Social Gerontology: A Multidisciplinary Perspective

833 Pages·2017·29.856 MB·English

by  Nancy R. Hooyman, Kevin Y. Kawamoto, H. Asuman Kiyak

Social Gerontology:
A Multidisciplinary
Perspective
This page intentionally left blank
Social Gerontology:
A Multidisciplinary
Perspective
Tenth Edition
Nancy R. Hooyman
University of Washington
H. Asuman Kiyak
University of Washington
In addition, we acknowledge the extensive contributions of Kevin Y. Kawamoto,
University of Hawaii, and Barbara Resnick, University of Maryland.
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Library of Congress Cataloging-in-Publication Data
Hooyman, Nancy R., author. | Kiyak, H. Asuman, 1951- author.
Social gerontology: a multidisciplinary perspective/Nancy R.
Hooyman, University of Washington, H. Asuman Kiyak, University of
Washington.
Tenth Edition. | Hoboken: Pearson, [2017] | Revised edition of
the authors’ Social gerontology, c2011. | Includes bibliographical
references and index.
LCCN 2016059003| ISBN 9780133894776 | ISBN 0133894770
LCSH: Gerontology. | Aging. | Older people—United States.
LCC HQ1061 .H583 2017 | DDC 305.260973—dc23 LC record available at
https://lccn.loc.gov/2016059003
10 9 8 7 6 5 4 3 2 1
Student Edition
ISBN 10: 0-13-389477-0
ISBN 13: 978-0-13-389477-6
Contents
Preface xii 2.1.2 Economic Implications of Aging
About the Authors xviii for Industrialized Countries 40
2.2 Modernization and Older Adults’
1 The Growth of Social Gerontology 1
Roles in Traditional Societies 42
2.2.1 Resources Held by Older Adults 43
1.1 The Field of Gerontology 2
2.2.2 Modernization Theory 46
1.1.1 Why Study Aging? 3
2.2.3 Modernization and Intergenerational
1.1.2 Careers in Aging 4
Relations in China 46
1.2 How Is Aging Defined? 6
2.2.4 Modernization and Filial Piety in China 47
1.2.1 Diversity and Terminology 6
2.2.5 Modernization and Intergenerational
1.2.2 How Do We Label Older Adults
Relations in Other Asian Countries 47
by Age Category? 8
2.3 Immigrants from Traditional Cultures
1.2.3 What Is Ageism? 8
to the United States 50
1.2.4 Confronting Perceptions and Real Issues 9
2.3.1 The Challenges of Biculturalism 51
1.3 An Active Aging Framework 9
2.3.2 Mental Health 52
1.4 A Person–Environment Perspective
2.3.3 Living Arrangements of Older Immigrants 53
on Social Gerontology 11
2.3.4 Financial Dilemmas Facing
1.4.1 Environmental Press 11 Immigrant Elders 54
1.4.2 Environmental Interventions 13
2.4 Implications for the Future 55
1.5 Growth of the Older Population 13 Summary: Aging in Other Countries and Across
1.5.1 Changes in Life Expectancy 13 Cultures in the United States 55
1.5.2 Maximum Life Span 14
1.5.3 Who Are the Oldest-Old? 15 3 The Social Consequences
1.5.4 Centenarians 16 of Physical Aging 57
1.5.5 Population Pyramids 18
3.1 Biological Theories of Aging 58
1.5.6 Support Ratios 19
3.1.1 Wear-and-Tear Theory 59
1.6 Population Trends 20
3.1.2 Cellular Aging Theory 59
1.6.1 Elders of Color 20
3.1.3 Immunological Theory 59
1.6.2 Geographic Distribution 21
3.1.4 Free Radical Theory 60
1.6.3 Educational and Economic Status 23
3.1.5 Mitochondrial DNA Mutation Theory 62
1.6.4 Impact of Demographic Trends 23
3.2 Can Aging Be Reversed or Delayed? 63
1.7 Longevity in Health or Disease 23
3.2.1 Growth Hormones 63
1.8 How Aging and Older Adults Are Studied 25
3.2.2 Caloric Restriction 63
1.8.1 Development of Gerontology
3.3 Research on Physiological Changes With Age 65
as a Scientific Discipline 25
3.3.1 Normal Changes Within the Body 66
1.8.2 Major Research Centers Founded 26
3.3.2 Changes in Organ Systems 67
1.8.3 Research Methods 26
3.3.3 Changes in the Musculoskeletal
1.8.4 Cross-Sectional Studies 27
and Kinesthetic System 69
1.8.5 Longitudinal Studies 27
