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 contents

PREFACE xiv Our Aging World 28

Ageism in the Future 29

1 Aging in America
2 Stereotypes and Images
An Interdisciplinary Topic 2
Person–Environment and Social Issues Stereotypes of Aging 35
Perspectives 5 Positive and Negative
The Person–Environment Approach 5 Stereotypes 36
Environmental Press 5 Who Is Old? 39
No Golden Age of Aging 6 The Legal Definition of “Old” 40
Personal and Social Definitions of Age 7 The Social Construction of Aging 41
Studies of Children’s Attitudes 43
Historical Perspectives on Aging 9
Changes in Attitude 43
Ageism 11 Studies of College Students’ Attitudes 44
Ageism Yesterday: The Early American
Explaining Stereotypes 46
Example 13
Historical and Cultural Explanations 47
Early Colonial Days 14
Social Forces: The Media 50
Shifting Status of Old Age 15
Television 50
The Aging Revolution: Demographics Advertising and Nonverbal
of Aging 16 Communication 52
Increasing Numbers of Aged 16 Movies 53
Global Aging 18 The Psychology of Prejudice 55
Increased Life Expectancy 19 Breaking Negative Stereotypes 55
Decreasing Birthrate 24 Emphasizing the Positive 56
Our Aging Nation 26 Consequences and Implications of
Living Arrangements 28 Stereotyping 57

vii

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 3 Social and Psychological 4 Physical Health and
Theories in Later Life Well-Being
Development The Aging Body: A Description 97
Early Developmental Normal Aging 98
Models 64 Health Status 100
Freud, 1856–1939 64 Chronic and Acute Conditions
Jung, 1875–1961 64 of Aging 101
Erikson, 1902–1994 65
Major Health Problems 103
Loevinger (1918–2008) 68
Accidents 107
Levinson, 1920–1994 68
Obesity and Diabetes 108
Transitions in Adult Life: Developmental
Why We Age: Theories of Aging 109
Patterns 69
Programmed Immune System 112
The Identification of Eras, Phases,
Free Radical Damage 112
or Stages 70
Young Adulthood 72 Longevity: The Role of Diet, Exercise,
Middle Age 73 and Mental Health 114
Late Life 79 Diet 114
Transitions in Late Life 81 Nutrition 115
Activity Theory 81 Exercise and Physical Fitness 116
Disengagement Theory 82 Changing Activity Patterns 118
Mental Health 119
Gerotranscendence 82
Continuity Theory: You Haven’t Changed Social and Environmental Factors in
One Bit 83 Longevity 121
Centenarians 121
Exchange Theory 85
Theoretical Roles of Individuals
and Society 86
Roles, Gender, and Ethnicity 86 5 Mental Health
Gender Development 86
The Psychology of Aging 126
Age Grading 87
Age Cohort 88 Cognitive Processes 128
Generations and Events 89 Basic Cognitive Functions 129
Longitudinal Studies 89 The Senses 129
The Maas-Kuypers Study 90 Sensory Memory 130
The Elder-Liker Study 90 Attention 130
The Baltimore Study 91 Perception 131
Cross-Sectional Studies: Coping and Psychomotor Speed 131
Adaptation 91 Intelligence 134

