43 Psychosocial Development in Older Adulthood

Ageism

As we have discussed throughout the course, our stereotypes about getting older lead us to assume, often unconsciously, that aging automatically brings poor physical health and mental decline. These stereotypes are reflected in everyday conversations, the media, and even in greeting cards (Overstreet, 2006). Age is not revered in most of the world today, and so laughing about getting older in birthday cards is one way to get relief. The conscious and unconscious negative attitudes  we have about getting older and those of us who are older people are examples of ageism, or prejudice based on age.  The term ageism was first used in 1969, and according to Nelson (2016), ageism 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.

Being the target of stereotypes can adversely affect individuals’ performance on tasks because they worry they will confirm the 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 the aging stereotypes will exhibit worse memory performance, worse physical performance, and reduced self-efficacy (Levy, 2009).

In terms of physically taking care of themselves, those who believe in negative stereotypes are less likely to engage in preventative health behaviors, less likely to recover from illnesses, and more likely to feel stress and anxiety, which can adversely affect immune functioning and cardiovascular health (Nelson, 2016).  Additionally, individuals who attribute their health problems to their age, had a higher death rate. Similarly, doctors who believe that illnesses are just natural consequence of aging are less likely to have older adults participate in clinical trials or receive life-sustaining treatment. In contrast, those older adults who possess positive and optimistic views of aging are less likely to have physical or mental health problems and are more likely to live longer. Removing societal stereotypes about aging and helping older adults reject those notions of aging is another way to promote health and life expectancy among older people. However, an even better way is for societies to take action to promote full inclusion of all of us at every age.

Minority status

In Canada research on visible minorities is sparse overall and tends not to distinguish between immigration status and visible minority status. Research is even more sparse for older people who belong to visible minority groups. Language and culture are challenges in understanding the issues and status of visible minority older people in Canada.  The limited research that has been done suggests the mental health and self-rated general health of older people who are visible minorities in Canada is below that of others their age who are not in visible minority groups as well as below the general Canadian population.

Older minority adults accounted for approximately 21% of the U. S. population in 2012, but are expected to reach 39% of the population in 2050 (U. S. Census Bureau, 2012). Unfortunately, racism is a further concern for minority older people already experiencing ageism. Older adults who are African American, Mexican American, and Asian American experience psychological problems that are often associated with discrimination by the White majority (Youdin, 2016).  Ethnic minorities are also more likely to become sick, but less likely to receive medical intervention. Older, minority women can face ageism, racism, and sexism, often referred to as triple jeopardy (Hinze, Lin, & Andersson, 2012), which can adversely affect their life in late adulthood. This also represents intersectionality.

Poverty rates

According to Quinn and Cahill (2016), the poverty rate for older adults  in the U.S. varies based on gender, marital status, race, and age. Women aged 65 or older were 70% more likely to be poor than men, and older women aged 80 and above have higher levels of poverty than those younger. Married couples are less likely to be poor than nonmarried men and women, and poverty is more prevalent among older racial minorities.  In 2012 the poverty rates for White older men (5.6%) and White older women (9.6%) were lower than for Black older men (14%), Black older women (21%), Hispanic older men (19%), and Hispanic older women (22%).

Living Arrangements

Do older people primarily live alone?

No. In 2014, of those 65 years of age and older, approximately 72% of men and 46% of women lived with their spouse (Vespa & Schondelmyer, 2015).  Between 1900 and 1990 the number of older adults living alone increased, most likely due to improvements in health and longevity during this time.  Since 1990 the number of older adults living alone has declined, because of older women more likely to be living with their spouse or children (Stepler, 2016c).

Women continue to make up the majority of older adults living alone in the U.S., although that number has dropped from those living alone in 1990 (Stepler, 2016a).  Older women are more likely to be unmarried, living with children, with other relatives or non-relatives. Older men are more likely to be living alone than they were in 1990, although older men are more likely to reside with their spouse. The rise in divorce among those in late adulthood, along with the drop-in remarriage rate, has resulted in slightly more older men living alone today than in the past (Stepler, 2016c).

Older adults who live alone report feeling more financially strapped than do those living with others (Stepler, 2016d). According to a Pew Research Center Survey, only 33% of those living alone reported they were living comfortably, while nearly 49% of those living with others said they were living comfortably. Similarly, 12% of those living alone, but only 5% of those living with others, reported that they lacked money for basic needs (Stepler, 2016d).

Do older people primarily live with family members?

No. There are significantly fewer older adults living in multigenerational housing; that is three generations living together, than in previous generations (Erber & Szuchman, 2015).  According to the Pew Research Center (2011), nearly 17% of the population lived in a house with at least two adult generations based on the 2010 census results.  However, ethnic differences are noted in the percentage of multigenerational households with Hispanic (22%), Black (23%), and Asian (25%) families living together in greater numbers than White families (13%).  Consequently, with the exception of some cultural groups, the majority of older adults wish to live independently for as long as they are able.

Do older people move after retirement?

