Lifespan__Late_Adulthood_Phase

Lifespan Development: Late Adulthood Phase When thinking about the changes one experiences throughout their life, you usually think of learning to walk in early childhood, transitioning through puberty in adolescence, and marriage and children in adulthood. One phase we may overlook is late adulthood and its significance. Older people, age 65 and up, encompass the fastest growing group in the United States today at 35.9 million. (Polan, 2007) The growth in this population requires further attention and research in the psychosocial and psychophysical changes that affect the elderly. Some important factors when exploring later adulthood include, allowing older adults to remain active in society, and the changes in roles that the elderly experience as they proceed through the aging process. Some oppressive influences that effect older adults and may cause them to disengage are abuse, mental development loss, depression, suicide, and dying. It is important to have a profound knowledge base of these oppressive influences in order to produce a positive impact on older adults through social work practices and policy. Activity Theory The main premise of activity theory is the more active elderly people are, the more likely they are to be satisfied with life. Instead of withdrawing themselves from society, they should seek to be more connected with relatives, friends, and community groups. Individuals seek to maintain continuity, meaning that a person will interact with new experiences in late adulthood the same way they did in earlier periods of their life. “Dynamic theories suggest that each person’s life is seen as an active, ever-changing, largely self propelled process, occurring within specific social contexts” (Polan, 2007). Activity theory represents the need for a parallel structure between dynamic theories and sustaining older adult’s place in society. Since activity theory stresses the importance of keeping active in life to maintain one’s happiness, this presents a problem for the elderly when they retire. Many people focus their lives around their careers, and may experience a loss of self-identity once they are no longer career oriented. We are in a generation where individuals are retiring at younger ages than ever before. Many retired adults continue their education, or perform volunteer work in their community. Both of these can enhance the health and well-being of the elderly and benefit society; thus supporting the idea of Activity Theory. There are two types of daily life activities that are vital to the concept of the activity theory. Everyone has their individual daily routines that are inclusive of what is necessary for their lives, and what is enjoyable for them. Our daily activities keep us centered to our goals, and maintain our self-independence. “Instrumental activities of daily life are actions that are important to independent living, and that require some intellectual competence” (Roberts, 2009). Activity is vital for making an older adult feel independent and important to society. Remaining active will provide the continuity that the individual needs to maintain their satisfaction in life. Activities of daily life include; eating, bathing, toileting, dressing, and walking from place to place. If these daily activities are taken from an adult, then they feel a sense of helplessness and often become depressed. Older adults, who can participate in instrumental activities of daily life without assistance, are still self-sufficient services and often live on their own. Older adults who are still self-sufficient enjoy paying bills, grocery shopping, attending social functions, and cooking. A good example of the activity theory can be seen on any military base. Military commissaries are government funded grocery stores that allow military and dependents to shop at a discount price. One reason why commissaries are able to get merchandise at a discount price is because they have self-employed baggers that work only for tips. The majority of the baggers are older citizens who have already retired from the military and still feel the need to be involved in that work environment. Some older adults will work there all day, for the sole purpose of meeting their social needs. The workers still need to feel like part of the community, and to feel needed or important (Wilcox, et al. 2009). Sometimes as the older adult progresses through the ageing process, their sensory and mental development can regress. Professionals can often re-teach older adults how to regain their independence, and how to work with their dysfunctions to maintain an active lifestyle. Activity theory serves as an excellent tool in working with the older adult population. As social workers, we should remember that staying active in life is what makes us feel that life is worth living. When we are assessing older adult clients and implementing their plan of care, we should advocate for resources that keep them as active as possible. The more active and independent an older adult can be the greater well-being and satisfaction they will experience. Changing Roles in Society, Family, and Work Change is constantly occurring in our lives, bodies, and environments. As people enter into the phase of late adulthood, they must address the multifaceted changes evolving in their lives. Participation in social events as well as maintaining relationships with family, friends, and neighbors are integral