15.1 Theories of Late Adulthood

Development in late adulthood may be more diverse than at any other age: Some elderly people run marathons and lead nations, whereas others can no longer walk or talk. Moreover, individuals vary within themselves in almost every measure from day to day, with some days much better than others (Krenk et al., 2012). Many social scientists try to understand the significance and origin of these variations and to describe the general course of old age.

Some theories of late adulthood have been called self theories because they focus on individuals’ perceptions of themselves and their ability to meet challenges to their identity. Other theories are called stratification theories because they describe the ways in which societies place people on a particular life path.

Self Theories

It can be said that people become more truly themselves as they grow old, an idea captured by Anna Quindlen:

The essential self is protected and rediscovered, despite all the changes that may occur. Self theories emphasize how people negotiate their personal challenges (Sneed & Whitbourne, 2005). Such negotiation is particularly crucial when older adults are confronted with multiple challenges like illness, retirement, and the death of loved ones.

A central idea of self theories is that each person ultimately depends on himself or herself. As one woman explained:

Studies of personality over the life span confirm the continuity of self. An individual’s high or low level on each of the Big Five personality traits (see Chapter 13) tends to remain the same, not only throughout the earlier adult years, but even when people are in their 80s (Mõttus et al., 2012).

IntegrityThe most comprehensive self theory was from Erik Erikson. His eighth and final stage of development is called integrity versus despair, a period in which older adults seek to integrate their unique experiences with their vision of community (Erikson et al., 1986). The word integrity is often used to mean honesty, but it also means a feeling of being whole, not scattered, and comfortable with oneself. (Integrity comes from the same root word as integer, a math term meaning “a whole number, not a fraction.”)

As an example of integrity, many older people express pride and contentment regarding their personal history. They are proud of their past, even when it includes events that an outsider might not consider worthy of pride—such as skipping school, taking drugs, or escaping arrest. Psychologists sometimes call this the “sucker to saint” phenomenon—that is, people interpret their experiences as signs of their nobility (saintliness), not their stupidity (Jordan & Monin, 2008).

As Erikson (1963) explains it, such self-glorifying distortions are far better than losing hope, or “feeling that the time is now short, too short for the attempt to start another life” (p. 269). As with every crisis, tension occurs between the two opposing aspects of development. Past crises, particularly Erikson’s fifth crisis of identity versus role confusion, reappear when the usual pillars of the self-concept (such as employment or good looks) crumble. One 70-year-old said, “I know who I’ve been, but who am I now?” (quoted in J. Kroger, 2007).

This tension helps advance the person toward a more complete self-concept. In this last stage,

That integration of death and the self is an important accomplishment of this stage. The life review (explained in Chapter 14) and the acceptance of death (to be explained in the Epilogue) are crucial aspects of the integrity envisioned by Erikson (Zimmermann, 2012).

Holding on to One’s SelfMost older people consider their personalities and attitudes quite stable over their life span, even as they acknowledge the physical changes of their bodies (Fischer et al., 2008). One 103-year-old woman observed, “My core has stayed the same. Everything else has changed” (quoted in Troll & Skaff, 1997). Sometimes it is a struggle to maintain a strong sense of self. As bodies and social relationships change, adults may need to revise their self theory about their identity.

The need to maintain the self may explain behaviour that younger people might consider foolish. For example, many elders hate to give up driving a car because the independence that driving offers them has become an integral part of their view of self, especially for men (Davidson, 2008). Also, objects and places become more precious in late adulthood than they were earlier, as people seek a way to hold on to identity (J. Kroger, 2007; Whitmore, 2001).

The tendency to cling to familiar possessions may be problematic if it leads to compulsive hoarding. While younger relatives may complain that the accumulation of old papers, furniture, and mementos takes up space and is a fire hazard, for the elderly, compulsive hoarding can be seen as maintaining the self: Possessions become a part of self-expression, and the elderly resist self-destruction (Ayers et al., 2010).

Similarly, many older people refuse to move from drafty and dangerous dwellings into smaller, safer apartments because abandoning familiar places means abandoning personal history. Likewise, they may avoid surgery or reject medicine because they fear anything that might distort their thinking or emotions: Their priority is self-protection, even if it means shortening life (S. W Miller, 2011–2012).

The need to preserve one’s self explains why many of the elderly strive to maintain childhood cultural and religious practices. For instance, grandparents may painstakingly teach a grandchild a language that is rarely used in their current community, or encourage the child to repeat rituals and prayers they themselves learned as children. In cultures that emphasize youth and novelty, the elderly worry that their old values will be lost and, thus, that they themselves will disappear from memory.

The importance of self-validation is particularly apparent among older immigrants. Many grew up with customs unlike those where they and their descendants now live. They may become depressed if they think their culture is not appreciated and struggle to reconcile their traditional values with those of their children (Abu-Bader et al., 2011; H. Y. Lee et al., 2011).

