WEEKLY SUMMARY

Chapter 1: Aging In America

Gerontology is the study of the human aging process from maturity to old age, as well
as the study of the older adult as a special population.
Gerontologists define aging in terms of (1) chronological aging, or number of years
since birth; (2) biological aging, or the changes reducing efficiency of organ systems;
(3) psychological aging, including memory, learning, adaptive capacity, personality, and
mental functioning; and (4) social aging, referring to social roles, relationship, and the
overall social context in which we grown old (Scheibe, Freund, & Baltes, 2007).
Cultural competence refers to the ability to honor and respect styles, attitudes,
behaviors, and beliefs of individuals, families, and staff who receive and provide
services (Yali & Revenson, 2004). Culturally competent practitioners are thus able to
support and reinforce older adults in achieving their own culturally appropriate sense of
self-efficacy, that is, to help elders develop personal mastery in a shifting internal and
external environment (Bullock-Yowell et al., 2011).
Historically the status of older people was related to property ownership that resulted in
the control of political resources. Ageism limits the potential development of
individuals on the basis of age. The media has used the term Detroit syndrome to
describe older people in terms of the obsolescence that exists for cars. Alex Comfort
(1976) used the term sociogenic to imply ageism in a broad sense. He described two
kinds of aging: physical, which is a natural biological process; and sociogenic, which has
no physical basis. Sociogenic aging is imposed on the elders by the folklore, prejudices,
and stereotypes about age that prevail in our society. The critical perspective in
gerontology draws attention to inequalities in U.S. society.
The population of Americans 65 years and older has greatly exceeded the growth of the
population as a whole, and the "oldest-old" (85 years and over) are the most rapidly
growing elderly age group. In the past decade, the number of men and women living to
85 years has increased dramatically; the number of those living past 85 has increased at
an even greater rate.

Chapter 2: Stereotypes and Images

Biomedicalization of aging emerged over a century ago with the growth of scientific
inquiry and subsequent breath-taking advances in medical sciences.
Compassionate stereotyping describes images that portray all older adults as
disadvantaged on some level, in need and deserving of help by others. The social
construction of self-addresses the idea that the way we interpret events in our lives is
partially the extent to which we have internalized the way society has defined or
categorized us.
Phenomenology is a methodology in which the meaning of an event is defined by the
person experiencing that event (or phenomenon), not a researcher's hypothesis.
A reversed stereotype of aging refers to older characters driving race cars, break-
dancing with great abandon, or referring to their amazing sex lives.

Chapter 3: Social and Psychological Theories in Later Life Development

Many metaphors are used to describe aging. In the narrative metaphor, development is
thought of as the story of a person's life. The emergent self-metaphor views the
individual as being highly self-directed and emphasizes choices and motivations as
primary factors in shaping development. The transcendent self-metaphor sees
development as being shaped by experience beyond the individual ego, sometimes from
a place of shared experience (Cruikshank, 2009).
Freud said that the influences shaping all that we are or will be occur in the first 8-10
years of life. From that point on, we replay the fears, insecurities, and issues that were
established through early interaction with our parent figures.
Jung said that over the life course, individuals move from self-in-society, a focus on
social interactions and institutions--to a more internal focus, or interiority. This process
of self-reflection begins to take place around midlife and becomes a central way in
which the individual is able to prepare for life's final state, death.
Each of Erikson's stages is identified with a developmental task, or challenge, to be
accomplished. The period in life of middle adulthood deals with the crisis of generativity
vs stagnation. In this stage generativity involves a concern for the welfare of society
rather than contentment with self-absorption. The crisis of later adulthood is integrity
versus despair. Erikson (1966) wrote " [ Integrity] is acceptance of one's one and only
life cycle as something that had to be and that, by necessity, permitted no substitutions.
The lack or loss of this (accumulated) ego integration is signified by fear of death."
The process of telling the "story" of life has been called life review,
or reminiscence. Levinson (1978) said the primary components of a life structure are
the person's relationships with others in the external world, identified as central
components and peripheral components, depending on their significance for the self and
the life. Through our life structure we are able to address the question, "What is my life
like now?" This question is addressed from a life course perspective-- life in context.
Ego-resiliency is the general capacity for flexible and resourceful adaptation to
external and internal stressors. The concept of "empty nest syndrome" has been used to
describe a midlife depression experienced by some women whose energies have been
focused on childrearing. Erikson said that the basic trust learned in infancy evolves
into the knowledge in old age of how interdependent we are. Continuity
theorists propose that a person's adaptations to young adulthood and middle age
predict that person's general pattern of adaptation to old age.