viii Contents

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 Learning and Memory 137 Social Networks 166
Primary Memory and Older Adult Friends and Neighbors 166
Working Memory 138 Social Organizations 167
Secondary Memory 139 Network Analysis 168
Tertiary Memory 140
Religion and Spirituality 169
Psychopathology and the Myth of
Strengthening Social Bonds 171
Senility 141
Functional Disorders 141
Anxiety Disorders 141
Generalized Anxiety Disorder 142 7 Intimacy and Sexuality
Obsessive-Compulsive Disorder 142
Phobia 142 Later-Life Couples 177
Depressive Disorders 142 Marital Status 178
Hypochondria 143 Older Adult Singles: Widowhood 182
Personality Disorders 144 Gender Differences in Widowhood 187
Affective Disorders 145 Older Adult Singles: Divorce 188
Schizophrenia 145 Older Adult Singles:
Organic Mental Disorders 145 The Never-Married 190
Alzheimer’s Disease 147 Remarriage 191
Multi-Infarct Dementia (MID) 150 Sexual Relationships and Sexuality 192
Alcoholism 150 Homosexual Relationships 194
Creutzfeldt-Jakob Disease 150
Sexual Invisibility 197
Parkinson’s Disease 150
Physical Attraction and Youth 197
Huntington’s Disease 151
Research on Sexuality 197
Caring for Older Adults with Mental
Masters and Johnson Studies 198
Illness 151
The Duke Longitudinal Study 199
Good Mental Health 152 Additional Studies on Sexuality 200
Improving Attitudes about Aging and
Sexuality 202
6 Friends, Family, Sexuality in Special Circumstances 202
and Community
Family Development in Later Life 156
Elders in the Kin Structure 156
8 Work and Leisure
Siblings in Older Adulthood 156 The Concept of Retirement 208
Variations in Kin Relations 161 The Trend toward Early Retirement 210
Grandparenting 162 Older Worker Discrimination 212

 Contents ix

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 Age Discrimination in the Profile of Poverty 254
Job Search 215 Culture of Poverty 254
On-the-Job Discrimination Relative Deprivation 254
and Ageism in Layoffs 216 A Piece of the Good Life 255
Myths about the Older Worker 219
Older Worker Performance 220
Adjustment to Retirement 220
The Taxpayer versus Early 10 Living Environments
Retirement 221
Retirement Preparation Programs 223 Person–Environment Fit 260

Work and Leisure Values 223 Living Environments 261

Work 224 Diversity in Living Arrangements 261
Leisure 225 Options and Choices for Living 262
Mobile Homes 265
Expanding Work and Leisure
Home Rental 265
Opportunities 226
Homelessness 265
Full-Time Work Opportunities 227
Dissatisfaction with Housing 271
Part-Time Work Opportunities 228
Personal Changes 271
Retraining 230
Financial Changes and Increasing
Leisure Opportunities 231
Maintenance 271
Urban Blight 272
Problems in Relocating 272
9 Finances and Lifestyles Shortage of Appropriate Housing 272
Uprooting 274
Financial Status 235 Migration 275
Diversity in Financial Status 237 Integration versus Segregation 277
Social Security or Social Aging in Place 279
Insecurity? 238 Downsizing 280
Worker to Retiree Ratio 239 Adult Day Care 281
Inequalities 242 Granny Units and Shared Housing 282
Private Pensions 243 Adult Communities 283
Pension Trends 243 Retirement Cities 283
Problems with Pensions 244 Assisted Living 283
Continuing Care Retirement Communities
Medical Expenses in Old Age 246
(CCRCs) 285
Medicare 247
Medigap 249 Nursing Homes 287
What Do They Offer? 287
Retirement Winners and Losers 250
Making the Decision to Move 288
House as an Investment 251
Locating a Nursing Home 289
Rural Elders 252 How Bad Are They? 291
Lifestyles of the Poor 254 New Trends in Nursing Homes 294