No. According to Erber and Szuchman (2015), most older people remain in the same location, and often in the same house, where they lived before retiring. Although some younger people (65-74 years) may relocate to warmer climates, once they are older (75-84 years) they often return to their home states to be closer to adult children (Stoller & Longino, 2001).  Despite the previous trends, however, the recent housing crisis has kept older people in their current suburban locations because they are unable to sell their homes (Erber & Szuchman, 2015).

Do older people primarily live in institutions?

No. Only a small portion (3.2%) of adults older than 65 lived in an institution in 2015 (United States Department of Health and Human Services, 2015).  However, as individuals increase in age the percentage of those living in  institutions, such as a nursing home, also increases.  Specifically: 1% of those 65-74, 3% of those 75-84, and 10% of those 85 years and older lived in an institution in 2015.  Due to the increasing number of baby boomers becoming older adults, the number of people who will depend on long-term care is expected to rise from 12 million in 2010 to 27 million in 2050 (United States Senate Commission on Long-Term Care, 2013).  To meet this higher demand for services, a focus on the least restrictive care alternatives has resulted in a shift toward home and community-based care instead of placement in a nursing home (Gatz et al., 2016).

Erikson: Integrity vs. Despair

How do people cope with old age? According to Erikson, the last psychosocial stage is Integrity vs. Despair.  This stage includes, “a retrospective accounting of one’s life to date; how much one embraces life as having been well lived, as opposed to regretting missed opportunities,” (Erikson, 1982, p. 112).   Those in older adulthood need to achieve both the acceptance of their life and the inevitability of their death (Barker, 2016). This stage includes finding meaning in one’s life and accepting one’s accomplishments, but also acknowledging what in life has not gone as hoped. It is also feeling a sense of contentment and accepting others’ deficiencies, including those of their parents.  This acceptance will lead to integrity, but if older people are unable to achieve this acceptance, they may experience despair.  Bitterness and resentments in relationships and life events can lead one to despair at the end of life. According to Erikson (1982), successful completion of this stage leads to wisdom in near the end of life.

Erikson’s theory was the first to propose a lifespan approach to development, and it has encouraged the belief that older adults still have developmental needs.  Prior to Erikson’s theory, older adulthood was seen as a time of social and leisure restrictions and a focus primarily on physical needs (Barker, 2016). A societal and individual focus on being as healthy and active as possible helps to promote integrity.  There are many avenues for older people to remain vital members of society, and they will be explored next.

Staying Active

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 (Lemon, Bengston, & Peterson, 1972).  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. Erikson’s concept of generativity applies to many older adults, just as it did in midlife.

The Generativity of Older People

Research suggests that generativity is not just a concern for midlife adults. Concerns about future generations continue as midlife adults become older adults.  As previously discussed, some older adults are continuing to work beyond age 65.  Additionally, they are volunteering in their community, and raising their grandchildren in greater numbers.

Volunteering

Many older adults spend time volunteering.  Hooyman and Kiyak (2011) found that religious organizations are the primary settings for encouraging and providing opportunities to volunteer. Hospitals and environmental groups also provide volunteer opportunities for older adults.  While volunteering peaks in middle adulthood in current cohorts, it continues to remain high among adults in their 60s, with about 40% engaging in volunteerism (Hooyman & Kiyak, 2011).  While the number of older adults volunteering their time does decline with age, the number of hours older adults volunteer does not show much decline until they are in their late 70s (Hendricks & Cutler, 2004). In the US, African-American older adults volunteer at higher levels than other ethnic groups (Taylor, Chatters, & Leving, 2004). Taylor and colleagues attribute this to the higher involvement in religious organizations by older African-Americans.

Volunteering aids older adults as much as it does the community at large. Older adults who volunteer experience more social contact, which has been linked to higher rates of life satisfaction, and lower rates of depression and anxiety (Pilkington, Windsor, & Crisp, 2012). Longitudinal research also finds a strong link between health in later adulthood and volunteering (Kahana, Bhatta, Lovegreen, Kahana, & Midlarsky, 2013). Lee and colleagues found that even among the oldest-old, the death rate of those who volunteer is half that of non-volunteers (Lee, Steinman, & Tan, 2011). However, older adults who volunteer may already be healthier, which is why they can volunteer compared to their less heathy age mates.

New opportunities exist for older adults to serve as virtual volunteers by dialoguing online with others from around the world and sharing their support, interests, and expertise. These volunteer opportunities range from helping teens with their writing to communicating with ‘neighbors’ in villages of developing countries. Virtual volunteering is available to those who cannot engage in face-to-face interactions, and it opens-up a new world of possibilities and ways to connect, maintain identity, and be productive.

Grandparents raising Grandchildren

According to the 2014 American Community Survey (U.S. Census, 2014a), over 5.5 million children under the age of 18 were living in families headed by a grandparent. This was more than a half a million increase from 2010. While most grandparents raising grandchildren are between the ages of 55 and 64, approximately 25% of grandparents raising their grandchildren are 65 and older (Office on Women’s Health, 2010a). For many grandparents, parenting a second time can be harder.  Older adults have far less energy, and often the reason why they are now acting as parents to their grandchildren is because of traumatic events.  A survey by AARP (Goyer, 2010) found that grandparents were raising their grandchildren because the parents had problems with drugs and alcohol, had a mental illness, were incarcerated, had divorced, had a chronic illness, were homeless, had neglected or abused the child, were deployed in the military, or had died.  While most grandparents state they gain great joy from raising their grandchildren, they also face greater financial, health, education, and housing challenges that often derail their retirement plans than do grandparents who do not have primary responsibility for raising their grandchildren.