parts of healthy aging during the period of late adulthood (Golden, Conroy, & Lawlor, 2009). Retirement is a multidimensional transition that can be just as unsatisfying for some as it is satisfying for others, due to the many parts of life that are affected by this change. Aging is a part of life and so are the changes that ensue. Older adults are privy to stressful conditions surrounding their social interactions, their families, and their jobs. Many of these changes force older adults into situations that result in feelings of loss of control or an inability to perform tasks or participate in activities that were once a part of their daily lives (Van Solinge & Henkens, 2008). With an increase in life expectancy rates, more research should be done and more support should be provided for the aging population who will experience the transitions of changing roles in reference to their society, family, and work. Emotional and social development is very important to maintain in late adulthood. One study concluded that older adults who have a select group of friends and actively participate in social functions are more likely to experience satisfaction in this phase of life as well as better overall health. By the time an adult reaches late adulthood, they have had the opportunity to create many social networks. These networks can be with friends, neighbors, coworkers, church members, or with other organizations (Golden, et. al, 2009). Based on the assertion of the Activity Theory, social interactions are essential to the continuity of life in older adulthood. Often times, in many societies, social supports for the aging population are not frequently occurring. This can serve as a barrier for an adult who desires to become more involved with social events because they are unable to access the supports that they need. Social interactions are among the most beneficial parts of life for the older adults. Younger generations can gain insight from their years of experience and the older adults can share what they have learned through the course of their lives. The family structure of the 21st century presents a very different picture than from those of the past. Family structures may also differ from culture to culture and from generation to generation. Late adulthood can affect one’s role in their family in various ways. Members of the aging population may change from being independent adults to those who depend on the care of family members, nurses, or friends and neighbors. They may be forced into situations of caring for their grandchildren and/or great grandchildren. Some studies support ideas that the current view of grandparents, based on young adult populations, is that they should serve many roles in their family. These include, but are not limited to being a friend to their grandchildren, while serving as a religious guide and family historian (Dellmann-Jenkins, M., Hollis, A., & Gordon, K., 2005). Ruiz (2008) found that in many African American families the role of the grandmother has shifted to being the primary caregiver. From 1960 to 1990 the number of African American families led by married couples decreased from 78% to 39% (Ruiz, 2008). This shift can also be attributed to factors including substance abuse in addition to other social and health epidemics, such as teen pregnancy and AIDS. This vulnerable population has been left with an insurmountable burden of maintaining financial support, caring for themselves, other elder family members or spouses, and their grandchildren (Ruiz, 2008). Based on the results of these studies, it is evident that the aging population takes on chameleon type qualities to help their families adjust and remain strong in the face of adversities. Transitioning into retirement impacts the life and well-being of the older adult in varying ways. Some members of the aging population are happy to bring their physically demanding jobs to a close. However, some older adults view their jobs as providing more essential value, thus, find less satisfaction with retirement. Those who retire must prepare themselves to deal with the loss of the social connections they developed with their co-workers and adjusting to the free time they now have. Participation in various leisure activities and volunteering helps foster the development of new identities and adds satisfaction to this transitional period. A study of volunteer roles found that volunteering does positively affect stability and provide support for those who are retired (Van Solinge & Henkens, 2008). Others are unable to consider retirement due limited finances, the need to support other members of their family, or lack of available government support. As life expectancy increases, so does the need for research and support for the older adult population. After all, had it not been for the past and current contributions that this age group has provided and the changes they demanded and employed, how different would our world be' Oppressive Influences Elder Abuse Elder abuse is any intentional or negligent act by a caregiver or any other individual that causes harm or maybe a serious risk of harm to a vulnerable adult. According to Help Guide, Tens of thousands of seniors across the United States are being abused (Gill, et al. 2008). Many victims of elder abuse are people that are older and vulnerable. The reason for this is because these individuals cannot help themselves and they depend on others to meet their most