We are considered in late adulthood from the time we reach our mid-sixties until death. The number of Americans aged 65 and older is projected to more than double from about 46 million in 2018 to over 98 million by 2060, and the 65-and-older age group’s share of the total population will rise to nearly 24 percent from 15 percent.
We are currently living in an aging society (Rowe, 2009). Because of increases in average life expectancy, each new generation can expect to live longer than their parents/caregivers generation and certainly longer than their grandparents’ generation. As a consequence, it is time for individuals of all ages to rethink their personal life plans and consider prospects for a long life. When is the best time to start a family, if at all? Will the education gained up to age 20 be sufficient to cope with future technological advances and marketplace needs? What is the right balance between work, family, and leisure throughout life? What's the best age to retire? How can I age successfully and enjoy life to the fullest when I'm 80 or 90?
Developmentalists divide this population into categories with an "optimal aging" view. That is, exploring older adults through the lens of health and social well-being. Optimal aging refers to an individual's capacity to function across various domains—physical, functional, cognitive, emotional, social, and spiritual—to one’s own satisfaction and acknowledges that people have different levels of these domains. The optimal aging lens honors this fact. "Typical" aging refers to those who seem to have the same health and social concerns as the median majority of those in the population. However, there is still much being done to understand exactly what "typical" aging means. Non-typical aging (formerly called impaired aging) refers to those who experience non-optimal health and dependence to a greater extent than would be considered typical. Aging "successfully" involves making adjustments as needed in order to continue living as independently and actively as possible. This is referred to as selective optimization with compensation. For example, a person who can no longer drive, is able to find alternative transportation. Or a person who is compensating for having less energy, learns how to reorganize their daily routine to avoid over-exertion. Perhaps nurses and other allied health professionals working with older adults will continue and strengthen the focus more on helping people remain independent than on simply treating illnesses. Promoting health and a person's sense of independence are vital for optimal aging.
Many media portrayals of older adults reflect negative cultural attitudes toward aging. In the United States, society tends to glorify youth and associate it with beauty and sexuality. In comedies, older adults are often associated with grumpiness, over-the-top silliness or senility meant to be "funny." Rarely do the roles of older people convey the fullness of life experienced by seniors—as employees, lovers, or the myriad roles they have in real life. What values does this reflect?
Ageism is discrimination (when someone acts on a prejudice) based on age and it exists in all cultures (Brownell, 2010). Ageist attitudes and biases based on stereotypes reduce older people to inferior or limited positions. Ageism happens when we believe in the stereotypes of older adulthood and treat people as though they are conforming to those stereotypes or as we expect them to conform to those stereotypes. Popular expressions like, "You can't teach an old dog new tricks," cause us to pass our 50th or 60th birthday thinking it is too late to start something new such as going back to college.
Stereotypes of people in late adulthood lead many to assume that aging automatically brings poor physical health and mental decline when these issues really fall on a spectrum depending on many factors about an individual, including the cumulative effects of how they treated their bodies in younger years. These stereotypes are reflected in everyday conversations, the media, and even in greeting cards (Overstreet, 2006). We have all seen the "over-the-hill" greeting cards that mock growing older starting at around age 40. Age is simply not revered in the United States, currently. The negative attitudes people have about those in late adulthood are examples of ageism, or prejudice based on age and it remains one of the most institutionalized forms of prejudice today. Nelson (2016) reviewed the research on ageism and concluded that when older individuals believed their culture’s negative stereotypes about those who are old, their memory and cognitive skills declined. In contrast, older individuals in cultures, such as China, that held more positive views on aging did not demonstrate cognitive deficits. It appears that when one agrees with the stereotype, it becomes a self-fulfilling prophecy, or the belief in one’s ability results in actions that make it come true.
Think about it: A lot of times in our society, older people can not help but feel left out or "out of it," not "cool", and behind-the-times. The message comes through clearly– “You have to be young to be okay” or you must be an older adult who is non-typical in some way (brilliant, rich, hilarious, etc.) to be considered valued. These messages also stifle the expectations of younger people regarding their own aging process. Many younger people today fear getting closer to their 50th or 60th birthdays and beyond, viewing ageing as a sad event.
One hindrance to society’s fuller understanding of aging is that people rarely understand the process of aging until they reach older age themselves (as opposed to childhood, for instance, which we can all look back on). Therefore, myths and assumptions about older adults and aging are common. Many stereotypes exist surrounding the realities of being an older adult. While individuals often encounter stereotypes associated with race and gender and are thus more likely to think critically about them, many people just accept age stereotypes without question (Levy 2002).
