06 Oct Be sure to follow directions f

Week 5: Overview

Introduction

This week we'll cover four topics: minority issues, women's issues, family relationships, and long-term care.

Learning Outcomes

· Define "double jeopardy" and describe how it affects various elderly minority groups

· Describe cycle of insular poverty

· Identify issues particular to older women and their longer life expectancy

· Chart the pattern of marital satisfaction over the average life span

· Describe how caregiving affects the "sandwich generation"

· Identify the five types of grandparenting from the study by Neugarten and Weinstein

· Compare and contrast the advantages and disadvantages of various forms of long-term care

· Week 5: Lecture

· Minority Issues

· You likely will become familiar with some of the discriminatory practices toward various minorities through the reports of your classmates and your own research. Here we will briefly address “double jeopardy,” a somewhat controversial concept that has general application to various minorities. Double jeopardy is the tendency for a member of a minority to be discriminated against, first by virtue of being a member of a racial or ethnic minority, and to be further disadvantaged by being older. Some would add that being female is a third dimension of jeopardy. Women's issues will be discussed shortly.

· Although some researchers have viewed the concept of double jeopardy as being overemphasized, many more have maintained its significance.  Clearly, most minorities experience hardships (lower income, substandard housing, etc.) that are less prevalent among native born, White Anglo-Saxon Protestants, or even among most Whites in general.

· One of my objectives in this course is to urge you to become more sensitive to the additional hardships faced by the majority of minority elderly. In his book titled The Other America, Frank Harrington asserts that most poverty in the United States is insular poverty, i.e., pockets of poverty in which one generation of poverty begets another. As an example, a poor Hispanic child grows up in a neighborhood where education is not emphasized, attends a substandard school, ends up with a relatively low-paying job, and retires with relatively low retirement income. One’s offspring continues the cycle and has the additional burden of helping provide for aging parents that may need financial and other assistance. If you say that there are many exceptions to my example, you are absolutely right. However, Harrington and others would likely say that we may hear too much of the Horatio Alger stories and lose sight of the norm.

· Week 5: Lecture

· Women's Issues

· Robert Butler, geriatrician and former Director of the National Institute on Aging, and Myrna Lewis have written extensively about the plight of the older woman. In recent decades the life expectancy of older women has been 5 – 7 years longer than that of older men. This fact alone presents many additional problems for older women, even though most of us value a longer life.

· Whereas over the past 20 years plus, generally more than 70% of older men (65 and older) are married and living with their spouses at any given point in time, less than half of older women are married and living with their spouses. This underscores the likelihood that most older females will spend a substantial part of their later years living alone. Older men are likely to have a spouse as a caregiver in later life but older women likely will have to find a different source of assistance. Living alone also has significant implications related to income, housing (especially upkeep), social life, etc. Butler once asked why the women’s movement focused so little attention on the plight of the older woman. It appears that little headway has been made in this area since Butler drew so much attention to it in the 1970’s. Issues of older women remain an area that lends itself to discussion and creative improvement.

· Week 5: Lecture

· Family Relationships

· In discussing family life and aging, four areas will be discussed briefly: spousal relationships, caregiving, grandparenting, and intergenerational equity. As anyone might expect, family life is a primary factor related to happy and successful aging for most.

· Roger Gould, a University of California at Los Angeles researcher, noted an inverted bell shape (or u-shaped) pattern of marital satisfaction. According to him, marriage tends to be very happy in the early years, begins gradually declining into the early middle years and then begins to increase again sometime in the middle years through later life. It appears that for those who survive the challenges of the middle years (roughly ages 35-55), marriage is very satisfying.

· There does not appear to be widespread consensus on what gender role patterns lend themselves best to happy and successful marriages. However, Robert Atchley, a noted author in gerontology, stated that egalitarian marriages tend to fare best. By this he meant that marriages that have flexible, rather than rigid, male and female roles tend to be most satisfying.

