On a local, state, and federal level, programs and services are available for those in later adulthood. What supports are available in your local community for individuals 65 years of age and above? Do you see any gaps in services? Given we are now living longer, do you believe the current array of resources is adequate to meet the growing need of those in this age group?
In response to your peers, engage openly in response to the posts of
How prevalent is elder abuse and neglect in our society? In this video, Catherine Aaronson speaks from the heart about elder abuse. She provides us personal experiences of her own grandmother, whom she describes as her best friend, and the maltreatment she suffered. Catherine is pointed in her views on empowering the elderly, listening to their voice and the power of families to support them. She is inspirational in the manner in which she speaks of the elderly and the changes we can make within our communities towards creating a better life for this vulnerable population.
Biological Aspects of Later Adulthood
This chapter will help prepare students to
· LO 1 Define later adulthood
· LO 2 Describe the physiological and mental changes that occur in later adulthood
· LO 3 Understand contemporary theories on the causes of the aging process
· LO 4 Describe common diseases and major causes of death among older adults
· LO 5 Understand the importance of placing the highest priority on self-care.
LeRoy was a muscular, outgoing teenager. He was physically bigger than most of his classmates and starred in basketball, baseball, and football in high school. In football he was selected as an all-state linebacker in his senior year. At age 16, he began drinking at least a six-pack of beer each day, and at 17 he began smoking. Because he was an athlete, he smoked and drank on the sly. Since LeRoy was good at conning others, he found it fairly easy to smoke, drink, party, and still play sports. That left little time for studying, but LeRoy was not interested in that, anyway. He had other priorities.
LeRoy received a football scholarship and went on to college. He did well in football and majored in partying. His grades suffered, and when his college eligibility in football was used up, he dropped out of college. Shortly after dropping out, he married Rachel Rudow, a college sophomore. She soon became pregnant and also dropped out of college. LeRoy was devastated after leaving college. He had been a jack for 10 years, the envy of his classmates. Now he couldn’t get a job with status. After a variety of odd jobs, he obtained work as a road construction worker. He liked working outdoors and also liked the macho-type guys with whom he worked, smoked, drank, and partied.
LeRoy and Rachel had three children, but he was not a good husband. He was seldom at home, and when he was, he was often drunk. After a stormy seven years of marriage that included numerous incidents of physical and verbal abuse, Rachel moved out and got a divorce. She and the children moved to Florida, along with her parents, so that LeRoy could not continue to harass her and the children. LeRoy’s drinking and smoking increased. He was smoking more than two packs a day, and he sometimes also drank a quart of whiskey.
A few years later, he fathered a child for whom he was required to pay child support. At age 39, he married Jane, who was only 20. They had two children and stayed married for six years. Jane eventually left because she became fed up with being assaulted when LeRoy was drunk. LeRoy now had a total of six children to help support, but he seldom saw any of them. LeRoy continued to drink and also ate to excess. His weight went up to 285 pounds, and by age 48 he was no longer able to keep up with the other construction workers. The construction company discharged him.
The next several years saw LeRoy taking odd jobs as a carpenter. He didn’t earn much, and he spent most of what he earned on alcohol. He was periodically embarrassed by being hauled into court for failure to pay child support. He was also dismayed because he no longer had friends who wanted to get drunk with him. When LeRoy was 61, the doctor discovered he had cirrhosis of the liver and told LeRoy he wouldn’t live much longer if he continued to drink. Since LeRoy’s whole life centered on drinking, he chose to continue to drink. LeRoy also noticed that he had less energy and frequently had trouble breathing. The doctor indicated that he probably had damaged his lungs by smoking and now had a form of emphysema. The doctor lectured LeRoy on the need to stop smoking, but LeRoy didn’t heed that advice either. His health continued to deteriorate, and he lost 57 pounds. At age 64, while drunk, he fell over backward and fractured his skull. He was hospitalized for three and a half months. The injury permanently damaged his ability to walk and talk. He is now confined to a low-quality nursing home. He is no longer allowed to smoke or drink. He is frequently angry, impatient, and frustrated. He no longer has friends. The staff detests working with him; his hygiene habits are atrocious, and he frequently yells obscenities. LeRoy frequently expresses a wish to die to escape his misery.