You’ve likely seen online calculators that promise to determine your “real age” as opposed to your chronological age. These ads target the notion that people may “feel” a different age than their actual years. Some sixty-year-olds feel frail and elderly, while some eighty-year-olds feel sprightly. Equally revealing is that as people grow older they define “old age” in terms of greater years than their current age. Many people want to postpone old age and regard it as a phase that will never arrive. Some older adults even succumb to stereotyping their own age group (Rothbaum 1983) forgetting briefly that they are that exact age!
How do Stereotypes Effect Older Adults?
Today, wealth, power, and prestige are often held by those in younger age brackets. The average age of corporate executives was fifty-nine years old in 1980. In 2008, the average age had lowered to fifty-four years old and today, we see huge numbers of CEO's of Fortune 500 companies in their 30's and early 40's. This makes the stereotyped view of older adults in the career field (especially for aging women) as obsolete and out of touch with today's market by those younger. What are some potential implications of this? Being the target of stereotypes can adversely affect individuals’ performance on tasks because they worry they will confirm those cultural stereotypes. This is known as stereotype threat, and it was originally used to explain race and gender differences in academic achievement (Gatz et al., 2016). Stereotype threat research has demonstrated that older adults who internalize aging stereotypes exhibit worse memory performance, worse physical performance, and reduced self-efficacy (Levy, 2009).
Figure 10.2.3: Are these street signs humorous or harmful? (Flickr license: Tumbleweed via Flickr)
Here's a story: Driving to the grocery store, Peter, 23 years old, got stuck behind a car on a four-lane main artery through his city’s business district. The speed limit was 35 miles per hour, and while most drivers sped along at forty to forty-five mph, the driver in front of him was going the posted speed. Peter pressed on his horn. He then tailgated the driver in an attempt to get him to speed up. Finally, Peter had a chance to pass the car. He glanced over. Sure enough, Peter thought, a gray-haired old man guilty of “DWE,” driving while elderly. At the grocery store, Peter waited in the checkout line behind an older woman. She carefully paid for her groceries, slowly lifted her bags of food into her cart, and shuffled slightly toward the exit. Peter, guessing her to be about eighty years old, was reminded of his grandmother. He paid for his groceries and caught up with her. "Here," he said, grabbing one of her bags without asking. “I can help you with your heavy grocery bags.” “No, thank you. I can get it myself,” she said and marched off toward her car.
Peter’s responses to both older people, the driver and the shopper, were prejudiced. In both cases, he made unfair assumptions. He assumed the driver drove cautiously simply because the man was a senior citizen, and he assumed the shopper needed help carrying her groceries just because she was an older woman. Responses like Peter’s toward older people are fairly common. He didn’t intend to treat people differently based on personal or cultural biases, but he did.
Ageism can vary in severity, of course. Peter’s attitudes are probably seen as somewhat mild, but relating to older adults in ways that are patronizing can be offensive and harmful. When ageism is reflected in the workplace, in healthcare, and in assisted-living facilities, the effects of discrimination can be more severe. Ageism can make older people fear losing a job, feel dismissed by a doctor, or feel a lack of power and control in their daily living situations.
In early societies, the elderly were respected and revered. Many preindustrial societies observed gerontocracy, a type of social structure wherein the power is held by a society’s oldest members. In some countries today, the elderly still have influence and power and their vast knowledge is respected. Reverence for the elderly is still a part of some cultures, but it has changed in many places because of social factors.
In many modern nations, however, industrialization contributed to the diminished social standing of the elderly. Today wealth, power, and prestige are also held by those in younger age brackets. The average age of corporate executives was fifty-nine years old in 1980. In 2008, the average age had lowered to fifty-four years old (Stuart 2008). Some older members of the workforce felt threatened by this trend and grew concerned that younger employees in higher level positions would push them out of the job market. Rapid advancements in technology and media have required new skill sets that older members of the workforce are less likely to have.
Changes happened not only in the workplace but also at home. In agrarian societies, a married couple cared for their aging parents. The oldest members of the family contributed to the household by doing chores, cooking, and helping with child care. As economies shifted from agrarian to industrial, younger generations moved to cities to work in factories. The elderly began to be seen as an expensive burden. They did not have the strength and stamina to work outside the home. What began during industrialization, a trend toward older people living apart from their grown children, has become commonplace.
Mistreatment and Abuse
Mistreatment and abuse of the elderly is a major social problem. As expected, with the biology of aging, the elderly sometimes become physically frail. This frailty renders them dependent on others for care—sometimes for small needs like household tasks, and sometimes for assistance with basic functions like eating and toileting. Unlike a child, who also is dependent on another for care, an elder is an adult with a lifetime of experience, knowledge, and opinions—a more fully developed person. This makes the care-providing situation more complex.
Elder abuse occurs when a caretaker intentionally deprives an older person of care or harms the person in his or her charge. Caregivers may be family members, relatives, friends, health professionals, or employees of senior housing or nursing care. The elderly may be subject to many different types of abuse.