x Contents 

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 The Omnibus Budget Reconciliation Act Growing Old behind Bars 330
of 1987 (OBRA) 295 Elder Abuse 332
No Place to Go 295 Nursing Home Abuse 334
Residents 295 Fraud 335
Social Referral 336
Land and Home Equity Fraud 336
11 The Oldest-Old and Mail-Order, Television,
and E-mail Fraud 336
Caregiving Telemarket Fraud 336
The Oldest-Old 301 Credit Card Fraud 338
Physical Health 302 Door-to-Door Sales Fraud 338
Living Arrangements and Investment Fraud 338
Marital Status 306 Estate and Planning Fraud 338
Evaluation of Life 306 Medical and Health Care Fraud 339
Informal Caregiving 307 Medical Quackery 340
Obligations of Adult Children Medical Devices 341
to Parents 308 Youth Restorers and Miracle Drugs 341
Weakened Family Support Cancer Cures 341
Systems 310 Arthritis Cures 342
Demography 310 Alcoholism and Drug Abuse 342
Women’s Changing Roles 310 Prescription Drugs 342
Changing Intergenerational Promoting Consumer Education 345
Relationships 311
Spousal Caregiving 311
Adult Children as Caregivers 314
Childlessness 315 13 Women and Ethnic
Elder Caregiving to Adult Children Groups
and Grandchildren 315
Women 351
Solving Caregiving Problems 316 Financial Status 352
Psychological Interventions and Respite Middle-Aged Boomer Women 353
Care for Caregivers 318 Single, Widowed, and Divorced Older
The Home Care Crisis 319 Women 353
Single Women 353
Widows 354
12 Special Problems Divorced Women 355
Upgrading the Financial Status
Crimes against Older People 324 of Older Women 355
Fighting Back 327 Double Standard of Aging 356
Aging Criminals 329 Institutionalized Racism
Older Professional Criminals 329 and an Aging Population 357

 Contents xi

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 African Americans 358 Open Awareness 390
Income and Housing 358 Disconnection 390
Health Care and Life Expectancy 361 Matter of Choice 392
Family and Social Relationships 363 Hospice 392
Future Outlook 364 Right to Die 394
Hispanic Americans 365 Advance Directives 396
Demographics 365 Suicide and Assisted Suicide 397
Minority Status 366 Assisted Suicide 399
Migration Patterns 366 Informed Consent to Treatment 401
Utilization of Services 366 More Ethics in Aging 401
Studying Ethnic Variations 368
Funerals 402
Asian Americans 369
Suicide 403
Japanese Americans 370
Differences by Gender and Race 404
Chinese Americans 370
Choosing to Die 405
Southeast Asian Americans 371
Self-Destructive Behavior 406
Native Americans 372 Future Trends 406
Cultural Uniformity and Diversity 373
Facing and Preparing for Death 407
Population Data 373
Education, Employment, and Income 374 Bereavement 407
Health Characteristics 375
Improving the Status
of Ethnic Elders 376 15 Politics, Policies, and
Programs
Early Rumblings 413
14 Death and Dying Older Adults and Politics Today 416
A Death-Denying Society? 381 Voting 416
Holding Office 417
Fear of Death 382
Political Associations 418
Living Fully until Death 385 American Association of Retired Persons
Stages of Grief 385 (AARP) 419
Stage 1: Denial and Shock 386 The National Committee to Preserve
Stage 2: Anger 386 Social Security and Medicare
Stage 3: Bargaining 386 (NCPSSM) 420
Stage 4: Depression 386 Alliance for Retired Americans (ARA);
Stage 5: Acceptance 387 formerly National Council of Senior
The Life Review 387 Citizens (NCSC) 420
Care of the Dying in Hospitals 389 National Council on Aging 421
Closed Awareness 390 The National Caucus and Center on Black
Suspicion Awareness 390 Aged (NCCBA) 422
Ritual Drama of Mutual Pretense 390 The Gray Panthers 422

xii Contents 

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 The Older Americans Act and Other Foster Grandparent Program 426
Programs 423 Activism and Advocacy 427
Meals and Nutrition 424
The Equity Issue 428
Friendly Visiting and Telephone
Reassurance 424 Epilogue: A New Generation of Older
Employment 424 Adults 430
Adult Day Centers 425
Other Services 425 INTERNET RESOURCES 434
Concerns about Social Security 425 REFERENCES 438
Two Programs Not Funded
NAME INDEX 459
by the OAA 425
Road Scholar 425 SUBJECT INDEX 465