The Positivity EffectAs you remember from Chapter 14, some people cope successfully with the changes of late adulthood through selective optimization with compensation. This is central to self theories. Individuals set their personal goals, assess their own abilities, and figure out how to accomplish those goals despite limitations. For some people, simply maintaining identity correlates with well-being (Ebner et al., 2006).

One strategy for selective optimization is known as the positivity effect. Elderly people are more likely to perceive, prefer, and remember positive images and experiences than negative ones (Carstensen et al., 2006). Compensation occurs via selective recall: Unpleasant experiences are reinterpreted as inconsequential. For example, with age, stressful events (economic loss; serious illness; the death of friends, family, or, in the future, oneself) are less likely to be considered central to one’s identity. That enables the elderly to be unperturbed by much of what happens; they maintain emotional health via positive self-perception (Boals et al., 2012).

The positivity effect is evident in many nations. After taking into account income, education, and gender, adults everywhere report gradually increasing happiness from age 50 on (Blanchflower et al., 2008).

Stratification Theories

A second set of theories, called stratification theories, emphasizes societal forces that place each person in a social strata or level. Such stratification makes it difficult for a person to earn more income, have better health, or live longer than people of their group. Stratification begins from day one, as babies are conceived in societies that are already stratified, or differentiated, by various dimensions such as gender, ethnicity, and SES (Lynch & Brown, 2011).

The problem with stratification is that it results in inequality for reasons beyond the individual. As the decades of life go by, stratification by age, gender, ethnicity, and income become increasingly burdensome, causing double, triple, or even quadruple jeopardy. We describe each of these in turn.

Stratification By AgeAgeism is, of course, stratification by age. Age affects a person’s life in many ways, including income and health. For example, seniority builds in the workplace, increasing income up to a certain point; then employment may stop when a person reaches a given age, with that person perhaps earning a pension but never as much income as before.

This is just one example of the many ways in which industrialized nations segregate elderly people, gradually shutting them out of the mainstream of society as they grow older (Achenbaum, 2005). That harms all generations because it limits social experiences: Younger as well as older people have a narrower perspective on life if they interact only with people their own age.

The most controversial version of age-stratification theory is disengagement theory (Cumming & Henry, 1961). This theory holds that, as people age, traditional roles become unavailable or unimportant, the social circle shrinks, co-workers stop asking for help, and adult children turn away to focus on their own children. According to this theory, disengagement is a mutual process, chosen by both older and younger generations. Children want to be with other children, adults with other adults, and older adults with one another or by themselves. Thus, younger people disengage from the old, who themselves voluntarily disengage from younger adults. They relinquish past roles, withdrawing from life’s action.

Disengagement theory provoked a storm of protest because people feared it justified ageism and social isolation. Many gerontologists insisted that older people need and want new involvements. Some developed an opposing theory, called activity theory, which holds that the elderly seek to remain active with relatives, friends, and community groups. Activity theorists contend that if the elderly disengage, they do so unwillingly (J. R. Kelly, 1993; Rosow, 1985).

Later research has found that elders who are more active are happier, intellectually more alert, and less depressed. This is true at younger ages as well, although some studies find that activity is particularly likely to correlate with high functioning at older ages (Bielak, 2010; Bielak et al., 2012).

Both disengagement and activity theories need to be applied with caution, however. Disengagement in one aspect of life (e.g., retiring from employment) does not necessarily mean disengagement overall: Many retirees disengage from work but find new roles and activities to participate in (Freund et al., 2009). The positivity effect, just described, may mean that an older person disengages from emotional events that cause anger, regret, and sadness, while actively enjoying other experiences (Brassen et al., 2012).

A cautionary note comes from research in China. One study found that among the Chinese young-old, activity correlated with health, particularly if the activities involved social interactions. But among the oldest-old, activity did not correlate with longevity: For some of the oldest Chinese, disengagement was more closely associated with health (R. Sun & Liu, 2008). Both theories—that all the elderly want to withdraw and that they all should stay active—may arise from cultural stereotypes.

Stratification By GenderFeminist theory draws attention to stratification that puts males and females on separate tracks through life. From pink or blue blankets for newborns’ bassinets to flowers or stripes for nursing home bedsheets, gender is signalled throughout life. These signals alert everyone—caregivers, family members, and strangers—to treat males and females differently. Such stratification, when combined with ageism, makes people expect older women to be, for instance, either warm and giving (grandmotherly, providing kindness and cookies) or sickly and dependent. Older men might be seen, for example, as elder statesmen or as grumpy and curmudgeonly.

The implications of gender divergence are illustrated by a study of caregiving among older married couples. Both sexes provided care if their spouse became needy, but they did so in opposite ways: Women quit their jobs, whereas men worked longer. To be specific, employed women whose husbands needed care were five times more likely to retire than were other employed women. By contrast, employed husbands whose wife needed care retired only half as often as other men (Dentinger & Clarkberg, 2002).

