Psychology of Aging

Erik Erikson's stages of psycho-social development

1. Infancy (birth to age 1) Trust versus mistrust 2. Early childhood (ages 1-3) Autonomy vs Guilt/Shame 3. Childhood (ages 3-6) Initiative versus Guilt 4. School age (ages 6-12) Industry vs inferiority 5. Adolescence (teens) Identity vs role confusion 6. Young Adulthood (20-40) Intimacy vs isolation 7. Middle adulthood (40-65) Generativity vs stagnation 8. Late adulthood (65+) Ego integrity vs despair

Rate of mental disorders among older adults

18% - 28%. Adults aged 65 - 1 in 5 meet the criteria for mental illness, if both emotional dysfunction and cognitive impairment are included. This figure is similar to that reported for individuals aged 18 and over, so the proportion of the population that meets the criteria for mental disorders does not seem to vary greatly with age. But different disorders predominate at different points in the lifespan, with cognitive disorders such as dementia being more prevalent in the older group.

Age-intergrated

A balance between education, work, and leisure is over the entire adult life span.

SOC model for job performance for older workers

A selection strategy would be including efforts to restrict or narrow one's range of work activities, an optimization strategy would require efforts to maximize one's work capabilities, a compensation strategy would entail efforts to create a positive impression by downplaying deficiencies and presenting oneself in a positive light.

Carl Jung (Stage Theorist of Personality)

Acknowledged the importance of biological factors. Theory extends past adolescence. Emphasis on the environment & society. Jung believed that throughout adulthood, we continue to grow toward the realization of our potential by balancing various aspects of our personality in response to both our inner needs and the demands of society. At different points in life, different aspects of one's personality can shift, with some aspects receding into the background and others coming to the forefront. Jung described personality in two dimensions: introversion/extraversion and masculinity/femininity. Young adulthood has higher demand of extroversion because in younger years, people are looking for a mate and trying to secure a vocation. In older adulthood, however, the demands of the social external world diminish, allowing for a more introverted personality. Regarding masculinity/femininity, young adulthood has stronger emphasis on same-sex tendencies. During middle and older adulthood, less pressure to operate in one's sex role and can practice characteristics of the opposite sex. Older men seem to be more tolerant than younger men of their domestic interests and focus on less competitiveness and older women are more domineering and less submissive compared to younger women.

Erik Erikson (Stage theorist of personality)

Acknowledges the contribution of biological factors and inner psychological processes to personality development. Also emphasizes cultural and social forces. Believe society had an expansive influence on development and that social institutions such as school and marriage play a positive role in psychological development. There are 8 stages of Erikson's theory, spanning from infancy into old age. Each stage involves a different crisis or challenge, that represents the central concern for that development period. Each challenge can be resolved positively or negatively~ If the challenge is resolved positively, the self will be strengthened, the social world expands, and the individual has a good chance of resolving the next challenge/stage positively. If the challenge is resolved negatively, the individual's development suffers because it will be more difficult to achieve a positive resolution in the stages that follow.

Mental Health & Aging

All ages are susceptible to mental illness equally. A high proportion of older adults report being happy and satisfied with their lives.

Marital Satisfaction:

Among older adults, feelings of closeness are associated with high self-esteem and reduced depression and anxiety, even when one or both members of the pair face some degree of disability. Upswing hypothesis of marital satisfaction: Phenomenon that characterizes some marriages over time. The level of marital satisfaction is high in the early years of marriage before the arrival of children, followed by a dip in the ensuing years when the focus is on rearing children and establishing careers. Later, material satisfaction shows an increase, or upswing, although perhaps not to quite as high a level as in the early years. Occurs around the time when children are launched. Being married seems to have a more uniformly positive influence on happiness and well-being for men than it does for women. Men as a group are better off when married, but women are better off only when they are happily married.

The Age Discrimination Act

Applies to companies with more than 20 workers. ADEA prohibits discrimination against workers aged 40 and older by making it illegeal to use age in hiring decisions, or terminate, demote, or reduce the salaries of older workers without showing good cause. One exception is that employment decisions can be based on age if it can be demonstrated that older employees are not capable of performing the job in a way that is reasonably necessary for the normal operation of the business.

Stereotypes about older adults

Assumptions are usually made about people based on their age. Age stereotypes can lighten the load of processing a great deal of complex information about older adults. Yet age stereotypes interfere with our ability to make judgements about a specific older adult as a unique individual. When age stereotypes are activated within our minds, we do not always realize it. Stereotypes about older adults are often negative.

Retirement as a Process

Atchley (1994) proposed that retirement takes place in a series of phases.Not every individual goes through every phase, but this framework is a way to consider retirement as a process rather than a single event that occurs only when a paid employee stops working. Pre-retirement Phase: Workers make remote and then more immediate plans for retirement. Once retirement actually occurs, some individuals experience a honeymoon phase, which is a period of euphoria and enthusiasm typified by a high level of activity. This honeymoon phase usually only lasts a year or two, which then turns into the disenchantment phase. Disenchantment : This phase includes feelings of emotional let down, boredom, or even depression. Reorientation Phase: Taking stock and beginning to fashion a realistic structure for their daily lives. Develop new interests, pursue hobbies, visit family and friends, or do volunteer work. Then comes the: Stability phase. Some people will enter a final termination phase, but not all. This is when the retirement role no longer suits their needs. Some miss working and will find work again.

Diagnosis of Depression

Because the symptoms of depression can vary, it can be easily misdiagnosed or confused with other conditions and it may remain unidentified by older adults, their families, and even health care workers. Depression can coexist or be confused with physical illness. Or can be confused from the side effects of medications used to treat illnesses such as cancer and heart disease. "Depletion Syndrome": Older adults who seem to be in a state of vague physical decline may actually be suffering from depression. Characterized by a loss of interest and legthargy rather than an intense depressed mood. Fatigue and sleep problems are assumed to be a normal consequence of aging when such symptoms can actually signify depression. Grief reactions can get mixed up with depression. Depression can also be overdiagnosed in patients. Overdiagnosis is a readiness to diagnose depression when symptoms actually stem from another source. Items on many self-report depression scales ask about somatic complaints, therefore if a diagnosis of depression is based on the number of such items older adults endorse, then depression could be overdiagnosed. Normal aging may be associated with some decline in memory functioning, and older adults often complain about it. With overdiagnosis, older adults' memory complaints are interpreted as a sign of depression when they actually stem from something else. Furthermore, health-care workers who are untrained may assume that older adults who complain about memory are suffering from dementia, in which case depression is underdiagnosed. If cognitive symptoms are automatically considered a sign of dementia when they are actually a sign of depression, then appropriate treatment intervention may not occur. Cognitive symptoms can signify more than one potential problem - so Differential Diagnosis - (that is, determining the exact basis for a particular constellation of symptoms) can be challenging.

