August, 2001 Issue 5
The Positive Aging Newsletter
Thursday, August 22, 2001
by Kenneth and Mary Gergen
Dedicated to Productive Dialogue Between Research and Practice
In this issue:
From Caretaking to the Co-caring Relationship
In our monthly search through journals and periodicals we have discovered not only a pervasive tendency for aging to be constructed as a downward life change, but the caretaking role is also bemoaned. In general, research and professional discussions treat caretaking as a noxious emotional, social and physical condition. Many articles speak of the intense stress of caretaking, with explorations launched into the possibility that caretaking generates immune deficiency. Popular media explore the tragedy of the "sandwich generation," composed primarily of women who are "stuck" between caring for growing children and aging parents. Support groups and therapeutic assistance are recommended.It seems an auspicious time to extend efforts to positively reconstruct aging to those who give them care. Without such exploration the mushrooming literature on caregiving can become self-fulfilling. As people come to believe the stories of grief, anxiety, stress, and financial turmoil that accompanies the taking on of this role, so are their expectations created. They come to see their role as "burdensome,""undesirable," and even "unfair." Some may feel trapped as caretakers, and feel guilty for wanting their parents to die. Often daughters are angry and frustrated when sons bow out of the role. Much family discord can result as the most available sibling gets "caught with the chore" of caretaking.Given the expansion of life expectancy, and families with fewer children, what seems especially needed is a broader and more optimistic framing of caregiving practices. In our view, the actions required to support an infirmed elderly are not intrinsically burdensome or stressful. It is the interpretation of the actions that makes them noxious - or not. People spend long hours caretaking their pets - for example, walking, feeding, and bathing a dog. The result is often a sense of satisfaction.Or, more significantly, few elderly people could match the full time demands required by the helpless infant. For most parents, the joy of caring for an infant greatly exceeds the costs of the sleepless nights, and days in which every waking moment can be consumed by the child's demands. Should there not be ways of understanding our support of the older person in need in the same way? We gain some advantage here by moving away from a concept of "caretaking" to one of "caregiving." The former term seems laced with images of obligation, while the latter suggests a more humane (and possibly fulfilling) orientation. Our own preference is for a more expanded view of the nurturing relationship in which co-caring is emphasized. To nurture is to give life, nourishment, support, and encouragement, and to do so in a way that is deeply rewarding. At the same time it is to recognize the positive role that the elderly person can play in the life of the caregiver. He or she also nurtures by adding positive meaning to the caregiver's life. And finally, the emphasis on co-caring calls attention to the potential of a fuller community to contribute to (and draw reward from) the outcomes. Extended family, neighbors, friends may all be engaged. We shall return to this issue in later editions of the Newsletter, and in the meantime would appreciate others' views on how to add positive meaning to this most significant of human roles.
Mary and Ken Gergen
- Planning Ahead and Life Satisfaction
Researchers propose that planning ahead gives people a greater sense of control over their lives. This sense of choosing what one wishes, as opposed to being knocked about by whatever comes along, breeds a greater sense of security and satisfaction. As these researchers propose, the older person's benefits from planning ahead may even be greater than for younger people. In effect, planning one's future (whether immediate or more long term) may be especially useful for older people. To explore these possibilities, researchers examined how planning ahead was correlated with life satisfactions in a sample ranging from 25-74. As the results indicated, younger people planned more into the future than older people, but older people who did plan their futures were more satisfied with their lives than those who did not. Men tended to be more future-oriented than women, Among the sample of older people, one respondent in his sixties, who was high in life satisfactions, answered the question of "What do you do to manage your daily life?" by responding, "I get up every day, plan a 9-5 schedule Monday through Friday.... The weekends are planned five months ahead." A man who was low in life satisfactions replied to this question, "I just get up and stumble through it." Interestingly, people who scored high on a measure of Openness to Experience were more likely to plan ahead. Those who scored high on Neuroticism (anxious and troubled about the present) planned less. Intellectual traits did not separate the planners from the drifters.
For details : Planning for the future: A life management strategy for increasing control and life satisfaction in adulthood. Kimberly M. Prenda & Margie E. Lachman, Psychology and Aging, 2001, 16, 206-216.
- Positive Affect and Reduced Risk of Stroke
Not only are positive feelings pleasurable in themselves, but research suggests they may contribute to lowering one's risk for stroke. This research was based on an extensive survey of over 2,000 noninstitutionalized adults in North Carolina over a six-year period. Scale measures were administered to assess emotional well being - both negative and positive affect. The results indicated that higher scores on the depression-scale were associated with higher incidence of stroke for both men and women. Likewise, higher scores on the positive affect scale were associated with lower incidence of stroke, but more so for men than for women. The results of the survey are compelling and call for further inquiry that would factor in the severity of the stroke, its location, and its type and that would search for explanatory evidence. The inverse relationship between positive affect and stroke is not necessarily causal and may be mediated by other factors. The authors also call for research that would test whether interventions to raise an older individual's level of positive affect can reduce his or her risk of stroke or improve recovery from stroke.