Note, however, that both partners sacrifice. Men stayed on the job so they could keep insurance and hire household help, and women quit to provide personal care. Both sexes followed the gender stratification of decades earlier: Women were socialized to be caregivers, and men’s employment patterns (not part-time, more seniority) typically included higher salaries and better insurance than women’s patterns (more interruptions, and hence less pay and benefits). In this situation, past stratification disadvantages the older women: Their caregiving response leads to poverty and loneliness.

Irrational, gender-based fear may also lead to unequal experiences for older men and women. For example, because adult children want to protect their mothers, they are more likely to persuade their widowed mothers to live with them than they are their widowed fathers, thus limiting their mothers’ independence. The children’s fear for the mother’s safety is not based on evidence. Men living alone are more likely than women to have a sudden health crisis and are more likely to be the victim of a violent crime (5 percent versus 2 percent) (P. Klaus, 2005).

In another example of stratification, women typically marry men a few years older than they are and then outlive them. Especially if they lived in rural areas (as most North Americans did until about 1950), married women often relied on their husbands to drive, to manage money, and to keep up with politics. Then, if the husband died, past gender stratification led to isolation, poverty, and dependence among the oldest-old widows.

Men, too, may be harmed. For instance, boys are taught that males are stoic, repressing emotions and avoiding medical care. Is that why, in every nation, adult women outlive men? This could be biological (protective hormones), but it could result from lifelong stratification, making men more vulnerable in old age.

Stratification By EthnicityLike age and gender, ethnic background affects every aspect of development throughout life, including education, health, place of residence, and employment. Stratification theory suggests that these factors accumulate, creating large discrepancies by old age that leave ethnic minority seniors at risk of becoming marginalized (National Advisory Council On Aging, 2005).

When one considers Canadian seniors, stratification by ethnicity is probably most evident among immigrants, especially those who arrived recently, and among Aboriginal peoples. In 2006, about 30 percent of Canadian seniors were immigrants, many of them from visible minorities (Ng, 2010). Aboriginal peoples accounted for 1 percent of Canada’s seniors (Chief Public Health Officer, 2010).

Common problems faced by ethnic minority and Aboriginal seniors include greater rates of poverty and illness and, for Aboriginal peoples, shorter life expectancies. In 2001, 13 percent of Aboriginal seniors, compared to 7 percent of non-Aboriginal seniors, were living in low-income households. Similarly, 50 percent of Aboriginal seniors not living with family were in low-income situations compared to 40 percent of non-Aboriginal seniors in the same living situation (Chief Public Health Officer, 2010). This income discrepancy is largely due to higher levels of unemployment among the Aboriginal population, higher percentages of Aboriginals working part time, lower levels of participation in the labour force (i.e., employed or looking for work), and lower wages for those employed (Turcotte & Schellenberg, 2006).

Higher poverty rates are also present among elderly immigrants, particularly those who are recent immigrants as compared to those who have been in the country longer than 10 years (Eigersma, 2010). For example, in 2003, 26 percent of recent immigrant seniors were in the lowest income quartile compared with 12 percent of long-term immigrant seniors and 15 percent of non-immigrant seniors (Eigersma, 2010). Statistics Canada reports that, in general, recent immigrant seniors experience higher unemployment rates, lower earnings, and greater difficulties in matching their qualifications to their employment (Turcotte & Schellenberg, 2006). Difficulties in finding a suitable job consequently impair new immigrants’ efforts to accumulate sufficient funds for retirement. As well, when recent immigrants do retire, they are often ineligible for Old Age Security benefits since that program requires a 10-year residency in Canada before a person can collect benefits (Eigersma, 2010; Jackson, 2001). In a culture where workers are expected to retire and live on pension income, many older immigrants (without a host country work history) are left unemployed, poor, and lonely.

A particular form of ethnic stratification may affect immigrant elders who find themselves dependent on their adult children within a culture stratified against both the old and the immigrant. Many traditional cultures expect younger generations to care for the elderly personally, but North American families tend to be nuclear families, not extended ones.

For some cultures, the traditional notion of adult children caring for their aging parents remains strong. In some Chinese families, for example, the thought of placing an ailing and aged parent in a nursing home may conflict with their sense of responsibility. One recent response to this problem has been the appearance of ethnoculturally focused nursing homes such as the Yee Hong Geriatric Care Centre that services the Chinese community in Mississauga, Ontario. About 10 Asian-focused nursing homes now exist in Canada, mainly for the Chinese and South Asian communities, but demand far outstrips availability. The average wait time for a space in a mainstream seniors’ facility in Ontario is 113 days; at the Yee Hong Centre, it can take 10 years to find a place (Bascaramurty, 2012).