Bereavement & Loss

Bereavement: refers to both the situation and the long-term process of adjusting to the death of someone to whom a person feels close. Grief: is the affective, or emotional, response to bereavement Mourning: Refers to culturally patterened ways of behaving and rituals followed when there is a loss. This could include participating in funeral or memorial services, burials, abstaining from everyday routines for specified time, dressing in certain kinds of clothing, and behaving in ways that are culturally acceptable for someone who has lost a loved one. Death of a child is viewed as a catastrophic event, but the death of an older adult is sad but acceptable.

size of older adults social network

Chronological age and individual differences in personality play a role in the size of older adults' social network. (Social networks reported by individuals in a study in berlin reported negatively to chronological age) The older the person, the smaller the social network. Older adults with smaller social networks are emotionally close to those who are in it.

Death & Dying in Older Adulthood

Death = Irreversible cessation of biological functioning. Life-sustaining treatments are available today, such as mechanical ventilation and artificial nutrition and hydration. These can prolong life even when patients are at death's door. Is the use of LST's a moral imperative? Or are LST's in the category of extraordinary care, which is regarded as non-standard/experimental. Dying = the process of physical decline that ends in death. Death is most likely to occur in old-age.

Care of the Dying Patient

Death is much less likely to occur in a home environment and more likely to occur in hospitals or nursing homes. Hospice Care: Euthanasia: Passive Euthanasia: Withholding action that would sustain a patient's life, such as failing to apply cardiopulmonary resuscitation after a heart attack or not using or even withdrawing life-sustaining medical treatment. Active Euthanasia: Involves taking action to induce a patient's death, such as administrating a lethal injection. "Assisted Suicide": the patient is provided with the means to end his or her own life. Slippery-Slope Argument: which has been made to oppose euthanasia on the basis that sanctioning passive euthanasia is the first step in a process that eventually sanctions active euthanasia. The patient must request euthanasia voluntarily, patient must be informed about his or her situation and prospects, must be experiencing lasting and unbearable suffering, and both patient and physician must believe there is no other reasonable solution. Finally, physician must meet with another physician to ensure all the above conditions have been met.

Psychopathology

Depression: Not a normal part of aging but is one of the most common disorders older adults experience. Symptoms of major depressive disorders are more severe and last longer than the less severe and more transient symptoms of milder depressive disorders. Depression has been differentiated into primary and secondary categories, where primary depression occurs in the absence of physical disorders or drug side effects and secondary depression either accompanies or can be traced to bodily illness or adverse reactions to medication. Those over the age of 65 are more likely to have unipolar depressive disorders vs bipolar disorder.

Robert Peck's necessary adjustments in old age

Described 3 adjustments that must occur in older adulthood. Success in each will result in positive growth, leading to what Erikson called ego integrity. Failure will lead to despair. 1.) Ego differentiation vs work-role preoccupation: Retirement from work is approaching or has already occurred, thus older adults must learn to define their worth outside the workplace. They must ask themselves, "Am I a worthwhile person only if I can perform a full time job, or can I be worthwhile in other ways?" A well-adjusted adult will have a varied set of roles and a complex sense of identity and self-worth that does not depend entirely on work. 2.) Body transcendence vs Body preoccupation: Late adulthood brings some physical decline, and aches and pains may prevent older adults from engaging in the same activities they did in their younger years. Cosmetic changes such as wrinkles. To adjust positively, older adults must rise above physical discomfort and avoid placing too much importance on appearance. 3.) Ego transcendence vs Ego Preoccupation: Adapting to the prospect that life is finite and that the focus must be on future generations and not on one's own needs. The older adult who makes this adjustment feels that he or she has achieved something of lasting meaning. This meaning could come from the knowledge that children have been raised, strong personal relationships have been formed, and meaningful contributions have been made to society. "Ego integrity"

Treatment of Depression

Drug therapy, shock therapy, psychological therapies, CBT,

Age-differentiated

Education is for the young, work is for the middle-aged, and leisure is for the older adulthood era.

Stage Theories of Personality

Emphasize changes that occur over the course of adulthood. Personality is something that unfolds over time and takes on different forms as people progress through their adult years. Linked to chronological age range. At each stage of age, certain qualities or traits are thought to predominate.

Effects of Retirement

For individuals who retire due to poor health or job loss through downsizing, retirement is not voluntary and could be associated with negative outcomes in the physical or psychological domains. During a two year longitudinal study, testing levels of self-esteem and depression was conducted every six months. One group retired and another group did not. For both groups, the level of self-esteem remained relatively stable over time, but depression scores actually declined in the group that retired. Some individuals experience anxiety surrounding the anticipation or actual event of retirement, but the loss of the work role does not usually result in an identity crisis. The transition into retirement can be smoother if individuals can still identify with their former occupations. How does retirement affect the marital relationship? Men take greater responsibility in house hold tasks. More leisure activities together but women feel an impingement on their freedom.

Social Interaction in Older Adulthood

Generally recognized that the level of social interaction declines somewhat in older adulthood. Factors such as loss of a partner through widowhood, loss of the work role through retirement, loss of income through both widowhood and retirement, loss of a familiar environment because of relocation, and in some cases loss of health are all associated with reduced opportunties for social interaction.

The older Worker

Generally refers to individuals aged 45 and older.