 Contents xiii

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 P r e fa c e

The face of aging has substantially changed in parents and grandparents of boomers are dy-
ing, most having lived much longer lives than
the past half century, and that change has been
did their parents and grandparents. Medical
almost exponential in the past five to ten years.
and social needs experienced by their aging
The “face of aging” refers not only to individ-
children, the boomers, has pushed innovation
ual physical and mental changes over time but
in medicine, health care delivery, social pro-
also to social, political, and cultural influences
gramming, education, and family structure.
on a population.
Gerontology is the integration of these ap-
War and global upheaval such as World
proaches and questions with a focus on out-
Wars II and the worldwide depression of the
come to adults of all ages. Gerontology is
1930s were major influencing events for our
interdisciplinary, addressing the complete per-
oldest-old. These people were children or
son and his/her family history; social history;
young adults looking ahead to educational
genetic history; and the political moment. It
and professional careers, striking out on their
also includes spiritual issues such as making
own and beginning their own families, when
meaning from life accomplishments and expe-
the economic crash occurred. World War II
riences, one’s relationship to things larger than
shifted life plans for that age cohort as careers
oneself, and gaining understandings of grief,
and educational plans were disrupted for ser-
dying, and death. No field of study more com-
vice to the country. The Korean and Vietnam
pletely integrates the mature person over the
wars loom as cultural shapers for boomers, and
life course than does gerontology.
the bombing of the Twin Towers on 9/11 has
This edition integrates social and cultural
shaped political perspective and attitudes for
perspectives with the story of the individual ag-
most everyone alive today. Even among those
ing process. It acknowledges global cultural
not yet born in 2001, the world they inherit has
influence: National boundaries are far more per-
been impacted by events beyond the control of
meable now than in the past. Those technologi-
their families or themselves. This includes the
cal advances and economic changes that have
worldwide economic crash in 2008, which in
extended our healthy, vigorous lives also connect
turn has influenced life course development as
us globally. We share a global interest in health
much as does one’s genetic makeup.
care and formal and informal policies impacting
In the past half decade, the leading edge
economic, educational, and political perspectives.
of the baby boomer generation has become
Learning can never come from a text-
eligible for Medicare and Social Security. The
book: Words do not generate knowledge;

xiv

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 they generate information. This text seeks to
help students understand issues and concepts, New to This Edition
and to encourage multiple ways of learning ●●
Chapter-by-chapter key concepts and learn-
and understanding the material. Each chapter ing objectives
ends with questions for discussion, experien- Each chapter is written with specific
tial learning, and exercises for using the Inter- learning objectives in mind, and those ob-
net as a learning tool. Each set of activities is jectives are named. For example, Chapter 1
integrated topically, theoretically, and peda- lists 15 objectives, or learning outcomes.
gogically, requiring a personal interaction of Chapter content is shaped by named key
students with the material. Included in each concepts that are related to the learning
chapter is a list of learning outcomes to be used objectives. In so doing, learners can under-
as a chapter guide. stand more specifically the purpose of chap-
ter content. With Chapter 1 as our example,
at its completion, students should be able
Features to define gerontology; predict demographic
changes as generations grow older; have a
●●
Key Concepts: These help students and greater understanding of different aging
faculty maintain focus on the main points patterns in developed and underdeveloped
of each chapter. They can be used as a countries, among other objectives.
framework for teaching and learning key Much like building blocks, these con-
topical ideas. cepts build chapter by chapter throughout
●●
Chapter Summary: Use as an organiza- the text. By completion of the book, stu-
tional tool for students to review. Each dents have been systematically exposed to
summary is linked to the chapter’s key the major multidisciplinary factors of aging
concepts, thereby reinforcing the learning in the United States.
framework. ●●
Greater integration of global issues
●●
Fieldwork Suggestions: These are experien- The well-being of American citizens
tial learning suggestions to guide teaching is inextricably linked to the well-being of
and learning. people around the world. This integration
●●
Discussion Questions: Use the questions includes health, monetary and political poli-
either as group discussions or as assign- cies and processes, and issues like natural
ments for written work. The questions disasters such as flooding and unnatu-
combine needs to think critically about ral disasters such as the tsunami-ravaged
theory as well as practice. Fukushima nuclear power plant in Japan.
It is beyond the scope of this text to
●●
Internet Activities: These suggestions for elaborate extensively on global issues; how-
exploration on the Internet challenge ever, cross-national topics are integrated in
students’ understanding of the power of the text and specifically addressed in as-
the Internet as a tool for learning. They signments and discussion questions. For
emphasize analysis of the complexity and example, Chapter 1 anticipates that stu-
reliability of Internet material. dents will be able to explain aging patterns
●●
Learning Objectives: The objectives itemize in countries with cultural and economic
the intent of the chapter for teaching and patterns different than ours; Chapter 10
learning purposes and can become a self- compares cross-cultural/cross-national pat-
learning guide for students. terns in housing preferences and living

