2001- September

Sept, 2001 Issue 6

The Positive Aging Newsletter

Tuesday, September 25, 2001

by Kenneth and Mary Gergen
Dedicated to Productive Dialogue Between Research and Practice

Issue No 6

In this issue:

COMMENTARY

 The Message of Positive Aging in a World of Terror So many of the normal concerns of daily life have been rendered trivial by the terrorist attacks of September 11 that it is difficult to return to issues of positive aging with the same energies. And yet, there is one message embedded within these efforts that rekindles the spirit. So often this work is guided by a view that, for us, seems essential in a world threatened by terrorism: Through our coordinated efforts we can create a better world. To rescue this message from the shoals of banality, let us point out two significant features. The first is the emphasis on coordination. There is no single line of research, successful intervention, empowerment program or logic that can create a new cultural view on the nature of aging. Coordinated efforts are essential; we must all rely upon each other; negotiate, seek understanding, and explore with those who disagree. It is this spirit of mutual sharing and exploration that is so vitally needed in our reactions to terrorism. No single nation, singular set of values, or unbridled commitment will suffice. If there is no increment in mutual understanding, efforts to "fight terrorism" may only increase its presence. Second, the impetus toward positive aging is fired by the vision of "better." The work featured in this Newsletter is not content to accept the traditional - almost naturalized - view of aging as decline. Concerted efforts together can lead us into a better form of life. In the same way, if attempts to fight terrorism are only based on a vision of returning to the status quo, we are likely to fail. It is precisely the "good old days" that planted the seeds for present-day terrorism. So, we do not find reasons for diminishing the efforts toward positive aging; on the contrary, by sustaining and extending the guiding vision we may move toward a better world.
Ken and Mary Gergen
For materials relating health issues in aging to the terrrorist crisis see
http://www.healthandage.com/Home/gm=14!gc=5!g.news=07250901.

RESEARCH

 - Emotional Support and Staying Smart
In the late 1980s , over 1,000 adults between the ages of 70-79, who were selected as highly functioning people, became part of the MacArthur Studies of Successful Aging. This study explores why some of the sample maintained strong cognitive functioning during the eight years following the original study. What characteristics separated those who had kept their wits sharpened from those whose wits had become a bit dull? Overall, it should be noted that on the average, there was no evidence of major decline. Those who were doing well in 1988 generally continued to do so. However, there were variations and the study revealed a most interesting result: The primary factor contributing to differences in maintaining cognitive functioning was "Frequency of Emotional Support." This variable was the average of two questions: "How often do or does (spouse/children/close friends and relatives) make you feel loved and cared for," and "How often is/are (spouse/children/ friends/ relatives) willing to listen when you need to talk about your worries or problems?" This variable, collected at the earlier interviews, was a substantial predictor of cognitive functioning 8 years later. If you often receive emotional support, you maintain a high level of mental functioning. The reasons for this relationship remain unclear. Perhaps such support creates an optimistic view of life, and with it an interest in the world and its complexities. Perhaps support builds the kind of confidence that stimulates engaged activity.However, the study also indicates that frequency of emotional support, while sufficient, is not necessary to sustaining cognitive functioning. For example, the results reveal that, holding emotional support constant, unmarried women are also more likely to remain smart than their married counterparts. Perhaps the greater challenge of being alone provokes greater activity. Interestingly, men who have more negative interpersonal relationships also remain mentally alert.  In this case conflict may also keep one on his toes. In any case, the researchers see the potential for therapeutic work to improve the social lives of older people. Having social ties that encourage emotional sharing seems an easy antidote to the dangers of depression and intellectual decline.
For details: Teresa E. Seeman, Tina M. Lusignolo, Marilyn Albert & Lisa Berkman, Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychology, 2001, 20, 243-255.