Since poverty often has negative impacts on a person’s health, it comes as no surprise that in 2001—the same year that 13 percent of Aboriginal seniors, compared to 7 percent of non-Aboriginal seniors, were living in low-income households—only 24 percent of non-reserve Aboriginal seniors reported that their health was very good to excellent (O’Donnell & Tait, 2003), compared to 36.4 percent among seniors in the general population (Statistics Canada, 2002). In 2003—the same year that 26 percent of recent immigrant seniors were in the lowest income quartile compared with 12 percent of long-term immigrant seniors and 15 percent of nonimmigrant seniors—only 28 percent of recent immigrant seniors reported that their health was very good to excellent, compared with 36 percent of long-term immigrants and 38 percent of non-immigrant seniors (Turcotte & Schellenberg, 2006).

A 2008 report for Statistics Canada found discrepancies in the mortality rates among various ethnic groups but especially for Aboriginal peoples. First Nations, Métis, and Inuit had substantially higher mortality rates than non-Aboriginal Canadians (see Figure 15.3). The highest rate of all was among registered Indians, a subgroup of First Nations (Wilkens et al., 2008). Another government report found that compared with other Canadian seniors, Aboriginal seniors tend to have double or triple the prevalence of certain chronic conditions that often end in death, such as heart disease, hypertension, diabetes, and arthritis (Health Canada in collaboration with the Interdepartmental Committee on Aging and Seniors Issues, 2002). Remember that living in poverty can place repeated stresses on a person that result in conditions such as hypertension and obesity as well as the other 8 to 14 indicators of allostatic load. Over the years, this can take a toll on a person’s health and well-being.

Stratification By SESFinally, the pivotal influence on the well-being of the elderly may be financial, not directly gender, ethnicity, or age. Income correlates with those three but is not caused by them (Bird et al., 2010). A child of a family with low SES will have less education, worse health, and a poorer work history (and thus more unemployment, fewer benefits, no pensions). He or she will experiences stress of all kinds, accumulating disadvantages that are increasingly limiting as the years go by (Bowen & González, 2010).

The problem may begin even before birth, since epigenetic factors—themselves affected by maternal health—shape the genetic expression (Shanahan & Hofer, 2011). Those who are born into low-SES families risk late-life illnesses, such as diabetes, as well as disabilities. Obviously, poverty among elders should be alleviated, but mitigating poverty early in life may be critical for well-being in late adulthood (Herd et al., 2011).

In 2010, 5.3 percent of seniors in Canada were living in poverty—that is, below what Statistics Canada calls the Low-Income Cut-Off (LICO) (see the discussion on LICO in Chapter 1) (Conference Board of Canada, 2013a). This represents a significant decrease in the LICO rate among Canadian seniors over the last almost 40 years; in 1976, almost 30 percent of seniors found themselves below LICO (see Figure 15.4). At least one expert, economics professor Lars Osberg of Dalhousie University, has hailed this drop in poverty rates among seniors as “the major success story of Canadian social policy in the twentieth century” (Osberg, 2001).

Perhaps the main reason for the decrease was the institution of the Canada Pension Plan and Quebec Pension Plan in 1966. Canadian seniors can also access two other government transfer programs:

1. Old Age Security. Almost all Canadians older than 65 receive OAS, which is an income supplement that averages about $450 a month.
2. Guaranteed Income Supplement. This provides additional funds to low-income seniors who are enrolled in OAS and meet certain other requirements.

In addition, some seniors have access to their own savings or private pension plans that they enrolled in at work.

Despite the drop in poverty rates among seniors, one group that remains vulnerable to low income in old age is women, especially those older than 75 and who have been widowed or are living alone for other reasons. Women often receive less than men from government pension plans because the benefits are usually linked to a person’s employment history. In the period between 2006 and 2010, the number of Canadian seniors living below LICO increased by about 160 000, and 60 percent of them were women (Conference Board of Canada, 2013a).

One important financial problem for the elderly is that inflation makes retirement income worth less than half of what it was when that money was first set aside. Those middle-aged adults who have adequate savings for retirement are in the minority: Typically, they are already wealthy, another example of SES stratification.

Internationally, stratification by income for the elderly varies a great deal (see Figure 15.5). Some nations provide free health care and heavily subsidized senior residences for everyone. One of these is Denmark, which also has the highest proportion of happy seniors. By contrast, other nations provide nothing at all, expecting family members to care for the elderly. In several Asian nations, it is illegal for adult children not to provide for their parents.

This is a developmental issue to which applying a cross-cultural approach would be useful. Every nation has had unexpectedly large increases in the number of older adults, and every nation is cutting government assistance to the economically disadvantaged. The resulting dilemma is more economically disadvantaged elders than in the past. Some nations have found better solutions than others, but nations can learn from one another.