 Preface xv

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 arrangements for older adults; and Chap- that are available for download. Go to login
ter 14 explores the universal emotion of cengage.com to create an account and log in.
grief and honors multicultural grieving and
burial processes. Instructor’s Manual
●●
Reorganization of subject matter for with Test Bank
a more effective sequence of learning
Streamline and maximize the effectiveness of
material
your course preparation using such resources
●●
Stronger links to policy, public will, and as chapter summaries, chapter outlines, key
policy implementation terms, video resources, and in-class activities.
Throughout, the text addresses the role This timesaving resource also includes a Test
of public policy and implementation in the Bank that offers 15 to 20 multiple-choice ques-
aging process. Chapter 4, for example, ex- tions, 10 to 15 true/false questions, and 3 to 5
plores physical and mental health from the essay questions for each chapter.
perspective of community support as well as
biological and personality factors. The role
of government support for later-life research
(Chapter 2); issues related to aging prison
Cengage Learning Testing
populations, elder abuse, and medical fraud
(Chapter 12); and sections in Chapters 9
Powered by COGNERO
(“Finances and Lifestyles”) and 11 (“The Cognero is a flexible, online system that allows
Oldest-Old and Caregiving”) are examples you to:
of a stronger integration of public policy,
●●
author, edit, and manage test bank content
policy implementation, and the public will. from multiple Cengage Learning solutions
The discussions of Social Security, Medicare, ●●
create multiple test versions in an instant
and Medicaid in Chapter 9 provide support ●●
deliver tests from your LMS, your class-
for classroom discussion of health care re- room, or wherever you want
form and the Affordable Care Act signed into
law by President Obama in 2010 and upheld
by the Supreme Court in 2012. Chapter 15
(“Politics, Policies, and Programs”) guides
PowerPoint Presentation
students to a jumping-off point for exploring Slides
cutting-edge policies relevant in whatever
state or nation they choose. These vibrant, Microsoft PowerPoint lecture
slides for each chapter assist you with your
●●
Integrated, extensive bibliography incor- lecture, by providing concept coverage using
porating professional literature as well as images, figures, and tables directly from the
popular literature and Internet sources textbook.

Supplements Acknowledgments
Instructor’s Companion Website Writing and editing a textbook is not a soli-
The book-specific website offers students a va- tary task. Thank you to the many people on
riety of useful resources such as an instructor’s the Cengage Publishing team, most especially
manual, test banks, and presentation slides Jean Smith and Seth Dobrin. Thanks also to the