- Caring and Caregiving: Bread Upon the Waters

Elderly mothers who have developed a securely attached relationship with their daughters may be amply rewarded. Or so suggests research on 80 mother-daughter pairs, in which an elderly mother was in need of her daughter’s care. The daughters interviewed in this study gave at least 5 hours of care each week to their mothers, who were at least 60 and who lived alone or with their daughters. The theoretical framework of the study was a life-span developmental view of attachment. Overall, the amount of instrumental care (e.g. grocery shopping, housework, errands, social service arrangements), that mothers received was not influenced by the kind of attachment they had with their daughters. While there was a significant range of differences in the hours given to instrumental care the major reason for difference was the extent of the mother’s need. Whether daughters had warm, secure, or difficult and distant relationships with their mothers made no difference in whether or not mother received life-supporting services. However, in the realm of emotional caring (e.g. spending time chatting, giving and receiving hugs and kisses, giving gifts, sending cards, looking at photo albums), daughters who felt a secure attachment, with low anxiety about their relationship with their mothers, were more giving. Additionally, in terms of the experience of caregiving, daughters who felt securely attached to their mothers were less likely to experience their helpfulness as difficult or depressing. The caregiving role was a positive psychological experience. Anxious daughters were more likely to feel that they were unable have a good relationship with their mothers; as one daughter said, "It never seems like I can do enough. And if I don’t go over there for a couple of days, I end up feeling guilty - It’s like I’m still trying to please her." Securely attached daughters feel better and give more emotional support. It is interesting to note that there was no difference by racial group between the European- and African-American pairs. However, women who worked outside the home, while unswerving in their instrumental support, were less likely to give emotional support to their mothers. They seem to be emotionally exhausted by the other social demands in their lives.
Finally, we are left to wonder about the relationship of sons to their mothers - or fathers. Is it possible that the emphasis on male autonomy, which is predicted by attachment theory, renders them insensitive to the needs of elderly parents?
For details: Brian D. Carpenter (2001). Attachment bonds between adult daughters and their older mothers: Associations with contemporary caregiving. Journal of Gerontology, 56B, 257-266.

- Personal Goals and the Sense of Well-being
In the August issue of the Newsletter we reported a study indicating a positive relationship between planning ahead and life satisfaction among the elderly. The present investigators furnish a detailed look into a closely related area: the relationship between personal goals and sense of well-being. Several studies are reported (the largest employing over 700 participants aged 65-90 yrs). Results of the first study indicate that older adults express a broad variety of aspirations that often extend a substantial distance into the future. Planning ahead for future years is pervasive. Most importantly, the sense of well-being (e.g. satisfaction with current life, sense of competence, occupational satisfaction) was positively correlated to long-term aspirations - especially aspirations for self-development (e.g. "living my life to the fullest") and altruistic contact (e.g. helping my children"). Having long term aspirations for self-development and helping others, seems to foster a sense of personal well-being. A follow-up study indicates that the elderly who planned and followed through with their goals were higher in life satisfaction and positive affect, and lower in anxiety and depression. As the authors reason, the relationship between goals and well-being may be bi-directional: a strong goal orientation may influence one’s sense of well-being, and the reverse may also occur. In addition to these studies, the authors briefly describe an effective goal intervention program to help elderly people set, plan, and achieve concrete and realistic personal goals. Those working in program development may be particularly interested in this resource.
For details: S. Lapierre, L. Bourrard, M. Dube, R. Labelle, and E. Bastin. Aspirations and well-being in old age. In P. Schmuck and K. Sheldon, (Eds). (2001). Life goals and well-being: Towards a positive psychology of human striving. (pp. 102-115). Kirkland, WA, US: Hogrefe & Huber

- Evidence of Declining Disability
Longevity of Americans continues to rise, but disability rates among older Americans appear to be declining. During the 1970s this was not the case. As longevity increased so did disability. However, in the 1980’s and 1990’s, a decline in disability rates set in. The authors of this study asked whether these recent, hopeful trends are real, and if so, why. The question has been explored by others, using various methods, time-points, and social distinctions. One study, for example, found that shifts in the educational composition of the cohorts were linked to the downward trend in disability, with the more educated clearly being more fortunate than those who did not finish high school. Increased education accounted for the decline in disability among the aged. Using data from the National Health Interview Survey, this study examined trends from 1982 to 1993. As the researchers found, major decreases in rate of disability did indeed take place, but only in the period 1982-1986. Improvements were experienced relatively widely across the population - men and women, Whites and non-Whites, and across most of the aging spectrum. However, confirming earlier results, there was a significant tendency for the more educated groups to experience less disability. Possibly, more appropriate use of medical services is responsible for the differential rates. All five surveys are consistent in showing that the major decline in disabilities was for those disabilities requiring routine care - chores, shopping, etc. - but not in the more severe forms of disability for which personal care is needed. Important policy decisions hinge upon future research into the causes for these encouraging disability trends: changes in Medicare, new public health efforts, and the provision of new technological and environmental services for those with disabilities.
For details: Robert F. Schoeni, Vicki A. Freedman, Robert B. Wallace, "Persistent, Consistent Widespread, and Robust? Another Look at Recent Trends in Old-Age Disability." Journal of Gerontology. 56B, 4 (2001), pp. S206-217

