have undeniable consequences: They needlessly shorten lives and dramatically increase the overall cost of health care. Ethnic and Gender Differences in Longevity Ethnic differences in average life expectancy are clear (National Center for Health Statistics, 2014). For example, African Americans' average life expectancy at birth is roughly five years lower for men and three years lower for women than that of European Americans. By age 65, though, the gap narrows somewhat—the average life expectancy for African Americans is only about two years less for men and about one year less for women than it is for European Americans, and by age 85, African Americans tend to live longer. Perhaps because they do not typically have access to the same quality of care that European Americans usually do and thus are at greater risk for disease and accidents, African Americans who survive to age 85 tend to be healthier than their European American counterparts. Like Sarah, the 87-year-old woman in the vignette, they may have needed little medical care throughout their lives. But this is not the whole story. For example, Latino Americans' average life expectancy exceeds European Americans' at all ages despite having, on average, less access to health care (National Center for Health Statistics, 2014). A visit to a senior center or a nursing home can lead to the question "Where are all the very old men?" The answer is that women tend to live longer. Women's average longevity is about five years more than men's at birth, narrowing to roughly one year by age 85 (National Center for Health Statistics, 2014). These differences are fairly typical of most developed countries but not of developing countries. Indeed, the female advantage in average longevity in the United States became apparent only in the early 20th century (Hayflick, 1996). Why? Until then, so many women died in childbirth that their average longevity as a group was reduced to that of men. Death in childbirth still partially explains the lack of a female advantage in developing countries today; however, part of the difference in some countries also results from infanticide of baby girls. In developed countries, socioeconomic factors such as access to health care, work and educational opportunities, and athletics also helped account for the emergence of the female advantage (Hayflick, 1998). Think About It How do ethnic and gender differences in life expectancy relate to biological, psychological, sociocultural, and life-cycle factors? What accounts for women's longevity advantage, especially in developed countries? Overall, men's rates of dying from 12 of the top 15 causes of death are significantly higher than women's at nearly every age, and men are more susceptible to infectious diseases (Pinkhasov et al., 2010). Explanations based on such ideas as women's second X-chromosome, more active immune functioning, and the protective effects of estrogen have not explained the difference. These results have led some to speculate that perhaps it is not simply a gender-related biological difference at work in longevity but rather a more complex interaction of lifestyle, greater susceptibility in men of contracting certain fatal diseases, and genetics (Pinkhasov et al., 2010). Tony Freeman/PhotoEdit Latina women live longer on average than other ethnic groups and are the fastest-growing group of older adults in the United States.

The Parental Role

Today, couples in the United States and most other developed nations typically have fewer children and have their first child later than in the past. The average age at the time of the birth of a woman's first child is about 25. This average age has been increasing steadily since 1970 as a result of several major trends regarding women: Many women postpone children because they are marrying later, they want to establish careers, or they make a choice to delay childbearing. In general, the data indicate that as the average level of women's education in a society increases, the birthrate decreases. In addition, the teen birthrate in the United States hit a historic low in 2012, continuing a trend of roughly 20 years of declining rates (Hamilton, Martin, & Ventura, 2013). Being older at the birth of one's first child is advantageous. Older mothers, like Denise in the vignette, are more at ease being parents, spend more time with their babies, and are more affectionate, sensitive, and supportive to them. In addition, there is a higher maternal investment in middle childhood and less child-perceived conflict in adolescence (Schlomer & Belsky, 2012). The age of the father also makes a difference in how he interacts with children (Palkovitz & Palm, 2009). Remember Bob, the 32-year-old first-time father in the vignette? Compared to men who become fathers in their twenties, men (like Bob) who become fathers in their thirties are generally more invested in their paternal role and spend up to 3 times as much time caring for their preschool children as younger fathers do. Father involvement has increased significantly, due in part to social attitudes that support it (Fogarty & Evans, 2010). Research clearly shows that being a father is an important aspect of men's lives across adulthood (Marsiglio & Roy, 2013). Parenting skills do not come naturally; they must be acquired. Having a child changes all aspects of couples' lives. As we have seen, children place a great deal of stress on a relationship. Both motherhood and fatherhood require major commitment and cooperation. Parenting is full of rewards, but it also takes a great deal of work. Caring for young children is demanding. It may create disagreements over division of labor, especially if both parents are employed outside the home (see Chapters 4 and 11). Even when mothers are employed outside the home (and roughly 70% of women with children under age 18 in the United States are), they still perform most of the child-rearing tasks. Even when men take employment leave, although more likely to share tasks, they still do not spend more time with children than fathers who do not take leave (Seward & Stanley-Stevens, 2014). In general, parents manage to deal with the many challenges of child rearing reasonably well. They learn how to compromise when necessary and when to apply firm but fair discipline. Given the choice, most parents do not regret their decision to have children. Think About It Should there be mandatory programs for parent education? Ethnic Diversity and Parenting Ethnic background matters a great deal in terms of family structure and the parent-child relationship. African American husbands are more likely than their European American counterparts to help with household chores, and they help regardless of their wives' employment status (Smith-Bynum, 2013). African American parents may buffer their children from involvement with drugs and other problems owing to their more conservative views about illegal substance abuse, which may in part be responsible for lower rates of drug and alcohol use among adolescent and young adult African Americans (Seffrin, 2012). Overall, most African American parents provide a cohesive, loving environment that often exists within a context of strong religious beliefs (Smith-Bynum, 2013; Teachman et al., 2013). Having a national role model in President Barack and Michelle Obama has also helped focus both social opinion and research on the normative functioning of family life in African American households (Smith-Bynum, 2013). © Joel Gordon Family ties among Native Americans tend to be very strong. As a result of several generations of oppression, many Native American parents have lost the cultural parenting skills that were traditionally part of their culture: children were valued, women were considered sacred and honored, and men cared for and provided for their families (Davis, Dionne, & Fortin, 2014). Thus, restoring and retaining a strong sense of tribalism is an important consideration for Native American families. Indeed, research shows that American Indian families receive more support from relatives in child rearing than do European Americans (Limb & Shafer, 2014). This support helps with the transmission of cultural values. In 2013, one of every six Americans was Latino, with about 25% of all children under 18 in the United States in 2013 being Latino, a figure that is expected to rise to about 36% by 2050 (U.S. Census Bureau, 2013b). Latino parents endorse the construct of proper behavior, or respeto, as a key value (Umaña-Taylor & Updegraff, 2013). For example, Latino mothers and fathers both tend to adopt similar authoritative behaviors in dealing with their preschool children, but mothers use these behaviors more frequently (Grau, Azmitia, & Quattlebaum, 2009). Latino families demonstrate two additional important values: familism and the extended family. Familism refers to the idea that the well-being of the family takes precedence over the concerns of individual family members. This value is a defining characteristic of Latino families; for example, Brazilian and Mexican families consider familism a cultural strength (Carlo et al., 2007; Lucero-Liu, 2007; Umaña-Taylor & Updegraff, 2013). Indeed, familism helps account for the significantly higher trend for Latino college students to live at home (Desmond & López Turley, 2009). The extended family is also very strong among Latino families and serves as the venue for a wide range of exchanges of goods and services, such as child care and financial support. Like Latinos, Asian Americans value familism (Meyer, 2007; Rodriguez-Galán, 2014) and place an even higher value on extended family. Asian American adolescents report very high feelings of obligation to their families compared with European American adolescents, although in fact, most caregiving is done by daughters or daughters-in-law, not sons (Rodriguez-Galán, 2014). Contrary to commonly portrayed stereotypes, Asian American families do not represent the "Model Minority," but experience the same challenges with parenting as all other groups (Xia, Do, & Xie, 2013). In general, males enjoy higher status in traditional Asian families (Tsuno & Homma, 2009). Among recent immigrants, though, women are expanding their role by working outside the home. Research shows that Chinese American parents experience less marital stress during the transition to parenthood than European American couples do, perhaps because of the clearer traditional cultural division of tasks between husbands and wives (Burns, 2005). Raising multiethnic children presents challenges not experienced by parents of same-race children. For example, parents of biracial children report feeling discrimination and being targets of prejudicial behavior from others (Hubbard, 2010; Kilson & Ladd, 2009). These parents also worry that their children may be rejected by members of both racial communities. Perhaps that is why parents of multiracial children tend to provide more economic and cultural resources to their children than do parents of single-race children (Cheng & Powell, 2007). In multiethnic families, you might think that the parent from a minority group takes primary responsibility for guiding that aspect of the child's ethnic identity. However, it is the mothers who are key in most respects (Schlabach, 2013). A study of children of European mothers and Maori fathers in New Zealand showed that the mothers played a major role in establishing the child's Maori identity (Kukutai, 2007). Similarly, European American mothers of biracial children whose fathers were African American tended to raise them as African American in terms of public ethnic identity (O'Donoghue, 2005). In general, multiracial adolescents experience more negative outcomes socially and emotionally if their mothers, rather than fathers, are a minority (Schlabach, 2013). It is clear that ethnic groups vary a great deal in how they approach the issue of parenting and what values are most important. Considered together, there is no one parenting standard that applies equally to all groups. Single Parents Single-parent households represent 36% of households with children under age 18 in the United States, up from 23% in 1980 (ChildStats.gov, 2013). Such households occur for many reasons, such as unmarried women living alone, giving birth, and divorcing, resulting in one custodial parent. In theUnited States, the proportion of births to unwed mothers has been increasing since the 1940s and is now about 36% (Shattuck & Kreider, 2013). The number of single parents, most of whom are women, continues to be high in some ethnic groups. About two-thirds of births to African American mothers, about 43% of births to Latina mothers, nearly 26% of births to European American mothers, and 11% of births to Asian American mothers are to unmarried women. Among the reasons are the desire to have children, failure to use contraception, high divorce rates, the decision to keep children born out of wedlock, and different fertility rates across ethnic groups. Two main questions arise concerning single parents: How are children affected when only one adult is responsible for child care? How do single parents meet their own needs for emotional support and intimacy? Many divorced single parents report complex feelings toward their children, such as frustration, failure, guilt, and a need to be overindulgent (Amato & Boyd, 2013). Loneliness when children grow up and leave or are visiting the noncustodial parent can be especially difficult to deal with (Anderson & Greene, 2013). Military families experience unique aspects of single parenting.When one parent in a two-parent household deploys, the remaining parent becomes a single parent. Separation anxiety is common among deployed parents, and the cycling of experience as a single parent and partner in a two-parent household with both parents present can create stress (Wadsworth, Hughes-Kirchubel, & Riggs, 2014). Single parents, regardless of gender, face considerable obstacles. Financially, they are usually less well-off than their married counterparts, especially single mothers. Having only one source of income puts additional pressure on single parents to provide all of the necessities. Integrating the roles of work and parenthood are difficult enough for two people; for the single parent, the hardships are compounded. Financially, single mothers are hardest hit, mainly because women typically are paid less than men and because single mothers may not be able to afford enough child care to provide the work schedule flexibility needed for higher-paying jobs. © Monkey Business Images/Shutterstock.com Being a single parent presents many challenges, but also satisfaction. One particular concern for many divorced single parents is dating. Several common questions asked by single parents involve dating: "How do I become available again?" "How will my children react?" "How do I cope with my own sexual needs?" They have reason to be concerned. Research indicates that single parents tend to report that children may interfere with dating and romance (Sommer et al., 2013). They report feeling insecure about sexuality and wondering how they should behave around their children in terms of having partners stay overnight (Lampkin-Hunter, 2010). Step-, Foster-, Adoptive, and Same-Sex Couple Parenting Not all parents raise their own biological children. In fact, roughly one-third of North American couples become stepparents or foster or adoptive parents sometime during their lives. To be sure, the parenting issues we have discussed so far are just as important in these situations as when people raise their own biological children. In general, there are few differences among parents who have their own biological children or who become parents in some other way, but there are some unique challenges (McKay & Ross, 2010). For example, research indicates that the predictors of relationship satisfaction of adoptive mothers are similar to predictors of relationship satisfaction among biological parents: well-being, partner support, and aspects of mental health (South, Foli, & Lim, 2013). A big issue for foster parents, adoptive parents, and stepparents is how strongly the child will bond with them. Although infants less than 1 year old will probably bond well, children who are old enough to have formed attachments with their biological parents may have competing loyalties. For example, some stepchildren remain strongly attached to the noncustodial parent and actively resist attempts to integrate them into the new family ("My real mother wouldn't make me do that"), or they may exhibit behavioral problems. As a result, the dynamics in blended families can best be understood as a complex system (Dupuis, 2010). Stepparents must often deal with continued visitation by the noncustodial parent, which may exacerbate any difficulties. These problems are a major reason that second marriages are at high risk for dissolution, as discussed later in this chapter. They are also a major reason why behavioral and emotional problems are more common among stepchildren (Crohn, 2006). Still, many stepparents and stepchildren ultimately develop good relationships with each other (Coleman, Ganong, & Russell, 2013). Stepparents must be sensitive to the relationship between the stepchild and his or her biological, noncustodial parent. Allowing stepchildren to develop a relationship with the stepparent at their own pace also helps. What style of stepparenting ultimately develops is influenced by the expectations of the stepparent, stepchild, spouse, and nonresidential parent, but several styles result in positive outcomes. Adoptive parents also contend with attachment to birth parents, but in different ways. Even if they don't remember them, adopted children may want to locate and meet their birth parents. Wanting to know one's origins is understandable, but such searches can strain the relationships between these children and their adoptive parents, who may interpret the actions as a form of rejection, and create difficulties for the adopted person (Curtis & Pearson, 2010). Families with children adopted from another culture pose unique issues in terms of how to establish and maintain connection with the child's culture of origin. For mothers of transracially adopted Chinese and Korean children, becoming connected to the appropriate Asian American community is an important way to accomplish this (Johnston et al., 2007). Research in the Netherlands found that children adopted from Columbia, Sri Lanka, and Korea into Dutch homes struggled with looking different, and many expressed a desire to be white (Juffer, 2006). Research in Sweden also revealed challenges in maintaining the culture from the child's country of origin (Yngvesson, 2010). Foster parents tend to have the most tenuous relationship with their children because the bond can be broken for a number of reasons that have nothing to do with the quality of the care being provided. For example, a court may award custody back to the birth parents or another couple may legally adopt the child. Dealing with attachment is difficult; foster parents want to provide secure homes, but they may not have the children long enough to establish continuity. Furthermore, because many children in foster care have been unable to form attachments at all, they are less likelyto form ones that will inevitably be broken. Thus, foster parents must be willing to tolerate considerable ambiguity in the relationship and to have few expectations about the future. Despite the challenges, the positive news is that placement in good foster caredoes result in the development of attachment between foster parents and children who were placed out of institutional settings (Smyke et al., 2010). Finally, many gay men and lesbian women also want to be parents. Some have biological children themselves, whereas others are increasingly choosing adoption or foster parenting (Patterson, Riskind, & Tornello, 2014). Although gay men and lesbian women make good parents, they often experience resistance from others to their having children (Clifford, Hertz, & Doskow, 2010); for example, some states in the United States have laws preventing gay and lesbian couples from adopting. The rapidly changing political landscape concerning same-sex marriage may have an impact on adoption opportunities as well. Research indicates that children reared by gay or lesbian parents do not experience any more problems than children reared by heterosexual parents and are as psychologically healthy as children of heterosexual parents (Biblarz & Savci, 2010). Substantial evidence exists that children raised by gay or lesbian parents do not develop sexual identity problems or any other problems any more than children raised by heterosexual parents (Goldberg, 2009). Children of gay and lesbian parents were no more likely than children of heterosexual parents to identify as gay, lesbian, bisexual, transgendered, or questioning. The evidence is clear that children raised by gay or lesbian parents suffer no adverse consequences compared with children raised by heterosexual parents. Children of lesbian couples and heterosexual couples are equally adjusted behaviorally, show equivalent cognitive development, have similar behaviors in school, and do not show different rates of use of illegal drugs or delinquent behavior (Biblarz & Savci, 2010; Patterson, 2013). Children of gay or lesbian parents might be better adjusted than adult children of heterosexual parents in that the adult children of gay and lesbian parents exhibit lower levels of homophobia and less fear of negative evaluation than do the adult children of heterosexual parents. Gay men are often especially concerned about being good and nurturing fathers, and they try hard to raise their children with nonsexist, egalitarian attitudes (Goldberg, 2009; Patterson, 2013). Evidence shows that gay parents have more egalitarian sharing of child rearing than do fathers in heterosexual households (Biblarz & Savci, 2010). These data will not eliminate the controversy, much of which is based on long-held beliefs (often religion-based) and prejudices. In the United States, the topic of lesbian and gay couples' right to be parents is likely to continue to play out in political agendas for years to come.

Death Anxiety

We have seen that how people view death varies with age. In the process, we encountered the notion of feeling anxious about death. Death anxiety refers to people's anxiety or even fear of death and dying. Death anxiety is tough to pin down; indeed, it is the ethereal nature of death, rather than something about it in particular, that usually makes us feel so uncomfortable. We cannot put our finger on something specific about death that is causing us to feel uneasy. Because of this, we must look for indirect behavioral evidence to document death anxiety. Research findings suggest that death anxiety is a complex, multidimensional construct. For nearly three decades, researchers have applied terror management theory as a framework to study death anxiety (Burke, Martens, & Faucher, 2010; Tam, 2013). Terror management theory addresses the issue of why people engage in certain behaviors to achieve particular psychological states based on their deeply rooted concerns about mortality (Arndt & Vess, 2008). The theory proposes that ensuring the continuation of one's life is the primary motive underlying behavior and that all other motives can be traced to this basic one. In addition, some suggest that older adults present an existential threat for the younger and middle-aged adults because they remind us all that death is inescapable, the body is fallible, and the bases by which we may secure self-esteem (and manage death anxiety) are transitory (Martens, Goldenberg, & Greenberg, 2005). That may be why some people seek cosmetic surgery as a way to deal with their death anxiety (Tam, 2013). Thus, death anxiety is a reflection of one's concern over dying, an outcome that would violate the prime motive. Neuroimaging research shows that terror management theory provides a useful framework for studying brain activity related to death anxiety. Quirin and colleagues (2012) found that brain activity in the right amygdala, left rostral anterior cingulate cortex, and right caudate nucleus was greater when male participants were answering questions about fear of death and dying than when they were answering questions about dental pain. Similarly, electrical activity in the brain indicates that people defend themselves against the emotions related to death (Klackl, Jonas, & Kronbichler, 2013). There is, then, neurophysiological evidence that shows that Jean's attempts to block thoughts of her own death in the opening vignette are common among people. On the basis of several diverse studies using many different measures, researchers now conclude that death anxiety consists of several components. Each of these components is most easily described with terms that resemble examples of great concern (anxiety) but cannot be tied to any one specific focus. Some research on U.S. and Atlantic Canadian adults indicates that components of death anxiety included pain, body malfunction, humiliation, rejection, nonbeing, punishment, interruption of goals, being destroyed, and negative impact on survivors (Power & Smith, 2008). To complicate matters further, each of these components can be assessed at any of three levels: public, private, and nonconscious. That is, what we admit feeling about death in public may differ greatly from what we feel when we are alone with our thoughts. In short, the measurement of death anxiety is complex, and researchers need to specify which aspects they are assessing. Think About It Why does death anxiety have so many components? Much research has been conducted to learn what demographic and personality variables are related to death anxiety. Although the results often are ambiguous, some patterns have emerged. For example, older adults tend to have lower death anxiety than younger adults do, perhaps because of their tendency to engage in life review, their tendency to have a different perspective about time, and their higher level of religious motivation (Henrie, 2010). Men show greater fear of the unknown than women do, but women report more specific fear of the dying process (Cicirelli, 2001). In Taiwan, higher death anxiety among patients with cancer is associated with not having a purpose in life and level of fear of disease relapse (Tang et al., 2011). BOB STRONG/Reuters/Landov Facing death on a regular basis often forces people to confront their death anxiety. Strange as it may seem, death anxiety may have a beneficial side. For one thing, being afraid to die means that we often go to great lengths to make sure we stay alive, as argued by terror management theory (Burke et al., 2010). Because staying alive helps to ensure the continuation and socialization of the species, fear of death serves as a motivation to have children and raise them properly. Learning to Deal with Death Anxiety Although some degree of death anxiety may be appropriate, we must guard against letting it become powerful enough to interfere with our normal daily routines. Several ways exist to help us in this endeavor. Perhaps the one most often used is to live life to the fullest. Kalish (1984, 1987) argues that people who do this enjoy what they have; although they may still fear death and feel cheated, they have few regrets. Adolescents are particularly likely to do this; research shows that teenagers, especially males, engage in risky behavior that is correlated with low death anxiety (Ben-Zur & Zeidner, 2009; Cotter, 2003). Koestenbaum (1976) proposes several exercises and questions to increase one's death awareness. Some of these are to write your own obituary (as you did earlier in this chapter) and to plan your own death and funeral services. You can also ask yourself What circumstances would help make my death acceptable? Is death the sort of thing that could happen to me right now? These questions serve as a basis for an increasingly popular way to reduce anxiety: death education. Most death education programs combine factual information about death with issues aimed at reducing anxiety and fear to increase sensitivity to others' feelings. These programs vary widely in orientation; they can include such topics as philosophy, ethics, psychology, drama, religion, medicine, and art. In addition, they can focus on death, the process of dying, grief and bereavement, or any combination of them. In general, death education programs help primarily by increasing our awareness of the complex emotions felt and expressed by dying people and their families. It is important to make education programs reflect the diverse backgrounds of the participants (Fowler, 2008). Research shows that participating in experiential workshops about death significantly lowers death anxiety in younger, middle-aged, and older adults and raises awareness about the importance of advance directives (Moeller et al., 2010)

Friendships

What is an adult friend? Someone who is there when you need to share? Someone not afraid to tell you the truth? Someone to have fun with? Friends, of course, are all of these things and more. Researchers define friendship as a mutual relationship in which those involved influence one another's behaviors and beliefs, and they define friendship quality as the satisfaction derived from the relationship (Blieszner & Roberto, 2012; Flynn, 2007). The role and influence of friends for young adults is of major importance from the late teens to the mid-twenties (Arnett, 2012, 2013) and continues to be a source of support throughout adulthood. Friendships are based predominantly on feelings and are grounded in reciprocity and choice. Friendships are different from love relationships in that they are less emotionally intense and usually do not involve sex (Blieszner & Roberto, 2012). Having good friendships helps boost self-esteem (Bagwell et al., 2005) and happiness (Demir, 2010). They also help us become socialized into new roles throughout adulthood. Friendship in Adulthood From a developmental perspective, adult friendships can be viewed as having identifiable stages (Levinger, 1980, 1983): Acquaintanceship, Buildup, Continuation, Deterioration, and Ending. This ABCDE model describes not only the stages of friendships but also the processes by which they change. For example, whether a friendship will develop from Acquaintanceship to Buildup depends on several factors that include the basis of the attraction, what each person knows about the other, how good the communication is between the partners, and the perceived importance of the friendship. Although many friendships reach the Deterioration stage, whether a friendship ultimately ends depends on the availability of alternative relationships. If new potential friends appear, old friendships may end; if not, they may continue even though they may no longer be considered important by either person. Longitudinal research shows how friendships change across adulthood, sometimes in ways that are predictable and sometimes not. For example, as you probably have experienced, life transitions (e.g., going away to college, getting married) usually result in fewer friends and less contact with the friends you keep (Blieszner & Roberto, 2012). People tend to have more friends and acquaintances during young adulthood than at any subsequent period (Sherman, de Vries, & Lansford, 2000). Friendships are important throughout adulthood, in part because a person's life satisfaction is strongly related to the quantity and quality of contacts with friends. College students who have strong friendship networks adjust better to stressful life events whether those networks are face-to-face (e.g., Brissette, Scheier, & Carver, 2002) or through online social networks (DeAndreaetal., 2012). © iStockphoto.com/Dem10 Despite concerns, social networking websites such as Facebook have not reduced the quality of friendships. The importance of maintaining contacts with friends cuts across ethnic lines as well. In addition, people who have friendships that cross ethnic groups or are diverse on other dimensions, such as religion or sexual orientation, have more positive attitudes toward people with different backgrounds (Aberson, Shoemaker, & Tomolillo, 2004; Goldstein, 2013). Thus, regardless of one's background, friendships play a major role in determining how much a person enjoys life. Researchers have long used three broad themes to explain the bases for adult friendships (de Vries, 1996): The most frequently mentioned dimension represents the affective, or emotional, basis of friendship. This dimension refers to self-disclosure and expressions of intimacy, appreciation, affection, and support, all of which are based on trust, loyalty, and commitment. A second theme reflects the shared, or communal, nature of friendship, in which friends participate in or support activities of mutual interest. The third dimension represents sociability and compatibility; our friends keep us entertained and are sources of amusement, fun, and recreation. These themes are found in friendships among adults of all ages (Blieszner & Roberto, 2012). They characterize both traditional (e.g., face-to-face) and online (e.g., Facebook) forms of friendships (Abbas, 2013). These three dimensions are fundamental to understanding how friendships are used to explain how people derive happiness from friendships. The key is that when people believe that they matter to a friend, they feel happy (Demir et al., 2013). But why does friendship have such positive benefits for us? Although scientists do not know for certain, they are gaining insights through neuroscience research. For example, Coan and colleagues (Beckes & Coan, 2013; Beckes, Coan, & Hasselmo, 2013; Coan, 2008) have found that being faced with threatening situations results in very different brain processing when faced alone or with a close friend. Specifically, neuroimaging showed definitively that the parts of the brain that respond to threat operate when facing threat alone but do not when facing the same threat with a close friend. It is becoming clear that close friendship literally changes the way the brain functions, resulting in our perception of feeling safer and that the trials we face are more manageable with friends than without them. The development of online social networks such as Facebook raised concerns among social commentators that adults' social friendship networks would decline in quality because in-depth interactions would be replaced with quick e-mails or postings. Research shows that this concern has no basis. Wang and Wellman (2010) examined friendship networks in adults aged 25 and 74. They documented that the quality of the friendship network was good overall, actually improving between 2002 and 2007. Most important, this improvement was documented whether people were nonusers of the Internet or heavily virtual. In fact, they found that heavy Internet users had the most friends, both online and offline. These results were supported by a study in Australia of adults aged 21 to 57 (Young, 2013). Facebook users were extremely positive about their online friendship activity. However, they mentioned that the risk of "de-friending" is a real phenomenon. In the case of online friendships, trust is an important factor because visual cues may not be present to verify the information being presented. Online environments are more conducive to people who are shy, allowing opportunities to meet others in an initially more anonymous setting in which social interaction and intimacy levels can be carefully controlled (Morahan-Martin & Schumacher, 2003). This relative anonymity provides a supportive context for the subsequent development of friendships online. Online connections can facilitate strong commitment between friends; research shows that most adults who have online, committed friendships report that they can get stronger and that such friendships go through the same cycles as traditional face-to-face friendships (Johnson et al., 2009). A special type of friendship exists with one's siblings, who are the friends that people typically have the longest and that share the closest bonds; in addition, the importance of these relationships varies with age (Carr & Moorman, 2011; Moorman & Greenfield, 2010). We will consider sibling relationships in more detail in Chapter 15. Men's, Women's, and Cross-Sex Friendships Men's and women's friendships tend to differ in adulthood, reflecting continuity in the learned behaviors from childhood (Blieszner & Roberto, 2012; Mehta & Strough, 2009). Women tend to base their friendships on more intimate and emotional sharing and use friendship as a means to confide in others. For women, getting together with friends often takes the form of getting together to discuss personal matters. Confiding in others is a basis of women's friendships. In contrast, men tend to base friendships on shared activities or interests. They are more likely to go bowling or fishing or to talk sports with their friends. For men, friendships are often, but not always, less intimate (Greif, 2009). Although men often use shared activities rather than shared confidences as the basis for friendships, men do tend to have a small number of friends with whom they have a close, personal relationship and with whom they share intimate information and feelings. What about friendships between men and women? These friendships have a beneficial effect, especially for men (Piquet, 2007). Cross-sex friendships tend to help men have lower levels of dating anxiety and higher capacity for intimacy; it is interesting, however, that such benefits are not evident for women. These patterns hold across ethnic groups, too. But cross-sex friendships can also prove troublesome as a result of misperceptions and pressures from third parties (e.g., spouses/partners) and organizations (e.g., companies may discourage such friendships) (Blieszner & Roberto, 2012; Mehta & Strough, 2009). Misperception about one's own or one's partner's sexual attractiveness to others is common and can be the basis for relationship difficulties (Haselton & Galperin, 2013). Some research shows that men tend to overperceive and women tend to underperceive their friends' sexual interest in them (Koenig, Kirkpatrick, & Ketelaar, 2007). Maintaining cross-sex friendships once individuals enter into exclusive dating relationships, marriage, or committed relationships is very difficult, and it often results in one partner feeling jealous (Haselton & Galperin, 2013).

