Saturday, October 20, 2018

“Give me my lunch. Now go away.”

“Give me my lunch. Now go away.”

Readers might be familiar with the stereotype of the older person who is needy and dependent but also somewhat withdrawn. Such a stereotypical older person might prefer to have a meal prepared by someone else rather than prepare it him- or herself. That person might also prefer to spend time at home alone rather than attend a party. Like most stereotypes, this may be true of a segment of older adults, but as we will show, it is not true for the majority. Many older people still want to have an effect on their world – to take responsibility for other people and for their environment to the extent that their health and strength permit. They would rather cook that meal for themselves if they are able to do so. And if they don't like to cook, they would probably choose to arrange for their own take-out meal. As for preferring to stay at home and enjoy the quiet life, about as many older people as younger ones have that preference. People just don't change very much in those ways.

Myth #20 Older adults prefer to be taken care of – they don't want a lot of responsibilities

Suppose we gave you a plant and said, “Here is a nice plant. Enjoy it. We'll take care of it for you.” Very pleasant, right? Or would it be better to say, “Here's a plant. You should probably water that thing if you want it to live!” Actually, in a classic real-world experiment conducted quite some time ago (Langer & Rodin, 1976), nursing home residents were given just this choice. Half of them were given the plant and instructed that they were responsible for taking care of it; the other half were given the plant without being told to care for it. After some period of time, residents who had been charged with caring for the plant and keeping it healthy were more cheerful and alert, participated more in activities, and reported a greater general sense of well-being than did those who simply sat by while the nursing home staff cared for the plant. The findings of this study certainly contradict the myth that having no responsibilities is ideal.
In yet another widely cited real-world study (Schulz, 1976), nursing home residents were visited by college students. One group of residents was allowed to control the frequency and duration of the college students' visits. A second group of residents got the same number of visits that lasted the same amount of time as the visits to the first group. However, this second group had no choice about either the frequency or the duration of the college students' visits. When Schulz controlled for the number, duration, and quality of these visits, he found that the positive impact the college students' visits had on the well-being of the residents was significantly higher when the residents were given control over their frequency and duration.
What about older adults who live in the community rather than in nursing homes or assisted living facilities? Gruenewald, Karlamangla, Greendale, Singer, and Seeman (2007) followed a sample of older adults (aged 70–79) from the MacArthur Study of Successful Aging over a seven-year period. At the outset, all participants were required to meet criteria that corresponded to the top third of their age group with regard to physical and cognitive functioning. Those who reported at the beginning of the seven-year period that they felt useful to others were, at end of the seven years, less likely to have become disabled and more likely to have survived than those who had said they did not feel useful to others.
Along the same vein, Thomas (2010) used data from a national sample of 689 older adults who participated in the Social Networks in Adult Life survey to determine whether it was better to give support or to receive support. Survey participants named people who were members of their social network; they also reported whether they had given and/or received emotional support (e.g., confiding, reassuring) and/or instrumental support (e.g., sick care) with respect to each one. Overall, older adults who gave more support than they received had a higher level of well-being than did older adults who received more support than they gave. Providing support seems to promote feelings of independence and usefulness, and being able to provide support to adult children and to friends has an especially positive effect. Interestingly, however, Thomas also found that receiving support is not necessarily negative for well-being – receiving support from a spouse or sibling was associated with positive feelings. In contrast, receiving support from adult children was not associated with positive feelings – presumably, it violates the natural order of expectations and takes away from older adults' feelings of independence. Overall, however, Thomas concluded that it is better for older adults to give than to receive.
By now you may be ready to concur that feeling useful and in control is a good thing, so let's delve into some views on how this may work. Investigators (Heckhausen & Schulz, 1995; Schulz & Heckhausen, 1996) differentiate between primary control processes and secondary control processes. Primary control processes refer to the actions and behaviors people use proactively to influence and shape a situation to fit their needs and desires. For example, if you live in a nursing home, the ability to choose the frequency and duration of college students' visits is a good example of exercising primary control. If your choices are honored, this is all to the good. Regardless of age, however, primary control processes cannot be applied in all situations. Furthermore, primary control processes are not uniformly successful when they are applied. When primary control processes are not possible, or when their success is unlikely, people often turn to secondary control processes, which depend more on internal resources. In general, secondary control processes involve accepting existing realities that cannot be changed and, in many instances, altering goals and expectations.
In the present context, the concepts of primary versus secondary control may be best illustrated using the example of the home environment. An 85-year-old woman who is determined to remain in her own home, living independently, may install a grab bar in her bathroom shower and strobe lights on her telephone in case she cannot hear it ring, both proactive efforts at primary control. She may otherwise continue living as she always has, doing her own housework and driving herself to the market to purchase groceries and other necessities. At some point, however, living with complete independence may become extremely difficult, and she may decide to redefine her conception of independence to mean just being able to continue residing in her home but perhaps not doing everything herself. Once she has revised her conception of independent living (a form of secondary control), she can hire someone to perform some of the tasks that she has always done herself but that have become too difficult, like cleaning the oven or changing the sheets. She can also engage someone to drive her to the grocery store and help her unpack the purchased items when they get home. Even though she is receiving some help, she is still able to view herself as independent.
Heckhausen (1997) proposed the optimization of primary and secondary control model to explain what people can do to maintain feelings of satisfaction and well-being. According to this model, age-related physical, cognitive, or social losses may reduce the likelihood that older adults will be successful in achieving all of their goals solely by exerting primary control. Therefore, older adults should be selective in their efforts at primary control. Being selective is adaptive because it allows older adults to direct their efforts at primary control in aspects of life in which the probability of success is highest. If they try to exert primary control in too many domains, some more difficult to control than others, they are likely to become frustrated and unfulfilled. Lachman (2006) concurs that older adults have the best chance of enjoying a high level of life satisfaction if they are adept at modifying what they hope to achieve in accordance with what is possible, and also if they select a small number of domains in which to exert primary control efforts.
In sum, research on control does not support the idea that older adults have a particularly strong desire or need for others to take care of them. For the frail elderly, even control over watering a plant in a nursing home promotes greater well-being than having someone else take responsibility for this task. When primary control fails or is not possible, secondary control is still a good thing. Furthermore, older people are more satisfied if they can provide support for someone else, rather than receive support and never reciprocate. It is important for younger and middle-aged adults to learn this lesson. It is natural for many people to want to take care of the older adults in every aspect of their lives and to have no expectations that they can exert control in any domain whatsoever. In the long run, however, that attitude does not do older adults any favors.

