Chapter 18
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Erikson’s Psychosocial Theory — eighth or final
stage of life is called ego integrity or despair; he
believed people who achieved positive outcomes to
earlier life crisis would be more likely to obtain ego
integrity than despair in late adulthood
Ego Integrity versus Despair — basic challenge is to
maintain the belief that life is meaningful and
worthwhile in the face of physical decline and the
inevitability of death; ego integrity derives from
wisdom, as well as from the acceptance of one’s
life span as being limited and occurring at a certain
point in history; adjustment in the later years
requires wisdom to let go
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Peck outlined three developmental tasks
that people face in late adulthood: 1) Ego
differentiation versus work-role
preoccupation; 2) Body transcendence
versus body preoccupation; 3) Ego
transcendence versus ego preoccupation
Ardelt (2008) writes that ego transcendence
grows out of self-reflection and willingness
to learn from experience; ego
transcendence is characterized by a concern
for the well-being of humankind in general,
not only of themselves and those they love
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Butler (2002) suggests reminiscence is a
normal aspect of aging; life reviews are
generally unguided; they can be extremely
complex and nuanced; they can be
incoherent and self-contradictory; life
reviews attempt to make life meaningful, to
help people move on with new relationships
as others in their lives pass on, and to help
them find ego integrity and accept the end
of life
Butler (2002) argues helping professionals
rely too much on drugs to ease the
discomforts of older adults; pilot programs
suggest therapists may be able to relieve
depression and other psychological
problems in older adults by helping them
reminisce about their lives
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Disengagement theory — older people and
society mutually withdraw from one another
as older people approach death; people in
late adulthood focus more on their inner
lives, preparing for the inevitable;
government or industry now supports them
through pensions or charity rather than vice
versa; family members expect less from
them; older people and society prepare to
let go of one another
Well-being among older adults is predicted
by pursuing goals, rather than withdrawal
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Activity theory — older adults are better
adjusted when they are more active and
involved in physical and social activities
Physical activity is associated with a lower
mortality rate in late adulthood; leisure and
informal social activities contribute to life
satisfaction among retired people; Israeli
study found benefits for life satisfaction in
activities involving the next generation, the
visual and performing arts, and spiritual
and religious matters, but there was also
value in independent activities in the home
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Robins et al (2002) recruited more than
300,000 individuals, who completed an
extensive on-line questionnaire which provided
demographic information and measures of
self-esteem; results indicated self-esteem of
males was higher than that of females; selfesteem highest in childhood and dipped with
entry into adolescence; self-esteem then rises
gradually throughout middle adulthood and
declines in late adulthood, with most of the
decline occurring between the 70’s and the
80’s; all this is “relative”; the measure of selfesteem is above the mid-point of the
questionnaire for adults in their 80’s
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Robins and Trzesniewski (2005) suggest
drop in self-esteem may be due to life
changes such as retirement, loss of a
spouse or partner, lessened social support,
declining health, and downward movement
in socioeconomic status; or older people
are wiser and more content
Older people express less “body esteem”;
older men express less body esteem than
older women; men more likely to
accumulate fat around the middle, women
accumulate fat in the hips; sexual arousal
problems more distressing for the male;
older adults with poor body esteem tend to
withdraw from sexual activity, often
frustrating their partners
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Older people who are independent think of
themselves as leading a “normal life,”; those
who are dependent on others, even only
slightly dependent, tend to worry more
about aging and encountering physical
disabilities and stress
A study of 441 healthy people aged 65–95
found dependence on others to carry out
the activities of daily living increased with
age
Interviews of stroke victims found
independence in toileting is important in
enabling older people to avoid slippage in
self-esteem
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Affects some 10% of people aged 65 and above
Depression in older people sometimes a
continuation of depression from earlier periods
of life and sometimes a new development
Depression goes undetected and untreated in
older people much of the time.