Creating a final scenario

When given the chance, many adults would like to discuss a variety of issues, collectively called end-of-life issues : management of the final phase of life, after-death disposition of their body and memorial services, and distribution of assets (Moeller et al., 2010). How these issues are confronted represents a significant generational shift (Green, 2008). Parents and grandparents of the baby boom generation spoke respectfully about those who had "passed away" and rarely planned ahead for or made their wishes known about medical care they did or did not want. Baby boomers are far more likely to plan and to be more matter-of-fact about the issues. People want to manage the final part of their lives by thinking through the choices between traditional care (e.g., that provided by hospitals and nursing homes) and alternatives (such as hospices, which we discuss in the next section), completing advance directives (e.g., health care power of attorney, living will), resolving key personal relationships, and perhaps choosing the alternative of ending one's life prematurely through euthanasia. What happens to one's body and how one is memorialized is very important to most people. Is a traditional burial preferred over cremation? A traditional funeral over a memorial service? Such choices often are based on people's religious beliefs and their desire for their family's privacy after they have died. Making sure that one's estate and personal effects are passed on appropriately often is overlooked. Making a will is especially important in ensuring that one's wishes are carried out. Providing for the informal distribution of personal effects also helps prevent disputes between family members. Whether people choose to address these issues formally or informally, it is important that they be given the opportunity to do so. In many cases, family members are reluctant to discuss these matters with the dying relative because of their own anxiety about death. Making such choices known about how they do and do not want their lives to end constitutes a final scenario. One of the most difficult and important parts of a final scenario for most people is the process of separation from family and friends (Corr et al., 2008; Corr & Corr, 2013; Wanzer & Glenmullen, 2007). The final days, weeks, and months of life provide opportunities to affirm love, resolve conflicts, and provide peace to dying people. The failure to complete this process often leaves survivors feeling that they did not achieve closure in the relationship, which can result in bitterness toward the deceased. © emipress/Shutterstock.com Deciding whether to have a traditional funeral is part of the creation of one's final scenario. Health care workers realize the importance of giving dying patients the chance to create a final scenario and recognize the uniqueness of each person's final passage. A key part of their role is to ease this process (Wanzer & Glenmullen, 2007). Any given final scenario reflects the individual's personal past, which is the unique combination of the development forces that the person experienced. Primary attention is paid to how people's total life experiences have prepared them to face end-of-life issues (Moeller et al., 2010). A person's final scenario helps family and friends interpret his or her death, especially when the scenario is constructed jointly, such as between spouses, and when communication is open and honest (Green, 2008). The different perspectives of everyone involved are unlikely to converge without clear communication and discussion. Respecting each person's perspective is key and greatly helps in creating a good final scenario. Encouraging people to decide for themselves how the end of their lives should be handled has helped people take control of their dying (Hains & Hulbert-Williams, 2013). Taking personal control over one's dying process is a trend that is occurring even in cultures such as Japan that traditionally defer to physician's opinions (Alden, Merz, & Akashi, 2012). The emergence of final scenarios as an important consideration fits well with the emphasis on addressing pain through palliative care, an approach underlying hospice

fluid intelligence

abilities that make you a flexible and adaptive thinker, allow you to make inferences, and enable you to understand the relations among concepts -abilities to understand and respond to any situation: especially inductive reasoning, integration, abstract thinking,

multidimensional

characteristic of theories of intelligence that identify several types of intellectual abilities

how does being a college student affect drinking

does not appreciably affect the likelihood of binge drinking overall, but college students tend to drink more at parties

what factors influence the development of a life-span construct

identity, values, and society

what does the average age for when rituals are completed increasing over time mean?

it means western society has no clear age-constant rituals that clearly mark the transition to adulthood

how does where you live affect development?

living on one's own accelerates the achievement of adulthood, whereas living with one's parents can slow the process of becoming an independent adult

interindividual variability

patterns of change that vary from one person to another

possible selves

represent what we could become, what we would like to become, and what we are afraid of becoming

quarterlife crisis

similar to a midlife crisis, but occurs in one's 20s A relatively new term for a period of self-exploration, search for meaning, and adjustment to daily hassles or life challenges

generativity

the attempt to create an appealing story "ending" that will yield new beginnings for future generations

crystallized intelligence

the knowledge you have acquired through life experience and education in a particular culture -includes breadth of knowledge, comprehension of communication, judgment, and sophistication with information

Friends, Siblings, and Socioemotional Selectivity

By late life, a person may have been friends with members of his or her social network for several decades. Research consistently finds that older adults have the same need for friends as do people in younger generations; it also shows that their life satisfaction is poorly correlated with the number or quality of relationships with younger family members yet is strongly correlated with the number and quality of their friendships (Blieszner & Roberto, 2012). Why? As will become clear, friends serve as confidants and sources of support in ways that relatives (e.g., children or nieces and nephews) typically do not. Friendships In Chapter 11, we explored the meanings and qualities of friendships across young adulthood and middle age. Patterns of friendship among older adults tend to mirror those in young adulthood (Rawlins, 2004). That is, older women have more numerous and more intimate friendships than older men do (Blieszner & Roberto, 2012). There are some important differences in later life, though. The quality and purpose of late-life friendships are particularly important (Bromell & Cagney, 2014; Schulz & Morycz, 2013). Friends are sometimes even more important to older adults in part because older adults do not want to become burdens to their families (Blieszner & Roberto, 2012; Moorman & Greenfield, 2010). As a result, friends help each other foster independence. Having friends also provides a buffer against the loss of roles and status that accompany old age, such as retirement or the death of a loved one, and can increase people's happiness and self-esteem (Schulz & Morycz, 2013). People who live alone especially benefit from friends in the neighborhood (Bromell & Cagney, 2014). And people who have ambivalent feelings about their social networks have shorter telomeres than people who have strong feelings about theirs (Uchino et al., 2012). In the case of online friendships (e.g., through social media), trust develops on the basis of four sources: (1) reputation; (2) performance, or what users do online; (3) precommitment (through personal self-disclosure); and (4) situational factors, especially the premium placed on intimacy and the relationship (Henderson & Gilding, 2004). Not surprisingly, online social network friendships develop much like face-to-face friendships in that the more time people spend online with friends, the more likely they are to self-disclose (Chang & Hsiao, 2014). Online environments are more conducive to people who are lonely (e.g., live alone), which make them potentially important for older adults (Cotton, Anderson, & McCullough, 2013). Siblings A special type of friendship exists with one's siblings; they are the friends who people typically have the longest and with whom people share the closest bonds. The importance of these relationships varies with age (Carr & Moorman, 2011; Moorman & Greenfield, 2010). The centrality of siblings in later life depends on several things: proximity, health, and degree of relatedness (full, step-, or half-siblings), for example. No clear pattern of emotional closeness emerges when viewing sibling relationships on the basis of gender. Brownie Harris/Flirt/Corbis Siblings play an important role in the lives of older adults. When sibling relationships are close and one sibling dies, the surviving sibling often reports reflecting, about or talking to the deceased sibling for advice (Vacha-Haase, Donaldson, & Foster, 2014). What is also clear is that sibling relationships in later life are affected by events in the lives of the siblings that may have occurred decades earlier (Knipscheer & van Tilburg, 2013). If there was no contact between the siblings over an extended period of time, it is unlikely that these relational rifts will be repaired. An important source for such tension is hard feelings stemming from perceived parental favoritism among siblings. This tension subsequently plays out when aging parents need care, and it may continue into the siblings' own late life (Gilligan et al., 2013). In such situations, jealousies that have their roots in childhood fester for decades, only to resurface when siblings need to coordinate parental care. More research into sibling relationships in late life is needed to provide a better understanding of how siblings (and step-siblings) get along and how they come to rely on each other for assistance in certain situations. Socioemotional Selectivity Think About It What role might siblings play in an older adult's autobiographical memory (see Chapter 14)? Older adults tend to have fewer relationships with people in general and to develop fewer new relationships compared with people in midlife and particularly in young adulthood (Blieszner & Roberto, 2012; Carr & Moorman, 2011). Carstensen and colleagues (Carstensen, 2006; Charles & Carstensen, 2010; English & Carstensen, 2014; Reed & Carstensen, 2012) have shown that the changes in social behavior seen in late life reflect a more complicated and important process. They propose a life-span theory of socioemotional selectivity , which argues that social contact is motivated by a variety of goals, including information seeking, self-concept, and emotional regulation. The relevance of each of these goals differs across the adult life span and results in very different social behaviors. For example, when information seeking is the goal, such as when a person is exploring the world, is trying to figure out how he or she fits into it, and is learning what others are like, meeting many new people is an essential part of the process. However, when emotional regulation is the goal, people tend to become highly selective in their choice of social partners and usually prefer people who are familiar to them. Carstensen and colleagues believe that information seeking is the predominant goal for young adults, that emotional regulation is the major goal for older people, and that both goals are in balance in midlife. Their research supports this view; people become increasingly selective about those they choose to have contact with. In addition, Magai (2008) summarizes several approaches to emotional development across adulthood and concludes that people orient more toward emotional aspects of life and personal relationships as they grow older and that emotional expression and experience become more complex and nuanced. Carstensen's theory provides a more complete explanation of why older adults tend not to replace, to any great extent, the relationships they lose: Older adults are more selective and have fewer opportunities to make new friends, especially in view of the emotional bonds involved in friendships.

programs for alcohol addiction

-abstinence -inpatient and outpatient programs at treatment centers -certain medications (gabapentin used to treat alcohol dependence) -various forms of counseling

prereflective thought

-do not acknowledge and may not even perceive that knowledge is uncertain -do not understand that some problems exist for which there is not a clear and correct answer -hold firm positions on controversial issues and does so without acknowledging other people's ability to reach a different (but nevertheless equally logical) position

rites of passage involving pain or mutilation

-female circumcision -getting a specific tattoo

health benefits of quitting smoking

-less than a year after quitting, the lungs regain their normal ability to move mucus out -risks of stroke and coronary heart disease return to normal after a period of roughly 15 years

examples of religious rites of passage

1) confirmation- christians mark transition from being a child spiritually to being an adult 2) judaism- bar and bat mitzvahs 3) quincenara- in latin american countries, a girls 15th birthday and transition between childhood and young womenhood, sometimes preceded by a mass if girls family is catholic

Seattle Longitudinal Study

The definitive study of the effect of aging on intelligence, carried out by K. Warner Schaie, involving simultaneously conducting and comparing the results of cross-sectional and longitudinal studies carried out with a group of Seattle volunteers.

Making Your End-of Life Intentions Known

Thinking about end-of-life matters raises complex legal, political, and ethical issues. In most jurisdictions, disconnecting someone from life support, for instance, is legal only when a person has communicated his or her wishes concerning medical intervention. Unfortunately, many people fail to take this step, perhaps because it is difficult to think about such situations or because they do not know the options available to them. But without clear directions, medical personnel may be unable to take a patient's preferences into account. For people such as Jane and Allan, who we met in the vignette at the beginning of this section, there are two ways to make one's intentions known. In a living will , a person states his or her wishes about life support and other treatments. In a health care power of attorney , an individual appoints someone to act as his or her agent for health care decisions (see Figure 16.2). A major purpose of both is for a person to make his or her wishes known about the use of life support interventions in the event the person is unconscious or otherwise incapable of expressing them, along with other related end-of-life issues such as organ transplantation and other health care options (Baumann et al., 2011; Castillo et al., 2011). A durable power of attorney for health care has an additional advantage: It names an individual who has the legal authority to speak for the person if necessary. Figure 16.2. North Carolina State University, A&T State University Cooperative Extension Example of a health care power of attorney document. Although there is considerable support for both mechanisms, there are several problems as well (Castillo et al., 2011; Moorman & Inoue, 2013). States vary in their laws related to advance directives. Many people fail to inform their relatives and physicians about their health care decisions. Others do not tell the person named in a durable power of attorney where the document is kept. Obviously, this puts relatives at a serious disadvantage if decisions concerning the use of life-support systems need to be made. A living will or a durable power of attorney for health care can be the basis for a "Do Not Resuscitate" medical order. A Do Not Resuscitate (DNR) order means that cardiopulmonary resuscitation (CPR) is not started should one's heart and breathing stop. In the normal course of events, a medical team will immediately try to restore normal heartbeat and respiration. With a DNR order, this treatment is not done. As with living wills and a health care power of attorney, it is extremely important to let all appropriate medical personnel know that a DNR order is in effect. Patient Self-Determination and Competency Evaluation A key factor in communicating your decisions about health care concerns your ability to make those decisions for yourself. The Patient Self-Determination Act, passed in 1990, requires most health care facilities to provide information to patients in writing that they have several rights. To make their own health care decisions To accept or refuse medical treatment To make an advance health care directive Patients must be asked if they have an advance directive, and, if so, make sure it is included in the medical record. Staff at the health care facility must receive training about advance directives and cannot make admissions or treatment decisions based on whether those directives exist. Although this legal requirement for health care facilities has been in effect for decades, its extension to individual physicians that would have included financial reimbursement for their discussions with patients about these issues was not included in the Affordable Care Act of 2010; that omission was due to opposition that such discussions would have created the equivalent of "death panels" (Pear, 2011). As a result, the opportunity to encourage people to think about what kind of medical care and intervention they desire before such situations arise was essentially lost. One major concern regarding end-of-life decisions is whether the person is cognitively or legally able to make them (Moye, Sabatino, & Brendel, 2013). There are two types of determination: the capacity to make decisions, which is a clinical determination, and a competency decision, which is made legally by the court (Wettstein, 2013). With capacity determinations, the issue is whether on a specific task the individual is able to make a decision and the abilities necessary are subject to measurement. With competency determinations, the individual is being judged with respect to a specific task or in general and the determination can be made subjectively by the court. At this point, the case law is limited regarding whether a person who lacks the capacity to make health care decisions can still designate a surrogate to make them on his or her behalf. This situation is rather common, though, given the tendency for families not to discuss these issues, individuals' reluctance to face the potential need, and politicization of the conversation in the health care arena. Guidelines for professionals regarding the assessment of competence are available, and they should be aware of the legal issues (Moye et al., 2013; Wettstein, 2013). Think About It What steps are necessary to ensure that advance directives about health care are followed? Research indicates that family members and other surrogate decision-makers are often wrong about what patients really want (Moorman & Inoue, 2013). This further emphasizes the critical need to discuss end-of-life issues ahead of time and ensure that the appropriate advance directives are in place and that key individuals are aware of them

Violence in Relationships

Up to this point, we have been considering relationships that are healthy and positive. Sadly, this is not always the case. Sometimes relationships become violent; one person becomes aggressive toward the partner, creating an abusive relationship. Such relationships have received increasing attention since the early 1980s, when the U.S. criminal justice system ruled that under some circumstances, abusive relationships can be used as an explanation for one's behavior (Walker, 1984). For example, battered woman syndrome occurs when a woman believes that she cannot leave the abusive situation and may even go so far as to kill her abuser. Many college students report experiencing abuse in a dating relationship; a national representative sample of more than 4,100 respondents revealed that 40% of them had experienced victimization by young adulthood (Halpern et al., 2009). Partner Abuse Prevention Education (PAPE) programs can be effective in addressing the causes and outcomes of violence in relationships in both emerging and young adults (Murphy, 2013). Being female, Latina, African American, having an atypical family structure (something other than two biological parents), having more romantic partners, partaking in early onset of sexual activity, and being a victim of child abuse predicts victimization. Although overall national rates of sexual assault have declined more than 60% since the early 1990s, acquaintance rape or date rape is still a major problem; college women are 4 times more likely to be the victim of sexual assault than are women in other age groups (Rape, Abuse, and Incest National Network, 2013), with 40% experiencing abuse in a dating relationship (DatingAbuseStopsHere.com, 2013). What range of aggressive behaviors occurs in abusive relationships? What causes such abuse? Based on considerable research on abusive partners, O'Leary (1993) proposed a continuum of aggressive behaviors toward a partner, which progresses as follows: verbally aggressive behaviors, physically aggressive behaviors, severe physically aggressive behaviors, and murder (see Figure 11.2). The causes of the abuse also vary with the type of abusive behavior being expressed. Figure 11.2. Source: O'Leary, K. D. (1993). Through a psychological lens: Personality traits, personality disorders, and levels of violence. In R. J. Gelles & D. R. Loseke (Eds.), Current controversies on family violence (pp. 7-30). Continuum of Progressive Behaviors in Abusive Relationships. Two points about the continuum should be noted. First, there may be fundamental differences in the types of aggression independent of level of severity. Overall, each year about 5 million women and 3 million men experience partner-related physical assaults and rape in the United States (Centers for Disease Control and Prevention, 2012a); worldwide, between 10% and 69% of women report being physically assaulted or raped (World Health Organization, 2002). The second interesting point, depicted in the table, is that the suspected underlying causes of aggressive behaviors differ as the type of aggressive behaviors change (O'Leary, 1993). Although anger and hostility in the perpetrator are associated with various forms of physical abuse, the exact nature of this relationship remains elusive (Norlander & Eckhardt, 2005). As can be seen in the table, the number of suspected causes of aggressive behavior increases as the level of aggression increases. Thus, the causes of aggressive behavior become more complex asthe level of aggression worsens. Such differences in cause imply that the most effective way to intervene with abusers is to approach each one individually and not try to apply a one-size-fits-all model (Buttell & Carney, 2007). Men are also the victims of violence from intimate partners, although at a rate about one-third that of women (Conradi & Geffner, 2009). Studies in New Zealand and the United States revealed that both men and women showed similar patterns of holding traditional gendered beliefs and lacking communication and anger management skills; however, intervention programs tend to focus on male perpetrators (Hines & Douglas, 2009; Robertson & Murachver, 2007). Research in Canada showed that heterosexual couples reported more instances of violence than did gay or lesbian couples (Barrett & St. Pierre, 2013). Culture is also an important contextual factor in understanding partner abuse. In particular, violence against women worldwide reflects cultural traditions, beliefs, and values of patriarchal societies; this can be seen in the commonplace violent practices against women, which include sexual slavery, female genital cutting, intimate partner violence, and honor killing (Parrot & Cummings, 2006). For example, cultures that emphasize honor, that portray females as passive (nurturing supporters of men's activities), and that emphasize loyalty and sacrifice for the family may contribute to tolerance of abuse. In addition, international data indicate that rates of abuse are higher in cultures that emphasize female purity, male status, and family honor. For example, a common cause of women's murders in Arab countries is brothers or other male relatives killing the victim because she violated the family's honor (Kulwicki, 2002). Intimate partner violence is prevalent in China (43% lifetime risk in one study) and has strong associations with male patriarchal values and conflict resolutions (Xu et al., 2005). © John Birdsall/The Image Works Many communities have established shelters for women who have experienced abuse in relationships. Alarmed by the seriousness of abuse, many communities have established shelters for battered women and their children as well as programs that treat abusive men. However, the legal system in many localities is still not set up to deal with domestic violence; women in some locations cannot sue their husbands for assault, and restraining orders all too often offer little protection from additional violence. Much remains to be done to protect women and their children from the fear and reality of continued abuse. Test Yourself 11.1 Recall Friendships based on intimacy and emotional sharing are more characteristic of . Competition is a major part of most friendships among . Love relationships in which intimacy and passion are present but commitment is not are termed . Chastity is an important quality that men look for in a potential female mate in cultures. Aggressive behavior that is based on abuse of power, jealousy, or the need to control is more likely to be displayed by . Interpret Why, according to Erikson, is intimacy (discussed in Chapter 9) a necessary prerequisite for adult relationships? What aspects of relationships discussed here support (or refute) this view? Apply Based on Schmitt and colleagues' (2004) research, what attachment pattern would Korean women likely have regarding romantic attachment? SOLUTION ↓ 11.1: 1. women 2. men 3. romantic love 4. traditional 5. men

metabolism

how much energy the body needs, slows down with age

why is marriage the most important rite of passage in most cultures

its a prelude to childbearing, which in turn provides clear evidence of achieving adulthood

postformal thought

thinking characterized by recognizing that the correct answer varies from one situation to another, that solutions should be realistic, that ambiguity and contradiction are typical, and that subjective factors play a role in thinking -originates in young adulthood

The Grief Process

How do people grieve? What do they experience? Perhaps you already have a good idea about the answers to those questions from your own experience. If so, you already know that the process of grieving is a complicated and personal one. Just as there is no right way to die, there is no right way to grieve. Recognizing that there are plenty of individual differences, we consider these patterns in this section. DreamPictures/Blend Images/Getty Images Dealing with the death of friends is often especially difficult for young adults. The grieving process is often described as reflecting many themes and issues that people confront that may be expressed through rituals (Norton & Gino, 2014). Like the process of dying, grieving does not have clearly demarcated stages through which we pass in a neat sequence, although people must face certain issues that are similar to those that dying people face. When someone close to us dies, we must reorganize our lives, establish new patterns of behavior, and redefine relationships with family and friends. Indeed, Attig (1996) provided one of the best descriptions of grief when he wrote that grief is the process by which we relearn the world. Unlike bereavement, over which we have no control, grief is a process that involves choices in coping—from confronting the reality and emotions to using religion to ease one's pain (Ivancovich & Wong, 2008; Norton & Gino, 2014). From this perspective, grief is an active process in which a person must do several things (Worden, 2008): Acknowledge the reality of the loss. We must overcome the temptation to deny the reality of our loss; we must fully and openly acknowledge it and realize that it affects every aspect of our life. Work through the emotional turmoil. We must find effective ways to confront and express the complete range of emotions we feel after the loss and must not avoid or repress them. Adjust to the environment where the deceased is absent. We must define new patterns of living that adjust appropriately and meaningfully to the fact that the deceased is not present. Loosen ties to the deceased. We must free ourselves from the bonds of the deceased to reengage with our social network. This means finding effective ways to say good-bye. The notion that grief is an active coping process emphasizes that survivors must come to terms with the physical world of things, places, and events as well as their spiritual place in the world; the interpersonal world of interactions with family and friends, the dead, and (in some cases) God; and aspects of their inner selves and their personal experiences (Ivancovich & Wong, 2008; Papa & Litz, 2011). Bertha, the woman in the vignette, is in the middle of this process. Even the matter of deciding what to do with the deceased's personal effects can be part of this active coping process (Attig, 1996). In considering the grief process, we must avoid making several mistakes. First, grieving is a highly individual experience (Mallon, 2008; Papa & Litz, 2011). A process that works well for one person may not be the best for someone else. Second, we must not underestimate the amount of time people need to deal with the various issues. To a casual observer, it may appear that a survivor is "back to normal" after a few weeks. Actually, it takes much longer to resolve the complex emotional issues that one must face during bereavement. Researchers and therapists alike agree that a person needs at least a year following the loss to begin recovery, and two years is not uncommon. Finally, "recovery" may be a misleading term. It is probably more accurate to say that we learn to live with our loss rather than that we recover from it (Attig, 1996). The impact of the loss of a loved one lasts a very long time, perhaps for the rest of one's life. Still, most people reach a point of moving on with their lives in a reasonable time frame (Bonanno, 2009; Bonnano, Westphal, & Mancini, 2011). Recognizing these aspects of grief makes it easier to know what to say to and do for bereaved people. Among the most useful things are to let the person know that you are sorry for his or her loss and that you are there for support, and mean what you say. Risk Factors in Grief Bereavement is a life experience that most people experience many times, and most people eventually handle it, often better than we might suspect (Bonanno, 2009; Bonanno et al., 2011). However, some risk factors may make bereavement more difficult. Several of the more important ones are the mode of death, personal factors (e.g., personality, religiosity, age, gender), income, and interpersonal context (social support, kinship relationship) (Kersting et al., 2011; Thieleman & Cacciatore, 2014). Most people believe that the circumstances or mode of death affects the grief process. A person whose family member was killed in an automobile accident has a different situation to deal with than a person whose family member died after a long period of suffering with Alzheimer's disease. It is believed that when death is anticipated, people go through a period of anticipatory grief before the death that supposedly serves to buffer the impact of the loss when it does come and to facilitate recovery (Haley, 2013; Lane, 2007). However, the research evidence for this is mixed. Anticipating the loss of a loved one from cancer or another terminal disease can provide a framework for understanding family members' reactions (Coombs, 2010). Not all family members experience it, though. However, people who do tend to disengage from the dying person (Haley, 2013; Lane, 2007). The strength of attachment to the deceased person does make a difference in dealing with a sudden as opposed to an unexpected death. Attachment theory provides a framework for understanding different reactions (Stroebe & Archer, 2013; Stroebe, Schut, & Boerner, 2010). When the deceased person was one with whom the survivor had a strong and close attachment and the loss was sudden, greater grief is experienced (Wayment & Vierthaler, 2002). However, such secure attachment styles tend to result in less depression after the loss due to less guilt over unresolved issues (because there are fewer of them) and things not provided (because more were likely provided). Few studies of personal risk factors have been done, and few firm conclusions can be drawn. To date, there are no consistent findings regarding personality traits that help buffer people from the effects of bereavement or that exacerbate them (Haley, 2013; Stroebe & Archer, 2013; Stroebe et al., 2010). There is some evidence to suggest that church attendance or spirituality in general helps people deal with bereavement and subsequent grief through the post-grief period (Bratkovich, 2010; Gordon, 2013). There are, however, consistent findings regarding gender. Men have higher mortality rates following bereavement than women, who have higher rates of depression and complicated grief (discussed later in this section) compared with men, but the reasons for these differences are unclear (Kersting et al., 2011). Research also consistently shows that older adults suffer the least health consequences following bereavement, with the impact perhaps being strongest for middle-aged adults, but strong social support networks lessen these effects to varying degrees (Papa & Litz, 2011). Two interpersonal risk factors have been examined: lack of social support and kinship. Studies indicate that social support and mastery help buffer the effects of bereavement more for older adults than for middle-aged adults (Haley, 2013; Papa & Litz, 2011). This may change as more support begins to come from online social networks, a medium that is used more widely by younger and middle-aged adults (Massimi, 2013)

examples of crystallized intelligence

Many popular television game shows (such as Jeopardy and Wheel of Fortune) are based on contestants' accumulated crystallized intelligence