3.3.4 Changes in the Respiratory System 70
1.8.6 Sequential Designs 27
3.3.5 Cardiovascular Changes and the Effects
1.8.7 Problems With Representative
of Exercise 71
Samples of Older Persons in Research 28
3.3.6 Changes in the Urinary
1.9 Implications for the Future 29 and Gastrointestinal System 73
Summary: The Growth of Social Gerontology 31 3.3.7 Changes in the Endocrine System 73
2 Aging in Other Countries and Across 3.3.8 Changes in the Nervous System 74
3.3.9 Changes in Sleep Patterns With Aging 76
Cultures in the United States 33
3.4 Changes in Sensory Functions 76
2.1 Global Trends 34 3.4.1 Changes in Vision 79
2.1.1 The Phenomenon of Global Aging 34 3.4.2 Changes in Hearing 83
v
vi Contents
3.4.3 Changes in the Sense of Touch 87 5 Cognitive Changes With Aging 140
3.4.4 Sense Changes in Taste and Smell 87
3.5 Implications for the Future 89 5.1 Intelligence and Aging 141
Summary: The Social Consequences 5.1.1 Primary Mental Abilities 141
of Physical Aging 89 5.1.2 Classic Aging Pattern 142
5.1.3 Problems in the Measurement
4 Managing Chronic Diseases and of Cognitive Function 142
5.1.4 Longitudinal Studies of Intelligence 143
Promoting Well-Being in Old Age 92
5.1.5 General Slowing Hypothesis 144
4.1 Defining Health 93 5.1.6 Intellectually Active Elders 145
4.1.1 Important Terminology in Health 5.1.7 Factors That Affect Intelligence and
and Aging Study 93 Learning 145
4.1.2 Defining Disability 94 5.2 The Process of Learning and Memory 146
4.1.3 Causes of Death in Old Age 97 5.2.1 Working or Primary Memory 146
4.1.4 Successful Aging 98 5.2.2 Permanent Long-Term Memory 147
4.2 Acute and Chronic Diseases 99 5.2.3 Spatial Memory 150
4.2.1 Acute Disease 99 5.3 Retrieval of Information: Recall and Recognition 150
4.2.2 Chronic Disease 99 5.3.1 Tip-of-the-Tongue States 150
4.2.3 Health Disparities and Social 5.4 The Role of Attention in Learning 152
Determinants 101
5.4.1 The Positivity Effect in Information
4.2.4 Negative Impacts of Chronic Illness 102 Processing 152
4.3 Heart Disease and Other Common 5.4.2 Executive Function 153
Chronic Conditions 103 5.5 Enhancing Cognitive Abilities in Old Age 155
4.3.1 Congestive Heart Failure 104 5.5.1 Cognitive Retraining 155
4.3.2 Strokes and Other Cerebrovascular 5.5.2 Memory Mediators 158
Problems 104
5.5.3 External Cognitive Aids 158
4.3.3 Cancer 107
5.5.4 Cognitive and Neural Plasticity 160
4.3.4 Diabetes 107
5.6 Wisdom and Creativity 160
4.4 Arthritis and Osteoporosis 109
5.6.1 Perspectives on Wisdom 161
4.4.1 Impact and Management
5.6.2 Perspectives on Creativity 161
of Arthritis 110
5.7 Implications for the Future 162
4.4.2 Chronic Pain 111
Summary: Cognitive Changes With Aging 163
4.4.3 Osteoporosis 112
4.4.4 Problems With the Kidneys 6 Personality and Mental Health
and Urinary Tract 114
in Old Age 165
4.5 Other Conditions of Concern 116
4.5.1 Chronic Obstructive Pulmonary 6.1 Defining Personality 166
Disease or Respiratory Problems 116 6.2 Stage Theories of Personality 166
4.5.2 Problems With the Intestinal System 117 6.2.1 Jung’s Psychoanalytic Perspective 167
4.5.3 Oral Diseases 118 6.2.2 Erikson’s Psychosocial Model 167
4.5.4 HIV/AIDS in the Older Population 118 6.2.3 Empirical Testing of Stage Theories 169
4.6 Medication Use and Misuse 121 6.2.4 Dialectical Models of Adult Personality 170
4.7 Accidents Among Older Adults 122 6.3 Trait Theories of Personality 171
4.7.1 Older Drivers 122 6.3.1 Alternatives to Trait Theory 172
4.7.2 Falls and Their Prevention 124 6.3.2 Emotional Expression and Regulation 172
4.8 Health Promotion for Older Adults 126 6.4 Self-Concept and Self-Esteem 172
4.8.1 The Relationship Between Health 6.4.1 Self-Concept 172
Practices and Health Outcomes 127
6.4.2 Self-Esteem 174
4.8.2 Exercise Is Central to Health Promotion 129
