Old Age: Personal and Social Adjustments

Old Age

  • Old age is the final stage of life, characterized as a period of moving away from earlier, more desirable stages like the prime of life or years of usefulness.
  • Individuals often reflect on past periods with regret and focus on the present, minimizing thoughts about the future.
  • The individual is never static and constantly changes throughout life.
  • Early life changes are evolutionary, leading to maturity, while later life changes are mainly involutional, regressing to earlier stages.
  • Such changes are a natural part of aging, affecting both physical and mental structures and functioning.
  • Age 60 is often considered the dividing line between middle and old age. However, chronological age is not a reliable marker due to individual differences in the onset of aging.
  • Improved living conditions and healthcare mean many individuals do not show signs of aging until their mid-sixties or early seventies.
  • Consequently, there is a trend to use age 65, the age of compulsory retirement in many businesses, as the start of old age.
  • Old age is subdivided into early old age (60-70) and advanced old age (70 to the end of life).

Characteristics of Old Age

  • Old age, like other life stages, has distinct physical and psychological changes.
  • These changes significantly influence personal and social adjustments, often leading to poor adjustments and unhappiness, making old age dreaded in American culture.

Old Age Is a Period of Decline

  • Senescence: The period of slow and gradual physical and mental decline where compensations can be made; may start in the fifties or sixties.
  • Senility: A period of significant physical breakdown and mental disorganization, characterized by eccentricity, absentmindedness, social withdrawal, and poor adjustment; can occur as early as the fifties or may not occur at all.
  • Decline stems from both physical and psychological factors. Physical decline relates to changes in body cells due to the aging process, not specific diseases.
  • Psychological causes include unfavorable attitudes toward oneself, others, work, and life in general, leading to senility. Lack of sustaining interests after retirement can lead to depression and disorganization, accelerating decline.
  • How individuals cope with life's stresses affects their rate of decline.
  • Motivation is key; those with little motivation to learn or maintain their appearance and attitudes deteriorate faster. The leisure time after retirement can bring boredom, reducing motivation.

There Are Individual Differences in the Effects of Aging

  • Individual differences in aging's effects have long been recognized. Cicero noted that not everyone becomes difficult with age.
  • Aging affects people differently due to variations in hereditary endowments, socioeconomic and educational backgrounds, and lifestyle patterns.
  • These differences are evident within the same sex but are more pronounced between men and women, as aging rates differ.
  • Increasing differences with age lead to varied reactions to situations; some view retirement as a blessing, others as a curse.
  • Physical aging generally precedes mental aging, though the reverse can occur if someone fixates on growing old and gives up mentally upon seeing the first physical signs.

Aging Requires Role Changes

  • Similar to middle age, the elderly must adopt new roles.
  • In cultures valuing efficiency, strength, and attractiveness, the elderly are often seen as useless and face unfavorable social attitudes because they cannot compete with younger individuals.
  • They are expected to take less active roles in social and community matters, resulting in fewer roles and changes in existing ones, often due to social pressures.
  • Old-age roles have few rewards, leading to feelings of uselessness, inferiority, and resentment, hindering personal and social adjustments.
  • Maintaining a positive identity is difficult when key roles are removed.

There Are Many Stereotypes of the Aged

  • Cultural stereotypes significantly influence role changes among the aged, leading to unfavorable social attitudes.
  • Sources of stereotypes include:
    • Folklore and Fairy Tales: Often depict the aged unfavorably, with some exceptions of kind, understanding elders.
    • Literature and Mass Media: Frequently portray the elderly negatively. Shakespeare made numerous references to physical and behavioral changes of old age, such as:
      • "Last scene of all,\nThat ends this strange eventful history,\nIs second childishness, and mere oblivion,\nSans teeth, sans eyes, sans taste, sans everything."
      • "His youthful hose, well saved, a world too wide\nFor his shrunk shank; and his manly voice,\nTurning again toward childish treble, pipes\nAnd whistles in his sound."
    • Scientific Studies: Studies of institutionalized elderly often reinforce negative stereotypes because of the focus on those in decline. Studies of non-institutionalized elderly provide less evidence to justify these stereotypes.
  • The common stereotype is of a physically and mentally worn-out, unproductive, accident-prone, crotchety, and hard-to-live-with individual who should be sidelined for younger people.
  • This stereotype makes aging seem negative.
  • Personal concepts of old age, influenced by cultural stereotypes rather than personal experiences, affect attitudes toward both elderly people and oneself as one ages, contributing to dread of old age.

