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Trends and Perspectives in Gerontology

Module 1: Trends and Perspectives in Gerontology

Current Trends in Gerontology: What Can We Expect in the Future?

This module will discuss important current concerns among gerontologists: diversity in the older adult population, the uncertain future of health care and social security, current issues in gerontology theory, and intergenerational integration. The module will provide an overview of gerontology education and careers. Last, it will provide a discussion of quantitative and qualitative research. This will help students formulate and answer their aging-related research questions.

Diversity in the Older Adult Population

The quickly burgeoning older population is quite diverse. Older adults vary tremendously in terms of socioeconomic status, ethnic background, family structure, level of family support, functional ability , age, and health. (Silverman, 1996; Cornman and Kingson, 1996). In particular, there is considerable diversity among older adults with respect to health status and functional ability. Many older adults are healthy, active, and independent. Others may have a degree of physical impairment with chronic illness. Still others may be quite functionally impaired and need help with activities of daily living. Thus, programs and services are needed that are responsive to a range of health and functional ability needs.

On the whole, the population of older adults is increasingly characterized by a higher level of education. These better-educated aging adults may be more proactive in their health care and demand more of health care, social services, and other services for older adults. At the same time, there is still considerable diversity among older adults in terms of education and social class. Thus, those who work with older adults need to be aware that some older adults may be quite proactive in obtaining needed resources. Other older adults may not be as knowledgeable and may need more assistance with securing health care and other resources.

Families vary in terms of their ability to meet the needs of frail elderly. Divorce, single-parent families, and more women in the workplace are common. Thus, it is often unclear who will care for frail older family members and how they will provide care.

Also, there is a growing number of ethnic-minority elderly, especially African American and Hispanic elderly. Aging people in different ethnic groups often have different health care and social service needs. Thus, health and social service providers need to be aware of the needs of elderly in different ethnic groups to most effectively meet these needs.

Think about this: What kinds of services and programs might be needed by an increasingly diverse older population? Do you think that different services and programs might be needed by aging people of different socioeconomic backgrounds, health statuses, functional abilities, ethnic backgrounds, and family supports? What kinds of services and programs might aging adults of different abilities and from different backgrounds need?

Uncertainty About Social Security and Health Care

Another issue on the horizon is the uncertainty of how Social Security and the health care system in the future will meet the needs of an older population (Cornman and Kingson, 1996).

The Fastest-Growing Group of Elderly People

The fastest-growing group of elderly people is the oldest old, or the 85 years+ group. This group of older adults may experience more physical frailty and chronic illness than their younger counterparts. How will health care and social services meet the needs of this rapidly growing group of older adults? How will families meet the needs of their very old frail members? Should caregiving be seen as a private family responsibility or a societal responsibility?

Think about this: Do you know people who care for aging family members? Do you think caregiving should be a societal and/or a family responsibility? If you think society should help caregivers of aging family members, how do you think it should help? Are there policies that you might want to learn more about or propose that might help frail elderly and their caregivers?

Gerontology Theory: Current Issues

Gerontology theory seeks to understand and explain the many aspects of the aging experience. That is why gerontologists are finding ways of describing how social class, gender, and ethnicity/culture affect social, psychological, economic, and political aspects of aging. Recent gerontological theory seeks to explain how and why different groups of elderly people have not had access to economic and other resources in their lives and how this creates inequities in the experience of aging for a number of elderly people (Hendricks, 1996). Social structures (e.g., roles in society for women and minority group members), and ideologies (e.g., racism, sexism) affect the experience of aging (e.g., health, retirement), especially for women and those from minority groups.

Specifically, gerontological theory attempts to explain the impact of the unequal distribution of power on the aging experience. For example, gerontological theory may attempt to explain how social structures and ideologies affect economic well-being and health in minority women. These women may not have the financial resources in later life that Caucasian men have had. They may not have worked outside the home. Also, they may not have had access to work roles that are of the same prestige and financial remuneration as those of their white male counterparts.

Also, in its attempt to understand aging, another line of gerontology theory calls for researchers to let elderly people themselves (rather than the researchers) define concepts and issues that are important to them: successful aging, creativity, humor, health, and well-being to name a few (Tornstam, 1992). Let's change the way we inquire about aging!

Think about this: Do you think gender, ethnic, and social class background affects the resources to which aging people have access? Do you think that economic, health, and other resources are equitably distributed among elderly persons from different backgrounds?

Intergenerational Equity and Integration

Will there be generational conflict in the future? Will the younger and older generations compete with each other for economic and other resources? Will young and old work together, side by side in the workplace and in their communities? What important roles are there in society for aging people?