Deciding Whether to Have Children

One of the biggest decisions couples must make is whether to have children. This decision appears complicated. You would think that potential parents must weigh the many benefits of child rearing—such as feeling personal satisfaction, fulfilling personal needs, continuing the family line, and enjoying companionship—with the many drawbacks, including expense and lifestyle changes, especially the balance between work and family. But apparently, this is not what most people do. Rijken (2009) reports that potential parents don't think very deliberately or deeply about when to have a child and that those who are career-oriented or like their freedom do not often deliberately postpone parenthood because of those factors. Rather, thoughts about having children seem not to cross their minds until they are ready to start thinking about having children. What may make a difference is the couple's self-esteem about parenting—when both people feel positive about being parents, they are more likely to have a child (Hutteman et al., 2013). Whether the pregnancy is planned (and over half of all U.S. pregnancies are unplanned), a couple's first pregnancy is a milestone event in a relationship in every culture, with both benefits and costs (Walker, 2014). Having a child raises many important matters for consideration, such as relationships with one's own parents, marital stability, career satisfaction, and financial issues. Parents largely agree that children add affection, improve family ties, and give parents a feeling of immortality and a sense of accomplishment. Most parents willingly sacrifice a great deal for their children and hope that they grow up to be happy and successful. In this way, children bring happiness to their parents (Angeles, 2010). Nevertheless, finances are of great concern to most parents because children are expensive. How expensive? According to the U.S. Department of Agriculture (2013), a family who had a child in 2012 would spend the following estimated amounts for food, shelter, and other necessities by the time the child turned 17: Those with household incomes less than $60,640 per year (in 2012 dollars) can expect to spend a total of $173,490 (in 2012 dollars) on a child from birth through high school, those with household incomes between $60,640 and $105,000 can expect to spend $241,080, and a family with a household income more than $105,000 can expect to spend $399,780. College expenses would be in addition to those amounts. These costs do not differ significantly between two-parent and single-parent households, but clearly are a bigger financial burden for single parents. No wonder parents are concerned. You can get an estimate of what it may cost you to raise a child by going to the USDA Center for Nutrition Policy and Promotion website Cost of Raising a Child Calculator. Some trends in the cost of having children are important. Because this survey was first done in 1960, the average cost of health care as a percentage of total child-rearing costs has doubled. Child care costs, on average negligible in 1960 because most mothers were not in the labor force, are now significant. For many reasons that include personal choice, financial instability, and infertility, an increasing number of couples are choosing to be child-free. Attitudes toward couples who choose not to have children have improved since the 1970s, with women having more positive views than men (Koropeckyj-Cox & Call, 2007). Social attitudes in many countries (Austria, Germany, Great Britain, Ireland, Netherlands, and the United States) are also improving toward child-free couples (Gubernskaya, 2010). © iStockPhoto.com/akurtz Having a child later in adulthood has many benefits. Couples without children have some advantages: higher marital satisfaction, more freedom, and higher standards of living. A major international study of older adult couples without children in Australia, Finland, Germany, Japan, the Netherlands, the United Kingdom, and the United States revealed highly similar patterns across all countries except Japan (Koropeckyj-Cox & Call, 2007). In Japan, the cultural norm of children caring for older parents created difficulties for childless older couples. The factors that influence the decision to be child-free appear to differ for women and men (Waren & Pals, 2013). For women, higher levels of education and economic factors increase the likelihood of remaining child-free, whereas holding traditional sex role beliefs decrease the chances of that decision. For men, though, neither education nor economic factors predict deciding to remain child-free, but traditional sex role beliefs lower the odds of that decision.

research for eriksons identity intimacy theory

-Montgomery (2005) found that a stronger sense of identity was related to higher levels of intimacy in young adults -other research found that identity formation correlated with intimacy in adults aged 35 to 45, but this relationship held even for those people who demonstrated diffusion (the lowest level of identity formation), which Erikson argued should not be the case

intellectual abilities and mortality

-higher intelligence, less mortality -ex: higher intelligence at the time these men enlisted was related to lower mortality from accidents, coronary heart disease, and suicide in middle age -ex: Similarly, changes in specific mental abilities related to memory predicted mortality in middle age in a study of more than 10,000 workers in Britain and in a study in Denmark

five representative mental abilities

-number: the basic skills underlying our mathematical reasoning -word fluency: how easily we produce verbal descriptions of things -verbal meaning: our vocabulary ability -inductive reasoning: our ability to extrapolate from particular facts to general concepts -spatial orientation: our ability to reason in thr 3d world

Could continuing brain development during adolescence and early adulthood explain shifts in behavior and document a biological marker for adulthood?

-some evidence that the prefrontal cortex, a part of the brain involved in high-level thinking, is not fully developed until a person reaches his or her mid twenties -Males argues this hypothesis is wrong because risk-taking behavior does not vary with age between young and middle-aged adults when sociodemographic conditions, such as poverty, are controlled (poverty is a stronger correlate of risky behavior than is brain development)

reflective reasoning

-true reflective judgment, understanding that people construct knowledge using evidence and argument after careful analysis of the problem or situation -hold firm convictions but reach them only after careful consideration of several points of view -realize that they must continually reevaluate their beliefs in view of new evidence

age differences in possible selves

-young adults listed family concerns—for instance, marrying the right person—as most important, getting started in an occupation also important -adults in their thirties listed family concerns last; their main issues involved personal concerns, such as being a more loving and caring person -By ages 40 to 59, family issues became most common—for example, being a parent who can "let go" of the children, reaching and maintaining satisfactory performance in one's occupational career as well as accepting and adjusting to the physiological changes of middle age were important to this age group

benefit of moderate drinkers (one or two glasses of bear/wine per day for men, one per day for women)

25% to 40% reduction in risk of cardiovascular disease and stroke than either abstainers or heavy drinkers, even after controlling for hypertension, prior heart attack, and other medical conditions

for how many high school graduates is going to college a marker of transition to adulthood

70%, but rates vary across income groups: more higher income, and rates vary across race/ethnicity differences but gaps are closing

Gender Differences in Occupational Selection

About 58% of all women over age 16 in the United States participate in the labor force (down from its peak of 60% in 1999), and they represent roughly 47% of the total workforce (Bureau of Labor Statistics, 2013a). Across ethnic groups, African American women participate the most (about 59%) and Latina women the least (about 56%). Compared with women in other countries, women in the United States tend to be employed at a higher rate (see Figure 12.4). Still, structural barriers remain for women in the United States. Let's take a look at both traditional and nontraditional occupations for women. Figure 12.4. Source: U.S. Bureau of Labor Statistics. (2010b). Women's to men's earnings ratio by age, 2009. Retrieved from www.bls.gov/opub/ted/2010/ted_20100708.htm. Women's earnings as a percentage of men's. Median usual weekly earnings of full-time wage and salary workers, by age, 1979-2009. Structural Barriers for Women: Traditional and Nontraditional Occupations In the past, women employed outside the home were likely to enter traditional, female-dominated occupations such as secretarial, teaching, and social work jobs. This was due mainly to their socialization into these occupational tracks. However, as more women enter the workforce and as new opportunities open for women, a growing number of them work in occupations that have been traditionally male-dominated, such as construction and engineering. The Bureau of Labor Statistics (2013a) categorizes women's nontraditional occupations as those in which women constitute 25% or less of the total number of people employed; the skilled trades (electricians, plumbers, carpenters) still have among the lowest participation rates of women. Trends can be seen in Figure 12.5. Figure 12.5. Source: These data are from the Current Population Survey (CPS), annual averages, Table 11. Employed persons by detailed occupation, sex, race, and Hispanic or Latino ethnicity (PDF). To learn more about women's employment, see Women in the labor force: A databook (2011 Edition), BLS Report 1034, December 2011. Women as a percent of total employed in selected occupations. Despite the efforts to counteract gender stereotyping of occupations, women who choose nontraditional occupations and are successful in them tend to be viewed negatively as compared with similarly successful men. In patriarchal societies, both women and men gave higher "respectability" ratings to males than to females in the same occupation (Sharma & Sharma, 2012). In the United States, research shows that men still prefer to date women who are in traditional careers (Kapoor et al., 2010). In addition, compared with women who work in traditional occupations, women who work in nontraditional occupations are less likely to believe that they are being sexually harassed when confronted with the same behavior (Bouldin & Grayson, 2010; Maeder, Wiener, & Winter, 2007).

Adolescence

Adolescents have more personal experience with death and grief than many people realize (Balk, 2014). Surveys of college students indicate that between 40% and 70% of traditional-aged college students will experience the death of someone close to them during their college years, such as a parent, sibling, or friend. Adolescence is a time of personal and physical change, when one is trying to develop a theory of self. When teenagers experience the death of someone close to them, they may have considerable trouble making sense of the event, especially if this is their first experience (Oltjenbruns & Balk, 2007). The effects of bereavement in adolescence can be quite severe, especially when the death was unexpected, and can be expressed in many ways, such as chronic illness, enduring guilt, low self-esteem, poorer performance in school and on the job, substance abuse, problems in interpersonal relationships, and suicidal thinking (Malberg, 2014; Morgan & Roberts, 2010). An important aspect of adolescent development is wanting to be perceived as part of the peer group. As a result, younger adolescents are particularly reluctant to discuss their grief (for instance, over the loss of a sibling), mainly because they do not want to appear different from their peers (Balk, 2014). This reluctance leaves them particularly vulnerable to psychosomatic symptoms such as headaches and stomach pains that signal underlying problems. Adolescents often do not demonstrate a clear end point to their grief over the loss of a sibling or parent; they continue to miss and to love their dead loved ones and try to find ways to keep them in their lives (Barrera et al., 2013). However, few nonbereaved peers were willing to talk with the bereaved students about their experience or even felt comfortable being with them (Balk, 2014). However, grief does not interfere with normative developmental processes. Bereaved adolescent siblings experience continued personal growth following the death of a loved one in much the same way as adolescents who did not experience such a loss (Balk, 2014; Malberg, 2014)

Great-grandparenthood

As discussed in Chapter 13, grandparenting is an important and enjoyable role for many adults. With increasing numbers of people—especially women—living to very old age, more people are experiencing great-grandparenthood. Age at first marriage and age at parenthood also play a critical role; people who reach these milestones at relatively young ages are more likely to become great-grandparents. Most current great-grandparents are women who married relatively young and had children and grandchildren who also married and had children relatively early in adulthood. Although surprisingly little research has been conducted on great-grandparents, their investment in their roles as parents, grandparents, and great-grandparents forms a single family identity (Drew & Silverstein, 2004; Moorman & Greenfield, 2010). That is, great-grandparents see a true continuity of the family through the passing on of genes. However, their sources of satisfaction and meaning apparently differ from those of grandparents (Doka & Mertz, 1988; Wentkowski, 1985). Compared with grandparents, great-grandparents are more similar as a group in what they derive from the role, largely because they are less involved with the children than the grandparents are. Three aspects of great-grandparenthood appear to be most important (Doka & Mertz, 1988). First, being a great-grandparent provides a sense of personal and family renewal—important components for achieving integrity. Their grandchildren have produced new life, renewing their own excitement for life and reaffirming the continuance of their lineage. Seeing their families stretch across four generations may also provide psychological support, through feelings of symbolic immortality, to help them face death. They take pride and comfort in knowing that their families will live many years beyond their own lifetime. Second, great-grandchildren provide new diversions in great-grandparents' lives. There are now new people with whom they can share their experiences. Young children can learn from a person they perceive as "really old" (Mietkiewicz & Venditti, 2004). Third, becoming a great-grandparent is a major milestone, a mark of longevity that most people never achieve. The sense that one has lived long enough to see the fourth generation is perceived very positively. As you might expect, people with at least one living grandparent and great-grandparent interact more with their grandparent, who is also perceived as more influential (Roberto & Skoglund, 1996). Unfortunately, some great-grandparents must assume the role of primary caregiver to their great-grandchildren, a role for which few great-grandparents are prepared (Bengtson, Mills, & Parrott, 1995; Burton, 1992). As more people live longer, it will be interesting to see whether the role of great-grandparents changes and becomes more prominent

Integrity versus Despair

As people enter late life, they begin the struggle of integrity versus despair , which involves the process by which people try to make sense of their lives. According to Erikson (1982), this struggle comes about as older adults such as Olive try to understand their lives in terms of the future of their family and community. Thoughts of a person's own death are balanced by the realization that they will live on through children, grandchildren, great-grandchildren, and the community as a whole. This realization produces what Erikson calls a "life-affirming involvement" in the present. The struggle of integrity versus despair requires people to engage in a life review , the process by which people reflect on the events and experiences of their lifetimes. To achieve integrity, a person must come to terms with the choices and events that made his or her life unique. There must also be an acceptance of the fact that one's life is drawing to a close. Looking back on one's life may resolve some of the second-guessing of decisions made earlier in adulthood (Erikson, Erikson, & Kivnick, 1986). People who were unsure whether they made the right choices concerning their children, for example, now feel satisfied that things worked out well. In contrast, others feel bitter about their choices, blame themselves or others for their misfortunes, see their lives as meaningless, and greatly fear death. These people end up in despair rather than integrity. Research shows a connection between engaging in a life review and achieving integrity; so life review forms the basis for effective mental health interventions (Westerhof, Bohlmeijer, & Webster, 2010), especially for older individuals with depression (Hallford & Mellor, 2013). A therapeutic technique called "structured life review" (Haight & Haight, 2007, 2013) has been shown to be effective in helping people deal with stressful life events. Who reaches integrity? Erikson (1982) emphasizes that people who demonstrate integrity come from various backgrounds and cultures and arrive there having taken different paths. Such people have made many different choices and follow many different lifestyles; the point is that everyone has this opportunity to achieve integrity if they strive for it. Those who reach integrity become self-affirming and self-accepting; they judge their lives to have been worthwhile and good. They are glad to have lived the lives they did

The Demographics of Aging

Did you ever stop to think about how many older adults you see in your day-to-day life? Did you ever wonder whether your great-grandparents had the same experience? Actually, you are privileged—there have never been as many older adults alive as there are now; so you see many more older people than your great-grandparents (or even your parents) did. The proportion of older adults in the population of industrialized countries has increased tremendously in this century, which is due mainly to better health care and to lowering women's mortality rate during childbirth. People who study population trends, called demographers, use a graphic technique called a population pyramid to illustrate these changes. Figure 14.1 shows population pyramids for the most developed and least developed countries combined around the world. Let's consider developed countries first (they're designated by the darker color in the figure). Notice the shape of the population pyramid in 1950, shown in the top panel of the figure. In the middle of the 20th century, there were fewer people over age 60 than under age 60; so the figure tapers toward the top. Comparing this to projections for 2050, you can see that a dramatic change will occur in the number of people over 65. Figure 14.1. From U.S. Census Bureau, 2010. Retrieved from www.census.gov/population/international/. Note the changing shapes of the distributions in terms of the proportion of the population that is young versus old over time and as a function of whether countries are considered developed or developing. These changes are also occurring in the least developed countries, shown in the lighter color. Notice that the figures for both 1950 and 2014 look more like pyramids because there are substantially fewer older adults than younger people. But by 2050, the number of older adults in developing countries also will have increased dramatically, changing the shape of the figure. The rapid increase in the number of older adults (individuals over age 65) will bring profound changes to everyone's lives. Because the growth of the child population in the United States essentially stops through the middle of this century, the average age of Americans will continue to rise (Pew Research Center, 2014). Older adults are already a major marketing target and wield considerable political and economic power. In the United States the sheer number of older adults will place enormous pressure on pension systems (especially Social Security), health care (especially Medicare, Medicaid, and long-term care), and other human services. The costs will be borne by smaller cohorts of taxpaying workers behind them. The growing strain on social service entitlement programs will intensify because the most rapidly growing segment of the U.S. population is the group of people over age 85. In fact, the number of such people will increase nearly 500% between 2000 and 2050, compared with about a 50% increase in the number of 20- to 29-year-olds during the same period. As we will see in this chapter and in Chapter 15, individuals over age 85 generally need more assistance with daily living than do people under 85, further straining the health care system. Think About It How will the demographic changes in the first 30 years of the 21st century affect social policy? The Diversity of Older Adults Older adults are a very diverse group. Older women outnumber older men in all ethnic groups in the United States, for reasons we will explore later. The number of older adults among ethnic minority groups is increasing faster than among European Americans. For example, the number of Native American elderly has increased by nearly two-thirds in recent decades, Asian and Pacific Islander elderly have quadrupled, older adults are the fastest-growing segment of the African American population, and the number of Latino American elderly is increasing the fastest (Pew Research Center, 2014). Older adults in the future will be better educated, too. At present, a little more than half of those over age 65 have only a high school diploma or some college, and roughly 20% have a bachelor's degree or higher. By 2030, it is estimated that 85% will have a high school diploma and about 75% will have a postsecondary credential (U.S. Census Bureau, 2014). These dramatic changes will be due mainly to better educational opportunities for more students and the greater need for formal schooling (especially college) to find a good job. Also, better-educated people tend to live longer—mostly because they have higher incomes, which give them better access to good health care and a chance to lead healthier lifestyles. Internationally, the number of older adults is also growing rapidly, and this growth is affecting nearly all countries globally (Pew Research Center, 2014). These rapid increases are due mostly to improved health care in developing countries. Such increases will literally change the face of the population as more people live to old age. Economically powerful countries around the world, such as China and Korea, are trying to cope with increased numbers of older adults that strain the country's resources. These demographic changes are especially difficult in countries where the cultural norm is for adult children to care for aging parents. For example, China is grappling with increased needs for health care for their older adult population. By 2040, China expects to have more than 300 million people over age 60. So it is already addressing issues related to providing services and living arrangements for the increasing number of older adults (Ren & Treiman, 2014). China and the United States are not alone in facing increased numbers of older adults. As you can see in Figure 14.2, the population of many countries will include substantially more older adults over the next few decades. All of the countries will need to deal with an increased demand for services to older adults and, in some cases, competing demands with children and younger and middle-aged adults for limited resources. Figure 14.2. From United Nations, Statistics Bureau, MPHPT, Ministry of Health, Labour and Welfare. The proportion of older adults (aged 65 years and over) is increasing in many countries and will continue to do so in the coming decades. Even though the financial implications of an aging population are reasonably predictable, the United States and many other countries have done surprisingly little to prepare. For example, little research has been done on the characteristics of older workers (even though mandatory retirement has been virtually eliminated for some time), on differences between the young-old (ages 65 to 80) and the oldest-old (over age 80), or on specific health care needs of older adults with regard to chronic illness—despite a call for such work as long ago as the early 1990s (American Psychological Society, 1993). As of 2014, the U.S. Congress had yet to adopt long-term plans for funding Social Security and Medicare, even though the first baby boomers became eligible for reduced Social Security benefits in 2008 and for Medicare in 2011. As we will see in Chapter 15, the consequences for the federal budget and for Americans resulting from this inaction are serious.

how does student thinking develop

He found that 18-year-old first-year college students tend to rely heavily on the expertise of authority figures (e.g., experts, professors, police, parents) to determine which ways of thinking are right and which are wrong. For these students, thinking is tightly tied to logic, as Piaget had argued, and the only legitimate answers are ones that are logically derived. Perceptions change over the next few years. Students go through a phase in which they are less sure of which answers are right—or whether there are any right answers at all. However, by the time they are ready to graduate, students are fairly adept at examining different sides of an issue and have developed commitments to particular viewpoints. Students recognize that they are the source of their own authority, that they must take a position on an issue, and that other people may hold different positions from theirs but are equally committed. During the college years, then, individuals become able to understand many perspectives on an issue, choose one, and still acknowledge the right of others to hold different views. Perry concluded that this kind of thinking is very different from formal operations and represents another level of cognitive development.

Adjustment to Retirement

How do people who go through the process of retirement adjust to it? Researchers agree on one point: New patterns of personal involvement must be developed in the context of changing roles and lifestyles in retirement (Potocˇnik, Tordera, & Peiró, 2013). People's adjustment to retirement evolves over time as a result of complex interrelations involving physical health, financial status, the degree to which their retirement was voluntary, and feelings of personal control (Ekerdt, 2010). How do most people fare? As long as people have financial security, health, a supportive network of relatives and friends, and an internally driven sense of motivation, they report feeling very good about being retired (Ekerdt, 2010; Hershey & Henkens, in press; Potocˇnik et al., 2013). One widely held view is that being retired has negative effects on health. Research findings show that the relation between health and retirement is complex. On the one hand, there is no evidence that voluntary retirement has any immediate negative effects on health (Hershey & Henkens, in press; Weymouth, 2005). In contrast, there is ample evidence that being forced to retire is correlated with significantly poorer physical and mental health (Donahue, 2007; Hershey & Henkens, in press). Health issues are also a major predictor of when a person retires, as a longitudinal study in England showed (Rice et al., 2010)

Well-Being and Emotion

How is your life going? Are you reasonably content, or do you think you could be doing better? Answers to these questions provide insight into your subjective well-being , an evaluation of one's life that is associated with positive feelings. In life-span developmental psychology, subjective well-being is usually assessed by measures of life satisfaction, happiness, and self-esteem (Oswald & Wu, 2010). Overall, well-being across adulthood looks like a U-shaped function, like that shown in Figure 15.2 (Cheng, Powdthaveea, & Oswald, 2014). Young-older adults are characterized by improved subjective well-being compared with middle-aged adults, although the extent of the difference depends on several factors, such as hardiness, chronic illness, marital status, the quality of one's social network, and stress (Charles & Carstensen, 2010). Figure 15.2. From A. Oswald "Happiness, Health, and Economics," Warwick University, http://imechanica.org/files/andrew_oswald_presentation_071129.pdf. The pattern of a typical person's happiness through life. These happiness-related factors and the overall shape of the function hold across cultures as well; for example, studies of Australian, German, Taiwanese, and Tanzanian older adults showed similar predictors of successful aging (Cheng et al., 2014; Hsu, 2005; Mwanyangala et al., 2010). Although gender differences in subjective well-being have been found to increase with age, they are most likely due to older women being particularly disadvantaged compared with older men with regard to chronic illness and its effect on ability to care for oneself, everyday competence, quality of social network, socioeconomic status, and widowhood (Charles & Carstensen, 2010). Such gender differences are smaller in more recent cohorts, indicating that societal changes over the past few decades have led to improvements in the way older women view themselves. Given the findings about higher level of well-being in older adults, researchers began wondering how well-being was related to emotions. People's feelings are clearly important, as they get expressed in daily moods and underlie mental health problems such as depression (Cacioppo et al., 2011; Isaacowitz, 2014). So how emotions are regulated in later life may provide insights into people's subjective well-being. Emotion-focused research in neuroscience is providing answers to the question of why subjective well-being tends to increase with age (Cacioppo et al., 2011). A brain structure called the amygdala, an almond-shaped set of nuclei deep in the brain, helps regulate emotion. Evidence is growing that age-related changes in how the amygdala functions may play a key role in understanding emotional regulation in older adults. Here's how. In young adults, arousal of the amygdala is associated with negative emotional arousal. When negative emotional arousal occurs, for example, memory for events associated with the emotion is stronger. But the situation is different for older adults—both amygdala activation and emotional arousal are lower. That may be one reason older adults experience less negative emotion, lower rates of depression, and better well-being (Cacioppo et al., 2011; Sakaki, Nga, & Mather, 2013; Winecoff et al., 2011). But that's not the whole story. In Chapter 13, we discovered that brain activity in the prefrontal cortex, which is associated with cognition, changes with age. Neuroimaging research shows that changes in cognitive processing in the prefrontal cortex also are associated with changes in emotional regulation in older adults. For example, research shows that the connection between certain parts of the prefrontal cortex (the medial prefrontal cortex) and the amygdala are more connected and active while older adults are at rest than it is in younger adults, and such connectivity is likely the reason older adults remember more positive emotional content (Sakaki et al., 2013). A good example of the kind of neuroimaging research that has led to these conclusions is described in the Spotlight on Research feature. Spotlight on Research The Aging Emotional Brain Who were the investigators, and what was the aim of the study? Although much research has examined the behavioral side of emotions, very little has examined the specific underlying neural mechanisms in the brain. Winecoff and colleagues (2011) decided to examine these mechanisms and discover whether they differed with age. How did the investigators measure the topic of interest? Winecoff and colleagues used a battery of tests to measure cognitive performance and emotional behavior. They tested participants' immediate recall, delayed recall, and recognition for 16 target words as measures of memory. They also administered a response-time test to measure psychomotor speed (see Chapter 14), and a digit-span test to measure working memory (see Chapter 14). The researchers also had participants complete three questionnaires to measure various types of emotions. After these measures were obtained, participants were given the cognitive reappraisal task depicted in Figure 15.3. In brief, participants learned a reappraisal strategy that involved thinking of themselves as an emotionally detached and objective third party. During the training session, they told the experimenter what they were thinking about the image to ensure task compliance, but they were instructed not to speak during the scanning session. During the functional magnetic resonance imaging (fMRI) session, participants completed 60 positive image trials (30 "Experience" and 30 "Reappraise"), 60 negative image trials (30 "Experience" and 30 "Reappraise"), and 30 neutral image trials (all "Experience"). Within each condition, half of the images contained people and the other half did not. The fMRI session provided images of ongoing brain activity. Figure 15.3. ©iStockphoto.com/Vetta Collection/RicAguiar; ©Niderlander/Shutterstock.com Winecoff, A., et al. (2011). Cognitive and neural contributions to emotion regulation in aging. Social Cognitive and Affective Neuroscience, 6, 165-176. Cognitive reappraisal task. Participants were trained in the use of a reappraisal strategy for emotion regulation. (A) On "Experience" trials, participants viewed an image and then received an instruction to experience naturally the emotions evoked by that image. The image then disappeared, but participants continued to experience their emotions throughout a six-second delay period. At the end of the trial, the participants rated the perceived emotional valence of that image using an eight-item rating scale. (B) "Reappraise" trials had similar timing, except that the cue instructed participants to decrease their emotional response to the image by reappraising the image (e.g., distancing oneself from the scene). Shown are examples of the negative (A) and positive (B) images used in the study. Who were the participants in the study? The sample consisted of 22 younger adults (average age = 23; range = 19 to 33 years) and 20 older adults (average age = 69; range = 59 to 73 years). Participants were matched on demographic variables, including education. Participants received the cognitive/memory/emotion tests on one day and the reappraisal task in the fMRI session on a second day. Participants were paid $55. What was the design of the study? The study used a cross-sectional design, with testing of two age groups over two sessions. Were there ethical concerns with the study? All participants provided written consent under a protocol approved by the Institutional Review Board of Duke University Medical Center. What were the results? Younger and older adults performed the reappraisal tasks similarly; that is, in the reappraisal condition, positive images were reported as less positive and negative images were reported as less negative. However, older adults' reports of negative emotion were higher than those of younger adults in the negative reappraisal situation. Examination of the fMRI results showed that reappraisals involved significant activation of specific areas in the prefrontal cortex for both positive and negative emotions. For both age groups, activity in the prefrontal area increased and activity in the amygdala decreased during the reappraisal phase. These patterns are shown in Figure 15.4. As you can see in the top figure, certain areas in the prefrontal cortex showed a pattern of activation that followed participants' self-reports of emotion regulation. Shown here are voxels activated in the contrast between "Reappraise-Negative" and "Experience-Negative" conditions. The top graphs show that for both positive and negative stimuli and for both younger and older adults, prefrontal activation increased in "Reappraise" trials compared with "Experience" trials. In contrast, the lower graphs show that in the amygdala (Amy), there was a systematic decrease in activation during emotion regulation between "Experience-Negative" and "Reappraise-Negative" conditions. Figure 15.4. Winecoff, A., LaBar, K. S. Madden, D. J., Cabeza, R., & Huettel, S. A. (in press). Cognitive and neural contributions to emotion regulation in aging. Social Cognitive and Affective Neuroscience, 6. Modulation of prefrontal and amygdalar activation by emotion regulation. Additional analyses of the fMRI data showed that emotion regulation modulates the functional interaction between the prefrontal cortex and the amygdala. Compared with older adults, younger adults showed more activity in the prefrontal cortex during "Reappraise" trials for negative pictures. No age difference in brain activation for positive pictures was found. Cognitive abilities were related to the degree of decrease in amygdala activation, independent of age. What did the investigators conclude? Winecoff and colleagues concluded that the prefrontal cortex plays a major role in emotional regulation, especially for older adults. In essence, the prefrontal cortex may help suppress (regulate) emotions in the same way that area of the brain is involved in inhibiting other behaviors. Importantly, the degree of emotional regulation was predicted by cognitive ability, with higher cognitive ability associated with higher emotional regulation. This may mean that as cognitive abilities decline, people are less able to regulate their emotions, a pattern typical in diseases such as dementia. Thus, besides evidence of underlying brain structures playing critical roles in emotion regulation, there may be a neurological explanation for the kinds of emotional outbursts that occur in dementia and related disorders. What converging evidence would strengthen these conclusions? Winecoff and colleagues studied only two age groups of healthy adults and did not include either old-old participants or adults with demonstrable cognitive impairment. It will be important to study those groups to map brain function changes and behavior more completely.