· Another major factor related to happiness in later life is the health of one’s spouse. The Rand Corporation conducted a study of what tended to contribute most to high morale and life satisfaction among older persons. Of the three factors that were concluded to contribute most, not surprisingly, one’s good health and adequate finances were identified. The third factor, and what may be sometimes overlooked, is the health of one’s spouse. One may tend to have somewhat more control over one’s own health and finances than on the health of one’s spouse.

Week 5: Lecture

Caregiving

The family remains the greatest single source of caregiving for older adults. Often to provide optimal care, there needs to be coordination between primary caregivers (family) and the aging network (the system of community resources for older adults such as homecare agencies, day care centers, senior centers, health clinics, etc.).

Of course, sometimes caregiving for older persons falls on the shoulders of the children of older persons, the so-called "sandwich generation" that may have the dual role of raising their own children while caring for their aging parents. The Health and Retirement Study that began in 1990 and has continued into this century reported that as many as two-thirds of the middle-aged sample had parents or parents-in-law in need of some form of caregiving.

Many researchers have emphasized the importance of what is referred to as a “continuum of care,” the provision of vital services as they are needed. Older people usually do not go from a state of full independence to a state of complete dependence. More frequently, there is a gradual need for increased services. Most researchers advocate facilitating the older person to remain as autonomous and independent as possible. Transitioning from the role of child to parenting one's own aging parents can be done too abruptly and completely.

Some researchers also caution observers from concluding that the offspring of older persons are usually the “givers” and older persons are usually the "takers." This point is made quite clear in the attached, titled " Intergenerational Equity or the New Ageism?

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". In the article, the Commonwealth Fund reported in its study that older persons are four times more likely to provide assistance to their children than vice versa.

And Thou Shalt Honor

Now watch the film, "And Thou Shalt Honor." Again, use the  form

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 provided to record the important points in the film for your own use.

· Click here to open the video "And Thou Shalt Honor"

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Another area that is replete with misconceptions is related to older adults and their grandchildren. Before we go on to discuss grandparenting in the next section, take a few minutes to complete the Older Adults and Grandchildren discussion.

 

Week 5: Lecture

Grandparenting

Below are important data from one of the most widely reported studies on grandparenting and aging (Neugarten and Weinstein, 1968). Five types of grandparenting are reported in the study:

1. Formal:  Grandparents of this style usually enjoy getting together with their grandchildren on holidays and other special occasions.  They are careful not to encroach on parenting which they leave to the parents.

2. Fun Seeker:  A key characteristic of this style is mutuality.  The grandparents actually enjoy very much doing activities with their grandchildren and often are younger grandparents.

3. Surrogate Parent:  These grandparents, usually females, actually take over the parenting role much of the time for their grandchildren.

4. Reservoir-of-family-wisdom:  Often the grandfather, these grandparents pride themselves in being a resource to their grandchildren, passing on both family and educational  information.

5. Distant-figure:  These grandparents are very atypical of the stereotype that most people have of grandparenting:  They don't particularly value their time with their grandchildren.

 

The study probably helps us to counter the tendency to stereotype the role of grandparent. There are many different approaches to implementing the grandparenting role, and there also are many different sources of significance for being a grandparent. See some of the original data from the Neugarten and Weinstein study below.

Study on Grandparenting and Aging	Grandmothers (N = 70)	Grandfathers (N=70)
Significance of Grandparenting Role
Biological Renewal	42%	23%
Emotional Self-Fulfillment	19%	27%
Resource Person to Child	4%	11%
Vicarious Achievement	4%	4%
Remote	27%	29%
Insufficient Data	4%	6%
Style of Grandparenting
Formal	31%	33%
Fun-Seeking	29%	24%
Parent Surrogate	14%	0%
Reservoir of Family Wisdom	1%	6%
Distant Figure	19%	29%
Insufficient Data	6%	8%
Ease of Role Performance
Comfortable / Pleasant	59%	61%
Difficult / Discomfort	36%	29%
Insufficient Data	5%	10%
Source: Neugarten and Weinstein, 1968

One of the major changes between the original Neugarten and Weinstein study and the more recent Health and Retirement Study is the percent of grandparents who are implementing the “parent surrogate” role. The Health and Retirement Study reports that more than 40 percent of the grandmothers in their 50’s and early 60’s are devoting 15 or more hours per week caring for their grandchildren. Even if this number of hours may not technically qualify as a “surrogate parent,” it does seem very substantial.