Some gerontologists feel that there will not be significant conflicts among older and younger generations, since older adults will be integrated into social roles, especially in the family (Uhlenberg, 2000; Foner, 2000). Because many older adults provide invaluable assistance to their families (e.g., financial assistance, child care), strong intergenerational bonds are often forged that mitigate against significant intergenerational conflict in the larger society. Also, as more older adults are found in the workplace and in their communities, bonds among people of different ages will be forged. This will alleviate tension between the young and old.

There are a variety of roles that aging adults could fill in families, neighborhoods, places of employment, and communities. These roles would give older people a sense of purpose and meaning. Also, the contributions of older adults would enhance the well-being of their communities.

It is important to think about different steps that communities, families, and employers could take to help older people fill productive, meaningful roles. This way the lives of older adults and others would be improved.

Think about this: Do you think the United States is headed for intergenerational conflict? What forces in your own family, workplace, and community bring young and old together or keep them apart? Are there opportunities in your community, family, and workplace for younger and older adults to interact and share ideas?

Education and Careers in Gerontology

Choosing a Career in Gerontology

Because of the explosion of the older population, gerontology and geriatrics are growing fields. Special training for those who work with older adults in various roles is becoming increasingly available. Those interested in a career in aging may either become gerontologists or gerontological specialists (Peterson, 1995). Gerontologists have a degree in gerontology. Geriatric specialists, on the other hand, choose to acquire training in a traditional academic discipline such as nursing, social work, or psychology, and specialize or acquire additional training in gerontology.

Think about this: Do you think you'd like to be a gerontologist or a geriatric specialist? What might be some of the advantages and disadvantages of each for you?

For those who desire a career in direct service to older adults, it may be helpful to think about the kinds of older adults you want to work with:

· Do you want to work with older adults who are in relatively good physical health and functionally independent, or do you wish to work with those who have health problems and may be cognitively and/or physically impaired?

· If you wish to work with elderly people who have health difficulties and impairments, with what kind and degree of impairment and disease are you interested in working?

The Association of Gerontology in Higher Education's publication, Careers in Aging: Opportunities and Options, presents the following recommendations for those desiring a career working with older adults:

· Decide whether you wish to pursue a career as a licensed healthcare or social services professional or whether you wish to work primarily with older adults outside the purview of a licensed profession.

· For those who wish to work in an established health or social services profession, decide on the field in which you wish to obtain training (e.g., nursing, medicine, social work, occupational therapy, speech and hearing therapy/audiology). Then pursue additional training in gerontology.

· If you desire work that focuses mainly on the needs of older adults but do not wish to work within a licensed profession, consider pursuing a degree program in gerontology.

Jobs in the Field of Aging

The jobs available within the field of aging vary in terms of the required level of education, the type of work, and the setting of the work. Those who work in the field of aging include those who work directly with older adults as well as those who are not direct care providers. Many professionals in the field of aging are found in the health and social services. However, there are a number of others who work for older adults in other areas.

Some jobs for those in the field of aging include:

· health or social services: positions in the health care/social services profession such as staff nurse, physician, psychologist, counselor, nursing home administrator, activities coordinator, recreational therapist, speech-hearing therapist/audiologist, social worker, geriatric nurse practitioner, health educator, nutritionist

· policy/legislation: policy planner/analyst

· marketing and product development: marketing specialists may market retirement communities and their programs, assisted-living facilities, nursing homes, leisure activities or organizations for older people, or health services for older adults; product specialists may develop health and other products for older adults

· academia: college professor, gerontological researcher/research assistant

Those who work in the field of aging may work in a variety of settings. These settings may include:

· health care settings: hospitals, hospice, rehabilitation centers, nursing homes, home health care, community health centers

· social service settings: adult day-care centers, senior centers, meals-on-wheels programs

· businesses: health insurance, product development

· housing: retirement communities, assisted-living centers, senior-housing complexes

· private organizations/agencies: National Council on Aging, American Association of Retired Persons, Gerontological Society of America

· research: National Institute on Aging, aging research centers/programs affiliated with medical schools and higher education

· government: area agencies on aging, state departments of aging

Listen to what some people who work with older adults have to say about their jobs:

· A nurse practitioner (See text version of this audio clip.)

· An activities coordinator at an adult day care center (See text version of this audio clip.)

· A social worker (See text version of this audio clip.)

Important Skills for Those Beginning Their Work with Older Adults

In addition to knowledge of psychological, social, and physical aspects of aging, there are other skills important to those entering work in the field of aging. Interpersonal and program-development skills are important for those just beginning to work with older adults (Bennett and Sneed, 1999). Interpersonal skills are quite important when working with older adults. Interpersonal skills include listening attentively; communicating an understanding of psychological, social, economic, and health issues often faced by older adults; assessing the needs of adult persons; and communicating clearly, both verbally and in writing, with older persons and other professionals. It is important to know how to plan and evaluate programs that meet the needs of older adults.