WEEKLY SUMMARY
Chapter 4: Physical Health and Well-Being
The absolute human life span is the maximum possible chronological age that the
human can live. Humans are considered capable of living about 120 years (Robine,
Crimmins, Horiuchi, & Zeng, 2007). As early as the 30s and 40s, most people
develop presbyopia, a condition in which near vision is impaired and the fine print of a
book or newspaper becomes difficult to see at close range. The majority of people over
the age 65 are in good health. Physical decline does become more apparent with
advancing age: those aged 75 and over usually have noticeable physical declines
compared to the middle aged, and those over 85 can be seen to have even more
noticeable declines. Ninety-five percent of Americans aged 65 and over live successfully
in the community.
The most widespread form of heart disease, coronary artery disease or ischemic heart
disease, is now the major killing disease in the United States and in other industrialized
nations as well. Two major disorders of the circulatory
system are atherosclerosis and hypertension. Falls are the most common cause of
accidental death among those 65 and over.
Biological aging is senescence, or the onset of the degenerative process, one that
usually becomes apparent between the ages of 40 and 45. A child born in the United
States today has a life expectancy of approximately 80 years. One immunological theory
of aging suggests that as the body ages, the immune system seems to increase its
capacity for autoimmune reactions and it develops more and more autoimmune
antibodies that destroy cells, even normal ones. Free radicals are highly reactive
molecules in the body that can damage cells, proteins, and DNA by altering their
structures. Calorie restriction clearly increases longevity in a number of species.
Patterns of exercise throughout the life and even exercise at any point during the life
produce positive physical and mental outcomes.

Chapter 5: Mental Health

The process of evaluating sensory information carried to the brain is
called perception. Cognitive pragmatics
reflects the knowledge and information of one's culture. Aerobic exercise and other
forms of physical activity have been shown to increase blood flow and increase speed of
reaction. The validity of IQ tests has been debated for years. They have been criticized
for being ethno-centric, sexist, and ageist (inadequate measures of applied knowledge)
(Lee, Blando, Mizelle, & Orozco, 2006). Crystallized intelligence is a measure of
knowledge you have acquired through experience and education.
Fluid intelligence refers to innate ability. Primary memory shows little change with age.
Age differences are found in working memory, or the processing of sensory stimuli to
give it meaning and transfer to longer-term storage.
It is a myth that older adults suffer from depression more than to younger adults.
Roughly 15 to 20 percent of older people suffer from mild depression or despondency,
and only 1 to 2 percent are clinically depressed. Multi-infarct dementia (MID) arises
from problems with blood flow to the brain. This vascular dementia is caused by a series
of small strokes (infarcts) that damage brain tissue over time.

Chapter 6: Friends, Family, and Community

Bonds between siblings typically extend throughout life and are reported to be second
only to mother-child ties in intensity and complexity. Siblings generally maintain contact
with one another, and sibling contact increases in old age. Middle age is the typical time
for becoming a grandparent. Half of Americans become grandparents by age 50
(Pilkauskas, 2012).
Lodges and fraternal organizations are the most commonly joined volunteer
associations. The term convoy (Antonucci & Akiyama, 1995) is used to evoke the image
of a protective layer of family and friends who surround a person and offer support.
Religiosity and spiritual well-being are independently associated with hope and positive
mood states in elderly people coping with cancer. Church and synagogue attendance for
older people exceeds that of other age groups. People aged 65 and over are the most
likely of any age group to belong to clubs, fraternal associations, and other church-
affiliated organizations.

Chapter 7: Intimacy and Sexuality

Intimacy is the need to be close to, to be part of, and to feel familiar with another
person. According to U.S. Census Data from 2010, more than three-quarters of men
between the ages of 65 and 74 were married, as to compared to 56% of women (U.S.
Census Bureau, 20010a). Older women are roughly half as likely to be married as are
older men (U.S. Census Bureau, 2010a). Among men, marriage is associated with a
lower risk of coronary heart disease, and socially isolated men and widowed women
seem at particular risk of a fatal cardiovascular event.
Men and women with good self-esteem also had good body attitudes, that is, they liked
their body. Body processes slow down with age, but do not stop. Masters and
Johnson found some changes do take place as a person ages. In men the ejaculatory
expulsion of semen is less forceful, and the erection may be lost faster after ejaculation.
It may also take longer to have another erection. For women, the walls of the vagina
become thinner, and they may produce less lubrication.
 WEEKLY SUMMARY
Chapter 8: Work and Leisure
In your text retirement is seen from the perspective of a social institution: it is a
person's definitive economic inactivity, with income from work replaced by income
established for support after employment ends. In 1935, with the passage of the Social
Security Act, all conditions for institutionalizing retirement were met. The law dictated
that people over 65 who had worked certain lengths of time were eligible for benefits,
and 65 became the age for retirement. Whether blue or white collar, most baby boomers
say they would like to retire by age 55. The U.S. Bureau of Labor report that workers
aged 45 and over have better safety records than younger workers.
Financial problems top the list of reasons for unfulfilled retirement expectations.
Palmore (2001) identified five types of retirement patterns: withdrawal, third-age
retirement, leisure retirement, protest retirement and acceptance retirement. With
the Reformation, religious reformers like Martin Luther and John Calvin suggested that
all work had an inherent dignity and value. A strong work ethic tends to be related to
low retirement satisfaction. The least satisfied retirees tend to be those with high work
values who do not perceive their retirement activities as being useful.