Week 5: Lecture

Long Term Care

In the previous textbook for this class, Diana Harris (The Sociology of Aging, 2007) defines long-term care as follows:

“Long-term care refers to an array of health-care, personal care, and social services provided over a sustained period of time to persons with chronic conditions and functional limitations.”

Harris adds that there are three major providers of long-term care: assisted living facilities, home health care, and nursing homes.

Harris compares and contrasts the advantages and disadvantages of the various forms of long-term care. Note that the bulk of community-based long-term care is provided by families or friends. We have already observed that is the preference of older persons. Even when health care is needed, older persons would prefer to receive it in their own homes. However, many older persons will reach a time when chronic conditions and functional limitations are so extensive that assisted living or nursing home care may be the most appropriate setting for care.

Three laws have done much to shape long-term care in the U.S.

1. The Social Security Act of 1935 helped provide the income for older persons to pay for private long-term care.

2. OBRA 87 helped to reform nursing homes by establishing provisions aimed at improving their quality of care standards.

3. Medicare / Medicaid laws of 1965 helped fund nursing home care.

It is very important to remember that Medicare provides very limited funding for nursing home care following hospitalization; Medicaid is a major source of funding for nursing home care, but it is means-tested and kicks in only after depleting most of one’s assets and having very limited income. You'll learn more about the major government programs and provisions in a later class.

Harris emphasizes that although nursing homes are often viewed very negatively, they may be very positive and the best setting for some older persons. For example, on the negative side, Dr. Robert Butler and others have observed that many older persons view nursing homes as a place where one goes to die. However, Harris’ example in Chapter 13 of an older couple who fared well in a nursing home and a number of examples from the videos shown in class (e.g. Eden Alternative) help show the positive side of nursing homes.

On a more personal note, your instructor heaps much praise on those who work in nursing homes. He too has heard the common complaint of nursing home staff mentioned by Harris: “overworked, underpaid, and under-appreciated.” Many of the staff in nursing homes are doing what so many of us are unwilling or unable to do and are paid very little in return. The ones who are dedicated and who provide quality care are clearly heroes to me. Keep these issues in mind when we discuss careers in aging later in the course.

Week 5: Activities

Readings

· Aging and the Life Course:  Chapters 8, 12, and 15

· Handouts

· Intergenerational Equity or the New Ageism?

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· Video Viewing Form

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Discussions

During this week, you should participate in the following discussions:

· Older Adults and Grandchildren

· Minority Reports

· Annual Editions Presentations

To receive participation points, you must post at least one substantive comment or reply for each discussion question in the week it's assigned. Substantive comments do not include simple statements of agreement or disagreement. Support your statements with references to class materials. Comments must be in complete sentences with correct grammar and spelling. Just as you would in person, participating in online discussion requires you to read and respond to your classmates' comments.

Assignments

Assignments are due at the end of week 5:

· Retirement Plan

· When I Grow Old Survey

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Week 7: Overview

Introduction

This week you will learn about political, educational, and religious aspects of aging. You'll learn about elderly involvement in the political system. We'll cover the educational needs of older adults, and the programs and services that fulfill those needs. We'll also discuss the religious beliefs and involvement of the elderly. You'll have access to some great resources that outline program benefits and eligibility requirements. Review all of the information from this class before taking the second exam.

Learning Outcomes

· Recall the goals and resources provided by the organizations discussed: AARP, Silver Haired Legislation, Elderhostel

· Describe voting trends for elderly, addressing both cross-sectional and longitudinal data

· Describe education participation rates among elderly in relation to personal and practical barriers

· Relate trends in religious participation among the elderly to historical trends among all groups and the study conducted by your professor

· Describe the difference between legislation and implementation in elder care in the U.S.