Myth #21 Older people are introverted and prefer to spend time alone

The myth that older adults are introverted and prefer to spend time alone may have originated in the early 1960s. Around that time, investigators from the University of Chicago Committee on Human Development were conducting the Kansas City Study of Adult Life, a project involving interviews with community-living residents of this mid-western city who ranged from 40 to 70 years of age. Included in this study was the Thematic Apperception Test (TAT) – participants were shown photos of characters pictured in ambiguous social situations and were asked to tell stories about them. Individuals in their 40s tended to tell stories about characters who were energetic and eager to take risks in order to master the challenges of the outside world. In contrast, individuals in the older age groups told stories in which characters were less willing to deal with challenging situations and less eager to make emotional investments in other people. On tests like the TAT, the responses people make to ambiguous pictures may reflect something about themselves that they would not otherwise be willing or able to articulate. If so, these TAT findings suggested that as people move from their 40s to their 70s, they become more reflective and preoccupied with inner life, a tendency referred to as increased interiority (Neugarten, Havinghurst, & Tobin, 1968). This view complemented that of the Swiss psychiatrist Carl Jung (1875–1961), who contended that in later adulthood the demands of the external world are reduced, and there is a shift from extraversion to introversion, which allows older adults to be more reflective (Stevens, 1994).
Based in part on the Kansas City Study TAT results, Cumming and Henry (1961) introduced disengagement theory. The main tenet of this theory is that as people grow older, they withdraw from society. At the same time, society withdraws from older adults, expecting that they will step aside to make room for the younger generation. Thus, older adults meet with societal approval when they take a back seat, and older adults who comply with this expectation end up with a high level of life satisfaction (Passuth & Bengston, 1988). Disengagement theory created quite a stir among gerontological investigators – it triggered a controversy regarding whether older adults are happier when they remain engaged in social activity (which had been assumed previously) or whether they would prefer to disengage from social activity.
Are older people happiest when they stay active socially, or would they prefer to withdraw from social engagement and spend time alone? Further inspection of the other tests that the Kansas City Study participants completed regarding both activity level and degree of life satisfaction revealed no single pattern associated with happiness. Some individuals reported being happy as well as active and involved, whereas others – a smaller proportion – reported being happy but with only a low level of involvement. In short, what makes one older adult happy may not work for another. It most likely depends on the personality traits of the individual.
Let's revisit McCrae and Costa's (1997) Five-Factor Model, which we introduced in the discussion of Myth #17, “Older people are hypochondriacs” (see Table 3.1). Recall that the FFM categorizes personality traits along five broad dimensions, or factors: neuroticism, extraversion, openness, agreeableness, and conscientiousness. The factor directly relevant to the present myth is E (extraversion); typically, individuals who score high on this factor (extraverts) are outgoing, sociable, talkative, and warm. In contrast, those who score low (introverts) are reserved, inhibited, taciturn, and sober.
When investigating age and personality, we can compare people of different ages at the same point in time (cross-sectional method) or we can follow the same people over time as they grow older (longitudinal method). When researchers compare people of different ages, the same personality factors and corresponding traits seem to emerge. Also, in studies that follow the same people over a period of years, the personality traits within each of the five factors tend to remain stable over time – people high on the traits that compose the extraversion factor when they were younger tend to remain so in their later years (McCrae & Costa, 1997). Likewise, those who scored low on extraversion when they were younger are not likely to become social butterflies in old age! In terms of extraversion, there is considerable stability across adult age groups.
But how would traits and behaviors associated with extraversion manifest themselves at various stages of life? For instance, a young extraverted adult may well enjoy a large network of friends with whom he or she socializes on a daily basis. In middle age, the same individual might be involved in many hours of work as well as countless hours of child-rearing, which leaves little time for socializing outside of co-workers or immediate family members. As an older adult, this person is likely to be retired from the paid workforce and less busy with childrearing, but there may be fewer opportunities for socializing. With retirement, the work-related social network is no longer available for most people. Also, children have usually left to form their own families and may live far away and visit only on occasion. Those who were married may now be widowed. Close friends may have passed away or relocated to be closer to family members or to reside in a more protected setting where help is available on the premises. People in late old age may have given up driving, and health problems could further restrict their mobility. In short, especially in the older years, most individuals experience a narrowing of their social network. This means there will probably be a reduction in the array of social opportunities that were readily available earlier in life.