Elroy Karas is 14 months younger than his brother LeRoy. Elroy’s early years were in sharp contrast to LeRoy’s. Elroy had a lean, almost puny, muscular structure and did not excel at sports. LeRoy was his parents’ favorite, and also dazzled the young females in school and in the neighborhood. Elroy had practically no dates in high school and was viewed as a prude. He did well in math and the natural sciences. He spent much of his time studying and reading a variety of books, and he liked taking radios and electrical appliances apart. At first, he got into trouble because he was not skilled enough to put them back together. However, he soon became known in the neighborhood as someone who could fix radios and electrical appliances.
He went on to college and studied electrical engineering. He had no social life but graduated with good grades in his major. He went to graduate school and obtained a master’s degree in electrical engineering. On graduating, he was hired as an engineer by Motorola in Chicago. He did well there and in four years was named manager of a division. Three years later, he was lured to RCA with an attractive salary offer. The group of engineers he worked with at RCA made some significant advances in television technology.
At RCA, Elroy began dating a secretary, Elvira McCann, and they were married when he was 36. Life became much smoother for Elroy after that. He was paid well and enjoyed annual vacations with Elvira to such places as Hawaii, Paris, and the Bahamas. Elroy and Elvira wanted to have children, but could not. When Elroy was in his early 40s, they adopted two children, both from South Korea. They bought a house in the suburbs and a sailboat. Elroy and Elvira occasionally had some marital disagreements but generally got along well. In their middle adult years, one of their adopted sons, Kim, was tragically killed by an intoxicated automobile driver. That death was a shock and very difficult for the whole family to come to terms with. But the intense grieving gradually lessened, and after a few years Elroy and Elvira put their lives back together.
Now, at age 67, Elroy is still working for RCA and loving it. In a few years, he plans to retire and move to the Hawaiian island of Maui. Elroy and Elvira have already purchased a condominium there. Their surviving son, Dae, has graduated from college and is working for a life insurance company. Elroy is looking forward to retiring so that he can move to Maui and spend more time on his hobbies—photography and making model railroad displays. His health is good, and he has a positive outlook on life. He occasionally thinks about his brother and sends him a card on his birthday. Since Elroy never had much in common with LeRoy, he seldom visits him.
Later adulthood is often the age of recompense (our return for the way we lived earlier). How we live in our younger years largely determines how we will live in our later years.
Later adulthood is the last major segment of the lifespan. The age of 65 has usually been cited as the dividing line between middle age and old age (Santrock, 2016). There is nothing magical or particularly scientific about 65. Wrinkles do not suddenly appear on the 65th birthday, nor does hair suddenly turn gray or fall out. In 1883, Germany set 65 as the criterion of aging for the world’s first modern social security system (Sullivan, Thompson, Wright, Gross, & Spady, 1980). When our Social Security Act was passed in 1935, the United States followed the German model by selecting 65 as the age of eligibility for retirement benefits.
Older people are an extremely diverse group, spanning an age range of more than 30 years. Looking at this age span biologically, psychologically, and sociologically, we can see a number of differences, for example, between Sylvia Swanson, age 65, and her mother, Maureen Methuselah, age 86. Sylvia owns and operates a boutique, making frequent buying trips to Paris, Mexico City, and San Francisco, while Maureen has been a resident of a nursing home since the death of her husband 13 years ago.
Gerontologists—doctors who specialize in medical care of older people—have attempted to deal with these age-related differences among older people by dividing later adulthood into two groups: young-old—ages 65 to 74 years; and old-old—ages 75 and above (Santrock, 2016).
Our society tends to define old age mainly in terms of chronological age. In primitive societies, old age was generally determined by physical and mental condition rather than by chronological age. Such a definition is more accurate than ours. Everyone is not in the same mental and physical condition at age 65. Aging is an individual process that occurs at different rates in different people, and sociopsychological factors may retard or accelerate the physiological changes. As Spotlight 14.1 indicates, people can continue to live productive lives long past the age of 65.
Spotlight on Diversity 14.1
· At 100, Grandma Moses was still painting.
· At 99, twin sisters Kin Narita and Gin Kanie recorded a hit CD single in Japan and starred in a television commercial.
· At 94, Bertrand Russell was active in international peace drives.
· At 93, George Bernard Shaw wrote the play Farfetched Fables.