6.5 Successful Aging 174
4.8.3 Motivation to Change Health Behaviors 131
6.5.1 Cognitive Functioning and a Sense
4.8.4 Improving the Impact of Health of Purpose 176
Promotion Programs 133
6.5.2 A Critique of the Successful Aging
4.9 Implications for the Future 136 Paradigm 177
Summary: Managing Chronic Diseases 6.5.3 Alternatives to the Model of Successful
and Promoting Well-Being in Old Age 138 Aging 178
Contents vii
6.5.4 Resilience 179 7.6.3 Medications 243
6.5.5 Positive Aging 180 7.6.4 Alcohol Use 243
6.6 Mental Disorders Among Older Persons 181 7.7 Psychological and Social Aspects of Sex,
6.6.1 Prevalence Rates 182 Sexuality, and Intimacy 244
6.6.2 Depression 182 7.7.1 Partner Availability 244
6.6.3 Therapeutic Interventions for Depression 186 7.7.2 Effects of Long-Term Care Facilities 244
6.6.4 Suicide Among Older People 190 7.7.3 Facilitating Older Adults’ Intimacy
and Sexuality 245
6.7 Anxiety and Paranoia 191
6.7.1 Schizophrenia and the Severely Mentally Ill 192 7.8 Implications for the Future 246
6.7.2 Dementia 193 Summary: Love, Intimacy, and Sexuality in Old Age 247
6.7.3 Parkinson’s Disease 195 8 Social Theories of Aging 249
6.8 Alzheimer’s Disease 197
6.8.1 Potential Causes and Risk Factors 197 8.1 The Importance of Social Theories of Aging 250
6.8.2 The Alzheimer’s Diagnosis 202 8.2 Social Gerontological Theory Before 1961 251
6.8.3 Treatment of AD 204 8.2.1 Role Theory 251
6.8.4 Caring for People With AD 208 8.2.2 Activity Theory 252
6.9 Substance Use and Dependency 210 8.3 The First Transformation of Theory 255
6.9.1 Heavy Alcohol Consumption 210 8.3.1 Disengagement Theory 255
6.9.2 Drug Misuse and Abuse 214 8.3.2 Gerotranscendence Theory 256
6.9.3 Gambling 216 8.3.3 Continuity Theory 257
6.10 Use of Mental Health Services 217 8.4 Alternative Theoretical Perspectives 257
6.11 Integrated Models of Care 218 8.4.1 Age Stratification Theory 257
6.12 Implications for the Future 219 8.4.2 Social Exchange Theory 260
8.4.3 Political Economy of Aging 260
Summary: Personality and Mental Health in Old Age 220
8.4.4 Life-Course Perspective 262
7 Love, Intimacy, and Sexuality 8.5 The Second Transformation of Theory 263
in Old Age 222 8.5.1 Social Constructivism 264
8.5.2 Social Constructionism 264
7.1 Attitudes and Beliefs About Sexuality
8.5.3 Critical Theory and Feminist
in Later Life 223
Perspectives 266
7.2 Myths and Reality About Sexuality
8.5.4 Postmodernist Theories of Aging 268
in Later Life 224
8.5.5 Successful Aging as a Positive
7.2.1 Early Studies of Sexual Activity 225 Perspective 271
7.2.2 Methodological Issues 225
8.6 Implications for the Future 272
7.2.3 Later Studies of Sexual Activity
Summary: Social Theories of Aging 272
and Satisfaction 226
7.3 Older LGBTQ Partners 228 9 Importance of Social Supports
7.3.1 Sociohistorical Context and Cohort Effect 229 for Older Adults 274
7.3.2 Older Lesbians 229
9.1 The Nature and Function of Informal Supports 275
7.3.3 Older Gay Males 230
9.1.1 The Impact of Informal Networks
7.3.4 Transgender Older Adults 231
and Social Supports on Well-Being 275
7.3.5 Implications for Service Providers 232
9.1.2 A Satisfying Base of Support 277
7.4 Women and Age-Related Physiological Changes 233
9.1.3 Variability in Social Supports 277
7.4.1 Perimenopause, Menopause,
9.1.4 Social Isolation 277
and Hot Flashes 234
9.2 Older Family Members 280
7.4.2 Urogenital Atrophy 235
9.2.1 Defining Family 281
7.4.3 Alternatives to Estrogen
to Treat Menopausal Symptoms 235 9.2.2 The Growth of the Multigenerational
Family 283
7.5 Men and Age-Related Physiological Changes 236
9.2.3 Older Spouses and Partners 285
7.5.1 Impotence 237
9.2.4 Marital Quality 286
7.5.2 Sexupharmaceuticals and Aging 238
9.2.5 Divorce in Old Age 287