Self-Concept

Ideas of ourselves about who we are are known as schemas. These play a part in how we define ourselves. Self-Concept is the image we have of ourselves, rather than being one general image, our self-concept consists of a collection of schemas that are related to different domains. Self-Esteem is the affective, or evaluative, aspect of the self-concept. A person with high self-esteem perceives him or herself as having worth. Self-esteem can occur in different domains; "I feel good about my appearance" or "I feel bad that I cannot understand computers." Self-esteem does not significantly decline in late life, but people often compare themselves to others, so self-esteem can be either high or low depending upon the group with which one compares oneself to.

The SOC and Ecological Model in Retirement

In work, older employees optimize their job performance when they compensate for age-related slowing by selecting and concentrating on aspects of their job for which they have expertise. Older workers adapt best if their skills and ability levels match the demands of the work environment. Living arrangements: Need an environment that matches an older adult's physical capabilities and social needs will maximize the likelihood of positive adaptation. Environments should not be so demanding that accidents are likely or that the older adult's ability to be as independent as possible is compromised. A close match between the older adult's competence and the demands of the living environment contributes to older adults' adaption and sense of well-being.

Possible Selves

Include schemas about what we may be like in the future (hoped-for selves) as well as what we are afraid of becoming (feared selves). Hope-for selves: Rich self, attractive self, independent self, or healthy self. Examples of feared selves: poor self, unattractive self, dependent self, or unhealthy self. Adults over age 60: Possible selves have less to do with occupation and career and more to do with establishing leisure pursuits and physical functioning. Invested in health. Possible selves, both hoped for and feared, continue well into old age.

Anxiety Disorders

Includes generalized anxiety disorder, phobias, obsessive-compulsive disorder, PTSD. Can coexist with depression, and symptoms of these two disorders overlap. As in depression, symptoms of anxiety include inability to concentrate, remember, or make decisions. The symptoms of both anxiety and depression can mimic those of cardiovascular disease and endocrine disorders. Furthermore, symptoms of anxiety such as rapid heartbeat and intestinal cramps can be side effects of some medications older adults take for chronic health problems. Some therapists are unaccustomed to working with older adults and might assume that behavioral manifestations of anxiety such as rambling speech and disorganized thinking are signs of dementia when it's really anxiety. Anxiety can occur with dementia, but a reduction in symptoms following relaxation exercises is one indication that an older adult's main problem is anxiety.

Convoy Model

Individuals move through life both affecting and being affected by a constellation of other people who play a central role in their network of social relationships and influence their well-being (family members & select friends)

Aging in Place

Individuals who remain in the same locale and continue to live in the same housing unit. May need to make physical modifications to insure ease and safety of bathing, cooking, climbing stairs, etc. Installing improved lighting, mounting railings, ramps, etc. Must be willing to enlist assistance with tasks such as transportation, shopping, meal prep, etc. For those who live alone or do not have family to help them with living, they can choose to share their home with unrelated individuals. Can be a source of additional income or could be provided in exchange for household repairs and chores. Or they may need to pay for supportive services. Medicare will only help for a limited time following hospitalization or certain medical procedures. Theres also the option of community based day care services for older adults.

Dementia

Individuals with dementia have deficits in memory, language, orientation, abstract thinking and reasoning, decision making, and problem solving. Unlike patients with delirium, patients with dementia maintain a normal level of consciousness until late in the disorder, although there can be changes in personality and emotional responsiveness. No two patients who are diagnosed with dementia are exactly alike.

Information seeking (socioemotional selectivity theory)

Information seeking calls for interactions with new people, or novel partners. In later adulthood, however, there is less need to acquire new information for future use. Social interactions also help us mold how we perceive ourselves - but in later adulthood, there is less motivation to develop identity, so we may prefer spending time with more familiar partners on whom we can rely to affirm who we are.

Personal Control

Internal Locus of Control: great feelings of personal control over what happens. Believe that experiencing positive outcomes and avoiding negative outcomes are contingent upon one's own efforts, actions, and behaviors. External Locus of Control: When one feels that their own efforts, actions and behaviors have little to do with what happens to them. They believe positive and negative outcomes are defined by change or other outside forces. Does the sense of personal control change over the adult lifespan? The belief is that as people move from young to older adulthood, the become less internal and more external in their locus of control. Older adults' feelings of internal control could be influenced by how others view them. Labeling older adults as "helpless" could have a negative effect on their feelings of personal control. If older adults feel they have little control, they may lose their motivation to engage in behaviors that could actually affect what happens to them. Primary Control processes: Actions and behaviors that influence, shape, or change the environment. Individuals use these processes to influence, shape, and change the environment to fit their needs and desires. Similar to the assimilative processes discussed earlier. Focuses on areas such as cognitive competence, social competence, or physical competence. One person might concentrate on mastering cognitive skills while another focuses on social skills. If too many attempts to achieve primary control meet with limited success or outright failure, the individual may become frustrated and discouraged and could begin to feel helpless and depressed. This is when secondary control processes come into play. Secondary Control Processes: Characterized by actions and behaviors directed internally. Similar to accommodative processes because they involve altering goals and expectations and accepting existing realities that cannot be changed. For example, a person who tries to become an expert at computer technician on their own may become frustrated, so a secondary control would be for this person to lower the expectation of being able to learn these skills without help. Optimization of Primary and Secondary Control: Physical and cognitive losses may reduce the likelihood of achieving primary control in advanced old age, so older adults must become increasingly selective about where they place their efforts. Being selective is adaptive because efforts at primary control can be directed toward areas where success is most attainable. In late adulthood, primary control may include compensatory strategies that require technical aids such as hearing aids and assistance from other people. Secondary may take greater control in older adulthood. "As the ratio of gains to losses in primary control becomes less and less favorable, the individual the individual increasingly resorts to secondary control processes.