IN THE NEWS

 A preview from George Vaillant and the Harvard Medical School Study In January Little Brown, will publish George Vaillant’s, Aging Well: Surprising Guideposts to a Happier Life from the Landmark Harvard Study of Adult Development. This volume will summarize the results of three longitudinal studies begun in the 1920’s, 1930’s and 1940’s in the U.S. Because of the potential significance of the findings, the media are already seeking information about the results. In this case the Philadelphia Inquirer interviewed George Vaillant, the author and practicing psychiatrist, for a preview. Vaillant described 7 keys to aging well. The primary physical health-related activity is to not smoke. Exercising "some," avoiding obesity, and avoiding alcohol abuse also contribute to living until 80. However, psychological approaches to life feature strongly in outcomes. For example, developing coping strategies that allow one to see life optimistically, despite the ordinary tragedies is very important to a long, good life, as Vaillant outlines. Having a solid marriage and keeping one’s mind active, especially with forms of continuing education can also be important. Citing the importance of developing the "right attitude" about life, Vaillant suggests that people, "Worry less about cholesterol and more about gratitude and forgiveness." Philadelphia Inquirer, September 16, 2001 pp 4-5.

BOOK ALERT

 Narrative Gerontology: Theory, Research, and Practice. Edited by Gary Kenyon, Phillip Clark, and Brian deVries. New York: Springer, 2001. This volume effectively extends the now voluminous literature on narrative in the social sciences to the field of aging. The metaphor of "life as story," is especially promising in narrative work because it focuses on what aging means to people (which is often more important than the physical changes taking place in their lives). Moreover there is an abiding optimism inhering in the possibility that life stories can be more flexibly transformed than material or physical conditions. This volume is especially appealing in its integration of theory, research and practice. The overall goal is to improve the quality of care and the quality of life for older adults, especially those with chronic illness and those near the end of their lives. A chapter by Bettina Becker on the ways in which narratives can change the experience of "ordinary pain," is especially provocative.

- Empowering Frail Elderly People: Opportunities and Impediments in Housing, Health,and Support Service Delivery. Edited by L. Heumann, M. McCall, and D,Boldy. Urbana: Univ. of Ill. Press.(2001) With so much of the work on positive aging devoted to the period of early aging, volumes devoted to enabling the "old old" to thrive are to be prized. The present volume provides a detailed discussion of the concept of empowerment in the context of social values. Most important, however, there are a dozen chapters that describe effective practices in working with the very old across a wide range of contexts, for example, home care services, community support, residential care, and in the nursing home (particularly with regard to enhancing individual rights). Important chapters on empowering those with severe physical and mental disability are included.

READER RESPONSE

 Last month we wrote about the desirability of finding more positive ways of understanding the relationship between the caregiver and the elderly they serve. Reader responses were very affirming. Exemplary is a message from Jane Seiling, who is currently the chief caregiver for her terminally ill mother of 92. As she wrote, "Taking care of my mother is an honor and privilege." At the same time we also received information of websites available to caregivers who wish to share their stories, insights and tribulations. See the ALZwell Caregiver Support website at www.alzwell.com. To connect and share with other caregivers, visit the ElderCare Forum Community Message Board at http://216.122.139.136/cgi-bin/ultimatebb.cgi

UPCOMING EVENTS

 - Redefining Retirement Communities: Innovations for a New Generation of Seniors. Oct. 1-2, Boston, MA. Sponsored by the New England Gerontological Association. Examines environments offering flexible housing with creative use of time. For more information, contact Chillis Silva Associates Senior Housing: 617-332-5335, or http://www.seniorhousing.com/


- The New Aging: Challenges of Creative Growth, a workshop exploring vital potentials for living and learning from maturity to late adulthood, for professionals and others who work with an older generation or wish to explore for themselves. Topics include creatively constructing the future, generative relationships, reconstructing loss and pain, appreciative living, healthy wealth, and meaning across generations. Workshop leaders include Ken and Mary Gergen and Robert and Sharon Cottor. Sponsored by the Novartis Foundation for Gerontology, The Taos Institute, and the Institute for Creative Change. Phoenix, AZ, Nov. 9-11. For more information see www.taosinstitute.net

- Annual meetings of the Gerontological Society of America, Chciago, Nov. 15-18. See especially the Kleemeier award lecture by Linda George, Duke Unviersity, on well-being in later life. For more see www.geron.org

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