The Dependent Care Dilemma

Many employed adults must also provide care for dependent children or parents. Employed Caregivers Many mothers have no option but to return to work after the birth of a child. In fact, nearly two-thirds of married and unmarried mothers with children under of 3 years of age are in the labor force (Bureau of Labor Statistics, 2013a). Some women, though, grapple with the decision of whether they want to return to work. Surveys of mothers with preschool children reveal that the motivation for returning to work tends to be related to financial need and how attached mothers are to their work. The amount of leave time a woman has matters; the passage of the Family and Medical Leave Act in 1993 entitled workers to take unpaid time to care for their dependents with the right to return to their jobs. This act resulted in an increase in the number of women who returned to work at least part-time (Schott, 2010). A concern for many women is whether stepping out of their occupations following childbirth will negatively affect their career paths. Indeed, evidence clearly indicates that it does (Aisenbrey, Evertsson, & Grunow, 2009; Fitzenberger, Sommerfeld, & Steffes, 2013). Even for short leaves, women in the United States are punished. But even in women-friendly countries such as Sweden and Germany, long leaves typically result in a negative effect on upward career movement. Often overlooked is the increasing number of workers who must care for a parent or partner. Of women caring for parents or parents-in-law, more than 80% provide an average of 23 hours per week of care and 70% contribute money (Pierret, 2006). As we will see in Chapter 11, though, providing this type of care can extract a high toll through stress. Whether assistance is needed for one's children or parents, key factors in selecting an appropriate care site are quality of care, price, and hours of availability (Helpguide.org, 2013). Depending on one's economic situation, it may not be possible to find affordable and quality care that is available when needed. In such cases, there may be no option but to drop out of the workforce or enlist the help of friends and family. Dependent Care and Effects on Workers Being responsible for dependent care has significant negative effects on caregivers. For example, whether responsible for the care of an older parent or a child, women and men report negative effects on their work, higher levels of stress, and problems with coping (Neal & Hammer, 2006). Roxburgh (2002) introduced the notion that parents of families dealing with time pressures feel more stress; indeed, subsequent research shows that besides having higher stress levels, "fast-forward families" also deal with impacts on career advancement and physical and mental health consequences of this life style (Ochs & Kremer-Sadlik, 2013). Women's careers are usually affected more negatively than men's. Think About It How do the effects of dependent care on mothers relate to the controversy concerning whether children should be placed in day care? How can these negative effects be lessened? When women's partners provide support and women have average or high control over their jobs, employed mothers are significantly less distressed than employed nonmothers or mothers without support (Lovejoy & Stone, 2012; Moen & Roehling, 2005). Research focusing on single working mothers also shows that those who have support from their families manage to figure out a balance between work and family obligations (Son & Bauer, 2010). Dependent Care and Employer Responses Employed parents with small children or dependent spouses/partners or parents are confronted with the difficult prospect of leaving them in the care of others. This is especially problematic when the usual care arrangement is unavailable. A growing need in the workplace is for backup care , which provides emergency care for dependent children or adults so that the employee does not need to lose a day of work. Does providing a workplace care center or backup care make a difference in terms of an employee's feelings about work, absenteeism, and productivity? Mike Greenlar/The Image Works Employers who provide day-care centers on-site have more satisfied employees. There is no simple answer. For example, just making a child-care center available to employees does not necessarily reduce parents' work-family conflict or their absenteeism, particularly among younger employees (Connelly, Degraff, & Willis, 2004). A "family-friendly" company must also pay attention to the attitudes of their employees and make sure the company provides broad-based support (Aryee et al., Chu, Kim, & Ryu, 2013; James, 2014). The keys are how supervisors act and the number and type of benefits the company provides. Cross-cultural research in Korea confirms that having a family-friendly supervisor matters (Aryee et al., 2013). The most important single thing a company can do is allow the employee to leave work without penalty to tend to family needs (Lawton & Tulkin, 2010). Research also indicates that there may be no differences for either mothers or their infants between work-based and nonwork-based child-care centers in terms of the mothers' ease in transitioning back to work or the infants' ability to settle into day care (Skouteris, McNaught, & Dissanayake, 2007). Because a large percentage of working mothers rely on family members for child care, what appears to make a difference is whether corporate policy meshes with people's child-care arrangements (Nowak, Naude, & Thomas, 2013). It will be interesting to watch how these issues—especially flexible schedules—play out in the United States, where such practices are not yet common. A global study of parental leave, such as that granted under the U.S. Family and Medical Leave Act, showed that the more generous the parental leave policies, the lower the infant mortality rates, clearly indicating that parental leave policies are a good thing (Ferrarini & Norström, 2010).

Changes in Appearance

On that fateful day when the hard truth stares back at you in the bathroom mirror, it probably doesn't matter to you that getting wrinkles and gray hair is universal and inevitable. Wrinkles are caused by changes in the structure of the skin and its connective and supporting tissues as well as by the cumulative effects of damage from exposure to sunlight and cigarette smoke (Aldwin & Gilmer, 2013). It may not make you feel better to know that gray hair is perfectly natural and caused by a normal cessation of pigment production in hair follicles. Male pattern baldness, a genetic trait in which hair is lost progressively beginning at the top of the head, often begins to appear in middle age. No, the scientific evidence that these changes occur to many people isn't what matters most. What matters is that these changes are affecting you. To make matters worse, you also may have noticed that your clothes aren't fitting properly even though you carefully watch what you eat. You remember a time not very long ago when you could eat whatever you wanted; now it seems that as soon as you look at food you put on weight. Your perceptions are correct; most people gain weight between their early thirties and mid-fifties, producing the infamous "middle-aged bulge" as metabolism slows down (Aldwin & Gilmer, 2013). People's reactions to these changes in appearance vary. Dean wonders how people will react to him now that he's balding. Some people rush out to purchase hair coloring and wrinkle cream. Others just take it as another stage in life. You've probably experienced several different reactions yourself. There is a wide range of individual differences, especially those between men and women and across cultures. As the cartoon depicts, certain changes on men in Western society are viewed as positive, but the same changes in women are not.

What Does Being Retired Mean?

Retirement means different things to men and women and to people in different ethnic groups (Loretto & Vickerstaff, 2013; Luborsky & LeBlanc, 2003; McClinton, 2010). It has also taken on new and different meanings since the beginning of the Great Recession in 2008 due to the abrupt change in people's planning and expectations as a result of the loss of savings or pensions (Sargent et al., 2013). Part of the reason it is difficult to define retirement precisely is that the decision to retire involves the loss of occupational identity, not what may be added to people's lives. What people do for a living is a major part of their identity; we introduce ourselves as postal workers, teachers, builders, or nurses as a way to tell people something about ourselves. Not doing those jobs any more means that we put that aspect of our lives in the past—"I used to work as a manager at the Hilton"—or say nothing at all. Loss of this aspect of themselves can be difficult to face, so some people look for a label other than "retired" to describe themselves. Think About It In the absence of mandatory retirement, is there such a concept as "early retirement?" That's why researchers view retirement as another one of many transitions people experience in life (Sargent et al., 2013; Schlossberg, 2004; Sterns & Chang, 2010). This view makes retirement a complex process by which people withdraw from full-time participation in an occupation (Sargent et al., 2013), recognizing that there are many pathways to this end (Everingham, Warner-Smith, & Byles, 2007; Sargent et al., 2013).

legal and medical definitions

Sociocultural approaches help us understand the different ways in which people conceptualize and understand death. But they do not address a very fundamental question: How do we determine that someone has died? The medical and legal communities have grappled with this question for centuries and continue to do so today. Let's see what the current answers are. Determining when death occurs has always been subjective. For hundreds of years, people accepted and applied the criteria that now define clinical death : lack of heartbeat and respiration. Today, however, the most widely accepted criteria are those that characterize whole-brain death. In 1981, the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research established several criteria still used today that must be met for the determination of whole-brain death. No spontaneous movement in response to any stimuli No spontaneous respirations for at least one hour Total lack of responsiveness to even the most painful stimuli No eye movements, blinking, or pupil responses No postural activity, swallowing, yawning, or vocalizing No motor reflexes A flat electroencephalogram (EEG) for at least ten minutes No change in any of these criteria when they are tested again 24 hours later For a person to be declared dead, all eight criteria must be met. Moreover, other conditions that might mimic death—such as deep coma, hypothermia, or drug overdose—must be ruled out. Finally, according to most hospitals, the lack of brain activity must occur both in the brainstem, which involves vegetative functions such as heartbeat and respiration, and in the cortex, which involves higher processes such as thinking. In the United States, all 50 states and the District of Columbia use the whole-brain standard to define death. A major problem facing the medical profession is how brain death is diagnosed in practice (Sung & Greer, 2011). In part, this is due to variable intervals taken to make the second assessment (Lustbader et al., 2011). Because patients who are declared brain dead on first examination do not spontaneously recover brain stem function and because long delays in second assessments lower the rate at which patients' families agree to organ donation, some medical professionals are calling for a single assessment or at least a simpler, more direct process (Sung & Greer, 2011). Brain death is also controversial from some religious perspectives. For example, some Islamic scholars argue that brain death is not complete death; complete death must include the cessation of respiration (Bedir & Aksoy, 2011). Roman Catholics focus on what they term "natural death" (Verheijde, 2010). It is possible for a person's cortical functioning to cease while brainstem activity continues; this is a persistent vegetative state , from which the person does not recover. This condition can occur following disruption of the blood flow to the brain, a severe head injury, or a drug overdose. Persistent vegetative state allows for spontaneous heartbeat and respiration but not for consciousness. The whole-brain standard does not permit a declaration of death for someone who is in a persistent vegetative state. Because of conditions such as persistent vegetative state, family members sometimes face difficult ethical decisions concerning care for the individual. These issues are the focus of the next section. Ensuring that the diagnosis of persistent vegetative state is correct is essential, as the cost of an erroneously deciding that it is present is very high. Research indicates that the clinical assessments typically done at the patient's bedside can have high error rates (Stender et al., 2014). The use of neuroimaging techniques, especially PET scanning, can improve accuracy if made part of the overall assessment process. What these tests provide is a way to determine if brain activity is occurring and is compatible with minimal consciousness. Neuroimaging not only helps the diagnosis, but is also useful in predicting long-term recovery. The key point is that much care should be exercised in assessing whether a patient has or does not have a chance of recovery

Remarriage

The trauma of divorce does not deter people from beginning new relationships, which often lead to another marriage. In the United States, men and women both typically wait about 3.5 years before they remarry (National Center for Health Statistics, 2013a). However, remarriage rates have plummeted since the 1990s by about 40% as more post-divorced couples choose to cohabit instead (Scarf, 2013). © Masterfile Although remarriage is common, adjusting to it can be difficult. For those who do remarry, rates vary somewhat across different groups and educational levels: European Americans are more likely to be married two or more times compared with other ethnic groups, as do people with lower educational levels (Elliott & Lewis, 2010). Military veterans are also more likely to be married more than once compared with nonveterans. In contrast to first marriages, remarriage has few norms or guidelines for couples, especially in how to deal with stepchildren and extended families (Elliott & Lewis, 2010; Scarf, 2013). The lack of clear role definitions may be a major reason why the divorce rate for remarriages is significantly higher (about 25%; even higher if stepchildren are involved) than for first marriages. Although women are more likely to initiate a divorce, they are less likely to remarry unless they are poor (Elliott & Lewis, 2010). However, because of the increase in financial resources, women generally tend to benefit more from remarriage than do men, particularly if they have children (Shafer & Jensen, 2013). Although many people believe that divorced individuals should wait before remarrying to avoid the so-called "rebound effect," there is no evidence that those who remarry sooner have less success in remarriage than those who wait longer (Wolfinger, 2007).

Coping with Grief

Thus far, we have considered the behaviors people show when they are dealing with grief. We have also seen that these behaviors change over time. How does this happen? How can we explain the grieving process? Numerous theories have been proposed to account for the grieving process, such as general life-event theories, psychodynamic theories, attachment theories, and cognitive process theories (Stroebe & Archer, 2013; Stroebe et al., 2010). All of these approaches to grief are based on more general theories, which results in none of them providing an adequate explanation of the grieving process. Two integrative approaches have been proposed that are specific to the grief process: the four-component model and the dual-process model of coping with bereavement. The Four-Component Model The four-component model proposes that understanding grief is based on four things: (1) the context of the loss, referring to the risk factors, such as whether the death was expected; (2) continuation of subjective meaning associated with loss, ranging from evaluations of everyday concerns to major questions about the meaning of life; (3) changing representations of the lost relationship over time; and (4) the role of coping and emotion-regulation processes that cover all coping strategies used to deal with grief (Bonanno et al., 2011; Bonanno, 2009). The four-component model relies heavily on emotion theory, has much in common with the transactional model of stress, and has empirical support. According to the four-component model, dealing with grief is a complicated process that can only be understood as a complex outcome that unfolds over time. There are several important implications of this integrative approach. One of the most important is that helping a grieving person involves helping them make meaning from the loss (Bratkovich, 2010; Wong, 2008). This model also implies that encouraging people to express their grief may not be helpful. An alternative view, called the grief work as rumination hypothesis , not only rejects the necessity of grief processing for recovery from loss but also views extensive grief processing as a form of rumination that may increase distress (Bonanno, Papa, & O'Neill, 2001). Although it may seem that people who think obsessively about their loss or who ruminate about it are confronting the loss, rumination is actually considered a form of avoidance because the person is not dealing with his or her real feelings and moving on (Robinaugh & McNally, 2013; Stroebe, Schut, & Stroebe, 2007). One prospective study has shown, for instance, that bereaved individuals who were not depressed prior to their spouse's death but then evidenced chronically elevated depression through the first year and a half of bereavement (i.e., a chronic grief pattern) also tended to report more frequently thinking about and talking about their recent loss at the six-month point in bereavement (Bonanno, Wortman, & Neese, 2004). Thus, some bereaved individuals engage in minimal grief processing, whereas others are predisposed toward more extensive grief processing. Furthermore, individuals who engage in minimal grief processing will show a relatively favorable grief outcome, whereas those who are predisposed toward more extensive grief processing will tend toward ruminative preoccupation and, consequently, toward a more prolonged grief course (Bonanno, 2009; Bonanno et al., 2011). As noted earlier, the grief work as rumination hypothesis also views grief avoidance as an independent but maladaptive form of coping with loss (Stroebe et al., 2007). In contrast to the traditional perspective, which equates the absence of grief processing with grief avoidance, the grief work as rumination framework assumes that resilient individuals can minimize processing of a loss through relatively automated processes, such as becoming distracted or shifting attention toward more positive emotional experiences (Bonanno, 2009; Bonanno et al., 2011). The grief work as rumination framework argues that the deliberate avoidance or suppression of grief represents a less effective form of coping (Wegner & Gold, 1995) that tends to exacerbate rather than minimize the experience of grief (Bonanno, 2009; Bonanno et al., 2011). The Dual Process Model The dual process model (DPM) of coping with bereavement integrates existing ideas regarding stressors (Stroebe & Archer, 2013; Stroebe et al., 2010). As shown in Figure 16.3, the DPM defines two broad types of stressors. Loss-oriented stressors concern the loss itself, such as the grief work that needs to be done. Restoration-oriented stressors involve adapting to the survivor's new life situation, such as building new relationships and finding new activities. The DPM proposes that dealing with these stressors is a dynamic process, as indicated by the lines connecting them in the figure. This is a distinguishing feature of DPM. It shows how bereaved people cycle back and forth between dealing mostly with grief and trying to move on with life. At times, the emphasis will be on grief; at other times, on moving forward. Figure 16.3. Stroebe, M. S., & Schut, H. (2001). Models of Coping with Bereavement: A review. In M. S. Stroebe, R. O., Hansson, W. Stroeve, & H. Schut (Eds.), Handbook of Bereavement Research: Consequences, Coping, and Care (pp. 375-403). Washington, DC: American Psychological Assocation . The dual process model of coping with bereavement shows the relation between dealing with the stresses of the loss itself (loss-oriented) and moving on with one's life (restoration-oriented). The DPM captures well the process that bereaved people report—at times, they are nearly overcome with grief, whereas at other times, they handle life well. The DPM also helps us understand how, over time, people come to a balance between the long-term effects of bereavement and the need to live life. Understanding how people handle grief requires understanding the various contexts in which people live and interact with others (Sandler, Wolchik, & Ayers, 2008)

low-density lipoprotein (LDL)

chemicals that cause fatty deposits to accumulate in arteries, impeding blood flow -high level= risk factor for cardiovascular disease

High-density lipoprotein (HDL)

chemicals that help keep arteries clear and break down LDLs -high level= protective factor

example of fluid intelligence

ex: What letter comes next in the series dfimrxe? Other typical ways of testing fluid intelligence include mazes, puzzles, and relations among shapes. These tests are usually timed, and higher scores are associated with faster solutions.

health concerns across age groups

for the two younger groups, being overweight and (for women) becoming wrinkled and unattractive when old were commonly mentioned as feared-for selves. For the middle-aged and older adult groups, fear of having Alzheimer's disease or being unable to care for oneself were frequent responses.

addiction

physical dependence on a substance such that withdrawal symptoms are experienced when deprived of that substance

Stages of reflective judgment

prereflective stages, quasi-reflective stages, reflective stages

two most important social influences on health

socioeconomic status (predictor of access to insurance and good health care) and education (predictor of living a healthy lifestyle and avoiding certain diseases)

Parieto-Frontal Integration Theory (P-FIT)

theory that proposes that intelligence comes from a distributed and integrated network of neurons in the parietal and frontal lobes of the brain

how to people become financially independent

-working series of part-time jobs -finding full-time employment -learning a trade (such as carpentry or plumbing) -starting their own business -join the military

what do different developmental trends of intelligences imply

1) learning becomes more difficult with age 2) intellectual development varies a great deal from one set of skills to another -individual differences in fluid intelligence remain relatively uniform over time, individual differences in crystallized intelligence increase with age, largely because maintaining crystallized intelligence depends on being in situations that require its use

four types of personal control

control from within oneself, control over oneself, control over the environment, and control from the environment

college enrollment patterns

-returning adult students who attend full-time are more likely to attend public two-year and private for-profit baccalaureate institutions than are traditional-aged students -Part-time returning adult students tend to enroll in patterns similar to traditional-aged students

how do men and women resolve identity and intimacy issues differently under certain circumstances

-some women resolve intimacy issues before identity issues by marrying and rearing children, and deal with the question of their own identity later -middle-aged women who go to college for 1st time is an example of this form of identity development

what role transitions are key markers for attaining adulthood

-voting -completing one's education -beginning full-time employment -leaving home and establishing financial independence -getting married -becoming a parent

The Price of Life-Sustaining Care

A growing debate in the United States, particularly in the aftermath of the Affordable Care Act passed in 2010, concerns the financial, personal, and moral costs of keeping people alive on life-support machines and continuing aggressive care when people have terminal conditions. For example, debate continues on whether secondary health conditions in terminally ill people should be treated. The argument is that such care is very expensive, that these people will die soon anyway, and that needlessly prolonging life is a burden on society. However, many others argue that all means possible should be used, whether for a very premature infant or an older adult, to keep that person alive despite the high cost and possible risk of negative side effects of the treatment or intervention. They argue that life is precious and that humans should not "play God" and decide when life should end. There is no question that extraordinary interventions are expensive. For example, health care costs can soar during the last year of a person's life. Data indicate that less than 7% of people who receive hospital care die each year, but they account for nearly 25% of all Medicare expenditures (Adamy & McGinty, 2012). Expenditures are typically less for those that have advance directives (discussed later in this chapter). The biggest challenge in confronting these differences in approach and cost is the difficulty in deciding when to treat or not to treat a disease that a person has. There are no easy answers. Witness the loud criticism when research evidence indicated that various types of cancer screening (e.g., breast, prostate) should not be provided to everyone as early or as often as initially thought. Despite the lack of evidence to support and the costs associated with continued mass screening, many patients and physicians continue the practice anyway. Failure to base care on evidence has a price. Whether that is affordable in the long run seems unlikely.

