I have been working with older adults and their families for nearly twenty years. Therefore, much of my understanding about aging came from this experience, as well as personal experiences. This program has truly married my practical knowledge with theoretical knowledge. I have been able to examine the current research and create a body of work that supports my understanding of the important issues facing society with regard to aging.
Value of Older Adults
I believe every human has the essential need to feel a sense of contribution, wither to their own lives, their families and relationships, and/or to society. Contribution takes different forms for individuals.
As a pioneer in the field of psychology, Erik Erikson helped to develop on of the major theoretical philosophies of human development. As Erikson, Erikson & Kivnick (1986) noted, “elders have both less and more” (as cited in Moody & Sasser, 2012, p. 41). This statement is profoundly simple. His theory is based upon that assumption that elders are able to take the time to contemplate the meaning of life. They are able to take life’s lessons and integrate them into their beliefs about life. Because of the wisdom of their years, elders have a greater ability to adapt to change.
The life cycle is an integrated whole. All the stages of life build upon one another create an entire psychology of the person. All of Erickson’s eight psychosocial themes are a part of a process that pervades the entire life cycle and are integral to life in time (Kivnick & Wells, 2013). The premise of Erikson’s theory is that development continues throughout adulthood. It should be noted however, an as Erikson acknowledged, identity issues faced in the early stages of life can recur, especially when people have reached mid-life and retirement (Osborne, 2009).
Elders face many challenges of identity in later years. For instance, in retirement, elders often feel a loss of identity. This can lead to psychological challenges and individuals can regress to identity challenges face in earlier developmental years.
I had the honor of interviewing a woman last year for the Sociology of Aging course who is the model for Erikson’s theory. She is in her late eighties, and throughout the story of her life, she describes common life events, experiences, and concerns associated with each of Erikson’s life stages. At this point, she is vitally involved in her world. She is also still developing as she copes with losses of friends and family members.
The adaptation and resiliency exhibited by elders can be attributed to the integration of the experiences in the unique stages of life. As a society, we must realize the opportunity to promote the psychological health and well-being of older adults. With the current social construction of aging and retirement, we are at risk of isolating our elders. We run the risk of taking away the process of vital involvement that elders need to experience meaning and satisfaction with life.
In fact, the principal of vital involvement requires us to recognize that elders are influencing their families, their communities, and even the field of gerontology (Osborne, 2009). When I visit long term care facilities, I am often saddened by the lack of social interaction among the residents. I see many of individuals staying in their own rooms day after day. There is often a sense within the facilities that the medical care that is being provided is enough. However, I do not believe this to be the case. Perhaps we, as gerontologists, can find ways to enrich our communities so that all individuals can get the care they need and participate in meaningful ways.
In the course Perspectives on Gerontology, I prepared a paper that details the best practices age-friendly practices throughout the world. In The Graying of our Planet, I argue that the opportunity to include older adults as a valuable part of society is essential for the well-being of our society. See below.
Supporting Older Adults and their families
The support provided to older adults by family members and friends is the backbone of our long-term care system. By the lack of policies and programs available for these “informal” caregivers, as they are known, are seemingly unvalued assets in the conversation on aging. In a panel discussion at the 2015 White House Conference on Aging, David Hyde Pierce very profoundly said “to age is to live and to care is to be human".
Under the provisions of the Older Americans Act passed in 1965, older Americans are offered a broad range of community-based services through a network of federal, state, and regional agencies (Hudson, 2010). The aging network, as it has been become known as, is know for the design and implementation of home and community based services for seniors at the state and local level (Hudson, 2010). Under Title III of the Older Americans Act, state units on aging (SUAs) to oversee the disbursement of funds and services (Hudson, 2010). The aging network coordinates social services such as legal services, ombudsman, caregiver support services, and senior centers, as well coordinating providers of transportation and meals delivery.
The network of providers of aging services, along with other human-services providers, is facing unprecedented challenges in meeting the needs of a growing older population (Burgess & Applebaum, 2009). The Older Americans Act was considered an afterthought after Medicare, the major legislative achievement of 1965. Unfortunately, funding deficiencies have been a major issue since the inception of the Older Americans Act. That, coupled with the growth in the aging population has made it a monumental task to overcome. In 2012, about 58,500 paid, regulated long-term care services providers served about 8 million people in the United States (Belza, Altpeter, Hooker, & Moni, 2014).
Area Agencies on Aging, the local organizations created to deliver services particularly to low-income, minority and rural seniors, are seeing their waiting lists grow and as a result, they are scrimping on home services, delivering fewer meals, providing fewer places for group meals, and offering fewer social and recreational programs (Pew Charitable Trusts, 2015). Families are having to bear the burden off providing these services for their loved ones. This additional burden is stressing many caregivers, as they struggle to keep up with the added burden, along with working and raising families.
The advantage that the Older Americans Act has on the delivery of services to millions of older Americans is that the infrastructure of providing support on a local level to the individuals in need is already in place and has been for fifty years. Local service providers have been identified and are in place to provide services. In order for the programming to truly be effective, adequate funding on both a federal and state level will be necessary. With adequate financial resources to provide for the growing aging population, programs like Medicare and Medicaid will not have to be utilized to the extent currently anticipated. Dollar for dollar, providing community based services to keep people at home longer, is more advantageous than having to provide institutionalized care to individuals at earlier points in their lives than is truly necessary.
As a country, we must decide on the priorities with regard to services and support for older adults. If home and community-based service is the preferred priority, then adequate funding will need to be placed in the hands of the agencies charged with the responsibility of providing the services. Older American and their families are demanding community-based services instead of institutional care (Hudson, 2010).