Education in Gerontology

The Association for Gerontology in Higher Education's Standards and Guidelines for Gerontology Programs provides guidelines for the development of gerontology certificate programs and gerontology associate's, bachelor's, master's, and doctoral degree programs. However, at this time there is neither accreditation for gerontology programs nor credentialing for individuals trained in gerontology.

Basically, degree and certificate programs in gerontology offer courses in the psychological, physiological/health, and social aspects of aging. There is usually a practicum or field experience in gerontology in which the student works with a professional in the field of aging. The student acquires expertise in servicing the needs of older adults and also has the opportunity to apply the content learned in gerontology classes. In addition, the program may offer a course in programs and policies for seniors in which students integrate gerontology knowledge with knowledge in their major area of study for their degree, and elective courses that enhance their gerontological knowledge base.

Research Methods

Quantitative Research

What kinds of questions might you have about the aging? Conducting research is a way to answer these questions. One common approach to research is quantitative method. This involves measuring and predicting behaviors, attitudes, and traits. One example of this is measuring one's level of social extraversion by the score one receives in a test on extraversion.

Basic quantitative research method includes correlational and experimental research.

Correlational Research

Correlational research examines relationships among variables. An example is the relationships among diabetic health status (measured in terms of blood sugar), frequency of exercise (measured in terms of the number of times one engages in aerobic exercise per week), and duration of exercise (measured in terms of the number of minutes one exercises). As the frequency and duration of exercise increase, the blood-sugar level decreases. This is an example of a negative correlation: as the level of one variable increases, the level of the other variable decreases.

A positive correlation is one in which as one variable increases or decreases, the other increases or decreases. An example of a positive correlation is the relationship between religiosity (e.g., defined in terms of the number of times one attends religious services) and perceived health status. The higher the level of religiosity, the higher the level of self-reported wellness or health.

A correlation or relationship between two variables doesn't mean that a change in one variable causes a change in the other. It simply means there is a relationship between two variables.

Experimental Research

Experimental research attempts to ascertain that a change in one variable causes a change in another variable. An experimental study manipulates the independent variable to examine its effect on the dependent variable . To examine the effect of manipulating the independent or manipulated variable on the dependent or outcome variable, an experiment is constructed in which study participants are randomly assigned to either an experimental or control group. The use of experimental and control groups is a way of measuring the effect of the independent variable on the dependent or outcome variable.

Experimental and control groups are the same or equal in every way except for intervention or manipulation used. The experimental group receives the intervention while the control group does not. The outcome variable is measured after the experimental group is given the intervention.

One example of the use of experimental research is to examine the effect of implementing a new health-promotion program for seniors on specific outcome or dependent variables. Click each of the steps below to take a closer look at how you would conduct this type of experimental study.

Longitudinal and Cross-Sectional Research

Developmental changes are examined by using longitudinal research. Longitudinal research examines the same group of people over time. This approach can ascertain developmental changes over time but takes a long time to complete. Cross-sectional research examines different cohorts or individuals of different generations at the same time. This can measure age differences but not age changes.

If you are interested, you may want to read about more complex research designs that attempt to understand the aging experience. See the appendix on research methods in the newest edition of Adult Development and Aging by J. M. Rybash, J. M. Roodin, and W. J. Hoyer.

Think about this: What kinds of correlational research questions about aging might you have? (e.g., What is the relationship between perceived health and age? What is the relationship between frequency of visits with friends and life satisfaction?) What kinds of research questions might you have that could be answered by experimental research? (e.g., What is the impact of participating in an aerobic exercise program three times a week on perceived health?)

Qualitative Research

Qualitative research is often not discussed in gerontology texts in nearly as much depth as quantitative research. Thus, this section will provide a discussion of the basic concepts and uses of the qualitative method.

You might have other questions about aging that don't involve measuring behaviors, attitudes, or traits. For example, you might want to ask about ethnic elderly people's perceptions of their relationships with their doctors to obtain information about how doctors might better build rapport and communicate with their ethnic older adult patients.

Another example: You might want to ask a question about how elderly people in different cultural groups define and perceive health and illness to help understand and meet their health-promotion needs. For example, health for an American may mean the ability to function independently. For someone from an Eastern culture, it may mean the ability to take care of and be helpful to other family members and one's community.

To answer these questions, qualitative research can be used. Qualitative research attempts to answer questions about how individuals or groups understand their lived experience and often how cultural values and norms may help to shape this understanding of experience.

Characteristics of Qualitative Research

· Qualitative research attempts to understand the experience of objects and events as it is described and understood by the study participants. Qualitative research obtains and uses rich, firsthand information on how individuals and groups experience and understand their world by observing and interviewing people in their natural environments.

· Qualitative research is inductive. It observes behavior and seeks to build explanations or theories based on these observations. It builds theories or explanations of phenomena from the ground up. This is in contrast to quantitative research, which is deductive. Quantitative research begins with hypotheses and tests them to build theories about behavior.