Developmental Changes in Leisure

Cross-sectional studies report age differences in leisure activities. Young adults participate in a greater range of activities than do middle-aged adults. Furthermore, young adults tend to prefer intense leisure activities, such as scuba diving and hang gliding. In contrast, middle-aged adults focus more on home- and family-oriented activities. In later middle age, people spend less of their leisure time in strenuous physical activities and more in sedentary activities such as reading and watching television (van der Pas & Koopman-Boyden, 2010). Longitudinal studies of changes in individuals' leisure activities over time show considerable stability over reasonably long periods and show that level of activity in young adulthood predicts activity level later in life (Hillsdon et al., 2005; Patel et al., 2006). Claude, the 35-year-old in the vignette who likes to fish and ski, is a good example of this overall trend. As Claude demonstrates, frequent participation in particular leisure activities during childhood tends to continue into adulthood. Similar findings hold for the pre- and postretirement years. Apparently, one's preferences for certain types of leisure activities are established early in life; they tend to change over the life span primarily in terms of how physically intense they are.

occupational expectations

Especially in adolescence, people begin to form opinions about what work in a particular occupation will be like based on what they learn in school and from their parents, peers, other adults, and the media. These expectations influence what they want to become and when they hope to get there. In adulthood, personal experiences affect people's opinions of themselves as they continue to refine and update their occupational expectations and development (Fouad, 2007). This usually involves trying to achieve their occupational goal, monitoring progress toward it, and changing or even abandoning it as necessary. Modifying the goal happens for many reasons, such as realizing that interests have changed, the occupation was not a good fit, they never got the chance to pursue the level of education necessary to achieve the goal, or they lack certain essential skills and cannot acquire them. Still other people modify their goals because of age, race, or sex discrimination, a point we will consider later in this chapter. Research shows that most people who know that they have both the talent and opportunity to achieve their occupational and career goals often attain them. A study showed that when high school students who were identified as being academically talented were asked about their career expectations and outcomes, they were surprisingly accurate 10 and even 20 years later (Perrone et al., 2010). What is also clear from research is that the biggest change has been in women's occupational and career expectations (Jacob & Wilder, 2010). In general, research shows that young adults modify their expectations at least once, usually on the basis of new information, especially about their academic ability. The connection between adolescent expectations and adult reality reinforces the developmental aspects of occupations and careers. Many writers believe that occupational expectations also vary by generation. Nowhere has this belief been stronger than in the supposed differences between the baby boom generation (born between 1946 and 1964) and the current millennial generation (born since 1983). On average, what people in these generations expect in occupations appears to be very different (Rusconi, Moen, & Kaduk, 2013). Millennials are more likely to change jobs more often than the older generations did and are likely to view traditional organizations with more distrust and cynicism. But contrary to most stereotypes, millennials are no more egotistical and are just as happy and satisfied as young adults were in every generation since the 1970s (Trzesniewski & Donnellan, 2010). However, they tend to have an inherent mistrust in organizations, prefer a culture focused on employee development, create information through interactive social media, be more globally aware and more comfortable working with people from diverse socioethnic backgrounds, and do best in situations that value innovation through teamwork (Dannar, 2013). Marc Romanelli/The Image Bank/Getty Images Reality shock typically hits younger workers soon after they begin an occupation. The importance of occupational expectations can be seen clearly in the transition from school to the workplace (Moen & Roehling, 2005). The 21st-century workplace is not one in which hard work and long hours necessarily lead to a stable career. It can also be a place in which you experience reality shock , a situation in which what you learn in the classroom does not always transfer directly to the real world and does not represent all that you need to know. When reality shock sets in, things never seem to happen the way we expect. Reality shock befalls everyone; for example, you can imagine how a new teacher feels when her long hours preparing a lesson result in students who act bored and are unappreciative of her efforts. Many professions, such as nursing and teaching, have gone to great lengths to alleviate reality shock (Pfaff et al., 2014; Wang & Fwu, 2014). This problem is best addressed through internship and practicum experiences for students under the careful guidance of experienced people in the field. The Role of Mentors and Coaches Entering an occupation involves more than the relatively short formal training a person receives. Instead, most people are oriented by a more experienced person who makes a specific effort to do this, taking on the role of a mentor or coach. A mentor or developmental coach is part teacher, part sponsor, part model, and part counselor who facilitates on-the-job learning to help a new hire do the work required in his or her present role and to prepare for future roles (Hunt & Weintraub, 2006). Mentoring and coaching are viewed as primary ways in which organizations invest in developing their talent and future leadership (Smits & Bowden, 2013). The mentor helps a young worker avoid trouble and provides invaluable information about the unwritten rules that govern day-to-day activities in the workplace, with mentors being sensitive to the employment situation (Bozeman & Feeney, 2007). As part of the relationship, a mentor makes sure that the protégé is noticed and receives credit from supervisors for good work. Thus, occupational success often depends on the quality of the mentor-protégé relationship and the protégé's perceptions of its importance, usually thought of as the "goodness of fit" of the relationship (Bozeman & Feeney, 2008). In times of economic downturns, mentors can also provide invaluable advice on finding another job (Froman, 2010). What do mentors get from the relationship? Helping a younger employee learn the job is one way to fulfill aspects of Erikson's phase of generativity. As we will see in Chapter 13, generativity reflects the needs of middle-aged adults to ensure the continuity of society through activities such as socialization or having children. Mentoring is an important way in which generativity can be achieved (Marcia & Josselson, 2013). Meta-analyses (see Chapter 1) of research clearly show benefits to the mentor for mentoring (Ghosh & Reio, 2013). In addition, leaders may need to serve as mentors to activate transformational leadership (leadership that changes the direction of an organization) and promote positive work attitudes and career expectations of followers. Bloom Productions/Photodisc/Getty Images Women employees typically prefer and may achieve more from a female mentor. Women and minorities have an especially important need for mentors (Ortiz-Walters & Gilson, 2013; Pratt, 2010). When paired with mentors, women benefit in many ways, including having higher career expectations and better perceived career development, as well as increased retention of diverse employees (Brown et al., 2013). For example, Latina nurses in the U.S. Army benefitted from mentors in terms of staying in the military and getting better assignments (Aponte, 2007). It is also critical to adopt a culturally conscious model of mentoring to enhance the advantages of mentoring for minority mentees (Brown et al., 2013; Campinha-Bacote, 2010). Culturally conscious mentoring involves understanding how an organization's culture, for example, affects employees and building those assumptions and behaviors into the mentoring situation. It can also involve addressing the cultural background of an employee and incorporating that into the mentoring relationship. Despite the evidence that having a mentor can have many positive effects on one's occupational development, there is an important caveat. How good the mentor is really matters (Tong & Kram, 2013). Having a poor mentor is worse than having no mentor at all. Consequently, prospective protégés must be carefully matched with a mentor, and mentorship programs need to select motivated and skilled individuals who are provided with extensive training. It is also in the organization's best interest to get the mentor-protégé match correct. How can prospective mentors and protégés meet more effectively? Some organizations have taken a page from dating and created speed mentoring as a way to help create better matches (Berk, 2010; Cook, Bahn, & Menaker, 2010).

Love Relationships

Love is one of those things everybody feels but nobody can define completely. (Test yourself: Can you explain fully what you mean when you look at someone special and say, "I love you"?) One way researchers have tried to understand love is to think about what components are essential. In an interesting series of studies, Sternberg (2006) found that love has three basic components: (1) passion, an intense physiological desire for someone; (2) intimacy, the feeling that one can share all one's thoughts and actions with another; and (3) commitment, the willingness to stay with a person through good and bad times. Ideally, a true love relationship has all three components; when couples have equivalent amounts of love and types of love, they tend to be happier. As we will see next, the balance among these components often shifts as time passes. Love through Adulthood The different combinations of love can be used to understand how relationships develop (Sternberg, 2006). Research shows that the development of romantic relationships is a complex process influenced by relationships in childhood and adolescence (Collins & van Dulmen, 2006) that are played out in many contexts, including social media (Schade et al., 2013). Early in a romantic relationship, passion is usually high, whereas intimacy and commitment tend to be low. This is infatuation: an intense, physically based relationship in which the two people have a high risk of misunderstanding and jealousy. Indeed, it is sometimes difficult to establish the boundaries between casual sex and hookups and dating in young adulthood (Giordano etal., 2012). Michael Goldman/The Image Bank/Getty Images Physical attraction tends to be high early in a relationship. But infatuation is short-lived. Whereas even the smallest touch is enough to drive each partner into wild, lustful ecstasy in the beginning, with time, it takes more and more effort to get the same level of feeling. As passion fades, either a relationship acquires emotional intimacy or it is likely to end. Trust, honesty, openness, and acceptance must be a part of any strong relationship; when they are present, romantic love develops. Although it may not be the stuff of romance novels or films, this pattern is a good thing. Research shows that people who select a partner for a more permanent relationship (e.g., marriage) during the height of infatuation are likely to support the idea that "love is blind"; those couples are more likely to divorce (Hansen, 2006). But if the couple gives their relationship more time and works at it, they may become committed to each other. By spending much of their time together, making decisions together, caring for each other, sharing possessions, and developing ways to settle conflicts, they increase the chances that their relationship will last. Such couples usually show outward signs of commitment, such as wearing a lover's ring, having children together, or simply sharing the mundane details of daily life, from making toast at breakfast to following before-bed rituals. Lemieux and Hale (2002) demonstrated that these developmental trends hold in romantically involved couples between 17 and 75 years of age. As the length of the relationship increases, intimacy and passion decrease but commitment increases. However, the ages of the couple may matter in terms of how quickly passion decreases; when both are emerging adults in college, some evidence indicates that passion levels do not decline over their years in school (Toba, 2010). Falling in Love Everybody wants to be loved by somebody, but having it happen is fraught with difficulties. In his book The Prophet, Kahlil Gibran points out that love is two-sided: Just as it can give you great ecstasy, so can it cause you great pain. Yet most of us are willing to take the risk. As you may have experienced, taking the risk is fun (at times) and difficult (at other times). Making a connection can be ritualized, as when people use pickup lines in a bar, or it can happen almost by accident, as when two people literally run into each other in a crowded corridor. The question that confronts us is "How do people fall in love?" Do birds of a feather flock together? Or do opposites attract? The best explanation of the process is the theory of assortative mating, which states that people find partners based on their similarity to each other. Assortative mating occurs along many dimensions, including education, religious beliefs, physical traits, age, socioeconomic status, intelligence, and political ideology, among others (Schwartz, 2013). Such nonrandom mating occurs most often in Western societies, which allows people to have more control over their own dating and pairing behaviors. Common activities are one basis for identifying potential mates. Except, that is, in speed dating situations. In that case, when people have very limited time to explore potentially common interests, it comes down to physical attractiveness (Luo & Zhang, 2009). People meet people in all sorts of places, both "real" and "virtual." Does that matter in terms of whether they will form a couple? Kalmijn and Flap (2001) found that it did. In an unusually large study, they showed that among 1,500 couples, meeting at school was most likely to result in the highest levels of homogamy—the degree to which people are similar. Some evidence also suggests that certain specialized social media environments can foster homogamy by bringing together people with common interests (Schwartz, 2013). Not surprisingly, the pool of available people to meet is strongly shaped by the opportunities available, which in turn constrain the type of people one is likely to meet. Speed dating provides a way to meet several people in a short period of time. Speed dating is practiced most by young adults (Fein & Schneider, 2013). The rules governing partner selection during a speed dating session seem similar to those of traditional dating: Physically attractive people, outgoing and self-assured people, and moderately self-focused people are selected more often, and their dates are rated as smoother (Eastwick, Saigal, & Finkel, 2010). The explosion of online dating makes it possible for adults to meet, flirt, date, and mate through virtual connections (Albright & Simmens, 2014; Fein & Schneider, 2013). But it is not only the socially anxious who are meeting this way. Surveys indicate that nearly 1 in every 5 couples in the United States meet online (compared with 1 in 10 in Australia and 1 in 20 in Spain and the United Kingdom; Dutton et al., 2009). Not surprisingly, people who meet online tend to be young and middle-aged adults, with a slightly stronger preference among middle-aged adults for online as opposed to speed dating. Research indicates that virtual dating sites offer both problems and possibilities, especially in terms of the accuracy of personal descriptions (Albright & Simmens, 2014). In the online world, initial decisions whether to pursue a potential mate work similarly to those of the offline world. First impressions are driven mainly by the perceived attractiveness of the person's photograph, whereas more deliberative decisions are influenced by perceived attractiveness as well as such self-described attributes as ambition (Sritharan et al., 2010). But this differs for men and women targets. A study of eye movements of people viewing Facebook profiles indicated that participants paid more attention to the physical appearance of female profile owners and to the personal information of male profile owners (Seidman & Miller, 2013). One increasing trend among emerging adults is the hookup culture of casual sex, often without even knowing the name of one's sexual partner (Garcia et al., 2013). Research indicates that both men and women are interested in having hookup sex, but also prefer a more romantic relationship over the long run. However, the perception that there are no strings attached to hookup sex appear wrong, as nearly three-fourths of both men and women eventually expressed some level of regret at having hookup sex. How do couple-forming behaviors compare cross-culturally? A few studies have examined the factors that attract people to each other in different cultures. In one now classic study, Buss and a large team of researchers (1990) identified the effects of culture and gender on heterosexual mate preferences in 37 cultures worldwide. Men and women in each culture displayed unique orderings of their preferences concerning the ideal characteristics of a mate. When all of the orderings and preferences were compared, two main dimensions emerged. Courtesy of John C. Cavanaugh These Egyptian women, performing traditional cultural tasks, are more likely to be desired as mates. In the first main dimension, the characteristics of a desirable mate changed because of cultural values—that is, whether the respondents' country has more traditional values or Western-industrial values. In traditional cultures, men place a high value on a woman's chastity, desire for home and children, and ability to be a good cook and housekeeper; women place a high value on a man being ambitious and industrious, being a good financial prospect, and holding favorable social status. China, India, Iran, and Nigeria represent the traditional end of this dimension. In contrast, people in Western-industrial cultures value these qualities to a much lesser extent. The Netherlands, Great Britain, Finland, and Sweden represent this end of the dimension; people in these countries place more value on Western ideals. The second main dimension reflects the relative importance of education, intelligence, and social refinement—as opposed to a pleasing disposition—in choosing a mate. For example, people in Spain, Colombia, and Greece highly value education, intelligence, and social refinement; in contrast, people in Indonesia place a greater emphasis on having a pleasing disposition. Note that this dimension emphasizes the same traits for both men and women. Chastity proved to be the characteristic showing the most variability across cultures, being highly desired in some cultures but mattering little in others. It is interesting that in their respective search for mates, men around the world value physical attractiveness in women, whereas women around the world look for men capable of being good providers. But men and women around the world agree that love and mutual attraction are most important, and nearly all cultures rate dependability, emotional stability, kindness, and understanding as important factors. Attraction, it seems, has some characteristics that transcend culture. Overall, Buss and his colleagues concluded that mate selection is a complex process no matter where you live. However, each culture has a describable set of high-priority traits that men and women look for in the perfect mate. The study also shows that socialization within a culture plays a key role in being attractive to the opposite sex; characteristics that are highly desirable in one culture may not be so desirable in another. In the Spotlight on Research feature, Schmitt and his team of colleagues (2004) had 17,804 participants from 62 cultural regions complete the Relationship Questionnaire (RQ), a self-report measure of adult romantic attachment. They showed that secure romantic attachment was the norm in nearly 80% of cultures and that "preoccupied" romantic attachment was particularly common in East Asian cultures. In general, what these large multicultural studies show is that there are global patterns in mate selection and romantic relationships. The romantic attachment profiles of individual nations were correlated with sociocultural indicators in ways that supported evolutionary theories of romantic attachment and basic human mating strategies. Spotlight on Research Patterns and Universals of Romantic Attachment around the World Who were the investigators and what was the aim of the study? One's attachment style may have a major influence on how one forms romantic relationships. To test this hypothesis, David Schmitt (Schmitt et al., 2004) assembled a large international team of researchers. How did the investigators measure the topic of interest? Great care was taken to ensure equivalent translation of the survey across the 62 cultural regions included. The survey was a two-dimension, four-category measure of adult romantic attachment (the Relationship Questionnaire) that measured models of self and others relative to each other: secure romantic attachment (high scores indicate positive models of self and others), dismissing romantic attachment (high scores indicate a positive model of self and a negative model of others), preoccupied romantic attachment (high scores indicate a negative model of self and a positive model of others), and fearful romantic attachment (high scores indicate negative models of self and others). An overall score of the model of self is computed by adding the secure and dismissing scores and then subtracting the combination of preoccupied and fearful scores. The overall model of others score is computed by adding the secure and preoccupied scores and then subtracting the combination of dismissing and fearful scores. In addition, there were measures of self-esteem, personality traits, and sociocultural correlates of romantic attachment (e.g., fertility rate, national profiles of individualism versus collectivism). Who were the participants in the study? A total of 17,804 people (7,432 men and 10,372 women) from 62 cultural regions around the world took part in the study. Such large and diverse samples are unusual in developmental research. What was the design of the study? Data for this cross-sectional, nonexperimental study were gathered by research teams in each country. The principal researchers asked the research collaborators to administer a nine-page survey to the participants that took 20 minutes to complete. Were there ethical concerns with the study? Because the study involved volunteers, there were no ethical concerns. However, ensuring that all participants' rights were protected was a challenge because of the number of countries and cultures involved. What were the results? The researchers first demonstrated that the measures used for model of self and model of others were valid across cultural regions, which provided general support for the independence of measures (i.e., they measure different things). Specific analyses showed that79% of the cultural groups studied demonstrated secure romantic attachments but that North American cultures tended to be high on dismissive and East Asian cultures high on preoccupied romantic attachment. These patterns are shown in Figure 11.1. Note that all the cultural regions except East Asia showed the pattern of model of self scores higher than model of others scores. Figure 11.1. Data from Schmitt et al. (2004). In this model of self and model of others levels across ten world regions, note that only in East Asian cultures were model of others scores significantly higher than model of self scores. What have the investigators concluded? Overall, Schmitt and colleagues concluded that although the same attachment pattern holds across most cultures, no one pattern holds across all of them. East Asian cultures in particular tend to fit a pattern in which people report that others do not get as emotionally close as the respondent would like and that respondents find it difficult to trust others or to depend on them. What converging evidence would strengthen these conclusions? Although this is one of the best designed among large cross-cultural studies, several additional lines of evidence would help bolster the conclusions. Most important, representative samples from the countries under study would provide more accurate insights into people's romantic attachment patterns. The growing popularity of online dating sites has also affected the role of culture in dating and mate selection. For example, traditional Chinese culture emphasizes the need to stay within one's status (Xu, Ji, & Tung, 2000). However, research examining couples who met on the Baihe website (a Chinese online dating service) showed that similarities on many dimensions in addition to social hierarchy are increasingly important (He et al., 2013). Emotional investment in a romantic relationship also varies by culture (Schmitt et al., 2004). Specifically, across 48 different cultures globally, people from cultures that have good health care, education, and resources and that permit young adults to choose their own mates tend to develop more secure romantic attachments than do people from cultures that do not have these characteristics. Cultural norms are sometimes highly resistant to change. Arranged marriages are a major way that some cultures ensure an appropriate match on key dimensions. For example, loyalty of the individual to the family is a very important value in India; so despite many changes in mate selection, about 95% of marriages in India are carefully arranged to ensure that an appropriate mate is selected (Dommaraju, 2010). Similarly, Islamic societies use matchmaking as a way to preserve family consistency and continuity and to ensure that couples follow the prohibition on premarital relationships between men and women (Adler, 2001). Matchmaking in these societies occurs through both family connections and personal advertisements in newspapers. To keep up with the Internet age, Muslim matchmaking has gone online, too (Lo & Aziz, 2009), increasing the pressure for the individuals in the couple to make their own decisions (Ahmad, 2012). As urbanization and globalization effects continue, pressures to move toward individual selection and commitment and away from traditional matchmaking continues to increase in many societies (Abela & Walker, 2014). Think About It What are the effects of increasing interactions among cultures on mate selection? Developmental Forces and Love Relationships As you no doubt know from your own experience, finding a suitable relationship is tough. Many things must work just right: timing, meeting the right person, luck, and effort are but a few of the factors that shape the course of a relationship. Centuries of romance stories describe this magical process and portray it as one of life's great mysteries. From our discussion here, you know that who chooses whom (and whether the feelings will be mutual) results from the interaction of developmental forces described in the biopsychosocial model presented in Chapter 1. Neuroscience research is also demystifying love relationships. Let's see how. Love is one of three discrete, interrelated emotion systems (the sex drive and attachment are the other two; Fisher, 2006). The brain circuitry involved in romantic love, maternal love, and long-term attachment overlap (Stein & Vythilingum, 2009). In terms of love, neurochemicals related to the amphetamines come into play early in the process, providing a biological explanation for the exhilaration of falling madly in love. Aron and colleagues (2005) reported that couples who were in the early stages of romantic love showed high levels of activity in the dopamine system, which is involved in all of the basic biological drives. Once the relationship settles into what some people might call long-term commitment and tranquility, the brain processes switch neurochemically to substances related to morphine, a powerful narcotic. People with a predilection to fall in love also tend to show left hemisphere chemical dominance and several changes in neurochemical processing (Kurup & Kurup, 2003). Additional research indicates that the hormone oxytocin may play an important role in attachment. In men, it enhances their partner's attractiveness compared to other females (Scheele et al., 2013); in women, it enhances their orgasms, among other things (Cacioppo & Cacioppo, 2013), which has earned it the nickname of the "cuddle hormone" (Lee et al., 2009). Love really does a number on your brain! And that's not all. The interactions among psychological aspects, neurological aspects, and hormonal aspects of romantic love help explain why couples tend to have exclusive relationships with each other. For women (but not men), blood levels of serotonin increase during periods of romantic love (Langeslag, van der Veen, & Fekkes, 2012). In addition, the stronger the romantic bond with their boyfriend, the less likely they are to be able to identify the body odor of a different male friend (Lundström & Jones-Gotman, 2009). That means that women's attention is deflected from other potential male partners the more they are romantically involved with one specific male. Psychologically, as we saw in Chapter 9, an important developmental issue is intimacy; according to Erikson, mature relationships are impossible without it. In addition, the kinds of relationships you saw and experienced as a child (and whether they involved violence) affect how you define and act in relationships you develop as an adult. Sociocultural forces shape the characteristics you find desirable in a mate and determine whether you are likely to encounter resistance from your family when you have made your choice. Life-cycle forces matter, too; different aspects of love are more or less important depending on your stage in life. For example, romantic love tends to be most prominent in young adulthood, whereas the aspect of companionship becomes more important later in life. In short, to understand adult relationships, we must take the forces of the biopsychosocial model into account. Relying too heavily on one or two of the forces provides an incomplete description of why people are or are not successful in finding a partner or a friend. Unfortunately, the developmental forces do not influence only good relationships. As we will see next, sometimes relationships turn violent.

Giving Back: Middle-Aged Adults and Their Aging Parents

No matter how old a person is, being someone's child is a role that people still play well into adulthood and, sometimes, into their sixties and seventies. How do middle-aged adults relate to their parents? What happens when their parents become frail? How do middle-aged adults deal with the need to care for their parents? Caring for Aging Parents Most middle-aged adults have parents who are in reasonably good health. But for nearly a quarter of adults, being a child of aging parents involves providing some level of care (Feinberg et al., 2011). How adult children become care providers varies a great deal from person to person, but the job of caring for older parents usually falls to a daughter or a daughter-in-law (Barnett, 2013). Daughters also tend to coordinate care provided by multiple siblings (Friedman & Seltzer, 2010). In Japan, even though the oldest son is responsible for parental care, his wife is the one who does the day-to-day caregiving for her parents as well as her in-laws (Lee, 2010). As described in the Real People feature, caring for one's parent presents a dilemma, especially for women (Roberto & Jarrott, 2014). Most adult children feel a sense of responsibility, termed filial obligation, to care for their parents if necessary. For example, adult child caregivers sometimes express the feeling that they "owe it to Mom or Dad" to care for them; after all, their parents provided for them for many years, and now the shoe is on the other foot (Gans, 2007). When needed, adult children often provide the majority of care to their parents in all Western and non-Western cultures studied, but especially in Asian and Latino cultures (Lai, 2010; Vega, 2014). Worldwide, caregiving situations tend to be better when the economic impact on the caregiving family is minimal; in rural China, for example, when middle-aged children care for aging parents, the financial impact on the caregivers is what matters most (Zhan, 2006). However, such cultural norms of caring for aging parents does not translate as well for Chinese and Latino immigrant families in the United States (Vega, 2014). Filial obligation also knows no borders; in an Australian study, middle-aged adults were found to be caring for parents in numerous other countries in Europe, the Middle East, Asia, andNew Zealand (Baldassar, Baldock, & Wilding, 2007). Real People Applying Human Development Taking Care of Mom Everything seemed to be going well for Joan. Her career was taking off, her youngest daughter Kelly had just entered high school, and her marriage to Bill was better than ever. So when her phone rang one June afternoon, she was taken by surprise. The voice on the other end was matter-of-fact. Joan's mother had suffered a major stroke and would need someone to care for her. Because her mother did not have sufficient medical and long-term care insurance to afford a nursing home, Joan made the only decision she could—her mom would move in with her, Bill, and Kelly. Joan firmly believed that because her mom had provided for her, Joan owed it to her mom to do the same now that she was in need. What Joan didn't count on was that taking care of her mom was the most difficult yet most rewarding thing she had ever done. Joan quickly realized that her days of lengthy business trips and seminars were over, as was her quick rise up the company leadership ladder. Other employees now brought back the great new ideas and could respond to out-of-town crises quickly. As hard as it was, Joan knew that her career trajectory had taken a different turn. And she and Bill had more disagreements than she could ever remember, usually about the decreased amount of time they had to spend with each other. Kelly's demands to be driven here and there also added to Joan's stress. But Joan and her mom were able to develop the kind of relationship they could not have otherwise and to talk about issues they had long suppressed. Although caring for a physically disabled mother was extremely taxing, Joan and her mother's ability to connect on a different level made it worthwhile. Caring for a parent places significant demands on the adult child. Joan's experience embodies the notion of the sandwich generation noted earlier. Joan's need to balance caring for her daughter and her mother can create conflict, both within herself and between the individuals involved (Neal & Hammer, 2006). Being pulled in different directions can put considerable stress on the caregiver, a topic we consider in the next section. But the rewards of caregiving are also great, and relationships can be strengthened as a result. More than 10 million Americans over age 50 provide unpaid care for older parents, in-laws, grandparents, and other older loved ones. The costs of doing so are high. The typical daughter caring for her parent has a cost impact in terms of lost wages and Social Security and other retirement benefits of roughly $325,000; for sons caring for a parent, it is roughly $285,000 (MetLife, 2010). Caring for an older parent often is not easy. It usually doesn't happen by choice; each party would just as soon live independently. The potential for conflict over daily routines and lifestyles can be high. Indeed, one major source of conflict between middle-aged daughters and their older mothers is differences in perceived need for care, with middle-aged daughters believing that their mothers needed care more than the mothers believed they did (Fingerman et al., 2012). The balance between independence and connection can be a difficult one (McGraw& Walker, 2004); among Japanese immigrants, one source of conflict is between caregiving daughters and older mothers who give unsolicited advice (Usita & Du Bois, 2005). Jed Share/Taxi/Getty Images Caring for an older parent creates both stresses and rewards. Caregiving Stresses and Rewards Providing care is a major source of both stresses and rewards. On the stress side, adult children and other family caregivers are especially vulnerable from two main sources (Pearlin, Mullan, Semple, & Skaff, 1990): Adult children may have trouble coping with declines in their parents' functioning, especially those involving cognitive abilities and problematic behavior, and with work overload, burnout, and loss of the previous relationship with a parent. If the care situation is perceived as confining or seriously infringes on the adult child's other responsibilities (spouse, parent, employee, etc.), then the situation is likely to be perceived negatively, which may lead to family or job conflicts, economic problems, loss of self-identity, and decreased competence. When caring for an aging parent, even the most devoted adult child caregiver will at times feel depressed, resentful, angry, or guilty (Cavanaugh, 1999; Cohen, 2013; Haley, 2013). Many middle-aged care providers are hard-pressed financially: They still may be paying child care or college tuition expenses, perhaps trying to save adequately for their own retirement, and working more than one job to do it. Financial pressures are especially serious for those caring for parents with chronic conditions (e.g., Alzheimer's disease) that require services such as adult day care that are not adequately covered by medical insurance even if the older parent has supplemental coverage. In some cases, adult children may need to quit their jobs to provide care if adequate alternatives such as adult day care are unavailable or unaffordable, usually creating even more financial stress. The stresses of caring for a parent mean that the caregiver needs to monitor his or her own health. Indeed, many professionals point out that caring for the care provider is an important consideration so as to avoid care provider burnout (Tamayo etal., 2010). On the plus side, caring for an aging parent also has rewards. Caring for aging parents can bring parents and their adult children closer together and provide a way for adult children to feel that they are giving back to their parents (Miller et al., 2008). Cross-cultural research examining Taiwanese (Lee, 2007) and Chinese (Zhan, 2006) participants confirms that adults caring for aging parents can find the experience rewarding. Cultural values enter into the care providing relationship in an indirect way (Knight & Sayegh, 2010). Care providers in all cultures studied to date show a common set of outcomes: Care providers' stressors are appraised as burdensome, which creates negative health consequences for the care provider. However, cultural values influence the kinds of social support that are available to the care provider. Things aren't always rosy from the parents' perspective either. Independence and autonomy are important traditional values in some ethnic groups, and their loss is not taken lightly. Older adults in these groups are more likely to express the desire to pay a professional for assistance rather than ask a family member for help; they may find it demeaning to live with their children and express strong feelings about "not wanting to burden them" (Cahill et al., 2009). Most of them move in only as a last resort. Many adults who receive help with daily activities feel negatively about the situation, although cultural norms supporting the acceptance of help, such as in Japanese culture, significantly lessen those feelings (Park et al., 2013). Think About It Why does parental caregiving fall mainly to women? Determining whether older parents are satisfied with the help their children provide is a complex issue (Cahill et al., 2009; Park et al., 2013). Based on a critical review of the research, Newsom (1999) proposes a model of how certain aspects of care can produce negative perceptions of care directly or affect the interactions between care provider and care recipient (see Figure 13.8). The important thing to conclude from the model is that even under the best circumstances, there is no guarantee that the help adult children provide their parents will be well received. Misunderstandings can occur, and the frustration that caregivers feel may be translated directly into negative interactions. Figure 13.8. Newsom, J. T. (1999). Another side to caregiving: Negative reactions to being helped. Current Directions in Psychological Science, 8, 185. Whether a care recipient perceives care to be good depends on interactions with the care provider and whether those interactions are perceived negatively.