xvi Preface 

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 reference librarians at Sonoma State University Leo University, Florida; Wendy Parker, Albany
in California who were cheerful and enthu- College of Pharmacy; and Daniel Van Dussen,
siastic in advising me on difficult-to-locate Youngstown State University.
materials. My family has been encouraging and stead-
Thank you Pamela Abbott-Enz, whose fast as I’ve written the 10th edition, providing
teaching skills and friendship allowed for very technical and moral support; food and remind-
useful idea exchanges to enhance teaching/ ers to eat; and humor/perspective in situations
learning objectives for the text. such as loss of my data following a computer
Thanks to the following also for thorough crash and the death of a keyboard. Thank you
review of the previous edition and very help- ever so much Alouise Hillier, my 93-year-old
ful comments and suggestions: Laura Brown, mom whose health, vigor, and good humor
State University of New York at Oswego; have been a huge moral support. Jennifer,
Kimberly Howell, California Lutheran Univer- Michael, Ben, Noah, Carol, Linda, Gabriele—
sity; Christine McClure, Cape Cod Community you are all part of the 10th edition of Aging,
College; Veronika Ospina-Kammerer, Saint the Individual, and Society. Thank you.

 Preface xvii

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Copyright 2015 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Aging in America
An Interdisciplinary Topic
Person–Environment and Social Issues Perspectives
1
No Golden Age of Aging
Personal and Social Definitions of Age
Historical Perspectives on Aging
Ageism
The Aging Revolution: Demographics of Aging
Global Aging
Our Aging Nation
Our Aging World
Ageism in the Future

AP Images/Gerald Herbert

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Who is growing old? We all are! In many peo- means to physically grow older. Its concern is
how we develop personally, socially, and glob-
ple’s minds, however, growing old is something
ally. This understanding, in turn, allows us to
that happens only to others and only to indi-
plan for our own well-being in later life, and
viduals older than themselves. If you have not
to consider issues of quality of later life on a
yet reached your 50s, can you imagine yourself
social level.
to be 65, 75, or 90? With reasonable care and
Gerontology as a scholarly field has changed
a bit of good luck, you will live 75 or more.
markedly since its fledgling beginnings in the
With advances in medical science and technol-
1950s. One of the earlier gerontologists, John
ogy, and an increased awareness of taking care
Rowe, described a “new gerontology” in which
of our bodies, we all can anticipate long lives.
the focus “goes beyond the prior preoccupation
But what will be the quality of our lives? As
with age-related diseases . . . to include a focus
we advance through life, aging may bring either
on senescence . . . and physiological changes
despair or enhanced vitality and meaning.
that occur with advancing age and that influ-
Indeed, in the 21st century, many social and med-
ence functional status as well as the develop-
ical issues of aging focus more on postponing
ment of disease” (Rowe, 1997, p. 367). To his
senescence (age-related loss of function) and on
concept of new gerontology, we might add a
ensuring a good quality of life than on ensur-
focus on the social issues that are inherent in
ing old age itself. For example, for the past
any society undergoing social, interpersonal,
30 years, research on the health risks of environ-
and economic change as rapidly as the United
mental factors like cigarette smoking or air and
States and other industrialized countries are
water quality; on genetics and genetic engineer-
doing now, in part because of their changing
ing; and on biochemical and pharmaceutical
demographics.
factors in health have all combined to increase
The term aging is wildly nonspecific: Wine
our longevity. Concern with living well in our
ages, babies age, galaxies age, we each are ag-
old age is now at least as great an issue for
ing right now regardless of our chronological
many people as concern with living a long life.
ages. Clearly that does not imply a common
biological process. Aging in the context of this
An Interdisciplinary Topic text refers to progressive changes during adult
years, but these changes are not necessarily
The study of aging is exciting and complex and negative nor do they necessarily reduce an in-
can be examined from many perspectives. It dividual’s viability. For example, gray hair is a
can be viewed through emotional, physiologi- result of aging, but does not impair a person’s
cal, social, cognitive, or philosophical lenses. functioning. Because of negative stereotyping,
These are the “core” areas, along with areas however, gray hair might have negative social
like public policy and economics. Gerontology meaning in some cultures.
is the study of the human aging process from Mutations that may accumulate over
maturity to old age, as well as the study of the time in certain genes in cells in the reproduc-
older adult as a special population. Geriatrics, tive system, on the other hand, describe age-
on the other hand, is the study of health and related loss of function, which is referred to
disease in later life. Geriatrics is concerned with as senescence. Gerontologists define aging in
the comprehensive health care of older people, terms of (1) chronological aging, or number
plus the well-being of their caregivers. Overlap of years since birth; (2) biological aging, or the
is clearly present: Gerontology adds a dimen- changes reducing efficiency of organ systems;
sion to the broad understanding of what it (3) psychological aging, including memory,