Hierarchial-Compensatory Model of Sibling Relationships

Intimate Siblings: highly devoted, share a relationship of mutual love and understanding, confide their personal thoughts and feelings, and consider each other "best friends." Contact is frequent, including visits and telephone calls. Congenial Siblings: Strong friendship and caring but their emotional ties are not as deep except in times of crisis or stress. Loyal Siblings: Bond based on family background and a strong sense of family obligation. Little contact but they appear upon request at important family occasions. Rarely exchange emotional support, But would help in times of illness or financial difficulties. Apathetic siblings: Not close and not interested in taking any responsibility for one another. Do not attend family occasions and rarely make contact if even they live close by. Can go years without seeing one another due to indifference. Hostile Siblings: Go out of their way to avoid one another. They feel disdain and anger towards one another. Reject requests for support. Emotionally involved in a negative way.

Alzheimer's disease

Irreversible brain disorder that develops over a period of years. The initial symptoms of memory loss are often mistaken for age-related memory changes. Difficult to differentiate from things that occur with normal aging: Individuals may complain about misplacing items, forgetting appointments, and forgetting names, and there might be slight impairment in language, concentration and judgement. Personality changes occur, such as rigidity, self-centeredness, and emotional lability, were noticed by those familiar with study participants who were diagnosed with AD. Cognitive function: Difficulty in language, such as finding words, problem solving, and decision making. First most obvious sign that something is wrong is when an episode such as the older adult gets lost while traveling to a familiar location. Older adult may also be unable to remember recent events. Those with AD however usually deny having any problems or difficulties. The cognitive losses AD victims experience have been traced to the death of brain cells (neurons) and breakdown of connections between them. In certain areas of the brain, there is extensive formation of neuritic plaques and tau (the chief component of neurofibrillary tangles), which interfere with neuronal functioning and neuron survival. Plaques and tangles are also seen in the brains of very old individuals but these are often less extensive than those that are found in patients diagnosed with AD. There are also large spaces (vacuoles) in the brains of patients with advanced AD.

Suicide

It is a behavior rather than a mental disorder, but suicidal ideas and/or actions are often associated with mental illness, particularly severe depression. Some view suicide as a final act driven by intolerable psychological pain and feelings of hopelessness. Suicide can be less likely in older adults who practice religion and attend church frequently. Firearms more common form of suicide for both older men and women, but more men than women use firearms as a means of suicide. Less direct methods of suicide include refusal to eat, refusal to seek medical care, or failure to follow a prescribed medical treatment. Older adults are more likely to commit suicide than younger adults. Men 65+ account for 80% of suicides among all who are 65+. European Men have highest rates of suicide. Individuals who take their own lives are probably suffering from depression, but their symptoms went unrecognized and untreated. Older adults, especially men, may not report sadness or other symptoms. Older women's lower rate of suicide could be related to the likelihood that they have a wider social network outside the marital relationship. Depression is one of the most frequent emotional disorders experienced by the older adult population. Yet when depression is diagnosed properly, it is one of the most treatable mental health problems experienced by older adults.

Risk factors of depression

Low levels of education and income. Women are more likely to report depression than men. But this is known to reverse in late life with men over the age of 80 to report more depressive symptoms. Since older adults have a relatively high incidence of physical illness and frequent use of medication, they are more at risk than other age groups for secondary depression.However, it is not clear whether depression is an outcome of physical illness or whether it increases an older adult's vulnerability to physical illness. Losing a loved one, loss of social support, loss of income can put one at risk for depression. Being the sole caregiver for a chronically ill family member. Heavy responsibility and social isolation. Cerebrovascular factors. Decreased blood flow to the hypothalamic area, which is associated with mood. Vascular lesions in the subcortical brain structures that are not dramatic enough to cause stroke or even hypertension could impede cerebral blood flow, resulting in the apathy and slowlness sometimes seen in late-life depression. Relationship between depression and heart disease has been noted by a number of investigators. Patients who suffer from depression seem to have poorer outcomes, including a decreased likelihood of survival, following heart attacks and also after coronary bypass surgery.

Prevalence of Depression

Lower incidences of major depressive disorders among community-living older adults than among younger adults. The rate of depression does not appear to be higher in older adults than it does in younger adults. However, when participants complete a brief symptom checklist, they usually report a higher incidence of depression. Up to 27% of older adults respondents have acknowledged having some symptoms of depression. It appears that older adults are more depressed in nursing homes than they are in community-living residents. One study showed that depression scores declined from early adulthood to late middle age but increased after the age of 75. However, the reasons for depressive symptoms probably differ for young adults and adults over the age of 75, because they are probably suffering from a physical illness or the loss of a loved one.

Lay Views of Personality

Many older adults feel a strong sense of continuity.

Retirement

Many people continue working well into old age, but there is an increasing trend for older workers to be employed in bridge jobs, which are usually part-time as opposed to full-time careers. Retirement is a social institution with rules about when it is permissible for workers to leave the paid labor force. It designates a social status that has become established as a historically new stage in the life course. Retirement is not always voluntary, because health limitations, job displacement, or the obligation to care for others.

Life After Retirement

Many view retirement as an active stage of life that occurs between the cessation of employment and the onset of frailties that can come with old age. The Busy Ethic: Keeping busier than when one was working. Most applicable to retirees in the young-old category (65-74). and must be in good health. What is important is that they keep busy and that others see that they are busy. Stems from the work ethic philosophy, where too much leisure time is viewed as negative without work to balance it. Individuals are viewed as virtuous and positive if they are diligent and industrious. May alleviate retirees' fears of becoming useless or obsolescent. Education after retirement: Many retirees take advantage of educational opportunities that are increasingly available for older adults. Many older adults want to learn basic computer skills for various reasons: combat lonliness by engaging in online chat rooms, engage in Skype to communicate to family members, utilize email, government agency access, shopping: older adults who can access the internet are known to express a higher level of psychological well-being copared with older adults who do not use the internet. Volunteer work: Many older adults take up volunteer work after they retire: However, those who volunteered earlier in life are more likely to volunteer once they retire. Those who volunteer report high self-rated health and feelings of well-being and having a meaningful purpose in life. Volunteering also contributes to personality growth by fostering openness to experience.

Generativity versus stagnation (40-65)

Middle aged adults who resolve this challenge positively are able to take responsibility for others and feel they are making a contribution to the next generation. Graced with the virtue of care.

