Growing older means confronting psychological highs and lows that come with entering the last phase of life. Young people moving into adulthood take on new roles and responsibilities as their lives expand, but an opposite arc can be observed in older age.
Each phase of life has challenges. As you likely recall, the psychologist Erik Erikson, in his psychosocial theory, broke the typical life span into eight phases. Each phase presents a particular challenge to overcome. In the final stage, late adulthood, the challenge is to embrace ego integrity over despair. Some people are unable to successfully overcome the challenge. They may have to confront regrets. They may have to accept that they will never reach certain career goals. Or they must come to terms with what their career success has cost them, such as time with their family or declining personal health. Others, however, are able to achieve a strong sense of ego integrity and are able to embrace the new phase in life. When that happens, there is tremendous potential for creativity. They can learn new skills, practice new activities, and peacefully prepare for the end of life.
Ego Integrity vs. Despair
Erikson believed that late adulthood is a time for making sense out of one’s life, finding meaning to one’s existence, and adjusting to inevitable death. He called this stage ego integrity vs. despair. Imagine being able to look back on life with the sense that whatever choices you made as a younger person, those choices served to help grow you (or others, or even the world) in some positive way. Of course, life does not typically involve perfect choices or linear growth. But a sense of general contentment and acceptance, understanding and tolerance of others are important features of integrity. Bitterness and unresolved resentments about life events can bring a sense of despair in older adulthood as one asks the question, "Did I live a meaningful life?" But, Erikson's theory leaves room to heal emotionally and gain a sense of "ego integrity". Some ways (and this is not an exhaustive list) include psychotherapy, strong social support, journaling, forgiving ourselves or others, and taking time to mourn our losses and move forward however feels right for us.
Here is a "snap shot" view of Ego Integrity vs. Despair:
Ego Integrity involves:
Feeling whole, complete, satisfied with achievements
Viewing life in the context of all humanity
Achieving psychosocial maturity
Despair (of this stage) involves:
Feeling too many decisions were wrong, yet time is now too short; holds strong regrets
Having an overall sense of bitterness; unaccepting of death
Enmeshed with a general sense of anger and contempt for others; blames others for personal failures
Aging and Sexuality
Figure 10.4.1: In Harold and Maude, a 1971 cult classic movie, a twenty-something young man falls in love with a seventy-nine-year-old woman. The world was shocked by this movie! What is your response to this picture, given that that the two people are meant to be lovers, not grandmother and grandson? (Flickr license; luckyjackson via Flickr)
It is no secret that people in the United States are unsettled about the subject of sex when it comes to older adults expressing their sexuality. It seems that no one wants to think about it or even talk about it. Most people want to believe that as we age, we become completely asexual, as though aging and asexuality automatically go hand-in-hand (ignoring also the fact that many people are asexual from an early age and others enjoy sexual activity well into their 90s and beyond). That fact is part of what makes 1971’s Harold and Maude so provocative. In this cult favorite film, Harold, a wealthy, alienated young man, meets and falls in love with Maude, a seventy-nine-year-old eccentric woman. What is so telling about the film is the reaction of his family, priest, and psychologist, who exhibit disgust and horror at such a match.
Although it still remains somewhat taboo to have an open, public national dialogue about aging and sexuality, the reality is that our sexual selves do not disappear after age sixty-five and older adults feel the consequences of the asexual-after-65 stereotype in ways including feeling isolated in sharing about their intimate lives to fear in seeking safe sex methods resulting in a rise in Sexually Transmitted Infections (STIs) among the aging population. "Older adults appear to be at increasing risk for STIs," says Dr. Khady Diouf, a reproductive infectious disease specialist at Harvard-affiliated Brigham and Women's Hospital. Diouf points to several possible reasons for the increase in STIs among older adults which includes not getting STI screening and treatment because both they and their doctors are often reluctant to raise the issue (Harvard Health Publishing).
Figure 10.4.2: Consistent with a cultural discomfort about aging and sex, openly license images depicting such things are hard to find. (Unsplash license; Renate Vanaga via Unsplash)
Aging and Social Interaction
Aging "Out": LGBTQ Seniors
How do different groups in our society experience the aging process? Are there any experiences that are universal, or do different populations have different experiences? An emerging field of study looks at how older lesbian, gay, bisexual, and transgender and queer (LGBTQ) people experience the aging process and how their experience differs from that of other groups or the culturally dominant group. This issue is expanding with the aging of the Baby Boomer generation; As the Baby Boomer generation ages, the older adult population will increase from 12.8 percent to an estimated 19 percent in 2030 (https://www.apa.org/pi/lgbt/resources/aging.aspx).
A study titled Shifting Social Context in the Lives of LGBTQ Older Adults found that more than 2/3 of LGBTQ older adults have experienced victimization and discrimination more than three times in their lives, including discrimination in health, aging, and disability services (Public Policy & Aging Report, 2018). As these older adults transition to assisted-living facilities, they have the added burden of “disclosure management:” Having to decide with each new caretaker if it is safe to be "out" and discuss a life partner they may be missing terribly or the loneliness involved. In one case study, a 78 year old lesbian lived alone in a long-term care facility. She had been in a long-term relationship of thirty-two years and had been visibly active in her community earlier in her life. However, in the long-term care setting, she was much quieter about her orientation, feeling safer with anonymity and silence (Jenkins et al. 2010).
Even with laws that have passed to promote protection of these older adults, new data from a survey (Discrimination in America; Harvard School of Public Health, 2017) shows that discrimination still abounds and discourages LGBTQ older adults from seeking care and that they often have trouble finding alternative services if they are turned away. These data underscore the importance of protecting LGBTQ people from discrimination in health care. In the future, this will undoubtedly be an expanding career field for gerontologists, psychologists, medical personnel, and caregivers. Services intended for the older adult population need to be assessed proactively with positive changes implemented as may be necessary to be welcoming for people who are both older and identify as LGBTQ.
Disengagement Theory
Disengagement theory (Cummings & Henry, 1961) suggests that during late adulthood, the individual and society mutually withdraw. Older people become more isolated from others and less concerned or involved with life in general. This once popular theory is now criticized as being ageist and used in order to justify treating older adults as second class citizens. Most older adults do not disengage from society.
Activity Theory
Many older adults want to remain active and work toward replacing opportunities lost with new ones. Those who prefer to keep themselves busy demonstrate the Activity theory, which states that greater satisfaction with one’s life occurs with those who remain active. Not surprisingly, more positive views on aging and greater health are noted with those who keep active than those who isolate themselves and disengage with others. Community, faith-based, and volunteer organizations can all provide those in late adulthood with opportunities to remain active and maintain social networks. According to Activity theory, social barriers to engagement, not the desires of aging adults, cause declining rates of interaction if that occurs. Erikson’s concept of generativity applies to many older adults, just as it did in midlife.
Continuity Theory
Another theory, Continuity theory, suggests that as people age, they continue to view the self in much the same way as they did when they were younger. Their approach to problems, goals, and situations is much the same as it was before. They are the same individuals, but simply in older bodies. Consequently, older adults continue to maintain their identity even as they give up previous roles. For example, a retired Coast Guard commander attends reunions with shipmates, stays interested in new technology for home use, is meticulous in the jobs she does for friends and displays mementos of life on the ship. She is able to maintain a sense of self as a result. We do not give up who we are as we age. Hopefully, we are able to share these aspects of our identity with others throughout life. Focusing on what a person can do and pursuing those interests and activities is one way to optimize and maintain self-identity.