2 Chapter 1

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 learning, adaptive capacity, personality, and The impact of context is huge: A society
mental functioning; and (4) social aging, re- that gives the aging person high status can
ferring to social roles, relationships, and the expect a more positive outcome for its aging
overall social context in which we grow old population, whereas a society that accords the
(Scheibe, Freund, & Baltes, 2007). aged a low or marginal status can expect more
negative outcome. Within the sociological cir-
cle are anthropologists, who, in documenting
Old age isn’t so bad when you consider the aging process around the world, find that
the alternative. cultures offer elders enormously varied roles.
Maurice Chevalier, New York Times, Also in the circle are political scientists, social
October 9, 1960 policy experts, and historians. Demographic
and population experts provide information on
the numbers and distribution of older people in
Perhaps the most basic discipline in the societies and countries around the world and
study of aging is biology. Without the biologi- provide projections of population trends for
cal aging process, we could all theoretically live consideration by politicians and generators of
forever, but the causes of biological aging are public policy.
still not clearly understood. A third lens from which aging is viewed
A study of biological aging includes all is that of psychology. In contrast with a so-
kinds of animals as well as detailed analyses ciological perspective, the psychological locus
of the human body. The effects of diet and ex- of inquiry is on the individual. Psychologists
ercise (lifestyle effects) on longevity are an im- are interested in the aging mind—how per-
portant focus of study, and the cutting-edge ception, motor skills, memory, emotions, and
field of genetics has dramatically changed our other mental capacities change over time. The
understanding of the complexity of the human psychological constructs of motivation, adapt-
organism. We can impact our biological health ability, self-concept, self-efficacy, and morale
through attention to lifestyle; however, we can all have an important impact on how we age.
do nothing—at this point—about our genetic Psychologists bring a perspective to solving
background. Recent research indicates, how- social problems that considers individuals in
ever, that genes determine about one-quarter terms of their life span, or particular places
of our longevity (Rattan & Singh, 2009). That in the life span rather than one point in time.
leaves three-quarters of how long we will live They view individuals as being dynamic and in-
up to factors such as lifestyle and social envi- teractive, existing in multiple webs of relation-
ronment—factors that can be addressed by ship, history, and culture. Psychologists focus
individuals and by society. We are more in con- on identifying the connections between internal
trol of what will be our well-being in later life (psychological) and external (social) aspects of
than we can imagine. an individual’s life.
A second component of gerontology, the Studies of older people cannot be complete
sociological perspective, examines the structure without including an understanding of philoso-
of society—its norms and values and their in- phy, spirituality, and ethics. Virtually all theo-
fluence on how a person perceives and reacts ries of human development suggest that the
to the aging process. Rather than focusing on psychological task of later life is to gain greater
individual experience, however, sociology fo- understanding of the life we have lived and of
cuses on groups of individuals and the cultural our own approaching death. We seem to gain
context in which they age. greater clarity of the meaning of our lives by