Appears to have multiple origins; can be
connected with the personality factor of
neuroticism; possible structural changes in the
brain; and a possible genetic predisposition to
imbalances of certain neurotransmitters.; may
be link between depression and physical
illnesses such as Alzheimer’s disease, heart
disease, stroke, Parkinson’s disease, cancer
Untreated depression can lead to suicide, esp.
in white men
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Depression connected with the loss of friends
and loved ones, but depression is a mental
disorder that goes beyond sadness or
bereavement
Loss of companions and friends will cause
profound sadness but mentally healthy people
bounce back within a year or so
Depression connected with memory lapses and
other cognitive impairment, such as difficulty
concentratingSome cases of depression are
simply attributed to the effects of aging or
misdiagnosed as dementia, even Alzheimer’s
disease
Depression in older people can usually be
treated successfully with the same means that
work in younger people, such as
antidepressant drugs and cognitive-behavioral
psychotherapy
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Older Americans report that they prefer to
remain in their homes as long as their
physical and mental conditions allow them
Older people with greater financial
resources, larger amounts of equity in their
homes, and stronger ties to their
communities are more likely to remain in
their homes
Older people with declining health
conditions, changes in their family
composition, and significant increases in
property taxes and costs of utilities are
likely to need to consider residing
elsewhere
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Older people who can no longer manage
living on their own may have access to
home health aides and visiting nurses to
help them remain in the home
Affluent older people may be able to afford
to hire round-the-clock or part-time live-in
help; others may move in with adult
children; others may move into assisted
living residences in which they have their
own apartments but community dining
rooms and nursing aid with physicians on
call and available in the facility
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Older adults may be most reluctant to relocate to
nursing homes because nursing homes signify the
loss of independence
Surveys indicate that older adults are relatively
more willing to enter nursing homes when they
perceive themselves to be in poor health and when
one or more close family members live near the
nursing home
“Elder abuse” — staff acts harshly toward residents,
sometimes in response to cognitively impaired
residents acting aggressively toward the staff;
well-selected and well-trained staff can deal well
with impaired residents
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Religion involves participating in the social,
educational, and charitable activities of a
congregation as well as worshiping; religion
and religious activities provide a vast arena
for social networking for older adults
As people undergo physical decline, religion
asks them to focus, instead, on moral
conduct and spiritual, not physical,
“substance” such as the soul; studies find
religious involvement in late adulthood is
usually associated with less depression and
more life satisfaction as long as it is done in
moderation
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Frequent churchgoing associated with fewer
problems in the activities of daily living
among older people
Older African Americans who attend
services more than once a week live 13.7
years longer, on average, than their
counterparts who never attend church; indepth interviews with the church-goers find
reasons such as the following for their
relative longevity: avoidance of negative
coping methods such as aggressive
behavior and drinking alcohol, evading
being victimized by violence, hopefulness,
and social support
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20% to 25% of marriages last half a century
or more, only to end with the death of one
of the spouses
Couples report less disagreement over
finances, household chores, and
parenting/grandparenting
Concerns about emotional expression and
companionship; older couples show more
affectionate behavior when they discuss
conflicts, and they disagree with one
another less in general; similarity in
personality is less of a contributor to
conflict than in midlife, consistent with the
finding that similarity in conscientiousness
and extraversion is no longer strongly
associated with marital dissatisfaction
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Older adults less likely than younger adults to
seek divorce; fear of loss of assets, family
disruption, and relocation, older adults do not
undertake divorce lightly; if divorcing, often
because they belong to an aberrant marriage
which is punitive or because one of the
partners has taken up a relationship with an
outsider
4% of older adults of the unmarried population
cohabit; less likely than younger people to wish
to remarry; older cohabiters report being in
more intimate, stable relationships; younger
cohabiters see their lifestyle as a prelude to
marriage, older cohabiters are more likely to
see their relationship as an alternate lifestyle
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Gay men and lesbians in long-term
partnerships tend to enjoy higher selfesteem, less depression and fewer suicidal
urges, and less alcohol and drug abuse
Gay men in long-term partnerships are also
less likely to incur sexually transmitted
infections
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Middle-aged male widowers are relatively
more capable of dealing with their loss than
older males
Men and women need to engage in the
activities of daily living (taking care of their
personal hygiene, assuming the
responsibilities that had been handled by