Stress and Health

No one has to explain to you how it feels to be stressed. Whether it's from an upcoming exam in this course, the traffic jam you endured on your way home yesterday, or the demands your children place on you, stress seems to be everywhere. There is plenty of scientific evidence that over the long term, stress is very bad for your health. But despite thousands of scientific studies, scientists still cannot agree on a formal definition of stress. What is certain is that stress involves both physiological and psychological aspects (Gouin et al., 2012) and predicts future chronic health conditions (Piazza et al., 2013). The most widely applied approaches to stress involve (1) focusing on the physiological responses the body makes through the nervous and endocrine systems and (2) understanding that stress is what people define as stressful. Let's consider each in more detail. © kurhan/Shutterstock.com Work-related stress is a major problem around the world and can have serious negative effects on physical and psychological health. Stress as a Physiological State There is widespread agreement among many research studies that people differ in their physiological responses to stress (Campbell & Ehlert, 2012). Prolonged exposure to stress results in damaging influences from the sympathetic nervous system (which controls, for example, respiration, perspiration, blood flow, muscle strength, and mental activity) and a weakening of the immune system (Cohen et al., 2012). These effects have a direct causative effect on susceptibility to a wide range of diseases, from the common cold to cardiovascular disease to cancer, and may play a role at the cellular genetic level in the aging process (O'Donovan et al., 2012). Gender differences in stress responses have also been documented. There is some evidence that the hormone oxytocin plays a different role in women than in men. Oxytocin is the important hormone in regulating reproductive activities such as breast feeding and for establishing strong bonds with one's children (Skuse & Gallagher, 2011). Researchers speculate that when stressed, men opt for a flight-or-fight approach, whereas women opt for a tend-and-befriend approach (Taylor, 2006). Fischer-Shofty, Levkovitz, and Shamay-Tsoory (2013) showed that oxytocin improves accurate perception of social interactions, but in different ways in men and women. In men, performance improved only for competition recognition, whereas in women, it improved for kinship recognition. The Stress and Coping Paradigm Suppose you are stuck in a traffic jam. Depending on whether you are late for an important appointment or have plenty of time on your hands, you will probably feel very different about your situation. The stress and coping paradigm views stress not as an environmental stimulus or as a response, but as the interaction of a thinking person and an event (Lazarus, 1984; Lazarus et al., 1985; Lazarus & Folkman, 1984). How we interpret an event such as being stuck in traffic is what matters, not the event itself or what we do in response to it. Put more formally, stress is "a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being" (Lazarus & Folkman, 1984, p. 19). Note that this definition states that stress is a transactional process between a person and the environment; that it takes into account personal resources; that the person's appraisal of the situation is key; and that unless the situation is considered to be threatening, challenging, or harmful, stress does not result. A diagram of the transactional model is shown in Figure 13.3. Figure 13.3. Based on Measuring stress: A guide for health and social scientists, edited by Sheldon Cohen, Ronald C. Kessler, and Lynn Underwood Gordon (Oxford University Press, Inc., 1995). The physical markers of stress are the result of complex and dynamic psychological processes. Appraisal Lazarus and Folkman (1984) describe three types of appraisals of stress. Primary appraisal categorizes events into three groups based on the significance they have for our well-being: irrelevant, benign or positive, and stressful. Primary appraisals filter the events we experience. Specifically, any event that is appraised as either irrelevant (things that do not affect us) or benign or positive (things that are good or at least neutral) is not stressful. So we literally decide which events are potentially stressful and which ones are not. This is an important point for two reasons. First, it means that we can effectively sort out those events that may be problems and those that are not, allowing us to concentrate on dealing with life's difficulties more effectively. Second, it means that we could be wrong about our reading of an event. A situation that may appear at first blush to be irrelevant, for example, may actually be very important, or a situation deemed stressful initially may turn out not to be. Such mistakes in primary appraisal could set the stage for real (or imagined) crises later on. If a person believes that an event is stressful, a second set of decisions, called secondary appraisal, is made. Secondary appraisal is the process that evaluates our perceived ability to cope with harm, threat, or challenge. Secondary appraisal is the equivalent of asking three questions: What can I do? How likely am I to be able to use one of my options successfully? and Will this option reduce my stress? How we answer these questions sets the stage for addressing them effectively. For example, if you believe that there is something you can do in a situation that will make a difference, then your perceived stress may be reduced and you may be able to deal with the event successfully. In contrast, if you believe that there is little you can do to address the situation successfully or to reduce your feelings of stress, then you may feel powerless and ineffective, even if others around you believe that there are steps you could take. Sometimes you learn additional information or experience another situation indicating that you should reappraise the original event. Reappraisal involves making a new primary or secondary appraisal resulting from changes in the situation. For example, you may initially dismiss an accusation that your partner is cheating on you (i.e., make a primary appraisal that the event is irrelevant), but after being shown pictures of your partner in a romantic situation with another person, you reappraise the event as stressful. Reappraisal can either increase stress (if your partner initially denied the encounter) or lower stress (if you discovered that the photographs were fakes). The three types of appraisals demonstrate that determining whether an event is stressful is a dynamic process. Initial decisions about events may be upheld over time, or they may change in light of new information or personal experience. Different events may be appraised in the same way, and the same event may be appraised differently at any two points in time. This dynamic process helps explain why people react the way they do over the life span. For example, as our physiological abilities change with increasing age, we may have fewer physical resources to use in handling particular events. As a result, events that were appraised as not stressful in young adulthood may be appraised as stressful in late life. Coping During the secondary appraisal of an event labeled stressful in primary appraisal, we may believe that there is something we can do to deal with the event effectively. Lazarus and Folkman (1984) view coping more formally as a complex, evolving process of dealing with stress that is learned. Much like appraisals, coping, an attempt to deal with stressful events, is seen as a dynamic, evolving process that is fine-tuned over time. Our first attempt might fail, but if we try again in a slightly different way, we may succeed. Coping is learned, not automatic. That is why we often do not cope very well with stressful situations we are facing for the first time (such as the end of our first love relationship). The saying "practice makes perfect" applies to coping, too. Also, coping takes time and effort. Finally, coping entails only managing the situation; we need not overcome or control it. Indeed, many stressful events cannot be fixed or undone; many times the best we can do is learn to live with the situation. It is in this sense that we may cope with the death of a spouse. People cope in different ways. At a general level, we can distinguish between problem-focused coping and emotion-focused coping. Problem-focused coping involves attempts to tackle a problem head-on. Taking medication to treat a disease and spending more time studying for an examination are examples of problem-focused coping with the stress of being ill or failing a prior test, respectively. In general, problem-focused coping entails doing something directly about the problem at hand. Emotion-focused coping involves dealing with one's feelings about a stressful event. Allowing oneself to express anger or frustration over becoming ill or failing an exam is an example of this approach. The goal here is not necessarily to eliminate the problem, although that may happen. Rather, the purpose may be to help oneself deal with situations that are difficult or impossible to tackle head-on. Several other behaviors can also be viewed in the context of coping. Many people use their relationship with God as the basis for their coping (Bade, 2000; Kinney, Ishler, Pargament, & Cavanaugh, 2003). For believers, using religious coping strategies usually results in positives outcomes when dealing with negative events. How well we cope depends on several factors. For example, healthy, energetic people are better able to cope with an infection than are frail, sick people. Psychologically, a positive attitude about oneself and one's abilities is also important. Good problem-solving skills put one at an advantage by creating several options with which to manage the stress. Social skills and social support are important in helping one solicit suggestions and assistance from others. Finally, financial resources are important; having the money to pay a mechanic to fix your car allows you to avoid the frustration of trying to do it yourself. Think About It How might life experience and cognitive developmental level influence one's ability to appraise and cope with stress? How Are Stress and Coping Related to Physical Health? A great deal of research has been conducted over the years examining links between stress and physical health. Being under chronic stress suppresses the immune system (resulting in increased susceptibility to viral infections), increases risk of atherosclerosis (buildup of plaque along the walls of arteries so that the arteries become stiffer and restrict blood flow), and hypertension (high blood pressure (Beckie, 2013; Aldwin & Gilmer, 2013). Research on middle-aged adults also shows significant impairment of memory and executive cognitive functions resulting from chronic stress (Karlamangla et al., 2014). However, these effects depend on the kind of event as well as one's socioeconomic status (Kemeny, 2003; McEwen & Gianaros, 2010). Experiencing negative events tends to lower immune function, whereas experiencing positive events tends to improve immune functioning. Many specific diseases and conditions are caused or exacerbated by stress (Aldwin & Gilmer, 2013; Beckie, 2013). Stress serves as a major trigger for angina (pain caused by interrupted blood flow to the heart); causes arrhythmias (irregular heartbeat) and blood to become stickier (making it more likely to cause a clot in an artery); raises cholesterol; reduces estrogen in women; increases production of certain proteins that damage cells; causes sudden increases in blood pressure; increases the risk of irritable bowel syndrome; causes weight fluctuations; is associated with the development of insulin resistance (a primary factor in diabetes); causes tension headaches, sexual dysfunction, and infertility; and results in poorer memory and cognitive performance. Clearly, chronic stress is harmful to one's health. Surprisingly, little research has been conducted to determine whether successful coping strategies reverse these health effects of stress. At best, we can only surmise that if stress causes these health problems, effective coping strategies may prevent them. How Are Stress and Coping Related to Behavior and Psychological Health? Probably the most well-known connection between stress and behavior involves the link with cardiovascular disease. Decades of research show that stress is related to hypertension and other forms of cardiovascular disease, and even the perception that stress impacts one's health is associated with increased occurrence of myocardial infarction (heart attack) (Nabi et al., 2013). Experiencing stress can trigger psychological processes and reactions. Although stress does not directly cause psychopathology, it does influence how people react and behave. For example, the stress many people experienced after the terrorist attacks of September 11, 2001, resulted in higher levels of anxiety experienced through nightmares, flashbacks, insomnia, traumatic grief, emotional numbing, and avoidance (LeDoux & Gorman, 2001). One very important effect of stress on psychological health is post-traumatic stress disorder. The National Institute of Mental Health (2014) defines post-traumatic stress disorder (PTSD) as an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. The kinds of traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. PTSD affects nearly 8 million Americans and can be a debilitating condition. Because not everyone who is exposed to very stressful situations develops PTSD, our understanding of what causes it is limited. Treatment is typically done through psychotherapy, with the addition of certain antidepressant medications in limited circumstances. © Markus Gann / Shutterstock.com Engaging in an aerobic exercise program throughout middle age is a great way to stay fit and healthy. Because stress is such a ubiquitous aspect of life, much effort (and consumer spending) goes into stress reduction techniques. For example, one popular approach is mindfulness-based stress reduction, being aware and nonjudgmental of whatever is happening at that moment (University of Massachusetts Medical School Center for Mindfulness, 2014). Common approaches using mindfulness-based stress reduction include yoga and meditation. Research indicates that using mindfulness-based techniques has many positive effects on physical and psychological health (Sharma, 2014). In addition, mindfulness techniques result in functional and structural changes in the brain, especially in areas related to control of stress and emotion as well as attention, memory, and sensory processing (Esch, 2014). On a larger scale, the Health and Safety Executive in the United Kingdom developed an extensive set of management standards to lower work-related stress (Cox & Griffiths, 2010; Health and Safety Executive, 2014). The management standards that were developed address six key areas, each with a goal and specific behaviors that organizations must address: demands, control, support, relationships, role, and organizational change. All of them are aimed at creating a healthy, lower-stress environment for workers. This independent agency monitors numerous health aspects of the workplace and has had a direct hand in developing many health-related policies in the United Kingdom.

Social Involvement and Successful Aging

One of the most important aspects of research on older adults has been a rethinking of late life as one of mostly inevitable decline to one that is a more multidimensional view that also has positive aspects, such as productive engagement with life and social involvement (Johnson & Mutchler, 2014). Some researchers use the term successful aging to denote a pathway through late life that focuses on positive outcomes through health and social engagement to achieve well-being. However, there is considerable debate about exactly what successful aging entails (Johnson & Mutchler, 2014; van den Bogaard, Henkens, & Kalmijn, 2013). The view that successful aging, in all its manifestations, is a goal for older adults grows out of the selective optimization with compensation model we considered in Chapter 1. In this case, the notion is that older adults experience the normative changes we considered in Chapter 14, such as physiological changes in vision and hearing and certain memory changes, and are adept at developing ways to compensate for them to continue living a full and productive life (Wahl et al., 2013). From this perspective, older adults strive to continue doing as much as possible of what they have always done. According to continuity theory , people tend to cope with daily life in later adulthood by applying familiar strategies based on past experience to maintain and preserve both internal and external structures. By building on and linking to one's past life, change becomes part of continuity. Thus, Sandy's new activities represent both change (because they are new) and continuity (because she has always been engaged in her community). In this sense, continuity represents an evolution, not a complete break with the past (Atchley, 1989). Research indicates that there is considerable evidence that people in late life typically continue to engage in activities similar to those they did earlier in adulthood, such as social and civic engagement (Donnelly & Hinterlong, 2010; Johnson & Mutchler, 2014). Additional evidence also indicates that within broad continuity of activities, people also strike out in some new directions; this is due in part to increased flexibility in their time and in part to emerging personal interests. This aspect of exploration has been called an "innovation theory" of successful aging (Nimrod & Kleiber, 2007). It turns out that innovation in such things as leisure activities helps preserve a sense of continuity (Nimrod & Hutchinson, 2010). Clearly, successful aging puts a different spin on later life. Like other periods of life, what any individual defines as "successful" for him or her will likely be influenced by many factors. Perhaps the best approach is to aim for harmonious aging (Liang & Luo, 2012), which aims for balance, not uniformity. In this view, "successful aging" is grounded in one's culture and reflects the fact that there is no one right way to age well. And it may come down to what you think about your own situation. If you are happy with your life, then perhaps that's all that's necessary. Think About It How do the five-factor theory of personality and the life-story approach to personality fit with successful aging? Of course, ensuring happiness is itself a complex matter. A very important aspect of that process is the match between one's competence and the forces that impinge on it, the topic to which we now turn.

Normal Grief Reactions

The feelings a person experiences during grieving are intense, which not only makes it difficult to cope but also can make a person question her or his reactions. The feelings involved usually include sadness, denial, anger, loneliness, and guilt. AMR ABDALLAH DALSH/Reuters/Landov How openly grief is expressed varies considerably across cultures. Many authors refer to the psychological side of coming to terms with bereavement as grief work. Whether the loss is ambiguous and lacking closure (e.g., waiting to learn the fate of a missing loved one) or certain (e.g., verification of death through a dead body), people need space and time in which to grieve (Berns, 2011; Rosenblatt, 2013). Even without personal experience of the death of close family members, people recognize the need to give survivors time to deal with their many feelings. However, American society does not support long periods of grieving and pressures bereaved individuals to come to "closure" as quickly as possible. But that is not how people feel or want to deal with their grief. Muller and Thompson (2003) examined people's experience of grief in a detailed interview study and found five themes. Coping concerns what people do to deal with their loss in terms of what helps them. Affect refers to people's emotional reactions to the death of their loved one; for example, most people have certain topics that serve as emotional triggers for memories of their loved one. Change involves the ways in which survivors' lives change as a result of the loss; personal growth (e.g., "I didn't think I could deal with something that painful, but I did") is a common experience. Narrative relates to the stories survivors tell about their deceased loved one, which sometimes includes details about the process of the death. Finally, relationship reflects who the deceased person was and the nature of the ties between that person and the survivor. Collectively, these themes indicate that the experience of grief is complex and involves dealing with one's feelings as a survivor as well as memories of the deceased person. How people show their feelings of grief varies across ethnic groups (Papa & Litz, 2011). For example, Latino American men show more of their grief behaviorally than do European American men (Sera, 2001). Such differences also are found across cultures. For example, families in KwaZulu-Natal, South Africa, have a strong desire for closure and a need for dealing with the "loneliness of grief" (Brysiewicz, 2008). In many cultures, the bereaved construct a relationship with the person who died, but how this happens differs widely—from "ghosts" to appearances in dreams to connection through prayer (Rosenblatt, 2001). In addition to psychological grief reactions, there are also physiological ones (McKissock & McKissock, 2012). Physical health may decline, illness may result, and use of health care services may increase. In some cases, it is necessary to treat severe depression following bereavement; we will consider complicated grief reactions a little later. Widows report sleep disturbances as well as neurological and circulatory problems (Kowalski & Bondmass, 2008). Widowers in general report major disruptions in their daily routines (Naef et al., 2013). In the time following the death of a loved one, dates that have personal significance may reintroduce feelings of grief. For example, holidays such as Thanksgiving or birthdays that were spent with the deceased person may be difficult times. The actual anniversary of the death can be especially troublesome. The term anniversary reaction refers to changes in behavior related to feelings of sadness on this date. Personal experience and research show that recurring feelings of sadness or other examples of the anniversary reaction are common in normal grief (Holland & Neimeyer, 2010). Such feelings also accompany remembrances of major catastrophes across cultures, such as Thais remembering the victims of a major flood (Assanangkornchai et al., 2007). Most research on how people react to the death of a loved one is cross-sectional. This work shows that grief tends to peak within the first six months following the death of a loved one (Maciejewski et al., 2007). However, some work has been done to examine how people continue grieving many years after the loss. Some widows show no sign of lessening of grief after five years (Kowalski & Bondmass, 2008). Rosenblatt (1996) reported that people still felt the effects of the deaths of family members 50 years after the event. The depth of the emotions over the loss of loved ones never totally went away, as people still cried and felt sad when discussing the loss despite the length of time that had passed. In general, though, people move on with their lives within a relatively short period of time and deal with their feelings reasonably well (Bonanno, 2009; Bonanno et al., 2011)

most common goal themes of life stories

agency (reflecting power, achievement, and autonomy) and communion (reflecting love, intimacy, and belongingness)

multidirectionality

developmental pattern in which some aspects of intelligence improve and other aspects decline during adulthood

how do programs try to reduce binge drinking

establishing low tolerance levels for antisocial behaviors associated with binge drinking: -working with athletes, fraternities, and sororities -changing expectations of upcoming freshmen -increasing number of nonalcoholic activities available to students

what factors effect excessive long-term drinking?

genetics; high stress, anxiety, or emotional pain; close friends or partners who drink excessively; and sociocultural factors that glorify alcohol.

returning adult students

college students over age 25 -implies that these individuals have already reached adulthood

Marriage and Same-Sex Partnerships

"It's great to be 72 and still married," said Lucia. "Yeah, it's great to have Juan around to share old times with and to have him know how I feel even before I tell him." Lucia and Juan are typical of most older married couples. Being married in late life has several benefits. A study of 9,333 European Americans, African Americans, and Latino Americans showed that marriage helps people better deal with chronic illness, functional problems, and disabilities (Pienta, Hayward, & Jenkins, 2000). The division of household chores becomes more egalitarian after the husband retires than it was when the husband was employed, irrespective of whether the wife was working outside the home (Kulik, 2001a, 2001b). Marital satisfaction improves once the children leave home and remains fairly high in older couples (see Chapter 13). However, research shows conflicting results regarding couples' satisfaction with marriage in late life (Moorman & Greenfield, 2010). There is some evidence that couples who had children report a rebound in satisfaction, whereas couples without children report a decrease. Other studies show that older couples are more likely to report positive behaviors in their spouse than are middle-aged couples (Henry et al., 2007). The tendency to report positive behaviors fits with the overall positivity effect in memory we encountered in Chapter 14. Many older couples exhibit selective memory regarding the occurrence of negative events and perceptions of their partner. As in the "For Better or For Worse" cartoon, older couples have a reduced potential for marital conflict and greater potential for pleasure, are more likely to be similar in terms of mental and physical health, and show fewer gender differences in sources of pleasure. In short, most older married couples have developed adaptive ways to avoid conflict. FOR BETTER OR FOR WORSE © 2001 Lynn Johnston Productions. Dist. By Universal Uclick. Reprinted with permission. All rights reserved. Very little research has been conducted on long-term gay and lesbian partnerships (Moorman & Greenfield, 2010). Based on the available data, it appears that such relationships do not differ in quality from long-term heterosexual marriages, nor are the concerns of the individuals different (Kimmel, 2014). As is true for heterosexual married couples, relationship satisfaction is better when partners communicate well and are basically happy themselves. Research on lesbians indicates that they are flexible and adapt to the challenges they face, including social marginalization and discrimination (Averett & Jenkins, 2012). The legal status of same-sex marriages is changing rapidly. Decisions by the U.S. Supreme Court in 2013 supporting the rights of same-sex couples led to quick changes in state laws. These changes pertain to the availability of marriage to same-sex couples and the recognition of same-sex marriage when couples get married in a state that provides that option and live in a state that does not. As the legal landscape continues to evolve, it will be a fertile area for research. So how do long-term relationships change and develop from midlife through late life? Wickrama et al. (2013) developed a model that takes into account the influences of genetic markers, personal characteristics, cumulative life experiences, and stressful events during the period from late midlife through later life. The model, shown in Figure 15.7, shows how all of these influences interact. Figure 15.7. Wickrama, K. A. S., O'Neal, C. W., & Lorenz, F. O. Journal of Family Theory & Review, 5, 15-34. doi: 10.1111/jftr.12000. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/jftr.12000/full. Marital Functioning from Middle to Later Years: A Life Course-Stress Process Framework. The key point in the model is that people bring their past with them when they enter late life, and those experiences, including their genetic makeup, work together to create the relationships that people experience as older adults. Although Wickrama et al. (2013) initially created the model to describe baby boomers' marriages as they experience retirement, the researchers point out that the model is likely applicable to other forms of long-term relationships, such as same-sex relationships and cohabitation