The Aged Have a Minority-Group Status

  • Despite the growing number of older people in America, they hold minority-group status, limiting their interaction with other groups and their power.
  • This status results from unfavorable social attitudes fostered by negative stereotypes.
  • As Rosow pointed out:
    • "Their second-rate citizenship is no accident, no minor misfunctioning of our institutions and values. It is inherent in the nature of our society. Underlying the practical immediacies of health and income, the deeper human problems of old people boil down to two central issues: (1) How will we share the fruits of our abundance with them, and by what principles? (2) How can we integrate them into our society on a basis of dignity and respect? Or, simply put, how can we redeem their second-class citizenship?"
  • This status puts the elderly on the defensive, affecting their personal and social adjustments and making their later years far from "golden."
  • They are vulnerable to exploitation due to illness, loneliness, and fears.

The Desire for Rejuvenation Is Widespread in Old Age

  • Minority-group status leads many elderly people to desire rejuvenation and to stay young.
  • Historically, methods included elixirs, alchemy, witchcraft, and searches for "fountains of youth."
  • Modern medicine focuses on warding off old age, experimenting with sex-hormone therapy to combat hormone deficiencies.
  • While sex-hormone therapy cannot reverse aging, it can improve health and vigor, slowing the aging process.
  • As Scheinfeld commented, the "Ponce de Leons remain as far from their Fountain of Youth as ever."

Developmental Tasks of Old Age

  • Developmental tasks in old age mainly concern the individual's personal life.
  • They include adjusting to declining strength and failing health, often requiring revisions in home and outside roles, and finding activities to replace work.
  • Meeting social and civic obligations is difficult due to health and income decline, leading to social inactivity.
  • Failing health and reduced income require new living arrangements, often radically different from earlier years.
  • Most older people must adjust to the death of a spouse, which is more common for women.
  • The death of a spouse often leads to reduced income and hazards of living alone, necessitating changes in living arrangements.
  • As grown children become involved in their own affairs, the elderly need to establish affiliations with their age group to avoid loneliness caused by reduced social contacts.
  • Returning to same-age affiliations is difficult because this group is largely rejected by society, diminishing motivation to engage with such a group.
  • Certain adjustment problems are unique to old age and include:
    • Physical helplessness, leading to dependency on others.
    • Economic insecurity.
    • Establishing living conditions matching new circumstances.
    • Making new friends.
    • Developing new activities for leisure time.
    • Learning to treat adult children as adults.

Adjustment to Physical Changes

  • Despite physical changes occurring with aging and primarily leading towards deterioration, individual differences are prevalent, resulting in variances in deterioration rates.
  • Varying rates of aging are discernible even within the same person.
  • Reproductive organs may age faster than other organs.

Changes in Appearance

  • Aging signs like bifocals to trifocals, dentures to death are evident.
  • The face displays most visible changes.
  • Cosmetics can camouflage some facial signs of aging in women.
  • Hands also reveal age, undergoing more changes than other body parts.
  • Common changes normally occurring during old age include:
    • Head Region
      • Nose elongates.
      • Mouth shape changes due to tooth loss.
      • Eyes appear dull.
      • Double or triple chin develops.
      • Cheeks droop and wrinkle.
      • Skin wrinkles and develops dark spots.
      • Head hair thins and grays.
    • Trunk Region
      • Shoulders stoop.
      • Abdomen bulges.
      • Hips sag.
      • Waistline broadens.
      • Breasts sag in women.
    • Limbs
      • Upper arms become flabby and heavy.
      • Legs become flabby.
      • Hands become bony.
      • Feet enlarge due to sagging muscles.
      • Nails thicken.

Internal Changes

  • Internal changes are pronounced but unobservable.
    • Changes in the skeleton result from hardening of the bones, mineral salt deposits, and modifications to the internal bone structure, leading to increased brittleness, fractures, and breaks and a slower healing process.
    • Nervous system changes, especially in the brain, include a loss in brain weight, dilation of the lateral ventricles, and a narrowing of the cortical tissue.
    • Changes in the central nervous system lead to a decrease in learning speed and intellectual decline.
    • Visceral changes include atrophy of the spleen, liver, testes, heart, lungs, pancreas, and kidneys.
    • Heart experiences significant transformations, becoming less soft and pliable and increasing in size even after the body stops growing.
    • The gastrointestinal tract, urinary tract, and smooth-muscle organs are least affected by aging.

Changes in Physiological Functions

  • Organ functionality changes. The regulation of body temperature becomes affected by impairments in the regulatory devices.
  • Old people cannot tolerate temperature extremes due to decreased vascularity of the skin.
  • Reduced metabolic rate and muscular vigor also make temperature regulation difficult.
  • Restoration of breathing and heart action takes longer following exertion.
  • Pulse rate and oxygen consumption are more varied than in younger people.
  • Elevated blood pressure is common due to increased rigidity of the aorta and central arteries.
  • Older people excrete less urine, and there is less creatine in their urine.
  • There is a decline in the amount and quality of sleep.
  • Most old people suffer from insomnia.
    • Digestive changes are perhaps the most marked in the regulatory functions. Eating difficulties are due to tooth loss and decreased senses of smell and taste.
    • Atrophy of glands in the stomach and bowels reduces digestive enzymes, requiring more fluids to lubricate and dissolve food.
    • Strength and ability to work decrease as muscular flabbiness and general weakness make it more difficult for the old person to use his muscles. Their ability to do strenuous work over a short time diminishes with age, while the ability to withstand a long, steady grind increases. Recovery from physical and mental fatigue takes longer, leading them to reduce work that requires either strength or speed.