Before we accept this rather dreary scenario at face value, let's look at some findings that could modify the picture of older adults as withdrawn and preferring to spend most of the time alone. Lang and Carstensen (1994) studied individuals between the ages of 70 and 104 and found that the older the person, the smaller the social network. But even into very late adulthood, most people still maintained a network of meaningful social/emotional ties. Lang, Staudinger, and Carstensen (1998) reported that even into the ninth decade of life, older adults who score relatively high on extraversion have larger social networks than age peers who score lower on extraversion. The absolute size of a social network may decline as people grow older, but it does not disappear. Rather, there is stability into late old age: compared with those who are low on extraversion (and probably always were), those who are relatively high on this factor tend to have larger social networks even if these networks are smaller in absolute size compared with their networks earlier in life. Extraverts do not become introverts in later life, although in an absolute sense perhaps they could be considered a little less extraverted.
Now let's consider age and social activity from the vantage point of socio-emotional selectivity theory (SST). SST is a contemporary lifespan model with direct relevance both to the nature of social activity and to the size of social networks (Carstensen, 1991, 1995; Carstensen, Gross, & Fung, 1997). According to SST, two main motives determine why people engage in social interactions: information-seeking and emotion regulation. The information-seeking motive – the need and desire to be exposed to something new – dominates early in life but begins to decline in importance prior to middle age. In contrast, emotion regulation (i.e., emotional fulfillment) takes a back seat to information-seeking early in life, but by middle age it becomes increasingly important. By late life, emotion regulation becomes the stronger motive for engaging in social interactions.
How does the motive for social interaction relate to the specific people with whom you prefer to socialize? If your main motive is information-seeking, you'll probably choose to make new acquaintances and participate in novel social interactions. Novel social interactions could end up adding an interesting new dimension to your social life. However, novel social interactions carry some risk, because people who are unfamiliar may turn out to be boring, annoying, or even insulting and threatening to your self-esteem. Alternatively, if your main motive for social interaction is emotion regulation, you might prefer to interact with people who are known to you and are not only enjoyable but also bolster your self-esteem. According to SST, the reduced social activity sometimes seen in old age is actually the result of an adaptive lifelong selection process: older adults prefer to spend time socializing with those already familiar to them, presumably individuals they can count on to make them feel good about themselves. Thus, important and emotionally fulfilling social relationships are maintained in older adulthood, but superficial relationships are filtered out. Even so, older adults high in extraversion are likely to maintain a larger network of meaningful social relationships into late old age, compared with those who are low in extraversion.
It may be the case that young adults with no pressing commitments are more likely than older adults to say they would prefer spending time with a new acquaintance. But when told to imagine they will be making a cross-country move in the near future, young adults tend to select a family member or close friend over a new acquaintance to socialize with in the little time they have in their old location (Fredrickson & Carstensen, 1990). The same finding was replicated in a study conducted in Hong Kong – young Asians told to imagine they would be emigrating in the near future were just as likely as older Asians to choose a familiar friend or family member with whom to socialize in the time remaining (Fung, Carstensen, & Lutz, 1999). In short, the social partner a person selects is influenced by perceived time left. Clearly, age and perceived time left are usually related – as we get older, we may feel that it is wiser to put our energy into social interactions that are familiar and known to give us pleasure, rather than taking a chance that socializing with a new acquaintance will be a worthwhile way of spending the time we have left.
In sum, the belief that older adults are introverted and prefer to spend time alone is clearly a myth. First, not all older adults are alike. Some are more outgoing and people-oriented than others and probably were that way even when they were younger. Even when they move into assisted living facilities, outgoing individuals will likely be the regular participants in scheduled social activities. Second, almost all older adults have a social network, albeit smaller in absolute size than it was earlier in their lives. A shrinking social network could be the result of losing relationships that older adults either cannot or do not want to replace. Nevertheless, they usually maintain close relationships with those who remain in their network.

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