Alcoholism

Not always apparent in the older population but chronic and acute alcoholism are not uncommon in older adulthood. Older adults are more sensitive to alcohol simply because of age-related biological changes whereby alcohol metabolism is slower so its effects persist for longer amounts of time. Older adults may need less alcohol than younger adults to become intoxicated and older adults should be careful drinking alcohol if they are on specific medications. Older adults are less likely to admit they have alcohol problems. They are less likely to run into problems that are alcohol related such as having fights or work issues. But the older drinker is more prone to health problems. Physicians are more likely to misdiagnosis alcohlism as depression in female patients. Older women drink at home, older men drink in public places.

Family Relationships

Nuclear Family Household: common in urban American society and consists of parents and their children who live under the same roof. For the parents, the nuclear family represents the family of procreation. For the children, the nuclear family represents the family of origin. Extended Family Household: Common in rural areas in earlier decades, consists of members from more than two generations (grandparents, parents children). all living under the same roof or in close proximity. Could include aunts, uncles, and cousins. Today, there are fewer multigeneration extended families living under the same roof, which has given rise to the myth that older adults are isolated from and abandonded by their families. Modified Extended Family: Consists of a broad kinship network including grandparents, parents, grandchildren, siblings, and even nephews, nieces and other relatives by blood or marriage. Frequent contact with one another but do not live under the same roof. Beanpole family structure: What families will be like in the future. Due to increase of life expectancy, more families will have four or even five living generations. But each generation will have fewer members because the birth rate is lower today than it was in earlier decades.

Intimancy at a distance

Older adults do not yearn to live under the same roof was their adult children. They welcome contact and involvement, but prefer to maintain their own households as long as they are able to.

Activity Theory

Older adults strive to maintain their level of social interaction by substituting new roles when old roles are lost. For example, a man who retires from paid employment might become involved in volunteer work. To the extent that older adults are successful in replacing social roles, they will enjoy high life satisfaction, or high morale and feelings of well-being.

Ego integrity versus despair

Older adults who positive resolve this challenge feel their lives have consistency, coherence, and purpose. Ego integrity is associated with contentment and satisfaction with the life one has led despite its imperfections. Graced with the virtue of wisdom.

Comparing Widows and Widowers

Older widows (women) greatly outnumber widowers (men). This is because women tend to marry men that are older, women have a longer life expectancy than men, and women are less likely to remarry . Widowers are more likely to remarry, but they marry younger women. Women were more hesitate to remarry because they were reluctant to give up their newfound freedom to do whatever they wanted. Women are more likely to live alone. Many widowed women find a social network of other widowed women. Widows who keep active and see friends seem to adjust the best. Widowed men find social connections through remarrying. Widows are at greater economic disadvantage compared to widowers. Advanced financial planning is the key. Loss can also occur through divorce.

Positive and Negative Aspects of Social Relationships

Older women who have problematic relationships do not lack social skills because they have good relationships as well. The connection between negative social interactions and negative feelings is especially strong when older adults are already experiencing multiple stressors - losing a spouse or friend, experiencing illness, moving, etc. Thus, as individuals age, they become more selective in their social relationships, maintaining ties with social partners who enhance their emotional well-being.

Job performance of older adults

Older workers are dependable, productive, and have lower accident rates than younger workers. When injury or illness occur, older adults may need more time to recover, but for male workers, absenteeism tends to decrease with age. Older workers are very committed to their jobs and have invested emotional energy. Furthermore, older workers have probably been in their position longer than younger workers and have more skills. When the job depends on crystallized (pragmatic) abilities and social requirements (teacher), job performance usually remains stable with increasing age. But with jobs such as air traffic controller, which depends heavily on Fluid performance, or occupations that call on physical strength, job performance is more likely to decline with age. Older adults may take longer to learn how to use computers than younger adults. Overall, older workers may be judged to be just as valuable as younger workers. But older workers may be less likely to receive promotions since they are seen to stay in the company longer.

Economics of Retirement

Other than savings and investments accumulated during the working years, pensions are an important source of income for most retirees. Pensions are regular payments that produce a steady income based on the retired worker's former participation in the paid labor force. These can come from the federal government or from private employers or corporations. Social Security: Those who have worked for the required number of quarters are not eligible for full social security benefits until they turn 66 or 67, retired workers are eligible for reduced benefits at the age of 62, with a dollar amount less by a percentage of what they would receieve if they waited until 66 or 67. More Social Security beneficiaries are women, and more women than men rely on Social Security benefits are their sole source of income. This explains why the poverty rate is higher among women than it is among men.

McAdam's Life Story Model

Personal myth to make sense of life. Integrates a reconstructed past with a perceived present and an anticipated future. Allows people to feel that their lives have unity and purpose. Ongoing narratives that shape their behavior & establish identity. Reflect values of the culture in which one lives. West cultures: enter the workplace, begin raising families, establish themselves in the community, and commit themselves to roles such as worker, spouse, parent, etc. Over time, they refine the plot of their life story, and my middle adulthood, they become concerned with integrating and balancing its various themes. Middle aged adults are considered to be in their prime but begin to think about their mortality and what will survive them after death. A "good" ending makes it possible for individuals to attain a kind of symbolic immortality, or legacy of the self, which will live on after their death.

Elder Abuse & Neglect

Physical, sexual, psychological, or material/financial. Neglect refers to intended or unintended failure to fulfill the older adult's needs. Failing to provide an older person who cannot properly care for himself or herself with necessities such as food, water, clothing, shelter, medicine, or comfort. Some instances there is self-neglect.

Sigmund Freud (Stage Theorist of Personality)

Psychoanalytic theory which emphasized the role of unconscious biological instincts in motivating behavior. Personality development proceeds in a series of psychosexual stages that begin in infancy and extend into adolescence. Believed early childhood experiences played a big role in the formation of the basic personality structure.

Social network

Refers to the structural characteristics of an individual's social ties, including the number, age, sex, relationship, and frequency of contact with people who are a part of it. Members of one's social network provide social support in various forms, either through assistance when we are ill, or help when we encounter financial difficulties. Others are people with whom we can confide when we are upset or worried and who can replenish our feelings of control and self-worth. Others are just people we enjoy spending time with. These kinds of social supports can buffer the negative effects of stress.