Chapter 9: Finances and Lifestyles

The United States began its Social Security program as a social welfare program to help
reduce the negative financial impact of the Great Depression (Quadagno,
2008). Medicare is a part of the Social Security system; those who are eligible for Social
Security benefits are also eligible for Medicare. Medigap policies are sold by private
companies to help cover the "gaps" in health care protection for which Medicare does
not provide. Prior to 1992, insurance carriers could sell any benefits they chose as
Medigap so long as minimum benefit requirements were met.

Chapter 10: Living Environments

Most people do not move from their own homes until they must do so for reasons of
safety. Aging in place has become a popular phrase reflecting people's general
preference to stay in their own home for as long as possible despite increasing frailty
and its associated problems. Many older people already live in formal retirement
communities known in the senior housing industry as naturally occurring retirement
communities (NORCs). These are buildings or neighborhoods where the residents have
aged over the years. There are many such neighborhoods throughout the country, both
in the suburbs, the rural Midwest, and inner cities. Neighborhoods, like individuals, go
through a life cycle of young to middle aged to old.

WEEKLY SUMMARY
Chapter 11: The Oldest-Old and Caregiving
The "oldest-old" more commonly refers to 85 and over. Other terms for the oldest-old--
the very old, the extreme aged, the dependent elderly and the frail elderly--have also
come into use, and they may have slightly different meanings. Respite care provides
short-term breaks that can restore energy and help caregivers regain balance in life.
Poorly paid paraprofessional home care workers are a transient work group with a high
turnover rate. Most training programs are minimal at best. In some states, home care
workers must undergo about 75 hours of training and pass a comprehensive test;
however, the requirements in many states include a few hours of training and no test.

Chapter 12: Special Problems

Though attacks on older people draw huge media attention, national surveys
consistently show that older adults are less likely to be victimized than younger adults.
Although less likely to be victims, older adults report a higher fear of crime than do
younger adults (Lanier & Dietz, 2012). Crime itself is endemic in the United States and
has been extensively studied (for example, Newman, 1984; Levitt, 2004). Crimes against
elders, however, have been less systematically examined. Current studies show that
older adults report higher levels of fear of crime than do other age groups; however,
crime data suggests that older adults are, in fact, less likely than younger cohorts to be
victims of crime (Lanier & Dietz, 2012).

Chapter 13: Women and Ethnic Groups

The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows women to keep
their health insurance coverage under their husbands' plans, at their own expense, for
up to three years after divorce, separation, or widowhood. The term double standard of
aging has been used to suggest the standard of aging for a woman that progressively
destroys her sense of beauty and self-worth, whereas the standard of aging for a man is
much less wounding.
Measured by numbers along, Native American elders constitute a very small percentage
of American society. By any social or economic indicator of living conditions, however,
Native American elders are possibly the most deprived of all ethnic groups in the United
States. Native Americans are the most rural of any ethnic group in the country (Hoyer &
Roodin, 2009). Native Americans usually have no work from which to retire. For most
over 65, old age is a continuation of poverty and joblessness that has lasted a lifetime.
Native American elders are more likely to suffer from chronic illnesses and disabilities
than any other ethnic aged group, and they have the lowest life expectancy.

Chapter 14: Death and Dying

Suicide in old age is statistically a man's issue--particularly older white men. In 2005,
the rates in old age for white and black women combined were about half that for white
men over 85 years of age (NIMH, 2009b). In 1980, Derek Humphrey founded the
Hemlock Society to help people make choices about how they would deal with terminal
illness. The motto of the society was "Good life, good death through control and choice."
Humphry gained international fame after writing Jean's Way, the personal account of
how he helped his terminally ill wife kill herself back in 1975. The society did not
believe that suicides were necessarily the result of poor mental health, but rather of a
sound decision based on good mental health in what is called rational suicide. Suicide is
twice as prevalent in western states as in the East and Midwest.

We live in a death-denying society. Elizabeth Kubler-Ross provided the foundation for

modern thanatology. The stages of death and dying that she discussed were denial and
shock, anger, bargaining, depression, acceptance, and finally hope.
Erik Erikson described a process of reminiscence as a source of life satisfaction for
older adults. The process of recollecting memories from the past helps to integrate past
experiences (who I was then) with the present (who I am now) and make reasonable
projections about the future (who will I be ... what will happen to me?). The life
reflection review resulting from this process may be told to other people, or it may be
preserved as private.
Life review is the form of reminiscence in which the reviewer actively evaluates the
past and attempts to resolve conflicts.
Interiority refers to a process common in mid-and later life of becoming more focused
on internal messages and stories and less focused on outside, social issues.
End of life curricula are not readily and fully available to medical students.
Palliative care is the medical specialty focused on relief of pain, stress, and other
debilitating symptoms of illness. Most people, when asked, express a desire to die at
home. Nearly 90 percent of all Americans will have a "managed death" in a hospital or
skilled nursing facility, which can lengthen life for up to several years through medical
and nursing interventions. Only about 30 percent of patients have advance
directives (AOA, 2011).
Passive euthanasia is the process of allowing people to die without using
extraordinary means to save their lives.
Assisted suicide is performing a deliberate act to end a person's life such as
administering a fatal injection. In November 1997, Oregon became the first state to pass
a law supporting physician-assisted suicide.