Aging in America 3

Copyright 2015 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 asking the very questions that have been asked of ethics and values requires that psychologists
throughout the history of humankind: What and health care practitioners be culturally com-
was this life all about? What is the relationship petent (Wang, 2007). Cultural competence re-
of the people I am connected with to the mean- fers to the ability to honor and respect styles,
ing of my life? What is my understanding of attitudes, behaviors, and beliefs of individu-
death—my own as well as the deaths of others? als, families, and staff that receive and provide
What is my legacy? services (Yali & Revenson, 2004). Culturally
In a related vein, ethical issues are central competent practitioners are thus able to sup-
in the care of older adults as well as in life de- port and reinforce older adults in achieving
cisions elders make themselves. Families are their own culturally appropriate sense of self-
the major care providers for frail elders in efficacy, that is, to help elders develop personal
the United States, and they deal with issues of mastery in a shifting internal and external envi-
competence and decision making; as well, au- ronment (Bullock-Yowell et al., 2011).
tonomy and family relationships are central Gerontologists, then, are multidisciplinary.
to families and therefore to the larger society They examine aging from a chronological
of which they are part (Vitaliano, Young, & perspective (age on the basis of years from
Zhang, 2004). Developing an understanding birth); they study biological and psychological

Hill Street Studios/Blend Images/Jupiter images

Multi-generational gatherings of friends and family are central to the transmission and validation of family and
cultural values.

4 Chapter 1

Copyright 2015 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 processes and individual meanings of aging; and leisure, and sexuality and relationships. We dis-
they look at the social meaning of aging includ- cuss the strengths and contributions that elders
ing changing roles and relationships brought bring to their families and communities, and
about by moving through the course of life. we discuss the perspectives that address wide-
Additionally, they study the meaning of aging spread patterns of behavior affecting quality of
from a contextual perspective: family, community, life indicators. The causes and solutions of so-
and national/geopolitical processes and events. cial problems do not remain at the individual,
Gerontologists apply their specialty and are or micro level, but must ultimately be found
practitioners in many fields—medicine, den- at a greater level—they require macro-level re-
tistry, occupational therapy, economics, social sponse. Generalized problems associated with
work, mental health, sociology, religion, educa- aging and with a society that is aging lie with
tion, recreation, and many other fields having large numbers of people; the causes and so-
to do with the health and well-being of individ- lutions impact everyone, not just an age-
uals and society. The field of geriatrics, a term identified segment of the population.
sometimes confused with gerontology, focuses
on preventing and managing later life illness The Person–Environment
and disease. Geriatrics is less multidimensional Approach
than gerontology, looking specifically at biolog-
ical and physiological health issues. Geriatrics A person–environment approach views the en-
is a medical model perspective; gerontology is a vironment as a continually changing context
biopsychosocial model. to which individuals adapt as they also adapt
Geriatricians are physicians who have spe- to the personal, psychological, and physical
cialized in internal medicine and family medi- changes inherent in the aging process. From
cine for the physiological health of care of this perspective, as aging people adjust to life’s
older adults. Geriatrics differs from gerontol- changes, this adaptation impacts the environ-
ogy in that the former is a medical specialty, ment, which—cycle-like—further changes the
and the latter, a study of the aging process from individuals as well as the social context (Hoyer &
individual, cultural, and social perspectives. Roodin, 2009).
The extent to which individuals are able to
adapt to the changing environment or adjust
the environment to their changing physical and
Person–Environment and social needs (home safety, food preparation,
other assistance) is a reflection of adaptation to
Social Issues Perspectives the aging process.
This reciprocity of change—person to en-
In this text, both social issues and psychological
vironment, environment to person—is known
perspectives and strategies are presented as fac-
as the person–environment model. The context
tors in understanding aging. Social situations
changes so individuals must change; individu-
that are problematic or undesirable for a large
als change, thereby impacting their context,
proportion of older adults, as well as those
and so the environment changes.
situations and solutions that function to pro-
mote well-being in later life, will be examined.
Chapter by chapter, the text addresses social is-
Environmental Press
sues affecting the lives of older people—issues Eventually, an individual’s ability to adapt
of status, roles, income, transportation, health, or change will become exhausted. Let’s use
housing, physical and mental health, work, an example. An 84-year-old woman becomes

Aging in America 5

Copyright 2015 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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