Despite relatively flat funding over the last decades, some agencies under the Act have shown success in being able to provide adequate services on limited financial resources. It is important that as a nation, we support the agencies that provide the most useful sources to the older adult population. The services provided by the area agencies contribute to the overall well-being of the older adult population not only through the critical social services provided, but also through the promotion of continued civic engagement and disease prevention that has become an important focus over later years (Hudson, 2010).
In the course, Public Policies and Aging, I prepared a policy brief, Valuing Those Who Care, to outline the need to build a national strategy to support family caregivers. In Valuing Those Who Care, I argue that it is time to formalize the current piece-meal efforts that are struggling to support family caregivers throughout the country and to urge policymakers to build an effective national strategy to support the individuals that the backbone of our long-term care system. The policy brief is below.
Respect and Inclusion
Old-age stereotypes contribute to ageism, which is a form of discrimination. Ageism is a termed first coined by Robert Butler and “allows the younger generations to see older people as different from themselves” (as cited in Johson, 2012). Unlike, other discriminations, such as sexism or racism, ageism is form of discrimination that most of the population has the potential to feel in their lives. This sets ageism apart from other forms of discrimination. Further research suggests that when the younger generations adopt old-age stereotypes, they are essentially discriminating against “their own future selves” (Johson, 2012).
As people age they must repeatedly redefine themselves (Schaie & Willis, 2011). The effects of ageism can have lasting effects on the emotional and physical well-being of individuals. Stereotypes about aging, often negative, are communicated to us by society across our lifetimes (Schaie & Willis, 2011).
One of the misperceptions about older adults is the image of older people as frail and weak and in need of protection. While well intended, the mindset of older individuals as disabled or frail has led society to build social constructs to take care of the less-able, aging members of society.
Collaboration between generations is an important way to change the attitudes towards aging. One of a number of examples of this is a program at Carnegie Mellon University. A professor, who is also an artist, has developed a program to collaborate with older people to create large-scale murals in public places. Younger artists are paired with older adults from the city. The idea is to utilize the elders as “custodians of history” to provide a historical vision of places throughout the city in order to draw the murals (Baker, 2014). They provide a richly textured backdrop to conversations that enable dialogue and promote cohesion (Baker, 2014). The murals in Pittsburg are collective collaboration. The value of the elders’ contributions is essential to the production of a collective depiction of social life (Baker, 2014). This is just one example that exemplifies how older individuals are vital to society as vast resources of knowledge and wisdom.
My viewpoints on this, and other aspects of inclusion, are found in my paper, The Graying of our Planet: Discovering Best Practices in Age-Friendly Initiatives, submitted for the course, Perspectives in Gerontology. The paper explores the challenges and opportunities facing the global community in the 21st century as a result of the current demographic trends in aging.
Ethics
Holstein, Parks, and Waymack (2011) contend that it is not only important merely provide to individuals with choice in programs and services. In fact, they should be provided meaningful choice, in order to allow individuals to live purposefully and coherently at any age. I have personally witnessed the care of older individuals, in an effort to “protect” an individual, which was degrading and devaluing. As Holstein et al. (2011) postulate, the current care paradigm supports the social emphasis on personal autonomy to the extent that it provides a false sense of control over our bodies and our lives as we age. As they further note, the shift towards chronic care and palliative care paradigms have no chance of success until society embraces the frailty of our bodies and life in general (Holstein et al., 2011).
As gerontologists, we are in a position to shed light on the problematic nature of the current care paradigm. Much of my professional work is with families. Every day, I see the struggle that families face the tremendous task of honoring the autonomy of their aging loved one, while at the same time putting the loved one and themselves at great risk. Many caregivers continually chase the illusive “balance” that they so desperately want and need as a result of this. As Holstein et al. (2011) propose, perhaps the field of gerontology can help society understand the concept of autonomy that is based in relationships.
References: Baker, D. (2014) Creative approaches to working with older people in the public realm. Working with Older People. 18(1) 10-17.
Belza, B., Altpeter, M., Hooker, S. P., & Moni, G. (2014). The CDC Healthy Aging Research Network: Advancing Science toward Action and Policy for the Evidence-Based Health Promotion Movement. Frontiers in Public Health, 2, 261. Retrieved at http://doi.org/10.3389/fpubh.2014.00261
Burgess, M., & Applebaum, R. (2009). The aging network in today's economy. Generations, 33(3), 40-46.
Holstein, M. B., Parks, J. A., & Waymack, M. H. (2011). Ethics, aging, and society: The critical turn. New York, NY, US: Springer Publishing Co.
Hudson, R. B. (Ed.). (2010). The new politics of old age policy. Johns Hopkins University Press.
Jonson, H. (2012) We Will be Different! Ageism and the Temporal Construction of Old Age. The Gerontologist. 53(2), 198-204.
Kivnick, H., & Wells, C. (2014). Untapped richness in Erik H. Erikson’s rootstock. The Gerontologist, 54(1), 40-50.
McArdle, P. (2012). Ageing: The New Ethical Frontier. Journal of Religion, Spirituality & Aging, 24(1-2), 20-29.
Moody, H.R. and Sasser, J.R. (2012) Aging Concepts and Controversies. SAGE Publications, New York.
Osborne, J. (2009). Commentary on Retirement, Identity, and Erikson's Developmental Stage Model. Canadian Journal On Aging, 28(4), 295-301.