Life Review

Reminiscence about personal memories from the past, reconstructed usually and not completely objective. Life review is an active and important part of the aging process, and older adults use it to integrate who they are now (present) and who they were before (past). Positive life review = meaningful life. Life review helps older adults achieve "Ego Integrity" . If life review comes out more negative, older adults will have wishes that they could have done things differently. Could lead to feelings of despair. Since only certain types of reminiscence are considered to be related to successful aging, it's best to encourage integrative and instrumental reminiscences but discourage those that stir up feelings of guilt.

SOC and Ecological Model with Mental Health

SOC Model says that maintaining an optimal level of mental health requires focusing selectively on aspects of life that are most fulfilling and minimizing those that are least fulfilling. This differs among individuals. Some like to be close to family while others like to be close to church. Focusing on the aspects of life that are most important can compensate for giving up less important ones. Ecological Model: mental health can be conceptualized in terms of the older adult's competence (which is related to the concept of diathesis or vulnerability) and the press of the environment (degree of stress/physical aspects of one's surroundings). Adaption can be viewed as maintaining mental health or minimizing any disabling effects of a mental disorder. Adaption is most likely when there is a match between an individual's competence and the degree of environmental press.

Paranoid Disorders

Schizophrenia: (Paranoid type) Characterized by delusions, hallucinations, and disorganization in speech and behavior. Paranoid disorders, however, can occur in milder forms other than schizophrenia. Personality disorder, for example. Those with paranoid disorders tend to construct faulty explanations or interpretations of evens. They are highly suspicious and distrustful of others when there does not seem to be a realistic basis for suspicion or distrust. Paranoia can occur in connection with a mood disorder such as depression or a cognitive disorder such as dementia. Often associated with sensory impairment in older adulthood, particularly VISION & HEARING. Example: Older woman attempts to follow a conversation among some acquaintances, but with all the background noise she is unable to decipher what they are saying, thus she may assume they are purposely excluding her and perhaps even gossiping about her. Paranoia disorders can also be found in cognitive functioning. Example: A man who misplaces his wallet or glasses may assume someone stole them. Another example, which is considered a defense against social isolation, is when an older women who does not receive any Mother's Day cards from her children finds it less threatening to conclude that someone has been stealing her mail rather than admit to herself or others that her adult children have forgotten about her. Some paranoid reactions are adaptive. They protect the older adult from feelings of decline or failure. Paranoid reactions could ultimately alienate important memebers of an older adult's social support system. To treat paranoid disorders, older adults need correcting in their sensory or cognitive deficits to the extent possible and providing a friendlier and familiar but structured environment. But an older adult's suspicions should be checked before writing off as unrealistic. Sometimes older adults really are encounter theft or gossip from others.

Disengagement Theory

Social and psychological withdrawal is a necessary component of successful aging. Older adults withdraw voluntarily from roles they played in middle age. At the same time, society withdraws from older adults, expecting them to step aside to make room for the upcoming younger generation. This mutual withdrawal of older individuals and society from each other benefits from them both.

Reciprocity

Social exchanges that are balanced in terms of support both provided and received. Each individual gives as much support as he or she receives. One suggestion is that we make deposits into a support bank by giving more support than we receive as long as we are able to do so. Later, we may need more support than we can give, at which point we feel it is legitimate to make withdraws from the support bank. Older adults usually provide greater support to adult offspring than adult offspring provide to older parents.

Social Exchange Theory

Social interactions can have both rewards and costs. Rewards entail positive feelings, but costs may include unpleasantness experienced during the course of a social exchange. A social interaction is balanced if both partners have an equal desire for the reward offered by the other. However, one partner may value the reward from the exchange more than the other partner. The concept of power enters in when there is imbalance in a social exchange. The less powerful partner values the exchange more and thus feels obliged to comply with the demands of the more powerful partner. Over time, such compliance becomes increasingly costly to the less powerful partner - thus the less powerful partner may decide to withdraw from the interaction. In nursing homes, United States Laws have inforced long-term care facilities to post a list of "Nursing Home Rights" since it can be difficult for older adults of long term care to experience difficult negotiating with administrators and staff members to get what they needs.

Emotion Regulation (socioemotional selectivity theory)

Social interactions, especially pleasant ones, fulfill emotional needs. According to SST, emotional fulfillment becomes more important in older adulthood. Older adults prefer to socialize with familiar people because they place great importance on the positive feelings that come from intimate and gratifying social interactions. Less guarantee of experiencing positive affect in interactions with novel partners. Social interactions may be influenced by perception of time. When time is seen as open-ended, or unlimited, our main motivation for engaging in social interactions is acquiring information and we tend to seek out new social partners. Yet when time is limited, emotional regulation becomes the primary motive. "Anticipated endings": When time limitations are explicitly stated, the young adults' preference for familiar social partner is similar to that of the older adults. SST predicts that social preferences are relation to the preception of time. Information seeking and novel social partners take precedence with time is unlimited.

Social Interactions and the SOC and Ecological Model

Socioemotional Selectivity Theory (SST) complements the SOC Model by specifying the goals of social interactions that older adults select and the strategies they use to insure that social interactions will optimize their needs. Social convoy becomes smaller as we get older but those who remain close provide social support, feelings of social embeddedness, and chances for positive social exchanges, which optimizes feelings of life satisfaction for older adults. Ecological Model: Social interaction and social ties represent one aspect of environment press. Older adults adapt best when environments offer access to social ties and sufficient opportunties for social interaction, especially with individuals who hold significance for them. However, older adults prefer to weed out relationships that have less importance, Adaptive functioning is maximized when older adults have opportunties for meaningful social interactions and when the likelihood of negative social exchange is minimized.