basic needs. Elder abuse can occur in settings such as hospitals, nursing homes, or even in the community. By having an understanding of the most common types of elder abuse which are physical, emotional, sexual, and neglect by caregivers, and knowing the warning signs of elder abuse, family members will be able to protect the ones they love. Physical elder abuse is when someone, usually the caregiver, uses non-accidental force against an elderly person. An elderly individual that is demonstrating signs of physical abuse tends to have bruises or scars on the skin, broken bones, or even burns. Some types of physical abuse are slapping, bruising, or restraining an elderly individual. An example of a situation of an elderly person going through physical abuse is if a caregiver slaps an elderly person in a nursing home because they are not following directions given by the caregiver as a form of punishment. Emotional elder abuse is when someone speaks to or treats elderly individuals in ways that may cause pain or distress. Types of emotional elder abuse include behaviors from the elderly individual that mimics signs of dementia, for example rocking, sucking, or mumbling to oneself. Some warning signs of emotional abuse are belittling, or threatening an elderly individual. An example of an emotional abuse victim is an elderly person that has a tense relationship with their caregiver by constantly arguing with one another causing a strain in the relationship and unnecessary stress. Sexual elder abuse is inappropriate contact with an elderly person without their consent. Certain contacts can include physical sexual acts, or showing an elderly person pornographic material. In order for one to know if an elderly individual has been sexually abused there would be some sort of signs that will show it. Bruises around the breast area or genital area, genital infections, or torn, stained, or bloody underclothing are some of the signs of someone who is a victim of sexual elder abuse. Neglect from the caregiver is when the caregiver fails to fulfill caretaking obligations. It can be active or passive. Active neglect by a caregiver is intentional. Passive neglect by a caregiver is unintentional. A research study was conducted on a focus group of individuals who were concerned with the fact that elderly people would not report elder abuse because they depended on the caregiver for care and support: The other group was concerned that older people often find it difficult to report abuse/mistreatment because they rely on the abuser for care and support (Cornes et al. 2010). This allows elderly individuals to be known as being naïve and have a sense of trust for their caregiver no matter if they are being neglected or not. Some signs that demonstrate that an elderly person has been neglected by their caregiver are when the elderly individual is left dirty; they may have bed sores on their body, unusual weight loss due to malnutrition, and unsafe living conditions where there is no heat, or running water to bathe with. Mental Development During the late adulthood stage, older adults experience many different challenges in life. As older adults go through the aging process, they tend to have a lot of different mental challenges that can be hard to bear. Some of these challenges are fear, grief, and depression due to loss of friends, spouse, family members, and even a child. Older adults need help in order to cope with these challenges. Being involved in physical activities, social activities, and mental activities can improve mental development in older adults so that they will be able to age gracefully and enjoy life in a positive way. Participating in regular physical activities can protect your cognitive and emotional health. Older adults that are inactive in their lives tend to go through depression, anxiety, and stress worse than older adults that are active in their lives. According to the internet article WebMD, one study suggested that regular physical activity three or more times a week delayed the beginning of dementia and Alzheimer’s disease ("Healthy aging –emotional and," 2008). Some physical activities older adults can participate in are walking, biking, swimming, or taking a water aerobics class. These activities can help older adults keep a positive attitude and sense of well-being over time. Older adults can improve their emotional health by participating in social activities such as staying in touch with friends, family, and volunteering in the community. Staying in touch with friends and family can alleviate feelings of depression and loneliness, and volunteering allows older adults to share wisdom and talents with others. The book Living Agelessly, describes different places and ways that older adults can volunteer. Some of these include volunteering at local hospitals or reading to the blind, running errands for an aging neighbor, or delivering meals to someone who is housebound. They may also become a foster grandparent to a child, or mentor teenagers (Altoonian, 2009). Each of these activities can be very rewarding to the elderly adult as well as to the rest of society. Elderly adults can improve their memory and mental sharpness by participating in cognitive activities such as reading, doing crossword puzzles, playing word games, and learning how to use a computer. These activities will all do their part in keeping the brain active, as well as helping the brain to develop and thrive, while an