Memory

"Memory is power" (Johnson-Laird, 1988, p. 41). Indeed it is when you think of the importance of remembering tasks, faces, lists, instructions, and one's personal past and identity. Perhaps that is why people put such a premium on maintaining a good memory in old age—many older adults use it to judge whether their mind is intact. Poor memory is often viewed as an inevitable part of aging. But is it? And if it is, what aspects of memory change happen to everyone and which ones don't? Many people such as Rocio, the woman in the vignette, believe that forgetting a loaf of bread at the store when one is 25 is not a big deal, but forgetting it when one is 65 is cause for alarm—a sign of Alzheimer's disease or some other malady. Is this true? In this section, we sort out the myth and the reality of memory changes with age. Working Memory One evening while you are watching television, you suddenly remember that your significant other's birthday is a week from tomorrow. You decide that a romantic dinner would be a great way to celebrate; so you go online, find a restaurant that is perfect for a romantic dinner, see that you must call to make a reservation, look at the phone number, pick up your phone, and call. Remembering the number long enough to dial it successfully requires good working memory. Working memory involves the processes and structures involved in holding information in mind and simultaneously using it to solve a problem, make a decision, perform some function, or learn new information. Working memory is an umbrella term for many similar short-term holding and computational processes relating to a wide range of cognitive skills and knowledge domains (Baddeley, 2012). Working memory has a relatively small capacity. Because working memory deals with information that is being used at the moment, it acts as a kind of mental scratch pad or blackboard. Unless we take some action to keep the information active (perhaps by rehearsal) or pass it along to long-term storage, the "page" we are using will be filled up quickly; to handle more information, some of the old information must be discarded. Working memory generally declines with age, and several researchers use this fact to explain age-related differences in cognitive performance on tasks that are difficult and demand considerable effort and resources. These findings can be integrated under "the goal maintenance account" (Braver & West, 2008) that has support from neuroscience research (Kopp et al., 2014). Taken together, working memory and psychomotor speed provide a powerful set of explanatory constructs for predicting cognitive performance (Salthouse, 2014a, 2014b). Neuroimaging studies reveal why these age differences occur. It turns out that both younger and older adults activate the prefrontal area of their brains (an area behind the forehead) during working memory tasks. But older adults activate more of it on easier tasks; they also exhaust their resources sooner (Cappell, Gmeindl, & Reuter-Lorenz, 2010; Heinzel et al., 2014). In a sense, older adults must devote more "brain power" to working memory compared with younger adults on average; so older adults run out of resources sooner, resulting in poorer performance. However, research shows that older adults can be trained to increase their working memory, which is reflected in more efficient brain processing (Heinzel et al., 2014). Implicit and Explicit Memory In addition to working memory, we can further divide memory into two other types: implicit memory, the unconscious remembering of information learned at some earlier time, and explicit memory, the deliberate and conscious remembering of information that is learned and remembered at a specific time. Explicit memory is further divided into episodic memory, the general class of memory having to do with the conscious recollection of information from a specific time or event, and semantic memory, the general class of memory concerning the remembering of meanings of words or concepts not tied to a specific time or event. Implicit memory is much like getting into a routine—we do things from memory, but we do not have to think about them. For example, the way we brush our teeth tends not to be something we consciously think about at the time. We just remember how to do it. Whether age differences in implicit memory are observed depends on the specific kind of implicit memory task in question (Howard & Howard, 2012). For example, learning sequences tends to show age differences, whereas learning spatial context does not. Amanda Edwards/Getty Images Entertainment/Getty Images Older adults perform as well as younger adults at semantic memory tasks, such as the TV show Jeopardy shown here, that involve remembering facts or words. More research has focused on explicit memory, and it is here where consistent age-related differences are observed, although even here there are exceptions (Light, 2012). When we probe a bit deeper, we find that on tests of episodic memory recall, older adults omit more information, include more intrusions, and repeat more previously recalled items. These age differences have been well documented, are large, and are not reliably lowered by a slower presentation or by cues or reminders given during recall. On recognition tests, age differences are smaller but still present. Older adults also tend to be less efficient at spontaneously using memory strategies to help themselves remember (Hertzog & Dunlosky, 2004), but they can learn to use such strategies effectively (Berry, Hastings, West, Lee, & Cavanaugh, 2010). In contrast, age differences on semantic memory tasks are typically absent in normative aging but are found in persons with dementia, making this difference one way to diagnose probable cases of abnormal cognitive aging (Grady, 2012). A final area of memory research concerns autobiographical memory, memory for events that occur during one's life. Autobiographical memories tend to be organized according to the periods in one's life when they occurred such that remembering some events from a particular time period can trigger others (Mace & Clevinger, 2013). When simply asked to remember whatever events they choose, older adults tend to report fewer details than do younger adults (Addis, Wong, & Schacter, 2008) and tend to remember more positive than negative events and even put a more positive spin on events once remembered more negatively (Boals, Hayslip, & Banks, 2014). Interestingly, neuroimaging research indicates that similar brain processes underlie autobiographical, episodic, and semantic memory, all of which have to do with retrieving "facts" (Burianova, McIntosh, & Grady, 2010). Neuroimaging studies indicate that when older adults take in and encode information, their prefrontal cortex shows overactivity, indicating that they are attempting to compensate for age-related brain changes (Kalpouzos, Persson, & Nyberg, 2012; Meunier, Stamatakis, & Tyler, 2014). When older adults retrieve information, neuroimaging studies show age-related differences in how the prefrontal cortex and hippocampus work together (Giovanello & Schacter, 2012). This research also indicates age-related compensatory brain activity in older adults for retrieval, similar to that seen in other cognitive processing (Oedekoven et al., 2013). Specifically, younger adults have more extensive neural network connections in the parietal and frontal regions involved in retrieval than do older adults. However, older adults show higher levels of brain activity more generally in these regions, indicating a likely compensatory strategy for less extensive networks. Overall, these data support the view that older adults process information in their brains differently than younger adults. These differences in part represent attempts at working around, or compensating for, the normal age-related changes that occur in information processing. When Is Memory Change Abnormal? The older man in the For Better or For Worse cartoon voices a concern that many older adults have: that their forgetfulness is indicative of something much worse. Because people are concerned that memory failures may reflect disease, identifying true cases of memory-impairing disease is extremely important. Differentiating normal and abnormal memory changes is usually accomplished through a wide array of tests that are grounded in the research findings that document the various developmental patterns discussed previously (American Psychiatric Association, 2013). Such testing focuses on measuring performance and identifying declines in aspects of memory that typically do not change, such as tertiary memory (which is essentially long-term memory) (Stoner, O'Riley, & Edelstein, 2010). © Lynn Johnston Productions, Inc. /Distributed by United Feature Syndicate When Is Memory Change Abnormal? Even if a decline is identified in an aspect of memory that is cause for concern, it does not automatically follow that there is a serious problem. A first step is to find out whether the memory problem is interfering with everyday functioning. When the memory problem does interfere with functioning, such as not remembering your spouse's name or how to get home, it is appropriate to suspect a serious, abnormal underlying reason. Once a serious problem is suspected, the next step is to obtain a thorough examination (Stoner et al., 2010). This should include a complete physical and neurological examination and a complete battery of neuropsychological tests. These may help identify the nature and extent of the underlying problem and provide information about what steps, if any, can be taken to alleviate the difficulties. Neuroimaging can help sort out the specific type of problem or disease the individual may be experiencing. The most important point to keep in mind is that there is no magic number of times a person must forget something before it becomes a matter for concern. Indeed, many memory-impairing diseases progress slowly, and poor memory performance may only be noticed gradually over an extended period of time. The best course is to have the person examined; only with complete and thorough testing can these concerns be checked appropriately. Remediating Memory Problems Remember Rocio, the person in the vignette who had to remember when to take several different medications? In the face of normal age-related declines, how can her problem be solved? Support programs can be designed to help people to remember. Sometimes people such as Rocio who are experiencing normal age-related memory changes need extra help because of the high memory demands they face. At other times, people need help because the memory changes they are experiencing are greater than normal. Camp and colleagues (1993; Camp, 2005; Malone & Camp, 2007) developed the E-I-E-I-O framework to handle both situations. The E-I-E-I-O framework combines two types of memory: explicit and implicit. The framework also includes two types of memory aids. External aids are memory aids that rely on environmental resources, such as notebooks and calendars. Internal aids are memory aids that rely on mental processes, such as imagery. The "aha" experience that comes with suddenly remembering something (as in, "Oh, now I remember!") is the O that follows these Es and Is. As you can see in Figure 14.10, the E-I-E-I-O framework allows different types of memory to be combined with different types of memory aids to provide a broad range of intervention options to help people remember. Figure 14.10. Data from Simonton (1997). The E-I-E-I-O model of memory helps categorize different types of memory aids. You are probably most familiar with the explicit-external and explicit-internal types of memory aids. Explicit-internal aids such as rehearsal help people remember phone numbers. Explicit-external aids are used when information needs to be better organized and remembered, such as using a smartphone to remember appointments. Implicit-internal aids represent nearly effortless learning, such as the association between the color of the particular wing of the apartment building one lives in and the fact that one's residence is there. Implicit-external aids such as icons representing time of day and the number of pills to take help older adults remember their medication (Murray et al. 2004). © Lisa F. Young / Shutterstock.com External memory aids such as pill organizers help people remember when certain medications need to be taken. In general, explicit-external interventions are most frequently used to remediate the kinds of memory problems that older adults face, probably because such methods are easy to use and widely available (Berry et al., 2010). For example, virtually everyone owns a smartphone or an address book in which they store addresses and phone numbers. Explicit-external interventions have other important applications, too. Ensuring that older adults take the proper medication at the proper time is a problem best solved by an explicit-external intervention: a pillbox that is divided into compartments corresponding to days of the week and different times of the day, which research shows to be the easiest to load and results in the fewest medication errors (Ownby, Hertzog, & Czaja, 2012). Nursing homes also use explicit-external interventions, such as bulletin boards with the date and weather conditions and activities charts, to help residents keep in touch with current events.

what environments encourage college student success

-colleges that consider student success everyone's responsibility (students, faculty, and staff) are more likely to create a supportive culture that fosters student's developmental progress -having positive psychological well-being, especially for ethnic minority students

features of returning adult students

-problem-solvers -self-directed -pragmatic -increased stress due to work-family-school conflict -relevant life experiences they can integrate with course work

Spirituality in Later Life

When faced with the daily problems of living, how do many older adults cope? According to research, older adults in many countries and from many different backgrounds use their religious faith and spirituality as the basis for coping, often more than they use family or friends (Ai et al., 2013; Ai, Wink, & Ardelt, 2010; Ardelt et al., 2013). For some older adults, especially African Americans, a strong attachment to God is what they believe helps them deal with the challenges of life (Cicirelli, 2004; Dilworth-Anderson, Boswell, & Cohen, 2007; Harvey, Johnson, & Heath, 2013). There is considerable evidence linking spirituality, religious-based coping, and health (Harvey et al., 2013; Krause, 2012; Park, 2007). In general, older adults who are more involved with and committed to their faith have better physical and mental health than older adults who are not religious (Ai et al., 2010; Krause, 2012). For example, older Mexican Americans who pray to the saints and the Virgin Mary on a regular basis tend to have greater optimism and better health (Krause & Bastida, 2011). Spirituality also helps improve psychological well-being (George, Palmore, & Cohen, 2014; Krause & Hayward, 2014) and helps patients following cardiac surgery (Ai et al., 2010). Upchurch and Mueller (2005) found that older African Americans were more likely to be able to perform key activities of daily living if they had higher levels of spirituality, and Troutman, Nies, and Mavellia (2011) found that older African Americans report that spirituality is an important part of their concept of successful aging. When asked to describe ways of dealing with problems in life that affect physical and mental health, many people list coping strategies associated with spirituality (Ai et al., 2010; Ardelt et al., 2013; Harvey et al., 2013; Krause, 2012; Krause & Hayward, 2014). Of these, the most frequently used were placing trust in God, praying, and getting strength and help from God. These strategies can also be used to augment other ways of coping. Caregivers for people with Alzheimer's disease and cancer, for example, also report using religion and spiritual practices as primary coping mechanisms (Robinson, 2013; Williams, 2014). © Kim-Jae-Hwan / AFP / Getty Images The spirituality of these Buddhist monks can serve as an important coping strategy. Researchers have increasingly focused on spiritual support —which includes seeking pastoral care, participating in organized and nonorganized religious activities, and expressing faith in a God who cares for people—as a key factor in understanding how older adults cope. Even when under high levels of stress, such as during critical illness or other major life trauma, people who rely on spiritual support report greater personal well-being (Ai et al., 2010; Krause & Hayward, 2014). Krause (2006) reports that feelings of self-worth are lowest in older adults who have very little religious commitment. When people rely on spirituality to cope, how do they do it? Krause et al. (2000) were among the first to ask older adults what they meant when they said that they were "turning it all over to God" and "letting God have it." The older adults in this study reported that turning problems over to God was a three-step process: (1) differentiating between things that can and cannot be changed, (2) focusing one's efforts on the parts of the problem that can be changed, and (3) emotionally disconnecting from those aspects of the problem that cannot be changed by focusing on the belief that God will provide the best outcome possible for those. These findings show that reliance on spiritual beliefs helps people focus their attention on parts of the problem that may be under their control. Think About It What psychological and sociocultural factors make religion and spiritual support important for minority groups? Neuroscience research has shown a connection between certain mindfulness practices and brain activity (Tang & Posner, 2013). For example, there is evidence that people who have practiced meditation show positive structural changes in areas of the brain related to attention and memory (Esch, 2014; Luders, 2014; Newberg et al., 2014). Thus, neurological evidence indicates that there may be changes in brain activity and in brain structure associated with spiritual practices that help people cope. An example of the changes that occur in brain activity between a normal resting state and a meditative state is shown in Figure 15.5. Notice the significant increase in activity during meditation. Figure 15.5. Wiley Online Library Annals of the New York Academy of Sciences, 1307, 112-123. doi: 10.1111/nyas.12187. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/nyas.12187/full#nyas12187-fig-0004. SPECT scans of a subject at rest and during peak meditation showing increased cerebral blood flow (arrows) during meditation. This kind of positive structural change has led some researchers (Luders, 2014; Newberg et al., 2014) to argue that meditation might offer promise as a way to help slow down, and perhaps even prevent, the brain changes that underlie brain diseases such as dementia. While it is still too early to tell for certain, the possibility that a practice done for centuries among all of the major world religions in one form or another, mindful meditation or contemplation, could prevent or reverse negative changes in the brain will undoubtedly be the focus of a great deal of research.

Widowhood

Alma, the woman in our vignette, still feels the loss of her husband, Chuck. "There are many times when I feel him around. When you're together for so long, you take it for granted that your husband will always be there. And there are times when I just don't want to go on without him. But I suppose I'll get through it." Traditional marriage vows proclaim that the union will last " 'til death do us part." Like Alma and Chuck, most older married couples will see their marriages end because one partner dies. For most people, the death of a partner is one of the most traumatic events they will ever experience, causing an increased risk of death among older European Americans (but not African Americans), an effect that lasts several years (Moorman & Greenfield, 2010). For example, an extensive study of widowed adults in Scotland showed that the increased likelihood of dying lasted for at least ten years (Boyle, Feng, & Raab, 2011). Despite the stress of losing one's partner, though, most widowed older adults manage to cope reasonably well (Moorman & Greenfield, 2010). Women are more likely to be widowed than are men. More than half of all women over age 65 are widows, but only 15% of men the same age are widowers. The reasons for this discrepancy are related to biological and social forces. As we saw in Chapter 14, women have longer life expectancies. Also, women typically marry men older than they are, as discussed in Chapter 11. Consequently, the average married woman can expect to live at least ten years as a widow. The impact of widowhood goes well beyond the ending of a long-term partnership; it is a known risk factor for mortality, among other things (Sullivan & Fenelon, 2014). Loneliness is a major problem. Widowed people may be left alone by family and friends who do not know how to deal with a bereaved person (see Chapter 16). As a result, widows and widowers may lose not only a partner but also those friends and family who feel uncomfortable including a single person rather than a couple in social functions (Guiaux, 2010). Feelings of loss do not dissipate quickly, as the case of Alma clearly shows. As we will see in Chapter 16, feeling sad on important dates is a common experience, even many years after a loved one has died. Men and women react differently to widowhood. In general, those who were most dependent on their partners during the marriage report the highest increase in self-esteem in widowhood because they had to learn the tasks formerly done by their partners (Carr, 2004). Widowers may recover more slowly unless they have strong social support systems (Bennett, 2010). Some people believe that the loss of a wife presents a more serious problem for a man than the loss of a husband for a woman. Older men are often ill-equipped to handle such routine and necessary tasks as cooking, shopping, and keeping house, and they may become emotionally isolated from family members. © Colin Young-Wolff / Photo Edit Widowers are less likely than widows to form new friendships, continuing a trend throughout adulthood that men have fewer close friendships than women have. © John Birdsall / The Image Works Older adults over age 85 are more likely to be frail and to need help with basic daily tasks. Although both widows and widowers suffer financial loss, widows often suffer more because survivor's benefits are usually only half of their husband's pensions. As a result, most widows suffer a drop in standard of living (Weaver, 2010). For many women, widowhood results in difficult financial circumstances, particularly regarding medical expenses (Kelley et al., 2013; Sullivan & Fenelon, 2014). An important factor to keep in mind about gender differences in widowhood is that men are usually older than women when they are widowed. To some extent, the difficulties reported by widowers may be partly due to this age difference. Regardless of age, men are perceived to have a clear advantage over women regarding opportunities to form new heterosexual relationships because there are fewer social restrictions on relationships between older men and younger women (Moorman & Greenfield, 2010). Actually, older widowers are less likely to form new, close friendships than are widows. Perhaps this is a continuation of men's lifelong tendency to have few close friendships (see earlier in this section and Chapter 11). For many reasons, including the need for companionship and financial security, some widowed people cohabit or remarry. A newer variation on re-partnering is "living alone together," an arrangement in which two older adults form a romantic relationship but maintain separate living arrangements (Moorman & Greenfield, 2010). Re-partnering in widowhood can be difficult due to family objections (e.g., resistance from children), objective limitations (decreased mobility, poorer health, poorer finances), absence of incentives common to younger ages (desire for children), and social pressures to protect one's estate (Moorman & Greenfield, 2010)

the hospice option

As we have seen, most people would like to die at home among family and friends. An important barrier to this choice is the availability of support systems when the person has a terminal disease. Most people believe that they have no choice but to go to a hospital or nursing home. However, another alternative exists. Hospice is an approach to assisting dying people that emphasizes pain management, or palliative care, and death with dignity (Knee, 2010; Winslow & Meldrum, 2013). The emphasis in hospice is on the dying person's quality of life. This approach grows out of an important distinction between the prolongation of life and the prolongation of death, a distinction that is important to Jean, the woman we met in the vignette. In hospice, the concern is to make the person as peaceful and comfortable as possible, not to delay an inevitable death. Although medical care is available through hospice, it is aimed primarily at controlling pain and restoring normal functioning. The approach to care in hospice is called palliative care , which is focused on providing relief from pain and other symptoms of disease at any point during the disease process (Reville, 2011). Modern hospices are modeled after St. Christopher's Hospice in England, founded in 1967 by Dr. Cicely Saunders. Hospice services are requested only after the person or physician believes that no treatment or cure is possible, making the hospice program markedly different from hospital or home care. The differences are evident in the principles that underlie hospice care: Clients and their families are viewed as a unit, clients should be kept free of pain, emotional and social impoverishment must be minimal, clients must be encouraged to maintain competencies, conflict resolution and fulfillment of realistic desires must be assisted, clients must be free to begin or end relationships, an interdisciplinary team approach is used, and staff members must seek to alleviate pain and fear (Knee, 2010). Two types of hospices exist: inpatient and outpatient. Inpatient hospices provide all care for clients; outpatient hospices provide services to clients who remain in their own homes. The outpatient variation, in which a hospice nurse visits clients in their home, is becoming increasingly popular, largely because more clients can be served at a lower cost. Having hospice services available to people at home is a viable option for many more people, especially in helping home-based caregivers cope with loss, but should be provided by specially trained professionals (Newman, Thompson, & Chandler, 2013). Hospices do not follow a hospital model of care. The role of the staff in hospice is not so much to treat the client as it is to be with the client. A client's dignity is always maintained; often more attention is paid to appearance and personal grooming than to medical tests. Hospice staff members also provide a great deal of support to the client's family. Hospice and hospital patients differ in important ways (Knee, 2010). Hospice clients are more mobile, less anxious, and less depressed; spouses visit hospice clients more often and participate more in their care; and hospice staff members are perceived as being more accessible. Research consistently shows that significant improvements in clients' quality of life occur after hospice placement or at the beginning of palliative care (Rocque & Cleary, 2013). Although hospice is a valuable alternative for many people, it may not be appropriate for everyone. Those who trust their physician regarding medical care options are more likely to select hospice than those who do not trust their physician, especially among African Americans (Ludke & Smucker, 2007). Most people who select hospice are suffering from cancer, AIDS, cardiovascular disease, pulmonary disease, or a progressive neurological condition such as dementia; two-thirds are over age 65; and most are in the last six months of life (Hospice Foundation of America, 2013a). Ed Kashi/VII/Corbis Hospice outpatient health care workers provide help for people with terminal diseases who choose to die at home. Needs expressed by staff, family, and clients differ (Hiatt et al., 2007). Staff and family members tend to emphasize pain management, whereas many clients want staff and family members to pay more attention to personal issues, such as spirituality and the process of dying. This difference means that the staff and family members may need to ask clients more often what they need instead of making assumptions about what they need. How do people decide to explore the hospice option? Families need to consider the following (Hospice Foundation of America, 2013b; Karp & Wood, 2012; Knee, 2010): Is the person completely informed about the nature and prognosis of his or her condition? Full knowledge and the ability to communicate with health care personnel are essential to understanding what hospice has to offer. What options are available at this point in the progress of the person's disease? Knowing about all available treatment options is critical. Exploring treatment options also requires health care professionals to be aware of the latest approaches and be willing to disclose them. What are the person's expectations, fears, and hopes? Some older adults, such as Jean, remember or have heard stories about people who suffered greatly at the end of their lives. This can produce anxiety about one's own death. Similarly, fears of becoming dependent play an important role in a person's decision making. Discovering and discussing these anxieties helps clarify options. How well do people in the person's social network communicate with each other? Talking about death is taboo in many families. In others, intergenerational communication is difficult or impossible. Even in families with good communication, the pending death of a beloved relative is difficult. As a result, the dying person may have difficulty expressing his or her wishes. The decision to explore the hospice option is best made when it is discussed openly. Are family members available to participate actively in terminal care? Hospice relies on family members to provide much of the care, which is supplemented by professionals and volunteers. We saw in Chapter 11 that being a primary caregiver can be highly stressful. Having a family member who is willing to accept this responsibility is essential for the hospice option to work. Is a high-quality hospice care program available? Hospice programs are not uniformly good. As with any health care provider, patients and family members must investigate the quality of local hospice programs before making a choice. The Hospice Foundation of America provides excellent material for evaluating hospice services. Is hospice covered by insurance? Hospice services are reimbursable under Medicare in most cases, but any additional expenses may or may not be covered under other forms of insurance. Think About It How might the availability of hospice relate to physician-assisted suicide? Hospice provides an important end-of-life option for many terminally ill people and their families. Moreover, the supportive follow-up services they provide are often used by surviving family and friends. Most important, the success of the hospice option has had significant influences on traditional health care. For example, the American Academy of Pain Medicine (2009) published an official position paper advocating the use of medical and behavioral interventions to provide pain management. Despite the importance of the hospice option for end-of-life decisions, terminally ill persons face the barriers of family reluctance to deal with the reality of terminal illness and to participate in the decision-making process and health care providers hindering access to hospice care (Karp & Wood, 2012; Knee, 2010; Melhado & Byers, 2011; Reville, 2011). As the end of life approaches, the most important thing to keep in mind is that the dying person has the right to state-of-the-art approaches to treatment and pain management. Irrespective of the choice of traditional health care or hospice, the wishes of the dying person should be honored, and family members must participate

what is the leading cause of death among young adults in the United States?

Between the ages of 25 and 44, it's accidents. -Young adult men aged 25 to 34 are nearly 2.5 times as likely to die as women of the same age -African American and Latino young adult males are 2 to 2.5 times as likely to die as their European American male counterparts, but Asian and Pacific Islander young adult males are likely to die at only half the rate of their European American male counterparts

12.1. Occupational Selection and Development

Choosing one's work is serious business. Like Monique, we try to select a field in which we are trained and that is appealing. Work influences much of what we do in life. You may be taking this course as part of your preparation for a career in human development, social services, psychology, nursing, allied health, or another field. Work is a source for friends and often for spouses/partners. People arrange their personal activities around their work schedules. Parents often choose child care centers in close proximity to where they work. And they often choose where they live based on where they work.

primary mental abilities

groups of related intellectual skills (such as memory or spatial ability)

Changing Priorities in Midlife

Joyce, a 52-year-old preschool teacher, thought carefully about what she believes is important in life. "I definitely feel differently about what I want to accomplish. When I was younger, I wanted to advance and be a great teacher. Now, although I still want to be good, I'm more concerned with providing help to the new teachers around here. I've got a lot of on-the-job experience that I can pass along." Joyce is not alone. Despite the evidence that personality traits remain stable during adulthood, many middle-aged people report that their personal priorities change during middle age. In general, they report that they are increasingly concerned with helping younger people achieve rather than with getting ahead themselves. In his psychosocial theory, Erikson argued that this shift in priorities reflects generativity, or being productive by helping others to ensure the continuation of society by guiding the next generation. Achieving generativity can be enriching. It is grounded in the successful resolution of the previous six phases of Erikson's theory (see Chapter 1). There are numerous avenues for generativity (Kotre, 2005), such as parenting, mentoring, and creating one's legacy by doing something of lasting importance. Sources of generativity do not vary across ethnic groups (Bates, 2009). Some adults do not achieve generativity. Instead, they become bored, self-indulgent, and unable to contribute to the continuation of society. Erikson referred to this state as stagnation, in which people are unable to deal with the needs of their children or to provide mentoring to younger adults. What Are Generative People Like? Research shows that generativity is different from traits; for example, generativity is more related to societal engagement than are traits (Wilt, Cox, & McAdams, 2010). One of the best approaches to generativity is McAdams's model (McAdams, 2013; Jones & McAdams, 2013), shown in Figure 13.7. Figure 13.7. © Cengage Learning® McAdams's model of generativity. Note that how one shows generativity (action) is influenced by several factors. This multidimensional model shows how generativity results from the complex interconnections among societal and inner forces. The tension between creating a product or an outcome that outlives oneself and selflessly bestowing one's efforts as a gift to the next generation (reflecting a concern for what is good for society) results in a concern for the next generation and a belief in the goodness of the human enterprise. The positive resolution of this conflict finds middle-aged adults developing a generative commitment, which produces generative actions. A person derives personal meaning from being generative by constructing a life story or narrative, which helps create the person's identity. The components of McAdams's model relate differently to personality traits. For example, generative concern is a general personality tendency of interest in caring for younger individuals, and generative action is the actual behaviors that promote the well-being of the next generation. Generative concern relates to life satisfaction and overall happiness, whereas generative action does not. For example, new grandparents may derive much satisfaction from their grandchildren and are greatly concerned with their well-being, but have little desire to engage in the daily hassles of caring for them on a regular basis. Although they can be expressed by adults of all ages, certain types of generativity are more common at some ages than others. For example, middle-aged and older adults show a greater preoccupation with generativity themes than do younger adults in their accounts of personally meaningful life experiences (McAdams & Olson, 2010). Middle-aged adults make more generative commitments (e.g., "save enough money for my daughter to go to medical school"), reflecting a major difference in the inner and outer worlds of middle-aged and older adults as opposed to younger adults. Similar research focusing specifically on middle-aged women yields comparable results. Hills (2013) argues that leaving a legacy, a major example of generativity in practice, is a core concern in midlife, more so than at any other age. Schoklitsch & Bauman (2012) point out that the capacity of generativity peaks during midlife but that people continue to accomplish generative tasks into late life (e.g., great-grandparenthood). How well do these ideas generalize across ethnic groups and cultures? A study of second-generation Chinese American women found similar trends in generativity with European American women (Grant, 2007). In one of the few studies to examine generativity across cultures, Hofer et al. (2008) examined it in Cameroon, Costa Rica, and Germany. They found that McAdams's model could be successfully applied across the three cultures. These data demonstrate that the personal concerns of middle-aged adults are fundamentally different from those of younger adults. In fact, generativity may be a stronger predictor of emotional and physical well-being in midlife and old age (Gruenewald, Liao, & Seeman, 2012; McAdams & Olson, 2010; Wilt et al., 2010). For example, among women and men, generativity is associated with positive emotion and satisfaction with life and work, and it predicts physical health. Considered together, these findings provide considerable support for Erikson's contention that the central concerns for adults change with age. However, the data also indicate that generativity is more complex than Erikson originally proposed and, while peaking in middle age, may not diminish in late life. Life Transition in Midlife We have seen that theorists such as Erikson believe that adults face several important challenges and that by struggling with these issues, people develop new aspectsof themselves. Erikson's notion that people experience fundamental changes in their priorities and personal concerns was grounded in the possibility that middle adulthood includes other important changes. Carl Jung, one of the founders of psychoanalytic theory, believed that adults may experience a midlife crisis. This belief led to the development of several theories suggesting that adulthood consists of alternating periods of stability and transition that people experience in a fixed sequence. Despite its appeal, though, there is no such thing as a universal midlife crisis. Instead, Labouvie-Vief and colleagues (e.g., Labouvie-Vief, Grühn, & Mouras, 2009; Grühn et al., 2013) offer some good evidence for a reorganization of self and values across the adult life span. They suggest that the major dynamic driving such changes may not be age-dependent but may follow general cognitive changes. As discussed in Chapter 8, individuals around middle adulthood show the most complex understanding of self, emotions, and motivations. Cognitive complexity also is shown to be the strongest predictor of higher levels of complexity in general. From this approach, a midlife "crisis" may be the result of general gains in cognitive complexity from early to middle adulthood. This increase in cognitive complexity may help people make what could be called midlife corrections. Abigail Stewart (Newton & Stewart, 2012; Torges, Stewart, & Duncan, 2008) found that well-educated women who reported regrets for adopting a traditional feminine role in life (i.e., they wished they had pursued an education or a career) and subsequently made adjustments in midlife were better off than those who did not make adjustments or had no role regrets at all. Stewart suggests that rather than a midlife crisis, such an adjustment may be more appropriately considered a midlife correction, reevaluating one's roles and dreams and making the necessary corrections. Perhaps the best way to view midlife is as a time of both gains and losses (Lachman, 2004). That is, the changes people perceive in midlife can be viewed as representing both gains and losses. Competence, ability to handle stress, sense of personal control, purpose in life, and social responsibility are all at their peak, whereas physical abilities, women's ability to bear children, and physical appearance are examples of changes that many view as negative. This gain-loss view emphasizes two things. First, the exact timing of change is not fixed but occurs over an extended period of time. Second, change can be both positive and negative at the same time. Thus, rather than seeing midlife as a time of crisis, one may want to view it as a period during which several aspects of one's life acquire new meanings.