Hypochondriasis

Somatoform disorder. Symptoms suggest a physical problem. Diagnosis is usually made when physical findings are negative despite a patient's preoccupation with illness and anxious concern with bodily functions. Usually resist any suggestion that their symptoms are related to emotional stress. Symptoms of hypochondriasis and depression can overlap. Some depressed individuals show signs of bodily preoccupation. The depressed individual will not seek out help actively, whereas the individual with hypocondriasis will make frequent trip to the doctor. Underlying basis for hypochondriasis in older adulthood: - Older Adults' anxiety about loss of social prestige and or financial security is shifted to heightened concern with bodily functioning. -American Society uses physical illness as an acceptable excuse for failure to perform, so those who claim physical illness are exempt from normal social responsibilities. -Could stem from social isolation - the energy that older adults previously invested in social interactions is turned inward, resulting in an exaggerated focus on bodily processes. Physicians should be willing to acknowledge and understand a patient's worry because it is helpful in reducing the patient's anxiety.

Employment in Older Adulthood

Some continue to work full-time or part-time while other retire from employment. Those who retire have better freedom to relocate to better climates but the majority continue to live in the same geographical location, and many keep living in the same house that they always lived.

Age-Segregated Living Arrangements

Some remain in the same locale but move to a different residence. Can select a house that is age-integrated or age-segregated. Age-integrated Housing: Apartments or condominiums that have no specific age requirements. Tenants are responsible for their own shopping needs, transportation, meal prep, etc. Some older adults also move into granny flats or attached separate houses at their family members residence, thus they are still living independently but have support close by. Age-segregated housing: Intended for individuals over a particular age, usually 62. Such living arrangements often include services such as group meals, planned in-house activities or social outings, transportation. Well suited for those with physical limitations or disabilities. *See page 323 for the types of housing on a cotinuum ranging from independence to dependence.

The Dying Trajectory

Sudden dying trajectory = Death of a healthy individual occurs instantaneously, such as a fatal car accident or after a brief acute illness. Gradual trajectory = death is certain to occur eventually but not immediately. Common in modern technologically advanced societies, which means the duration of the dying process is much longer than it once was. The gradual trajectory allows the dying individual time to resolve personal issues such as rifts with family members and to make decisions about the distribution of property to family members, friends, and charities. Alzeheimer's Disease is a gradual trajectory.

Risk factors of Alzheimer's Disease

Symptoms usually appear after the age of 65, and the risk continues to increase with age. Age is the most significant risk factor. Another risk factor is gender - women are more susceptible than men, even when woman's greater longevity is taken into account. In regards to prevention, there is speculation that highly educated people are more protected against dementia because they hare more "brain reserve" than people with less education. Engaging in cognitive stimulating activity is known to help. The association of lifestyle factors such as physical exercise - more exercise is beneficial to the brain. Nutritious diets help as well. Further more, what is the role of genetics in risk factors of AD? Early onset of AD does seem to be associated with specific genetic mutations. For late onset, there is no obvious family history or inheritance pattern. Some genes are known to predispose rather than cause AD. APOE allele has been linked to late onset of AD. Those who have difficulties in identifying familiar odors (olfactory disorders), but further research needs to be conducted to determine what role the APOE allele plays in olfactory brain structures and whether a decline in olfactory functioning can predict AD. Some scientists think that there is a complex series of events that happen in the brain that interact to trigger AD. AD may result from a series of pathological processes associated with age (reduced reserve capacity) .

Living Arrangements

The majority of older adults do not relocate across state lines, but those who do are often seeking milder climates and opportunities for year-round outdoor recreation. The majority of older adults remain in their native geographical areas after they retire.

Individual Differences in Coping & Adjustment

The study of individual differences in personality of older adults is often coupled with an interest in which older adults experience high levels of life satisfaction and psychological well-being. Life satisfaction is associated with self-acceptance, positive relations with others, autonomy, and feelings of environmental mastery, purpose in life, and personal growth. Closely tied to the idea of well-being is coping. Coping is important for older adulthood due to the many losses one faces.

Personality Dimensions & Traits

Theorists focus on whether personality is consistent over time. The Baltimore Longitudinal Study: Followed same individuals over time. Costa & McCrae studied individuals aged from their 20s into their 80s. Completed two well-established self-report personality inventories.By analyzing the participants responses, the researchers proposed that a personality structure consists of five dimensions or facots: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness (Five-factor model of personality), From there Costa & McCrae developed self-report questionnaire, known as the Revised NEO Personaltiy Inventory, which measured six traits that make up each of the five factors. Results showed that the same five personality factors continued to emerge in their self-report responses, indicating a consistency over time in the personality factors. They also retained their approximate rank order on the factors compared to others their age. High scores on some are associated with positive affect and feelings of well-being, while high scores on others are not. Being high on extraversion is associate with positive affect while high on neuroticism is associated with negative affect and a lower degree of well-being. The choices we make at various transition points are influenced by where we fall on the five personality factors, and that personality functions jointly with age to influence whether outcomes are positive at various stages of development. Mid-life crisis = more susceptible to those who are crisis prone, such as neurotics.

Intimacy versus isolation (ages 20-40)

Those who resolve this challenge and are able to successfully form positive give and take relationships with others are graced with the virtue of love

The Assimilation, Accommodation, and Immunization (AAI) Model

Three self-protective coping strategies, or processes, that individuals use to maintain personal continuity and integrity of the self. Assimilation: Tenacious goal pursuit. The first process activated when individuals detect a gap between hoped-for goals and actual circumstances. Intentional actions or efforts. Can be preventive, corrective, or compensatory. In later adulthood, such efforts are often directed toward maintaining resources and avoiding mismatches between skills and demands. Especially important goal in later life is minimizing health risks, so assimilative efforts could include modification of eating and exercise habits, Maintaining a competent and independent level of functioning, such as coping with changes in physical capabilities by assimilative actions such as installing grab bars in the bathroom, strobe lights on telephones, and emergency buttons in each room. If the continued use of assimilative strategies are clearly unattainable, the next process known as accommodation can be activated. Accommodation: characterized by flexible goal adjustment. This method is usually unintentional. Involves reevaluating, adjusting, or even redefining personal goals and preferences in accordance with situational and personal limitations. Includes revising one's goals and aspirations and changing one's standards of self-evaluation. Immunization: Shields individuals against threats to aspects of the self-concept that are central to their identity. Like accommodative processes, immunizing processes are usually unintentional and they protect people from information that conflicts with their definitions they have of themselves. A golfer who usually wins every single tournament begins to lose tournaments. He may attribute his poor scores to substandard maintenance of the golf-course, to his recent sleeping problems, or to the loud conversations of the other members of the foursome that distract him from the game. Immunizing processes are also like rationalizations, but they help preserve the continuity of one self-concept and prevents one's self-esteem from plummeting. However, immunizing processes cannot serve a protective purpose forever, but they allow further assimilative actions to improve