inactive brain loses power as time goes by. Involvement in physical activities help keep older adults physically active, social activities help older adults build relationships with others, and cognitive activities help keep their brain active. These are some ways that mental development in older adults can be improved. Disengagement Theory When older adults gradually decrease their contact with family members and friends, and become socially detached from the roles that they previously held in society, they are experiencing something called disengagement (Achenbaum & Bengtson, 1994). The disengagement theory views aging as a process of steady withdrawal between the elderly and other members of society. According to the theory, disengagement benefits both the older population and the rest of society. This can occur when someone’s health deteriorates and they cannot fulfill the positions that they previously held. It is much easier to disengage and become self preoccupied than it is to admit that they are getting too old to fill their previous roles in society. Some have given the perspective that gradual withdrawal from society preserves social balance and provides a method for the transfer of knowledge and power from the older generation to the young (Achenbaum & Bengtson, 1994). By gradually taking oneself out of the societal equation, one is free to die without completely disrupting the way society functions. This theory has been the cause of much debate due to its general terms. For example, although many elderly people may disengage from their former work life and associates, they may fully engage in church life or family life. This theory is too quick to assume that older people gradually become more useless to society as they age, and that they are not valuable additions to society (Achenbaum & Bengtson, 1994). Another criticism of the disengagement theory is that it assumes that older people who do disengage do so willingly. The theory fails to realize that many times elderly people are seen as a burden and are placed in nursing homes to make life easier for the family. One could not help but to disengage when placed in such a predicament as being removed from their home and life as it was once known. (Achenbaum & Bengtson, 1994) Depression in Late Adulthood Clinical depression is a debilitating illness that can totally incapacitate an elderly person. Growth cohort of this population has seen an increased demand for treatment in this area. It is estimated that eight to 20 percent of community-dwelling elderly adults and one-third of all institutionalized elderly adults suffer from some form of depression (U.S. Department of Health and Human Services [USDHHS], 2001). Most elderly adults suffer from a milder form of clinical depression. It is estimated that less than five percent suffer from major depression (USDHHS, 2001). Even though an elderly person may be diagnosed with minor depression, they still may present with depressed mood, low energy, negativity, and appetite and sleep disturbances, all signs of clinical depression. Many elderly adults also suffer from a form of depression known as an adjustment disorder with depressed mood (McInnis-Dittrich, 2009). Adjustment disorder revolves around a specific event that has occurred in the individual’s life. Examples of this would be loss of a loved one, retirement, or the development of a major illness. These and other negative events precipitate a heightened emotional response. The danger of adjustment disorder is that the individual associates their sadness with just the event and not a treatable mental illness. It is important to realize that clinical depression is not a normal part of life or the aging process. Depressed elderly people can receive treatment through medication, counseling, or both to help them live normal and functional lives. When depression is left untreated the results can be catastrophic. A lower quality of life and increased emotional as well as physical pain may occur. Suicide also becomes an increased danger with untreated depression (McInnis-Dittrich, 2009). Suicide Suicide in late adulthood is a major concern. Within the population group of persons over the age of 65, the suicide rate is higher than any other group. Although the elderly account for only 13 percent of the population in the United States, they account for 16 percent of all completed suicides (Centers for Disease Control and Prevention [CDC], 2005). This figure proves suicide is not a problem exclusive to the young and middle adulthood periods of human development. It is amazing that the same attention is not given to the elderly in suicide prevention as the other groups. Death and Dying As the elderly face the challenges of depression, health issues, or even just aging itself, they inevitably think of their own death. Those older adults who have faced the loss of a loved one or suffer from chronic health problems may come to welcome death rather than fear it. Even with elderly adults who do not suffer from depression or illness there may be a general feeling of being ready to die at anytime. They have come to terms with death and may have made provisions for their final arrangements (McInnis-Dittrich, 2009). If death comes over a period of time such as a month or two there may be some physical and psychological symptoms that indicate death is close (Karnes, 1986). First, when a person becomes aware that death is inevitable they may begin the separation