· At 93, Dame Judith Anderson gave a one-hour benefit performance.
· At 91, Eamon De Valera served as president of Ireland.
· At 91, Adolph Zukor was chairman of Paramount Pictures.
· At 91, Hulda Crooks climbed Mount Whitney, the highest mountain in the continental United States.
· At 90, Pablo Picasso was producing engravings and drawings.
· At 89, Albert Schweitzer headed a hospital in Africa.
· At 89, Arthur Rubinstein gave one of his greatest recitals in New York’s Carnegie Hall.
· At 88, Michelangelo drew architectural plans for the Church of Santa Maria degli Angeli.
· At 88, Konrad Adenauer was chancellor of Germany.
· At 87, Mary Baker Eddy founded the Christian Science Monitor.
· At 85, Coco Chanel was the head of a fashion design firm.
· At 84, W. Somerset Maugham wrote Points of View.
· At 82, Leo Tolstoy wrote I Cannot Be Silent.
· At 81, Benjamin Franklin effected the compromise that led to the adoption of the U.S. Constitution.
· At 81, Johann Wolfgang von Goethe finished Faust.
· At 80, George Burns won an Oscar for his role in The Sunshine Boys.
· At 77, Ronald Reagan was finishing his second term as president of the United States.
These internationally noted individuals prove that age need not be a barrier to making major contributions in life. Unfortunately, the discrimination against older people in our society prevents many of them from having a meaningful and productive life.
It is a mistake to view later adulthood as a time of inevitable physical and mental decline. Stereotyping later adulthood as an “awful” life stage is erroneous, and sadly is a factor in older adults’ being treated as “second-class citizens” by some people who are younger.
On the whole, people today are living longer and faring better than at any time in history. In Japan, old age is a mark of status. For example, travelers to Japan are often asked their age when checking into hotels—to ensure that if they are older adults they will receive proper deference (Papalia & Martorell, 2015).
In the United States, older adults as a group are healthier, more numerous, and younger at heart than ever before. Many 70-year-olds think, act, and feel as 50-year-olds did two decades ago. On television, older adults are less often portrayed as cranky and helpless, and more often as respected and wise.
The process of aging is called senescence. Senescence is the normal process of bodily change that accompanies aging. Senescence affects different people, and various parts of the body, at different rates. Some parts of the body resist aging more than others. In this section, we will look at the aging process in later adulthood.
Changes in physical appearance include increased wrinkling, reduced agility and speed of motion, stooping shoulders, increasing unsteadiness of the hands and legs, increased difficulty in moving, thinning of hair, and the appearance of varicose veins. Wrinkling of the skin is caused by the partial loss of elastic tissue and of the fatty layer of the skin.
The acuity of the senses generally deteriorates in later years. The sense of touch declines with age due to drying, wrinkling, and toughening of the skin. The skin also has increased sensitivity to changes in temperature. Since the automatic regulation of bodily functions responds at a slower rate, older people often “feel the cold more.” Exposure to cold and to poor living conditions may cause abnormally low body temperature, which is a serious problem for some older people. They cannot cope as well as younger people with heat either, and therefore cannot work as effectively in moderately high temperatures as younger people can.
The sense of hearing gradually deteriorates. The ability to hear very high tones is generally affected first. As time goes on, the level of auditory acuity becomes progressively lower. Many older people find it difficult to follow a conversation when there is a competing noise, as from a radio, television, or other people talking. An impairment in hearing is five times more likely in those aged 65 to 79 than it is in individuals aged 45 to 64 years. Men are more apt to experience hearing impairments than are women (Santrock, 2013b). People who have a hearing impairment are apt to feel lonely and isolated, as they cannot as readily join in conversations. Sometimes such an impairment and related feelings of isolation facilitate the development of personality quirks that make people harder to get along with, which further increases their loneliness. (We see once again how the physical and social environment can affect emotional development.)
Vision also declines. Most people over age 60 need glasses or contact lenses to see well. The decline in vision is usually caused by a deterioration of the lens, cornea, retina, iris, and optic nerve. The power of the eye to adjust to different levels of light and darkness is reduced, and color perception is also reduced. Older people are likely to have 20/70 vision or less, they are not as able to perceive depth as others are, and they cannot see as well in the dark, a problem that keeps many of them from driving at night. Half of the legally blind persons in the United States are over 65 (Papalia & Martorell, 2015).