7.6 Chronic Diseases and Sexuality 239
9.2.6 Remarriage and Cohabitation
7.6.1 Diseases of the Prostate 239
in Old Age 288
7.6.2 Impact of Other Diseases on Sexuality 241
9.2.7 Dating in Old Age 289
viii Contents
9.3 LGBTQ Informal Supports 291 10.7 LGBTQ Caregivers 338
9.3.1 Importance of a Life Course Perspective 292 10.8 Caregivers of Color 339
9.3.2 Coming Out in Old Age 292 10.8.1 African American Caregivers 340
9.3.3 LGBTQ Partnerships in Old Age 292 10.8.2 Latina Caregivers 340
9.3.4 LGBTQ Elders of Color 295 10.8.3 Asian and Pacific Islander Caregivers 341
9.3.5 Legal Issues and LGBTQ Social Supports 295 10.8.4 Native American/American Indian
9.4 Older People Living Alone 297 Caregivers 341
9.5 Childless Older Adults 298 10.9 Caregiving for Persons Living With Dementia 342
9.6 Sibling Relationships and Other Kin 300 10.9.1 Issues of Loss and Grief 343
9.7 Intergenerational Relationships 301 10.9.2 Informative Programs and Helpful
Practices 343
9.7.1 Adult Children 302
10.10 Legislation to Support Family Caregivers 343
9.7.2 Grandparenthood and
Great-Grandparenthood 303 10.10.1 Family and Medical Leave Act 343
9.7.3 Grandparent Households 305 10.10.2 The National Family Caregiver
9.7.4 Legal Issues Related to Grandparent Support Program (NFCSP) 345
Caregiving 310 10.11 Supportive Services for Family Caregivers 346
9.7.5 Great-Grandparents 312 10.11.1 Caregiver Assessment 347
9.7.6 The Effects of Divorce and Changing 10.11.2 Service Utilization 348
Marital Patterns on Grandparenthood 312 10.11.3 Multicomponent Interventions 349
9.8 Friends and Neighbors as Social Supports 312 10.11.4 Support Groups 351
9.8.1 Friendship and the Life Course 313 10.11.5 Psychoeducational Resources 351
9.8.2 Value of Friendship as Informal Support 314 10.11.6 E-Supports 351
9.9 Interventions to Strengthen 10.11.7 Respite Care 353
or Build Social Supports 314 10.11.8 Future Service Directions
9.9.1 Personal Network Building 315 for Family Caregivers 354
9.9.2 Mutual Help Networks 10.12 Elder Mistreatment 356
and Community-Building 316 10.12.1 Incidence and Types of Elder
9.9.3 Intergenerational Initiatives 316 Mistreatment 356
9.10 Relationships With Pets 319 10.12.2 Types of Mistreatment
and Warning Signs 356
9.11 Implications for the Future 320
10.12.3 Most Common Types of Mistreatment 357
Summary: Importance of Social Supports
for Older Adults 321 10.12.4 Assessment and Reporting 364
10.13 Underpaid Caregivers: Direct Care Workers 366
10 Opportunities and Challenges 10.13.1 Who Is a Direct Care Worker? 367
of Informal Caregiving 323 10.13.2 Racial Inequities 368
10.13.3 Impact on Quality of Care 368
10.1 Who Are Informal Caregivers? 324
10.13.4 Advocacy and Policy Change 370
10.2 Trends Affecting Caregiving 326
10.13.5 A Movement to Change the Way We Care 371
10.2.1 Societal and Demographic Trends 326
10.14 Implications for the Future 371
10.2.2 Complex Levels of Care 326
Summary: Opportunities and Challenges
10.2.3 The Future of Family Caregiving 327
of Informal Caregiving 373
10.3 The Costs of Informal Care 328
10.3.1 Stressors and Burden 328 11 Living Arrangements
10.3.2 Factors That Intensify Burden 328
and Social Interactions 374
10.3.3 Primary Costs for Families 329
10.3.4 Physical Health Costs 330 11.1 Person–Environment Theories of Aging 375
10.3.5 Emotional or Mental Health Costs 331 11.2 The Aging Experience in Rural, Urban,
10.3.6 Financial Costs 331 and Suburban Areas 377
10.4 Gains for Caregivers 331 11.2.1 Rural Older Adults 377
10.5 The Type of Care Relationship 334 11.2.2 Suburban Older Adults 378
10.5.1 Adult Children Caring for Parents 334 11.2.3 Urban Older Adults 379
10.5.2 Spouses or Partners as Caregivers 334 11.3 Relocation 380