their spouse, and remaining connected to
the larger social community)
Widowhood more likely to lead to social
isolation than is marital separation; reasons
for isolation are physical, cognitive, and
emotional
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Widowhood leads to a decline in physical
and mental health, including increased
mortality and deterioration in memory
functioning
Loss of a spouse heightens risks of
depression and suicide among older adults,
more so among men than women
Men who are widowed are more likely than
women to remarry, or at least to form new
relationships with the other sex; women,
more so than men, make use of the web of
kinship relations and close friendships
available to them; men may be less adept
than women at various aspects of self and
household care
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Single older adults without children just as
likely as people who have had children to be
socially active and involved in volunteer
work
They tend to maintain close relationships
with siblings and long-time friends; very
old (mean age = 93) mothers and women
who have not had children report equally
positive levels of well being
Married older men without children appear
to be especially dependent on their spouses
Parents seem to be more likely than people
without children to have the social network
that permits them to avoid nursing homes
or other residential care upon physical
decline
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Older sibling pairs tend to give each other
emotional support; true among sisters
(women more likely than men to talk about
feelings) who are close in age and
geographically close
After being widowed, siblings (and children)
tend to ramp up their social contacts and
emotional support; support begins to
decrease within two to three years; a
sibling, especially a sister, often takes the
place of a spouse as a confidant
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Older people narrow friendships to friends
who are most like them and share similar
activities
To regulate their emotions they tend to
avoid “friends” with whom they have had
conflict over the years
Friends form social networks which keep
elders active and involved
Friends remain confidants with whom older
adults can share feelings and ideas
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Friends provide emotional closeness and
support
Friendships help older adults avert feelings
of depression
Social networking helps with physical and
psychological well being of older adults in
the community and in residential living
facilities
Older adults have a difficult time forming
new friendships when they relocate; with
time, patience and encouragement new
friendships can develop
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Grandparents provide a perspective on the
behavior and achievements of their
grandchildren they might not have had with
their own children
Both cohorts view each other in a positive
light and see their ties as deep and
meaningful
Grandparents-grandchildren conceptualize
their relationships as distinct family
connections that involve unconditional love,
emotional support, obligation, and respect
Grandparents and adult grandchildren often
act as friends and confidants; their
relationship can seem precious, capable of
being cut short at any time
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The average person has two decades of life in
front of him or her at the age of 65 indicating a
need retirement planning (Arias, 2007)
Retirement planning may include regularly
putting money aside in plans (IRAs, Keoghs,
and various pension plans in the workplace);
investing in stocks, bonds, or a second home
Men in same-sex couples are more likely than
women in same-sex couples to do retirement
planning, but women who do such planning are
more likely to do it interdependently
Older adults who are best adjusted to
retirement are highly involved in a variety of
activities
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Couples in relationships—including married
heterosexuals, cohabiting heterosexuals,
and gay and lesbian couples—usually but
not always make their retirement plans
interdependently; the greater the
satisfaction in the relationship, the more
likely the couple are to make their
retirement plans together
In married couples, husbands more often
than wives tend to be in control of the
plans, although control was also related to
the partner’s workload and income level
Men in same-sex couples are more likely
than women in same-sex couples to do
retirement planning, but women who do
such planning are more likely to do it
interdependently
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Adjustment of older retirees may be
affected by their pre-retirement work
identities; upscale professional workers
continue to be well-adjusted and had high
self-esteem; they considered themselves
retired professors or retired doctors or
retired lawyers
Hourly wage earners and other blue collar
workers had lower self-esteem and were
more likely to think of themselves as simply
a retired person
The following factors made adjustment to
retirement difficult: a lengthy attachment to
work, lack of control over the transition to
retirement, worrying and lack of selfconfidence
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Americans in their 70s report being
generally satisfied with their lives
Many older people are robust; according to
a national poll of some 1,600 adults by the
Los Angeles Times, 75% of older people say
they feel younger than their years
Definitions of successful aging include
physical activity, social contacts, self-rated
good health, the absence of cognitive
impairment and depression, nonsmoking,
and the absence of disabilities and chronic
diseases such as arthritis and diabetes;
another definition includes high cognitive
functioning, and high social networking