Sensory Changes

  • All sense organs function less efficiently. However, slow sensory changes usually allow for adjustment.
  • Glasses and hearing aids compensate for impaired vision or hearing loss.
  • Eyes and ears are most affected.
    • Vision
      • Decline in seeing at low light levels and color sensitivity. Most old people suffer from presbyopia-farsightedness. This is due to diminishing elasticity of the lenses.
    • Hearing
      • Loss of ability to hear high tones, with men experiencing greater hearing loss than women.
      • Atrophy of the nerve and end organs in the basal turn of the cochlea, although most can hear tones below high C as well as younger people.
    • Taste
      • Marked changes happen due to atrophy of taste buds in the tongue and cheeks, increasingly widespread with age.
    • Smell
      • Becomes less acute due to atrophy of cells in the nose and increased hairiness of the nostrils.
    • Touch
      • Skin dryness reduces the sense of touch.
    • Sensitivity to Pain
      • Decline occurs at different rates in different parts of the body.

Sexual Changes

  • The male climacteric occurs later and lasts longer than menopause.
  • Sexual potency declines during the sixties and continues with age.
  • Like menopause, it involves declining gonadal functioning.
    • Common Effects
      • Waning of secondary sex characteristics, voice becomes higher; hair on face and body becomes less pronounced.
      • Decreased masculinity.
      • Decreased sexual functioning, though desire and ability may still be present.
  • Cultural influences affect sex drive, with anxieties influencing attitudes and behavior.
  • Unfavorable social attitudes toward sex among older people and doubts about sexual capacities may lead to abstinence or avoidance of remarriage.
  • The strength of the sex drive depends on general health and earlier sexual adjustments.
  • Those with poor earlier adjustments lose sex drive earlier.

Changes in Motor Abilities

  • Old people move slower and have less coordination, due to physical and psychological causes.
  • Physical causes include a decrease in strength and energy, lack of muscular tone, stiffness of joints, and tremors.
  • Psychological causes stem from awareness of decline and feelings of inferiority compared to younger people.
  • Emotional tension from psychological causes can hasten changes or decrease motivation to perform.
  • Even under favorable conditions, motor abilities decline. However:
    • Decline in strength is most pronounced in the flexor muscles of the forearms and in the muscles which raise the body. Elderly people tire quickly and require a longer time to recover from fatigue than younger people.
    • Decrease in speed is shown in tests of reaction time and skilled movements, such as handwriting. It is especially marked after age sixty.
    • Learning new skills, even when the individual believes that learning a new skill will benefit him personally, he learns more slowly than a younger person, and the end result is less satisfactory.
    • Awkwardness, old people tend to become awkward and clumsy, which causes them to spill and drop things, to trip and fall, and to do things in a careless, untidy manner. The breakdown in motor skills proceeds in inverse order to that in which the skills were learned, with the earliest-learned skills being retained longest.

Changes in Mental Abilities

  • There are marked individual variations in mental decline; no specific age or pattern is universally characteristic.

  • Higher intellectual levels experience less mental decline.

  • Studies of gifted individuals show mental decline sets in later than believed.

  • Physical decline contributes to mental decline; sex-hormone treatment improves mental abilities in elderly women.

  • Hypertension can lead to intellectual loss, which is not, per Wilkie and Eisdorfer, part of the "'normal' aging process".

  • Lack of environmental stimulation affects mental decline.

  • Continued practice slows decline.

  • Those who continue to work have better brain function than those who are idle.

  • Eisdorfer concluded:
    *Response patterns may in large measure be influenced by socially and psychologically mediated interaction with the environment.

  • The mental decline associated with old age may not be as significant as popularly supposed or as reported in earlier studies and may be the result of discrepancies in the choice of groups at different age levels for comparisons and of the differences between education now and at the time the elderly groups were schoolchildren. According to Schaie et. al.:
    *Conventional cross-sectional studies confound historical (generational) with individual (ontogenetic) change components. Since such designs sample individuals differing not only in age but also in terms of generation-related environmental backgrounds, the resulting age differences provide most inappropriate evidence for ontogenetic change.

  • Factors such as unfamiliarity with testing and bias due to institutionalized persons can skew results.

  • Since speed slows with age, timed mental ability tests may be unfair. Lorge suggests considering the