· In regard to major U.S. federal programs to assist the elderly mentioned in the lecture, recall sources of administration and funding, services provided, and the target population

· Week 7: Lecture

· Political Aspects of Aging

· Comprising approximately 14 percent of the total U.S. population, older persons could be a major factor in determining the outcomes of local, state, and national elections.  However, gerontologists for nearly a half century have reported the same observation:  Rarely do older persons vote as a bloc in any election.  Older adults tend to maintain their party affiliation, whether Republican or Democrat.  The political clout of older persons tends to manifest itself in ways other than regular elections, including participation in national organizations like the American Association of Retired Persons (AARP) and involvement in state lobbying and legislative efforts.

· AARP is comprised of more than 40 million members aged 50 (yes 50!!) and over.  The organization regularly supports and /or conducts research aimed at improving the lives of individuals roughly 50 and over.  Publications that are free or very low cost are made available; services (e.g., various forms of insurance) are offered; and policy positions related to older adulthood are advocated regarding issues and legislation affecting that age group.  AARP also has state affiliates who are kept abreast of national AARP advocacy.  I urge you to visit the AARP website (Links to an external site.)  and learn more about the extensive offerings of this organization.  It is likely that several gerontology courses could be taught beneficially just relying on AARP resources alone!

· Another example of older adult participation in the political process relates to a program that began in Missouri in 1972 (see the Silver Haired Legislature handout

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· ).  Missouri started a Silver Haired Legislature in 1972 to provide an opportunity for older persons to actively advocate for legislation primarily for older adults in that state.  Older adult delegates are elected through area agencies on aging (agencies that will be addressed in Class Eight of this course).  The delegates are expected to become familiar with some of the major interests of their constituents and then to convene each year in the state capitol to actually develop mock legislation.  At the end of the legislative session, delegates prioritize five bills that they would like to see enacted into law.  As you can see in the attachment, many of the bills prioritized by the Silver Haired Legislature have been made into laws in Missouri.

· The discussion above is significant in part because most states reportedly have developed their own versions of a silver-haired legislature.  This has resulted in older persons exercising an active and direct role in the political process.

· In the 2008 presidential and congressional campaigns the state of the U.S. economy and concerns related to the wars in both Iraq and Afghanistan likely resulted in older adult issues being pushed far into the background of political priorities.  And, major funding challenges remain in regard to Social Security, Medicare, Medicaid, and other programs that greatly impact the older adult population.

Week 7: Lecture

Education and Aging

Few gerontologists have found ways to attract older persons to participate in regular educational offerings.  In 1974, a study supported by the National Council on Aging reported that only 2 percent of the U.S. population 65 and over were participating in organized and systematic educational programs at that time.  By 1981 the participation level had grown to 5 percent, but the comparison is fallacious because the questions about participation had changed (from “current participation” to “participation during the past year”).  “Lack of interest” was the major reason for not participating, but it was followed by the rationale of “…I’m too old…” to participate.  Even in the presence of very low cost and free educational programs for older persons at many different venues (churches, adult educational programs, colleges and universities, senior centers, hospitals, etc.), a relatively small percentage of older eligibles participate.

As early as 1971, Howard McClusky asserted at the White House Conference on Aging that older persons needed not only practical information (e.g., Social Security and Medicare benefits, how to access programs and services, financial guidance, healthcare updates, etc.) but also education aimed at personal growth and development.  Harris (Sociology of Aging, 2007) describes the five categories of McClusky’s hierarchical needs theory and their meanings:

1. Coping Needs

2. Expressive Needs

3. Contributive Needs

4. Influence Needs

5. The Need for Transcendence

Harris provides a rationale regarding the importance of lifelong learning.  Clearly, each stage of life confronts individuals with new challenges related to adjustment to that stage and to living a rich and full life in general.  Much more could be done to attract older persons to potentially beneficial programs aimed at problem-solving, adult development, and life enrichment. 