10.6 The Gendered Nature of Family Care 335 11.3.1 Relocation Stress 381
10.6.1 Feminist and Cultural Perspectives 336 11.4 Housing Patterns of Older People 382
10.6.2 Women in the Middle 336 11.4.1 Independent Housing 382
Contents ix
11.4.2 Aging in Place or in Community 382 13.1.1 Critique of the Concept
11.4.3 Aging-Friendly Communities 384 of Productive Aging 431
11.5 Planned Housing 391 13.1.2 Productivity in Its Broadest Context 432
11.5.1 Two Categories of Older Adult 13.2 Retirement 433
Residential Facilities 391 13.2.1 Timing of Retirement 434
11.5.2 Assisted Living 391 13.2.2 Person–Environment Factors
11.5.3 Adult Family Homes 394 and Retirement Decisions 434
11.5.4 Skilled Nursing Facilities (SNFs) 395 13.2.3 Satisfaction With Retirement 434
11.5.5 Culture Change in Long-Term Care 398 13.2.4 Baby Boomers and
Retirement/Unretirement 438
11.6 Social and Health Services to Promote
13.2.5 Those Who Don’t Retire 438
Aging in Place in the Community 399
11.6.1 Home Health Care 401 13.3 Employment Status 440
11.6.2 Adult Day Care and Adult Day 13.3.1 Productivity in Continuing Work 441
Health Care 402 13.3.2 Barriers to Employment 441
11.6.3 Housing Policy and Growing 13.4 Sources of Income and Economic Status 443
Housing Needs 403 13.4.1 Sources of Income 444
11.6.4 Aging in Place on the Streets 403 13.4.2 Poverty Among Old and Young 445
11.6.5 Aging in Place Among Older Prisoners 407 13.4.3 Hunger Among Older Americans 446
11.7 Implications for the Future 408 13.4.4 Public Assistance 447
Summary: Living Arrangements 13.5 Patterns and Functions of Nonpaid
and Social Interactions 410 Roles and Activities 448
13.5.1 The Role of Leisure 448
12 Enhancing Older Adults’ 13.5.2 Religious Participation, Religiosity,
Lives Through Technology 412 and Spirituality 449
13.5.3 The Value of Spiritual Well-Being 453
12.1 Technology and Older Adults 413 13.5.4 The Importance of Spiritual
12.1.1 Who Has Access to Technology? 413 Assessments 454
12.1.2 Caregiver Use of Technology 415 13.6 Civic Engagement 456
12.2 Smart Homes 416 13.6.1 Conservative and Progressive
12.2.1 Advancing Smart Home Technology 417 Views on Civic Engagement 457
12.2.2 Practicalities of Smart Homes 13.6.2 Critiques of Civic Engagement 458
for Older Adults 417 13.6.3 Creating Opportunities 458
12.2.3 Online News and Information 418 13.6.4 Membership in Voluntary Associations 459
12.3 Lifelong Learning and Distance Education 419 13.7 Volunteerism 460
12.3.1 Lifelong Learning Opportunities 419 13.7.1 Differences in Volunteerism
12.3.2 Distance Education 420 by Race and Socioeconomic Status 462
12.4 Health Information and Self-Monitoring 420 13.7.2 Cognitive, Physical, and Social
Benefits of Volunteerism 463
12.4.1 Quality Control and Online
Health Information 420 13.7.3 Rewards Connected to Time
in Volunteerism 464
12.4.2 Self-Monitoring Technologies 420
13.8 Lifelong Learning Programs 465
12.4.3 Health Connectivity 422
12.4.4 Therapy for Psychological Well-Being 423 13.9 Political Participation 466
13.9.1 Voting Behavior 467
12.5 Connections and Socialization 424
13.9.2 Senior Power 468
12.6 Brain Games 424
13.9.3 Age-Based Politically Influential Groups 469
12.6.1 Research and Cognitive Games 424
13.10 Implications for the Future 471
12.6.2 Suggestions for Elder-Appropriate Games 424
12.6.3 Ethical Considerations Summary: Productive Aging 473
of Game Technology 427
12.7 Implications for the Future 428 14 Death, Dying, Bereavement,
Summary: Enhancing Older Adults’ and Widowhood 475
Lives Through Technology 429
14.1 The Changing Context of Dying 476
13 Productive Aging 430 14.1.1 The Role of Medical Technology 476
14.1.2 Where Older Adults Die 477
13.1 What Is Productive Aging? 431 14.1.3 Attitudes Toward Death 478