For details: Glenn Oster, Kyriakos S. Markides, Kristen Peek, & James S. Goodwin, "The Association Between Emotional Well-Being and the Incidence of Stroke in Older Adults." Psychosomatic Medicine, 2001, 63, 210-215
- Social Support and Recovery from Injury
We know that falls leading to injury is one of the hazards of aging. Yet, research into recovery is scarce; most research relating to falls focuses on prevalence and risk factors. This study, from the Netherlands, analyzed the impact of education and social support on short-term and long-term recovery in instrumental activities of daily living. Are the more educated more likely to engage in the kinds of regimens that would yield more rapid recovery, and does the availability of friends and family enhance or impede recovery rate? In searching for effects, the researchers were careful to control for a number of possibly contaminating influences (e.g. cognitive functioning, depression, severity, and age at which the fall occurred). The results of the research first indicated that educational level is not significantly associated with recovery. Most important, long-term recovery (5 -12 months after injury) was significantly related to social support. The more support for the individual, the more rapid the recovery. This research did not reveal precisely how this positive effect was achieved (for example, emotional involvement or hands on assistance). However, what follows clinically is that the professional team involved in recovery-care should encourage and even facilitate social support after fall-related injuries.
For details: Gertrudis I.J.M. Kempen, Winnie Scaf-Klomp, Adelita V. Ranchor, Robbert Sanderman, and Johan Ormel, "Social Predictors of Recovery in Late Middle-Aged and Older Persons After Injury to the Extremities: A Prospective Study." Journal of Gerontology, 56B, 4 (2001), pp. S229-236
- Aging Volunteers Enhance Childcare Program
The aging population represents an enormously rich resource - both within communities and the nation as a whole. Here researchers report on a national study of older adults working in contexts of childcare as volunteers or aides. Observations, interviews, and a rating scale were used to identify the unique contributions of older adults , none of whom had been formally trained as early childhood educators. The findings indicated that the nurturing presence of the older adults added a distinct familial dimension to these settings that complemented the more instrumentally oriented actions of the trained teachers. Although the volunteers' actions were not always consistent with professional standards for early childhood educators, the authors argue that they made a significant and unique contribution that enriched all participants. The authors make recommendations for training and support to include older adults effectively in preschool classrooms as part of an intergenerational caregiving team.
For details: Benefits of intergenerational staffing in preschools.
Elizabeth Larkin and Sally Newman,
Educational-Gerontology. 2001; Vol 27: 373-385
Prescribe Pets, Not Prozac: Review of Companion Animals in Human Health, Edited by Cindy C. Wilson & Dennis C. Turner. Sage, 1998 Although the findings are neither voluminous nor conclusive, most scholars who study human-pet interactions believe this relationship is a valuable one for human well-being. This volume summarizes the research tradition related to human-animal interactions, with an emphasis on the ways in which animals are helpful companions for people. As one source defined it: "Pets are perceived as always available, predictable in their responses, and non-judgmental. They provide a sense of esteem in that pets are perceived as both caring about their owners, and needing them, regardless of the owner's status as perceived by self or others. Pets can also give tactile comfort and recreational distraction from worries. Pets are less subject to provider burnout." (McNicholas & Collis, 1995). Specialized chapters focus on hippotherapy (horse riding therapy), seeing eye dogs, other "service animals," and the care and welfare of pet and service animals. The expansion of "service animals" in the U.S. is anticipated, with the increasing numbers of elderly people, some of whom are greatly benefited by dogs trained specifically to help them cope with deficits such as hearing loss. The chapters, in general, are well-written and respectful of scientific standards of judgment, as well as enthusiastically pro-pet.
McNicholas, J., & Collis, G. M. (1995). The end of a relationship: Coping with pet loss. In I. Robinson (Ed.). The Waltham book of human-animal interaction: Benefits and responsibilities of pet ownership (pp. 127-142). Oxford, UK: Pergamon.
Of Continuing Significance:
Ageism Negative and Positive, 2nd. edition, by Erdman B Palmore. (Springer Publishing, 1999) M. Powell Lawton writes, "a portratit of older people in America that is both scientifically impeccable and extremely readable...(the book) calls attention to ways in which individual, social groups, and social institutions undervalue older people." The Self and Society in Aging Processes, Edited by Carol D. Ryff and Victor W. Marshall (Springer Publishing, 1999). Glen Elder writes, "Essential reading for all who wonder about how society influences the way we age."
Our longstanding friend, T. George Harris, founding editor of Psychology Today, writes to inform readers of Beliefnet.com, a website that carries an enormously rich array of materials treating the relationship between spirituality and health. His own significant essay on Creativity in the Later Years is now featured on the site. In this essay, Harris pays special tribute to NIMH psychiatrist, Gene Cohen's, volume, "The Creative Age--Awakening the Human Potential in the Second Half of Life." He sends on this quote, which is well worthy of broader circulation. Treating the fear of death, Cohen writes, "[W]e regain a sense of emotional balance that allows us to meet fear with the right flow of courage and inspiration to take on change and the process of engaging in exploration, innovation and creativity...it offers exciting opportunities for creative growth and new forms of expression."
- 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. 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
Posted on Wed, August 1, 2001
by Dawn Dole