One of the most successful educational programs for people 55 and over, from the standpoint of percentage increase in participation in recent years, is the Road Scholar program (formerly Elderhostel program).  Started in 1975 as the Elderhostel program, the program has  provided educational offerings in more than 90 countries.  Go to the  Elderhostel web site (Links to an external site.)  and review the nuts and bolts of this approach to educating older persons.  If you have any interest in this topic, I urge you to get on the Road Scholar mailing list to review the extensive sessions available each quarter of the year.

View the video below on services that were provided by Elderhostel.  Many of these same programs are provided by Road Scholar. 

Is there a difference between the way one should attempt to educate adults as opposed to teaching youth?  Malcolm Knowles, a prolific writer on adult education, points out some major differences.  Keep in mind his emphasis is on adults, not necessarily older adults.

Knowles differentiates pedagogy (methodology for teaching children) from andragogy (methodology for teaching adult learners).  He says there are three major differences. 

1. Adults have a “crystallized self-concept,” which indicates that less “discovery of self” focus is needed. 

2. Adults tend to be more “problem-centered,” as opposed to “subject-centered”; practical information tends to be more valued. 

3. Adult learners have “broad experiences” from which they can draw to enrich a learning situation. 

I urge you to at least reflect on Knowles observations as you present information to your peers in this class.  Especially emphasizing practical information and sharing your rich experiences with one another are important.

Again, it should be emphasized that older persons have abundant opportunities for free or very low cost education.  One very significant example that underscores this point is the opportunities available in Missouri.  The Missouri legislature enacted a “Senior Citizens’ Tuition Exemption” law that permits a resident of that state who is at least sixty-five years of age or older to be awarded a scholarship to most public post-secondary educational institutions in Missouri.  Individuals age 65 and older may attend classes free on a space available, non-credit basis.  See the handout titled “ Senior Citizens’ Tuition Exemption

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Week 7: Lecture

Religion and Aging

Harris (Sociology of Aging, 2007) quotes sociologist Johnstone’s (1988) definition of religion as “a system of beliefs and practices by which a group of people interprets and responds to what they feel is sacred and usually supernatural as well…” Harris adds that “… studying and measuring religiosity – interest and involvement in religious activities – are difficult to do scientifically.” Also, the ideological and ritualistic dimensions of religion may not be closely related, as Harris notes.

You may recall the item on religiosity on the “Facts on Aging Quiz” that you took as a part of Session One. Gerontologists regularly have refuted the commonsense notion that people become more religious as they age. Review the tables below and the accompanying narrative on religious trends and aging in your text. You likely would draw the same conclusion. Do you see how research methodology might be a major factor contributing to the belief in one’s becoming more religious as s/he ages? According to the research reported in these tables, a higher percentage of older persons compared to adults under age 65 report a belief in God and more frequent church attendance. However, these data are primarily from cross-sectional data; older persons today grew up in a period when organized religion was more highly emphasized; often, they have been more religious throughout their lives.

(Both tables from: Harris, Diana K., The Sociology of Aging (Third Edition).  Lanham, Maryland:  Rowman and Littlefield, 2007. Tables 11.3 and 11.4)  Notice the section on “Religion and Personal Well Being” in your text (p. 54).  A consistent finding in the literature on aging is that religiosity tends to contribute to a sense of well-being. Your instructor did a study on group counseling and aging as a part of his doctoral thesis. One of the six counseling groups in the study were retired Catholic sisters at St. Mary of the Woods College in Terre Haute, Indiana. Interestingly, the sisters had higher mean scores on life satisfaction and adjustment scales than any of the other five groups who participated.

Belief in God, 1998
Ages	Believe and have no doubts	Believe but have doubts
18 – 24	54%	17%
45 – 54	62%	1%
65 and older	71%	9%
Source: National Opinion Research Center (1998)
Attendance at Religious Services, 1998
Ages	At least weekly	At least monthly	Less than once a year or never
18 – 24	16%	19%	39%
45 – 54	35%	16%	28%
65 and older	50%	13%	25%
Source: National Opinion Research Center (1998)

(Both tables from: Harris, Diana K., The Sociology of Aging (Third Edition). Lanham, Maryland: Rowman an