In many older people, the eyes eventually appear sunken due to a gradual loss of orbital fat. The blink reflex is slower, and the eyelids hang loosely because of reduced muscle tone.
Cataracts are a common concern of older people. A cataract is a clouding of the lens of the eye, or of its capsule, that obstructs the passage of light. The consequences of a cataract for visual functioning depend on its location. The most common form of a cataract involves hardening of cell tissues in the lens. Cataracts prevent light from passing through and can thus cause blurred vision and blindness. In severe cases, double vision may result. Cataracts generally can be surgically removed and a substitute lens implanted. More than half of older adults develop cataracts (Papalia & Martorell, 2015). Fortunately, with the development of corrective lenses and new surgical techniques for removing cataracts and implanting artificial lenses, many vision losses can be fully or partially restored.
A frequent cause of blindness among older people is glaucoma, which occurs when fluid pressure in the eye builds up. This pressure, if untreated, damages the eye internally. If this disease (which seldom has early symptoms) is detected through routine vision checkups, it can be treated and controlled with eyedrops, medication, surgery, or laser treatments.
Macular degeneration, which is age related, is the leading cause of functional blindness in older people. This condition occurs when the center of the retina gradually loses the ability to sharply distinguish fine details. Smokers are about two-and-a-half times as likely to develop this condition (Papalia & Martorell, 2015).
The senses of taste and smell have reduced functional capability during advancing years. Much of this reduced sensitivity appears to be related to illness and poor health rather than to a deterioration of sense organs due to age. Taste is often based on what people can smell. More than four out of five persons over 80 years of age have major impairments in smell, and more than half have practically no sense of smell at all (Papalia & Martorell, 2015). Because food loses its taste for those who have serious impairments in smell and taste, those affected eat less and are often undernourished.
The vestibular senses, which function to maintain posture and balance, also lose some of their efficiency. As a result, older people are more prone to fall than younger adults. Older people are also more apt to suffer from dizziness, which increases the likelihood they will fall.
As people grow older, their gums gradually recede, and the teeth increasingly take on a yellowish color. Periodontal disease (a disease of the gums) becomes an increasing problem. Many older people eventually lose many of their teeth; the problem is more severe for people from low income levels, who often have financial and transportation barriers to receiving dental care (Santrock, 2016). Having teeth replaced with dentures takes several weeks of adjustment, and the person is not able to eat or sleep as well during this period. Poor teeth or the use of dentures may also be traumatic, as it indicates that the person is aging physically. A person’s disposition can be adversely affected. On the other hand, for some people dentures improve their appearance and may lead to an improved self-concept. Many of the facial evidences of later adulthood can be prevented by proper dental care throughout life or by using dentures. Dental health is related to a combination of innate tooth structure and lifelong eating and dental health habits.
In later adulthood, the voice may become less powerful and more restricted in range. Public speaking and singing abilities generally deteriorate earlier than normal speaking skills. These changes are partly due to the hardening and decreasing elasticity of the laryngeal cartilages. Speech often becomes slower, and pauses become longer and more frequent. If there are pathological changes in the brain, slurring may occur.
The skin in many older people becomes somewhat splotchy, paler in color, and loses some of its elasticity. Some of the subcutaneous muscle and fat disappears, resulting in the skin hanging in folds and wrinkles.
Older people can do most of the same things that younger people can do, but they do them more slowly. A key factor in the high accident rates of older people is a slowdown in the processing of information by the central nervous system (Papalia & Martorell, 2015). It takes older people longer to assess their environment, longer to make a decision after assessment, and then longer to implement the right action. This slowness in processing information shows up in many aspects of older people’s lives. Then rate of learning new material is slowed, and the rate at which they retrieve information from memory is reduced.
Have you ever been irritated when an older person was driving a car slowly in front of you? Perhaps you even blasted your car horn in an attempt to hurry that person along. We need to remember that older people are probably functioning at the pace that is safe for them.