In a 2009 study on the topic led by Dr. Ron Acierno, the team of researchers identified five major categories of elder abuse: 1) physical abuse, such as hitting or shaking, 2) sexual abuse, including rape and coerced nudity, 3) psychological or emotional abuse, such as verbal harassment or humiliation, 4) neglect or failure to provide adequate care, and 5) financial abuse or exploitation (Acierno 2010).
The National Center on Elder Abuse (NCEA), a division of the U.S. Administration on Aging, also identifies abandonment and self-neglect as types of abuse. The table below shows some of the signs and symptoms that the NCEA encourages people to notice.
Signs of Elder Abuse. The National Center on Elder Abuse encourages people to watch for these signs of mistreatment. (Chart courtesy of National Center on Elder Abuse)
Bruises around breasts or genitals, torn or bloody underclothing, unexplained venereal disease
Emotional/psychological abuse
Being upset or withdrawn, unusual dementia-like behavior (rocking, sucking)
Neglect
Poor hygiene, untreated bed sores, dehydration, soiled bedding
Financial
Sudden changes in banking practices, inclusion of additional names on bank cards, abrupt changes to will
Self-neglect
Untreated medical conditions, unclean living area, lack of medical items like dentures or glasses
How prevalent is elder abuse? Two recent U.S. studies found that roughly one in ten elderly people surveyed had suffered at least one form of elder abuse. Some social researchers believe elder abuse is underreported and that the number may be higher. The risk of abuse also increases in people with health issues such as dementia (Kohn and Verhoek-Oftedahl 2011). Older women were found to be victims of verbal abuse more often than their male counterparts.
In Acierno’s study, which included a sample of 5,777 respondents age sixty and older, 5.2 percent of respondents reported financial abuse, 5.1 percent said they’d been neglected, and 4.6 endured emotional abuse (Acierno 2010). The prevalence of physical and sexual abuse was lower at 1.6 and 0.6 percent, respectively (Acierno 2010).
Other studies have focused on the caregivers to the elderly in an attempt to discover the causes of elder abuse. Researchers identified factors that increased the likelihood of caregivers perpetrating abuse against those in their care. Those factors include inexperience, having other demands such as jobs (for those who weren’t professionally employed as caregivers), caring for children, living full-time with the dependent elder, and experiencing high stress, isolation, and lack of support (Kohn and Verhoek-Oftedahl 2011).
A history of depression in the caregiver was also found to increase the likelihood of elder abuse. Neglect was more likely when care was provided by paid caregivers. Many of the caregivers who physically abused elders were themselves abused—in many cases, when they were children. Family members with some sort of dependency on the elder in their care were more likely to physically abuse that elder. For example, an adult child caring for an elderly parent while at the same time depending on some form of income from that parent, is considered more likely to perpetrate physical abuse (Kohn and Verhoek-Oftedahl 2011).
A survey in Florida found that 60.1 percent of caregivers reported verbal aggression as a style of conflict resolution. Paid caregivers in nursing homes were at a high risk of becoming abusive if they had low job satisfaction, treated the elderly like children, or felt burnt out (Kohn and Verhoek-Oftedahl, 2011). Caregivers who tended to be verbally abusive were found to have had less training, lower education, and higher likelihood of depression or other psychiatric disorders. Based on the results of these studies, many housing facilities for seniors have increased their screening procedures for caregiver applicants.
Where Have the Multi-Generational Households Gone?
In the United States, the experience of being an older adult has changed greatly over the past century. In the late 1800s and early 1900s, large numbers of U.S. households were home to multi-generational families, and the experiences and wisdom of elders was respected. They offered wisdom and support to their children and often helped raise their grandchildren. In some countries today, older adults still have influence and power and their vast knowledge is respected. Multi-generational U.S. families began to decline after World War II, and their numbers reached a low point around 1980. But now, they are on the rise again. In fact, the number of Americans living in multi-generational family households have continued to rise, despite improvements in the U.S. economy since the Great Recession. In 2016, a record 64 million people, or 20% of the U.S. population, lived with multiple generations under one roof, according to a new Pew Research Center analysis of census data (http://www.pewresearch.org/fact-tank...al-households/).
Figure 10.2.1 (Unsplash license; Vidar Nordli-Mathisen via Unsplash)
![Five sets of road signs, the top one green and the bottom one red in each set, are shown along the right-hand side of a road in a desert setting. The green signs all read “Senior Center” and feature an arrow pointing left. The blue signs, from front to back, read “Don’t Forget,” “Remember to [u]Turn![/u]”, “Wake Up!”, “Lunch Only $4,” and “Turn Now.”](https://oercommons.s3.amazonaws.com/media/courseware/openstax/m52956/Figure_13_03_02.jpg)
Figure 10.2.3: Are these street signs humorous or harmful? (Flickr license: Tumbleweed via Flickr)