Stages in Long-Distance Migration

Three stages to long-distance migration: Stage 1: "Amenity Migration" Usually occurs immediately after retirement, older adults who migrate are usually in the young-old (65-74) age category. Most are in good health, have intact marriages and adequate financial resources, and are eager to join with age peers in taking full advantage of swimming pools, games of golf, etc. Stage 2: "independence Maintenance" Older adults in their mid- or late 70s are beginning to experience moderate physical or cognitive difficulties. A number of them have had spouses die and some have seen their financial resources dwindle. Thus, migration tends to occur in the reverse direction - from the sun belt back to the frost belt - because older adults return to hometowns or places where they can count on informal care and support from family members. They can still live on their own but need some help to do so. Stage 3: "Dependency Moves" Not all reach this stage but those that do have severe disabilities. Require more help than informal caregivers. Need supportative environment. Assisted living.

Hour glass effect in sibling relationships

Ties that were strong when siblings lived under the same roof tend to weaken in young and middle adulthood, but often they are reactivated in the later years.

Older Adults & Mental Health services

Today's older cohort does not make full use of the available mental health services because they could believe that mental health problems entail long-term stays in locked hospital wards, and that such problems are best kept to oneself. But future generations will most likely not feel this way. Most psychological needs of older adults will depend heavily on Medicare.

Perceptions of the personality traits of others (lay views of personality)

Viewed development as multidirectional, with both gains and losses over the adult life span. Gains were viewed as becoming more wise, responsible, and level-headed. Losses were defined as an increase in undesirable traits such as weak, dependent, and stubborn. Expected gains outnumbered expected losses.

The Diathesis-Stress Model

Why do some individuals suffer from depression while others do not? The diathesis-stress model as a framework for understanding why disorders such as depression occur. Diathesis : refers to an individual's level of vulnerability (for example, genetic propensities, acquired biological vulnerability, or psychological factors) Stress: refers to negative events (loss of a loved one, loss of job, illness, etc) individuals with high diathesis are especially sensitive to stressful conditions and may succumb to a disorder even if the stress level is not very high. Those with low diathesis can withstand moderate levels of stress without succumbing; if they do succumb with higher stress, the disorder will be relatively mild and short-lived. **Careful consideration of age-related and/or cohort-related differences in diathesis, as well as level of exposure to stress at different stages of development, could help us understand why mental disorders such as depression could occur more (or less) frequently at different stages of life.

Loss of a Spouse

Widowhood: refers to the status of a person who has lost a spouse through death and has not remarried. The bereavement Process: Early on there are strong feelings of grief, including disbelief, confusion, numbness, sadness, and in some cases anger and guilt. The widowed individual may feel abandoned, lonely, depressed, and preoccupied with thoughts of the event surrounding the loved one's death. Some feel relief if their partner suffered with an long terminal illness. There is variation in the time course of people's reaction to the loss of a loved one. For some, the grief is intense then subsides quickly, for others the grief continues for months after the death. Feelings of psychological and physical distress usually taper off after 12 months, but never to a level as low as that of individuals who are not bereaved. "You never get over it - You learn to live with it." Successful mastery of the bereavement process is thought to involve three tasks: 1) Accepting the loss intellectually (being able to make sense of why the loss occurred 2) Accepting the loss emotionally (no longer feeling the need to avoid reminders of the loss) 3) Recovering to a normal level of functioning The nature and length of the bereavement process is related to the bereaved individual's personality traits, the social support available, the circumstances surrounding the death, and the bereaved's competence in handling the tasks of daily living on his or her own. Older people experiencing widowhood may lack emotional support from others and social involvement. The lonliness for bereaved older adults may be especially intense because many are left to live on their own for the first time in decades.

End of Life Decisions

Wills: Formal document that states how individuals want their property distributed to heirs upon their death. At the time a will is drawn up, a person must be of sound mind and not subject to undue influence. A will can be changed at any point before death as long as the person remains of sound mind. The signing of a will must be witnessed by the specific number of people required by state law, and witnesses cannot have any personal interest in the will. Handwritten or holographic wills may be accepted. A will usually names a personal representative who will carry out the business of collecting the property of the deceased and notifying those to receive it. Dying INTESTATE means dying without a testament stating their wishes of distributing their property. The Living Will: Individuals can specify what type of medical care they would choose in the event they lack the capacity to express their wishes at some time in the future. With a living will, a person diagnosed with terminal illness can have a say in what, if any, medical intervention should be used to prolong life in the event he or she becomes unable to express a preference later. It is an advanced directive: refers to the individual's wishes for his or her own end-of-life care. The living will instructs physicians and family members about a patient's wishes regarding the use of medical treatments that would artifically prolong the dying process if death is determined to be inevitable.

socioemotional selectivity theory

a life-span model which proposes that the reduced social activity often seen in old age reflects a lifelong selection process. The number of individuals in a person's social network may be smaller in older adulthood than it was in younger adulthood. Closer relationships are maintained in older adulthood while superficial ones are filtered out, and age-related reductions in social interactions can be adaptive. Two goals, or motives, when it comes to social interactions: Information seeking or emotion regulation.

Hierarchical-Compensatory Model

individuals have a hierarchy of relationships that they call upon when they need support. When a spouse or adult children are not available because of death, divorce, or geographical distance, older adults compensate by turning to siblings, who are lower down in the hierarchy. This could explain why sibling support is stronger among older adults who are single widowed, than among older adults who are married or have adult children. Those with only one sibling versus multiple siblings were less likely to receive support in a time of need and less likely to expect sibling support would be available. Chances are greater is sibling is a sister versus a brother.

Sandwich Generation

middle-aged adults who are caught between the competing demands of two generations: their parents and their children