The slower processing times and reaction times have practical implications for drivers. Older people have higher accident rates than do middle-aged adults. Their rates are similar to those of teenagers (Papalia & Martorell, 2015). However, the reasons for these relatively high accident rates differ. Teenagers frequently have accidents because they tend to be more reckless and often take risks. Older people tend to have accidents because they are slower in getting out of the way of potential problems and they have less efficient sensorimotor coordination. Older people have as great a need to drive as others. Being able to drive often means the difference between actively participating in society or facing a life of enforced isolation. Older drivers can compensate for any losses of ability by choosing easier routes, driving slower, driving shorter distances, and by only driving in daylight.
Physical exercise and mental activity appear to reduce losses in psychomotor skills, such as in the areas of speed, strength, and stamina. Regular exercise also helps to maintain the circulatory and respiratory systems and helps people be more resistant to physical ailments that might be fatal, such as heart attacks.
The notion that there is a general intellectual decline in old age is largely incorrect. Most intellectual abilities hold up well with age. Older people do tend to achieve somewhat lower scores on IQ tests than younger people, and the scores of older people gradually decline as the years pass (Santrock, 2016). In explaining such differences, Papalia and Martorell (2015) note that a distinction needs to be made between performance and competence. While older people show a decline in performance on IQ tests, their actual intellectual competence may not be declining. Their lower performance on IQ tests could be due to a variety of factors. With their diminished capacities to see and hear, they have more difficulty perceiving instructions and executing tasks. Due to their reduced powers of coordination and agility, they may perform less well. They may be more fatigued, and fatigue has been found to suppress intellectual performance. Speed is a component of many IQ tests, and older people have a decline in speed because it takes them longer to perceive, longer to assess, and longer to respond (Santrock, 2016). In addition, when older people know they are being timed, their anxiety increases, as they know that it takes them longer to do things than it used to; such increased anxiety may actually lower performance (Papalia et al., 2012).
Ethical Question 14.1
1. Do you believe most older people will gradually become senile? If you answered yes, does this belief affect how you relate to an older person?
There are still other factors in older people’s IQ test performance. IQ tests include items that are designed to test intelligence in younger people; as a result, some of the items may be less familiar to older people—which lowers their scores. Older people are consistently more cautious than the young; this may hinder their performance on IQ tests, which generally emphasize risk taking and speed. Older people are more apt to have self-defeating attitudes about their abilities to solve problems; such attitudes may become self-fulfilling prophecies on IQ tests.
When older adults lose the capacity to drive a vehicle, it severely restricts their social interactions, is an assault on their mental well-being, and lessens their independence.
The reduced performance by older people on IQ tests may also be partly due to a lessening of continuing intellectual activity in later adulthood. It appears that the reduced use of one’s intellectual capacities results in a reduction of intellectual ability. Such a proposition underscores the need for older people to remain intellectually active.
A terminal drop in intelligence—that is, a sudden drop in intellectual performance—often occurs a few weeks or a few months before death from a terminal illness (Papalia & Martorell, 2015). A terminal drop is not limited to older people; it is also found in younger people who have a terminal illness.
It is not possible at this time to draw definite conclusions as to whether intellectual functioning actually declines in later adulthood. IQ scores do go down, but that does not mean intellectual competence declines, for the reasons cited. Continuing intellectual activity serves to maintain intellectual capacities. Further information about myths surrounding intellectual and physical functioning of older people is presented in Highlight 14.1.
Senility can be defined as an irreversible mental and physical deterioration associated with later adulthood. Many people erroneously believe that every older person will eventually become senile. This is simply not accurate. Although the physical condition of older people deteriorates somewhat, older people can be physically active until they are near death. Furthermore, the vast majority of older people show no signs of mental deterioration (Santrock, 2016).
Senility is not a true medical diagnosis, but a wastebasket term for a range of symptoms that, minimally, include memory impairment or forgetfulness; difficulty in maintaining attention, and concentration; a decline in general intellectual grasp and ability; and a reduction in emotional responsiveness to others.
Those older people who appear disoriented and confused are apt to be suffering from one or more of over 100 illnesses, many of which are treatable. Infections, an undiagnosed hardening of the blood vessels in the brain, Alzheimer’s disease, anemia, brain tumors, and thyroid disorders—these are only a few of the medical conditions that can cause a person to have senility-like symptoms.
A person’s maximum height is reached by the late teens or early 20s. In future years, there is little or no change in the length of the individual bones. In older people, there may be a small reduction in overall height due to a progressive decline in the discs between the spinal vertebrae. The b
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