Social Networks in Older Adulthood

A person’s social network consists of the people with whom one is directly involved, such as family, friends, and acquaintances (Fischer, 1982).  As individuals age, changes occur in these social networks, and The Convoy Model of Social Relations and Socioemotional Selectivity Theory address these changes (Wrzus, Hanel, Wagner, & Neyer, 2013).  Both theories indicate that less close relationships will decrease as one ages, while close relationships will persist. However, the two theories differ in explaining why this occurs.

The Convoy Model of Social Relations suggests that the social connections that people accumulate differ in levels of closeness and are held together by exchanges in social support (Antonucci, 2001; Kahn & Antonucci, 1980).  According to the Convoy Model, relationships with a spouse and family members, people in the innermost circle of the convoy, should remain stable throughout the lifespan. In contrast, coworkers, neighbors, and acquaintances, people in the periphery of the convoy, should be less stable.  These peripheral relationships may end due to changes in jobs, social roles, location, or other life events.  These relationships are more vulnerable to changing situations than family relationships.  Therefore, the frequency, type, and reciprocity of the social exchanges with peripheral relationships decrease with age.

The Socioemotional Selectivity Theory focuses on changes in motivation for actively seeking social contact with others (Carstensen, 1993; Carstensen, Isaacowitz & Charles, 1999).  This theory proposes that with increasing age, our motivational goals change based on how much time one has left to live.  Rather than focusing on acquiring information from many diverse social relationships, as noted with adolescents and young adults, older adults focus on the emotional aspects of relationships.  To optimize the experience of positive affect, older adults actively restrict their social life to prioritize time spent with emotionally close significant others. In line with this theory, older marriages are found to be characterized by enhanced positive and reduced negative interactions and older partners show more affectionate behavior during conflict discussions than do middle-aged partners (Carstensen, Gottman, & Levenson, 1995). Research showing that older adults have smaller networks compared to young adults, and tend to avoid negative interactions, also supports this theory.

Relationship with adult children

Many older adults provide financial assistance and/or housing to adult children.  There is more support going from the older parent to the younger adult children than in the other direction (Fingerman  & Birditt, 2011).  In fact in general through the lifespan, more aid flows from older generations to  younger than vice versa. This is related to the developmental or intergenerational stake hypothesis (Lynott & Roberts, 1991) developed by theorists in the early 70s. According to this hypothesis, which has been supported by much research over time, parents tend to perceive closer relationships with their adult children than those adult children perceive with their parents. It is thought that this is due to the greater emotional investment parents have in their children than vice versa. However, generally, neither generation perceives itself to be in conflict with other generations, Lynott and Roberts found.  In addition to providing for their own children, many older people are raising their grandchildren. Consistent with socioemotional selectivity theory, older adults seek, and are helped by, their adult children providing emotional support (Lang & Schütze, 2002).

Lang and Schütze, as part of the Berlin Aging Study (BASE), surveyed adult children (mean age 54) and their aging parents (mean age 84). They found that the older parents of adult children who provided emotional support, such as showing tenderness toward their parent, cheering the parent up when he or she was sad, tended to report greater life satisfaction.  In contrast, older adults whose children provided informational support, such as providing advice to the parent, reported less life satisfaction.  Lang and Schütze found that older adults wanted their relationship with their children to be more emotionally meaningful. Daughters and adult children who were younger, tended to provide such support more than sons and adult children who were older. Lang and Schütze also found that adult children who were more autonomous rather than emotionally dependent on their parents, had more emotionally meaningful relationships with their parents, from both the parents’ and adult children’s point of view.

Friendships

Friendships are not formed in order to enhance status or careers, and may be based purely on a sense of connection or the enjoyment of being together. Most older people have at least one close friend. These friends may provide emotional as well as physical support. Being able to talk with friends and rely on others is very important during this stage of life. Bookwala, Marshall, and Manning (2014) found that the availability of a friend played a significant role in protecting  health from the impact of widowhood. Specifically, those who became widowed and had a friend as a confidante, reported significantly lower somatic depressive symptoms, better self-rated health, and fewer sick days in bed than those who reported not having a friend as a confidante. In contrast, having a family member as a confidante did not provide health protection for those recently widowed.

Loneliness or solitude?

Loneliness is the discrepancy between the social contact a person has and the contacts a person wants (Brehm, Miller, Perlman, & Campbell, 2002). It can result from social or emotional isolation. Women tend to experience loneliness due to social isolation; men from emotional isolation. Loneliness can be accompanied by a lack of self-worth, impatience, desperation, and depression. Being alone does not always result in loneliness. For some, it means solitude. Solitude involves gaining self-awareness, taking care of the self, being comfortable alone, and pursuing one’s interests (Brehm et al., 2002).