Results of Seattle Longitudinal Study

First, intellectual development during adulthood is marked by a gradual leveling off of gains between young adulthood and middle age followed by a period of relative stability and then a time of gradual decline in most abilities. Second, these trends vary from one cohort to another. Third, individual patterns of change vary considerably from person to person.

what recomendations are made to lower cholesterol level

replacing foods high in saturated fat (ice cream) with foods low in fat (fat-free yogurt)

Anxiety Disorders

Imagine you are about to give a speech to an audience of several hundred people. During the last few minutes before you begin, you start to feel nervous, your heart begins to pound, your mouth gets dry, and your palms get sweaty. These feelings, common even to veteran speakers, are similar to those experienced more frequently and intensely by people with anxiety disorders. Anxiety disorders involve excessive, irrational dread in everyday situations and include problems such as feelings of severe anxiety for no apparent reason, phobias with regard to specific things or places, and obsessions or compulsions in which thoughts or actions are performed repeatedly (National Institute of Mental Health, 2014). Although anxiety disorders occur in adults of all ages, they are particularly common in older adults owing to loss of health, relocation stress, isolation, fear of losing independence, and many other reasons. Anxiety disorders are diagnosed in about 17% of older men and 21% of older women (Fitzwater, 2008). The reasons for this gender difference are unknown. Common to all the anxiety disorders are physical changes that interfere with social functioning, personal relationships, or work. These physical changes include dry mouth, sweating, dizziness, upset stomach, diarrhea, insomnia, hyperventilation, chest pain, choking, frequent urination, headaches, and a sensation of a lump in the throat (Segal et al., 2011). These symptoms occur in adults of all ages, but they are particularly common in older adults because of loss of health, relocation stress, isolation, fear of losing control over their lives, or guilt resulting from feelings of hostility toward family and friends. An important issue concerning anxiety disorders in older adults is that anxiety may be an appropriate response to the situation. For example, helplessness anxiety is generated by a potential or actual loss of control or mastery (Varkal et al., 2013). For example, a study in Turkey showed that older adults are anxious about their memory, reflecting at least in part a realistic assessment of normative, age-related decline. In addition, a series of severe negative life experiences may result in a person's reaching the breaking point and appearing highly anxious. Many older adults who show symptoms of anxiety disorder have underlying health problems that may be responsible for the symptoms. In all cases, the anxious behavior should be investigated first as an appropriate response that may not warrant medical intervention. The important point is to evaluate the older adult's behavior in context. These issues make it difficult to diagnose anxiety disorders, especially in older adults (Fitzwater, 2008; Segal et al., 2011). The problem is that there usually is nothing specific that a person can point to as the specific trigger or cause. In addition, anxiety in older adults often accompanies an underlying physical disorder or illness. Anxiety disorders can be treated with medication and psychotherapy (Segal et al., 2011). The most commonly used medications are benzodiazepine (e.g., Valium and Librium), SSRIs (Paxil, among others), buspirone, and beta-blockers. Although moderately effective, these drugs must be monitored carefully in older adults because the amount needed to treat the disorder is very low and the potential for harmful side effects is great. For older adults, the clear treatment of choice is psychotherapy, especially relaxation therapy (Beck & Averill, 2004). Relaxation therapy is highly effective, is easily learned, and presents a technique that is useful in many situations (e.g., falling asleep at night).

Biological Theories of Aging

Much research on aging has focused on answering the question of why peop0le and other living organisms grow old and die. With regard to human aging, three groups of theories have provided the most insights. Rate-of-Living Theories One theory of aging that seems to make sense postulates that organisms have only so much energy to expend in a lifetime. (Couch potatoes might like this theory and may use it to explain why they are not physically active.) The basic idea is that the rate of a creature's metabolism is related to how long it lives (Barzilai et al., 2012). Several changes in the way hormones are produced and used in the human body have been associated with aging, but none have provided a definitive explanation. Although some research indicates that significantly reducing the number of calories that animals and people eat may increase longevity, research focusing on nonhuman primates shows that longer lives do not always result from restricting calories. Furthermore, the quality of life that would result for people on such a diet raises questions about how good a strategy calorie restriction is (Barzilai et al., 2012). Cellular Theories A second family of ideas points to causes of aging at the cellular level. One notion focuses on the number of times cells can divide, which presumably limits the life span of a complex organism. Cells grown in laboratory culture dishes undergo only a fixed number of divisions before dying, with the number of possible divisions dropping depending on the age of the donor organism; this phenomenon is called the Hayflick limit, after its discoverer Leonard Hayflick (Hayflick, 1996). For example, cells from human fetal tissue are capable of 40 to 60 divisions; cells from a human adult are capable of only about 20. What causes cells to limit their number of divisions? Evidence suggests that the tips of the chromosomes, called telomeres, play a major role in aging by adjusting the cell's response to stress and growth stimulation based on cell divisions and DNA damage (Behl & Ziegler, 2014). Healthy, normal telomeres help regulate the cell division and reproduction process. An enzyme called telomerase is needed in DNA replication to fully reproduce the telomeres when cells divide. But telomerase normally is not present in somatic cells; so with each replication, the telomeres become shorter. Eventually, the chromosomes become unstable and cannot replicate because the telomeres become too short. Some researchers believe that in some cases, cancer cells proliferate so quickly because telomeres are not able to regulate cell growth and reproduction (Lin, Epel, & Blackburn, 2012; Londoño-Vallejo, 2008). Current thinking is that one effective cancer treatment may involve targeting telomerase (Harley, 2008). Other research indicating that the telomeres can be lengthened is promising (Epel, 2012). Chronic stress may accelerate the changes that occur in telomeres and thereby shorten one's life span (O'Donovan et al., 2012). Research also shows that moderate levels of exercise may slow the rate at which telomeres shorten, which may help slow the aging process (Savela et al. 2013). A second cellular theory is based on a process called cross-linking, in which certain proteins in human cells interact randomly and produce molecules that are linked in such a way as to make the body stiffer (Behl & Ziegler, 2014; Cavanaugh, 1999). The proteins in question, which make up roughly one-third of the protein in the body, are called collagen. Collagen in soft body tissue acts much like reinforcing rods in concrete. The more cross-links there are, the stiffer the tissue is. For example, leather tanning involves using chemicals that create many cross-links to make the leather stiff enough for use in shoes and other products. As we age, the number of cross-links increases. This process may explain why muscles, such as the heart, and arteries become stiffer with age. However, few scientific data demonstrate that cross-linking impedes metabolic processes or causes the formation of faulty molecules that would constitute a fundamental cause of aging (Hayflick, 1998). Thus, even though cross-linking occurs, it probably is not an adequate explanation of aging. R. Ian Lloyd / Masterfile Eating a healthy diet can delay the appearance of age-related diseases. A third type of cellular theory proposes that aging is caused by unstable molecules called free radicals, which are highly reactive chemicals produced randomly in normal metabolism (Dutta et al. 2012). When these free radicals interact with nearby molecules, problems may result. For example, free radicals may cause cell damage to the heart by changing the oxygen levels in cells. The most important evidence that free radicals may be involved in aging comes from research with substances that prevent the development of free radicals in the first place. These substances, called antioxidants, prevent oxygen from combining with susceptible molecules to form free radicals. Common antioxidants include vitamins A, C, and E, and coenzyme Q. A growing body of evidence shows that ingesting antioxidants postpones the appearance of age-related diseases such as cancer, cardiovascular disease, and immune system dysfunction (Dutta et al., 2012), but there is no direct evidence yet that eating a diet high in antioxidants increases the life span (Behl & Ziegler, 2014; Berger et al., 2012). Programmed-Cell-Death Theories What if aging were programmed into our genetic code? This possibility seems more likely as the explosion of knowledge about human genetics continues to unlock the secrets of our genetic code. Even when cell death appears random, researchers believe that such losses may be part of a master genetic program that underlies the aging process (Freitas & de Magalhães, 2011; Mackenzie, 2012). Programmed cell death appears to be a function of physiological processes, the innate ability of cells to self-destruct, and the ability of dying cells to trigger key processes in other cells. At present, we do not know how this self-destruct program is activated, nor do we understand how it works. Nevertheless, there is increasing evidence that many diseases associated with aging (such as Alzheimer's disease) have genetic aspects. It is quite possible that the other explanations we have considered in this section and the changes we examine throughout this text are the result of a genetic program. We will consider many diseases throughout the text that have known genetic bases, such as Alzheimer's disease. As genetics research continues, it is likely that we will have some exciting answers to the question, Why do we age?

Occupational Insecurity

Over the past few decades, changing U.S. economic conditions (e.g., the move toward a global economy), changing demographics, and a global recession have forced many people out of their jobs. Heavy manufacturing and support businesses and farming were the hardest-hit sectors during the 1970s and 1980s. But no one is immune anymore. The Great Recession of the late 2000s and early 2010s resulted in many middle- and upper-level employees worldwide losing their jobs. As a result, many people feel insecure about their jobs. Economic downturns create significant levels of stress, especially when they create massive job loss (Sinclair et al., 2010). Like Fred, the autoworker in the vignette, many worried workers have numerous years of dedicated service to a company. Unfortunately, people who worry about their jobs tend to have poorer physical and psychological well-being (Blau, Petrucci, & McClendon, 2013; Waters, Briscoe, & Hall, 2014). For example, anxiety about one's job may result in negative attitudes about one's employer or about work in general, which in turn may result in diminished desire to be successful. Whether there is any actual basis for people's feelings of job insecurity may not matter; sometimes what people think is true about their work situation is more important than what is actually the case. Just the possibility of losing one's job can negatively affect physical and psychological health. For example, Mantler and colleagues (2005) examined coping strategies for comparable samples of laid-off and employed high-tech workers. They found that although unemployed participants reported higher levels of stress compared with employed participants, employment uncertainty mediated the association between employment status and perceived stress. That is, people who believe that their job is in jeopardy—even if it is not—show levels of stress similar to unemployed participants. This result is due to differences in coping strategies. People deal with stress in several different ways; two of the more common are emotion-focused coping and problem-focused coping. Some people focus on how the stressful situation makes them feel, so they cope by making themselves feel better about the situation. Others focus on the problem itself and do something to solve it. People who used emotional avoidance as a strategy reported higher levels of stress, particularly when they were fairly certain of the outcome. Thus, even people whose jobs aren't really in jeopardy can report high levels of stress if they tend to use emotion-focused coping strategies.

Women's Occupational Development

The characteristics and aspirations of women who entered the workforce in the 1950s and those of the baby boomers (born between 1946 and 1964), Generation X (born between 1965 and 1982), and the Millennials (born since 1983) are significantly different (Dannar, 2013; Strauss & Howe, 2007). Women in previous generations had fewer opportunities for employment choice and had to overcome more barriers. In the 21st century, women entrepreneurs are starting small businesses at a faster rate than men and are finding that a home-based business can solve many of the challenges they face in balancing employment and a home life. As the Millennial Generation heads into the workforce, it will be interesting to see whether their high degree of technological sophistication will provide still more occupational and career options. Technologically mediated workplaces may provide solutions to many traditional issues, such as work-family conflict. But when Millennial Generation women choose nontraditional occupations, their attitudes toward those jobs are more similar to than different from previous generations' attitudes (Real, Mitnick, & Maloney, 2010). In the corporate world, unsupportive or insensitive work environments, organizational politics, and lack of occupational development opportunities are most important for women working full-time (Yamini-Benjamin, 2007). Female professionals leave their jobs for two main reasons. First, the organizations in which women work are thought to idealize and reward masculine values of working—individuality, self-sufficiency, and individual contributions—while emphasizing tangible outputs, competitiveness, and rationality. Most women prefer organizations that more highly value relationships, interdependence, and collaboration. Second, women may feel disconnected from the workplace. By midcareer, women may conclude that they must leave these unsupportive organizations to achieve satisfaction, growth, and development at work and to be rewarded for the relational skills they consider essential for success. But as we will see later in this chapter, whether women leave their careers or plateau before reaching their full potential in the organization because of lack of support, discrimination, or personal choice is controversial. Such barriers are a major reason women's workforce participation is discontinuous. Because they cannot find affordable and dependable child care (or because they choose to take on this responsibility), many women stay home while their children are young. Discontinuous participation makes it difficult to maintain an upward trajectory in one's career through promotion and in terms of maintaining skills. Some women make this choice willingly; however, many find themselves forced into it.

The Third-Fourth Age Distinction

The development of the science of gerontology, the study of older adults, in the latter part of the 20th century led to cultural, medical, and economic advances for older adults (e.g., longer average longevity, increased quality of life) that in turn resulted in fundamental positive changes in how older people are viewed in society. Gerontologists and policy makers became optimistic that old age was a time of potential growth rather than of decline. This combination of factors is termed the Third Age (Baltes & Smith, 2003). As we will see in this chapter and in Chapter 15, much research has documented that the young-old (ages 60 to 80) do have much to look forward to. However, recent research shows conclusively that the oldest-old (over age 80) typically have a much different experience, which is referred to as the Fourth Age (Baltes & Smith, 2003; Gilleard & Higgs, 2010; Lamb, 2014). The oldest-old are at the limits of their functional capacity, and few interventions to reverse the effects of aging have been successful to date. We will see that the rates of diseases such as cancer and dementia increase dramatically in the oldest-old and that other aspects of psychological functioning (e.g., memory) also undergo significant and fairly rapid decline. Baltes and Smith (2003) view the differences between the Third Age and the Fourth Age as important for research and social policy. They characterize the Third Age as the "good news" about aging and the Fourth Age as the "bad news." The "Good News": The Third Age (Young-Old) Increased life expectancy, with more older people living longer and aging successfully Substantial potential for physical and mental fitness, with improvement in each generation Evidence of cognitive and emotional reserves in the aging mind High levels of emotional and personal well-being Effective strategies to master the gains and losses of later life The "Bad News": The Fourth Age (Oldest-Old) Sizeable losses in cognitive potential and ability to learn Increases in the negative effects of chronic stress High prevalence of dementia (50% in people over age 90), frailty, and multiple chronic conditions Problems with quality of life and dying with dignity The Third and Fourth Ages approach is grounded in the "selective optimization with compensation" model described in Chapter 1. The description of gains and losses in the Third and Fourth Ages flows naturally from this life-span perspective. As you proceed through this chapter and the next, keep in mind the distinction between the Third and the Fourth Ages. Note the different developmental patterns shown by the young-old and oldest-old. In Chapter 15, we will consider some of the social policy implications of this distinction. In the meantime, think about the issues raised in the What Do You Think? Feature—how long do you want to live?

Ethnicity and Occupational Development

Unfortunately, little research has been conducted from a developmental perspective related to occupational selection and development for people from ethnic minorities. Rather, most researchers have focused on the limited opportunities ethnic minorities have and on the structural barriers, such as discrimination, they face. Most of the developmental research to date focuses on occupational selection issues and variables that foster occupational development. Three topics have received the most focus: nontraditional occupations, vocational identity, and issues pertaining to occupational aspirations. Women do not differ significantly in terms of participation in nontraditional occupations across ethnic groups (Bureau of Labor Statistics, 2013a). However, African American women who choose nontraditional occupations tend to plan for more formal education than necessary to achieve their goal. This may make them overqualified for the jobs they get; for example, a woman with a college degree may be working in a job that does not require that level of education. Whether an organization is responsive to the needs of ethnic minorities makes a big difference for employees. Ethnic minority employees of a diverse organization in the Netherlands reported having more positive feelings about their workplace when they perceived their organizations as responsive and communicative in supportive ways (Dinsbach, Fiej, & de Vries, 2007). Still, more needs to be accomplished for all ethnic groups to have equivalent opportunities.

Housing Options

Where one lives carries meaning well beyond having a roof over one's head and a place to eat and sleep. Having a stable home offers a place where things are familiar and services are nearby; it also is a way to add to one's sense of identity (Pynoos et al., 2010). Living independently, as most older adults do, provides a measure of one's ability to provide self-care, ensures that older adults are rooted in their attachment to their home, and provides a way to fulfill their desire to age in place. Communities must take the rising number of older adults into account when planning housing. As we just saw, the number of older adults with disabilities is rising; so the design and location of housing and support services is now a major issue. Such planning should be conducted within the framework of the competence-environmental press model considered earlier in this chapter and the selective optimization with compensation model discussed in Chapter 1. Specifically, there should be a match between the person's competence and the level of supports provided by the environment. Let's take a closer look at the types of places in which older adults live. Living Arrangements The U.S. Census Bureau defines a household as an individual who lives alone or a group of individuals who live together. More than one in five households in the United States is headed by someone at least 65 years old (ProximityOne, 2014). Including those aged 60 to 64 brings that proportion to one in every three. Before the end of this decade, the number of households headed by people 60 to 69 years old is expected to double as the baby boom generation ages. Most older adults do whatever they can to adapt their homes and activities to accommodate the changes that occur with age (Pynoos et al., 2010; Pynoos et al., 2012). This reflects a deeply held desire of most older adults that they age in place. The idea of aging in place reflects a balancing of environmental press and competence through selection and compensation. Being able to maintain one's independence in the community is often important for people, especially in terms of their self-esteem and ability to continue engaging in meaningful ways with friends, family, and others. Despite the challenges that arise due to physical changes, the death of a spouse or partner, a sudden illness, or another event, aging in place provides a sense of self-determination and independence, even if assistance is needed to achieve these outcomes. These feelings are reflected in the results from a nationally representative sample of adults (Keenan, 2009). About half of adults over age 55 who thought it likely that they would need to move in with family or friends said that they would not like this arrangement. A few older adults are considered homeless in that they are not members of a household (and consequently are unaccounted for in national databases). The mortality rate for homeless older adults is very high; most homeless people do not survive to old age, which accounts in part for the low numbers of homeless older adults. Mental health and substance abuse problems are higher in homeless individuals, and the lack of adequate support services coupled with the increased number of people aged 65 and over is raising concern that there may be a significant increase in the number of homeless older adults (White & Lewinson, 2014). In general, older adults live in their own home or apartment, in an assisted living situation (a formal assisted living facility or a shared single-family home with family or friend), or in long-term care facilities. Which of these arrangements provides the optimal setting for a particular person depends on the person's functional health. Functional health refers to the ability to perform the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) discussed earlier in this section. As a person's functional health diminishes, the level of support needed from the environment increases and the optimal housing situation changes. Let's take a closer look at each of the major types of housing to see how this works. Independent Living Situations. Like most older adults, Annie wanted to live independently. She has lived in the same neighborhood of a large city her whole life, so it's become a part of her. Besides, everything is familiar to her. An important reason Annie feels this way is that where one lives usually takes on special meaning. A sense of place refers to the cognitive and emotional attachments that a person puts on his or her place of residence, by which a "house" is made into a "home." Scheidt and Schwarz (2010) point out that a sense of place comprises an important part of people's identity. As a result, aging in place in one's home carries enormous psychological meaning for older adults. Because aging in place to create a sense of place is so important, there are many approaches to ensuring that this is at least a possibility. A common way of achieving this is through home modification, one approach to changing the environment to maintain the optimal match with the person's competence level. Home modifications can range from minor changes (e.g., replacing knobs on cabinets with pull handles that are more easily grasped) to extensive renovation (e.g., widening doorways and bathrooms to provide access for wheelchairs). Colin Young-Wolff/PhotoEdit One way that older adults can age in place is to renovate their home to accommodate wheelchairs. Little research has been done to evaluate the benefits of home modification. Wahl et al. (2012) concluded that home modification tends to help people address ADL and IADL challenges. These outcomes push for using home modification as a way to help older adults age in place successfully and to think about housing arrangements in general (Granbom et al., 2014). Assisted Living. Bessie lived in the same home for 57 years. Her familiar surroundings enabled her to manage the challenges of failing eyesight and worsening arthritis that made it hard to walk. Finally, her children convinced her that she needed to relocate to an assisted living facility that would provide the necessary support for her to continue to have her own space. Bessie is fairly typical of people who move to assisted living facilities. Assisted living facilities provide a supportive living arrangement for people who need assistance with ADLs or IADLs but who are not so impaired physically or cognitively that they need 24-hour care. Estimates are that nearly two-thirds of residents of assisted living facilities over age 65 have an ADL or IADL limitation (AgingStats.gov, 2012) and that about half have some degree of memory impairment (Pynoos et al., 2010). Assisted living facilities usually provide support for activities of daily living (e.g., assistance with bathing) as well as meals and other services. Health care personnel are available to assist with medications and certain other procedures. Assisted living facilities provide a range of services and care, but they are not designed to provide intensive, around-the-clock medical care. As residents become frailer, their needs may go beyond those the facility can provide. Policies governing discharge for this reason, usually to a long-term care facility, may result in competing interests between providing for the residents increasing medical needs and providing a familiar environment. Nursing Homes. The last place Sadie thought she would end up was in a bed in a nursing home. "That's a place where old people go to die," she would tell her friends. "It's not gonna be for me." But here she is. Sadie fell a few weeks ago and broke her hip. Because she lives alone, she needs to stay in the facility until she recovers. She detests the food; "tasteless," she calls it. Doris, who is 87 and has dementia, lives a few doors down. Sadie and Doris are representative of the people who live in nursing homes—some temporarily, some permanently. If given the choice, the vast majority of older adults do not want to live there; they and their families would prefer that they age in place. Sometimes, though, placement in a nursing home is necessary because of the older person's needs or the family's circumstances. A nursing home is a type of long-term care facility that provides medical care 24 hours a day 7 days a week using a team of health care professionals that includes physicians (who must be on call at all times), nurses, therapists (e.g., physical, occupational), and others. Misconceptions about nursing homes are common. Contrary to what some people believe, only about 5% of older adults live in nursing homes on any given day. As you can see in Figure 15.10, the percentage of older adults enrolled in Medicare who live in a long-term care facility at any given point in time increases from 2% in those aged 65 to74 to about 14% of adults over age 85 (AgingStats.gov, 2012). However, over their lifetime, over 50% of older women and about 30% of older men will spend at least some time in a long-term care facility (Georgia Health Care Association, 2012). The gender difference is due to the fact that older women take care of their husbands at home, but in turn need to relocate to a long-term care facility for their own care because their husbands are, on average, deceased. Figure 15.10. SOURCE: Centers for Medicare and Medicaid Services, Medicare Current Beneficiary Survey. Older Americans: 2012: Key Indicators of Well-Being, "Indicator 36: Residential Services," p. 60. Retrieved from http://agingstats.gov/agingstatsdotnet/Main_Site/Data/2012_Documents/Docs/EntireChartbook.pdf. Percentage of Medicare enrollees aged 65 and over residing in selected residential settings by age group. Who is the typical resident of a nursing home? Currently she is over 85 years old; is European American; and has about a 50-50 chance of having dementia, depression, or both (Harris-Kojetin et al., 2013). The decision to place a family member in a nursing home is a difficult one (Caron, Ducharme, & Griffith, 2006; Krull, 2013). Placement decisions can occur in reaction to a crisis, such as a person's impending discharge from a hospital or another health emergency, or can be the outcome of many months or even years of conversation among family members. The decision tends to be made by partners or adult children, often in consultation with medical and spiritual advisers, a finding that generalizes across ethnic groups—especially when there is evidence of cognitive impairment (Almendarez, 2008; Caron et al., 2006; Krull, 2013). Selecting a nursing home should be done carefully. The Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services provides a detailed Nursing Home Quality Initiative website that is a guide for choosing a nursing home based on several key quality factors. Among the most important things to consider are quality of life for residents (e.g., whether residents are well groomed, the food is tasty, and rooms contain comfortable furniture); quality of care (whether staff members respond quickly to calls, whether staff and family are involved in care decisions); safety (whether there are enough staff members, whether hallways are free of clutter); and other issues (whether outdoor areas are available for residents to use). These aspects of nursing homes reflect the dimensions that states consider in their inspections and licensing process. Emerging Housing Arrangements. In response to the need to provide support for older adults who require assistance with ADLs and IADLs and their desire to age in place, new approaches to housing options have emerged that provide both. These movements include programs that infuse a different culture into nursing homes as well as those approaches that create small-scale living (usually six to ten residents) in a community-based setting with an emphasis on living well rather than on receiving care (Pynoos et al., 2010). The Eden Alternative seeks to eliminate loneliness, helplessness, and boredom from the lives of those living in long-term care facilities and to create a community in which life is worth living. This can be achieved by rethinking how care is provided in the older person's own home or in long-term care facilities through training. The Green House Project creates small neighborhood-integrated homes for six to ten residents in which older adults receive a high level of personal and professional care. The Green House Project takes the principles of the Eden Alternative and creates a different culture of care in the community. The Pioneer Network focuses on changing the culture of aging in America irrespective of where older adults live. Like the Eden Alternative, this approach focuses on respecting older adults and providing maximally supportive environments for them. The Pioneer Network, as part of the larger cultural change in caring for older adults, advocates for a major emphasis on making nursing homes more like a home. Various cohousing and cluster housing options provide additional alternative approaches. Cohousing is a planned community that is modest in size and is built around an open, walkable space designed to foster social interaction among neighbors (Pynoos et al., 2010). Neighbors provide care for each other when it is needed. Personal autonomy is a core value for the people who create cohousing developments (Nusbaum, 2010). Cluster housing combines the aging-in-place philosophy with supportive services (de Jong et al., 2012). A key feature is that services are provided to the residents by staff hired by the owner or by a service provider under contract. The aging-in-place philosophy in these settings emphasizes individual choice on the part of residents in terms of what services to use. This approach is also being adopted in other countries, such as the Netherlands (de Jong et al., 2012). These alternatives to traditional housing options for older adults indicate that the choices for how one spends late life and that appropriate support systems are in place are becoming more varied. Such alternatives will be important as the baby boom generation enters the years in which support services will be needed even more. Researchers need to focus their attention on documenting the types of advantages these alternatives offer and exploring their relative effectiveness

McAdams story

identity change over time is a process of fashioning and refashioning one's life story. This process is strongly influenced by culture. At times, the reformulation may be at a conscious level, such as when people make explicit decisions about changing careers. At other times, the revision process is unconscious and implicit, growing out of everyday activities. The goal is to create a life story that is coherent, credible, open to new possibilities, richly differentiated, able to reconcile opposing aspects of oneself, and integrated within the sociocultural context.

National Institute on Alcohol Abuse and Alcoholism strategies

in order of effectiveness: -one-on-one interventions for at-risk students and programs directly challenging students' expectations regarding alcohol use -working with local officials to make alcohol more difficult to obtain illegally -social norms programs, enforcement of campus alcohol policies, and designated driver programs -alcohol education programs

binge drinking

type of drinking defined for men as consuming five or more drinks in a row and for women as consuming four or more drinks in a row within the past 2 weeks

life-span construct

unified sense of the past, present, and future based on personal experience and input from other people