process where they begin to withdraw from family and friends. Next the person may appear confused or disoriented and may sleep most of the time. In addition, the person may appear to be talking to people who are deceased (Karnes, 1986). Last of all the individual may experience a surge of energy that may lead the family to believe a recovery is occurring, but this is an indicator that death is imminent (Karnes, 1986). Implications for Social Work The life span phase of late adulthood has multidimensional issues that could benefit from continued research, increased education and awareness, and implementing new policies. These new polices may serve to protect the lifestyles and liberties to sustain the quality of life in late adulthood. Based on the assertion of the Activity Theory it is imperative that older adults, remain active in order to maintain fulfillment in their lives. Social workers must pay closer attention to the resources that are available for older adults. More emphasis needs to be placed on adequate recreational activities to enhance the lives of adults in this stage of life. As roles change, older adults become more disconnected socially as a result of physical or mental illness, minor depression, retirement, and are more at risk for elder abuse. Macro levels of social work should be explored concerning creating policies that will ensure that this vulnerable population has all necessary resources to maintain a satisfactory quality of life. In contrast, the Disengagement Theory finds that the person will inevitably withdraw from family as well as other members of society. Based on research, this theory suffers many criticisms. Social workers must effectively and efficiently to address these misconceptions, in order to preserve the life expectancy of the older adult. Some clients may feel that disengaging from society is the norm for this age group, but social workers can assist clients in uncovering ways to help them continue to stay active in society. Social workers must be more proactive in identifying and addressing instances of elder abuse. Social workers need to be an advocate for raising awareness and recognition of the existence of these problems. Problems are not considered problems, until society identifies them as such. Stricter punishments should be placed upon those who abuse the elderly in an effort to reduce the occurrence. Policies should be created to help the families become more informed about the details of the abuse and the steps they should take to help protect their loved ones and others. Hopefully, through research and social work practice, the late adulthood phase will receive all the attention it most definitely warrants to ensure the well-being of our older adults. References Achenbaum, A. W., Bengtson, V. L., (1994) Re-engaging the Disengagement Theory of Aging: On the History and Assessment of Theory Development in Gerontology. The Gerontologist. 56(12), 756-763 Altoonian, L. (2009). Living agelessly creating a lifestyle for midlife and beyond. New York, NY: DiMedica. Centers for Disease Control and Prevention. (2005). Web-based injury statistics query and reporting system. Retrieved September 09, 2010, from Washington D.C.: Author: http://www.cdc.gov/nicipc/wisqars/default.htm Cornes, M., Manthorpe, J., & Haselden, N. (2010). Rural dimensions of elder abuse: contributions to the No Secrets review from rural older people. The Journal of Adult Protection, 12(3), 20-29. Gill, et al. (2008, February). Elder abuse and neglect: warning signs, risk factors, prevention, and help. Retrieved from http://www.helpguide.org/mental/elder. Golden, J., Conroy, R., & Lawlor, B. (2009). Social Support Network Structure in Older People: Underlying Dimensions and Association with Psychological and Physical Health. Psychology, Health & Medicine, 14(3), 280-290. Healthy aging-emotional and mental vitality. (2008, June 12). Retrieved from http://www.webmd.com/healthy-aging Karnes, B. (1986). Gone from my Sight: The dying experience. Stillwell: Author. McInnis-Dittrich, K. (2009). Social Work With Older Adults. Boston: Pearson Education, Inc. Perry, L.S. (2010). Human Factors: The Aging Workforce. Professional Safety, 22-28. Polan, Elaine. (2007). Journey across the life span [electronic resource]: human development and health promotion (3rd ed.). Philadelphia: F.A. Davis. Roberts, R. Albert. (2009). Social Workers Desk Reference (2nd ed.). New York, New York: Oxford University. Ruiz, D.S. (2008). The Changing Roles of African American Grandmothers Raising\ Grandchildren: An Exploratory Study in the Piedmont Region of North Carolina. The Western Journal of Black Studies, 32(1), 62-71. Slasberg, C., (2010). Can personalization be a reality for older people' Working with Older People 14(3), 15-22. U. S. Department of Health and Human Services. (2001). Mental health: Culture, race and ethicity. Washington D.C. Retrieved September 08, 2010, from Department of Health and Human Services, Offic of the Surgeon General, Substance Abuse and Menta Health Services: http://www.surgeongeneral.gov/mentalhealth/chapter5/sec3.html Van Solinge, H. & Henkens, K. (2008). Adjustment to and Satisfaction With Retirement: Two of a Kind' Psychology and Aging, 23(2), 422-434. Wilcox., Sharkey., Mathews., Laditka., Laditka., Logsdon., Sahyoun., Robare., Liu. (2009). Perceptions and Beliefs About the Role of Physical Activity and Nutrition on Brain Health in Older Adults. The Gerontologist, 49(1), 11.