· Qualitative research is contextual. It pays attention to the context of the behavior of individuals or groups (the setting, such as a city, town, community; the culture) and how this may influence particular ways of experiencing and understanding events. The focus is on observing, describing, and understanding the lived experience of individuals and/or groups in a particular setting. This is in contrast to quantitative research, which focuses on measuring and controlling variables in a laboratory setting.

Theoretical Basis for Qualitative Research

Qualitative research is based on the theoretical perspectives of symbolic interactionism and phenomenology. Symbolic interactionism attempts to explain the evolution of meaning through interaction with others. Phenomenology seeks to explain the experience of individuals and groups.

Data Collection in Qualitative Research

In qualitative research, the establishment of trust and rapport with study participants is the foundation of the research. The researcher cannot obtain in-depth and accurate information about an individual's or group's experience (e.g., of aging) unless rapport with study participants is readily established. Thus, establishing rapport enables the researcher to gain access to important sources of data.

Qualitative researchers use various means of collecting information or data from the people they are studying to help them understand the experience of study participants. One way of gathering data is through participant observation . The researcher may venture into the field and participate in rituals, ceremonies, or other activities of the individuals being studied. Another way of collecting data is by interviewing study participants. Interviews use open-ended questions to allow study participants to provide in-depth information about their experiences and understanding of people and events.

For example, qualitative researchers may use interviews to gather important information from individuals from different ethnic groups regarding their perceptions of the most important outcomes for them as a result of participation in a program, how particular programs or services have helped them, and what factors in the program were most beneficial to them and why.

An ethnography of an individual or group can be done in which the experience of the individual or group and how the larger culture may shape this experience can be closely examined. An ethnography of one individual or life story often involves using unstructured interviews and participant observation, reading personal journals or diaries, reading or listening to stories, and examining artifacts important in the life of the person studied.

One example of ethnography would be a study of the life story of an older war veteran to better understand the impact of war on his or her life and personal development. The researcher would interview the person about their experience of their childhood, adolescence, and adulthood. Then the researcher would ask questions concerning the person's perceptions of the impact of the war on his or her life. The researcher might, with the study participant's permission, read personal journals and ask the study participant if the researcher could view and examine artifacts important to the participant, such as news clippings, military artifacts, and other objects or artifacts. The researcher might also listen to the participant's war and other personal stories that would give the researcher information and insight regarding the study participant's understanding of their life and development.

Data Analysis

The analysis of qualitative research data involves examining important themes that emerge from the interviews, observations, stories, journals, and artifacts. It might also involve linguistic, literary, and psychological analysis of data. The researcher also examines relationships among themes, the patterns in meanings given to events and people, and how these meanings are developed. (Hendricks, 1996; Gubrium and Holstein, 1994; and Berman, 1994).

Think about this: What kinds of research questions about aging might you have that qualitative research might help you answer?

Why Qualitative Research Is Used

Qualitative research is used to describe how individuals give meaning to objects and events in their lives. It is also used to understand how culture helps to shape these meanings. For example, the concepts of "well-being," "health," and "satisfaction" may have different meanings for individuals in different cultures. Qualitative research can be used to clarify these meanings. This way, the aging experience of individuals from different backgrounds may be more fully understood. This may provide considerable assistance in planning and evaluating services, programs, and policies that are relevant to the needs of older adults from diverse sociocultural backgrounds.

Researchers have increasingly been using qualitative research to evaluate health services and other programs. This helps researchers understand, for example, how aging people from different ethnic groups perceive the usefulness of health care providers and health services. It may ask questions about ethnic elderly people's perceptions of what services were most helpful, how they were most helpful, and how culture may influence these perceptions.

Ethical Issues in Research

All researchers must assure the safety of study participants. Safety and ethicality are assured by doing the following:

· Informed consent must be obtained before beginning any study. Participants must be informed about any potential risks and benefits of participation in the study.

· Study participants must be given information about the study and must know that they have the right to withdraw from the study at any time.

· Study participants must be assured that all information collected by the researcher will be held confidential.

· Participants must be competent to decide whether to participate in the study.

References

Association for Gerontology in Higher Education. (1995). Careers in aging: Opportunities and options. [Brochure]. Peterson, D. A., Douglass, E. B., & Lobenstine, J. C.: Authors.

Bennett, J. M., & Sneed, J. (1999). Practice competencies for entry-level professionals in the field of aging. Educational Gerontology, 25 (4), 305–315.

Berman, H. J. (1994). Analyzing personal journals of later life. In A. Sankar & J. F. Gubrium (Eds.), Qualitative methods in aging research. Thousand Oaks, CA: Sage.

Connelly, J. R., & Rich, T. A. (1997). Introduction. In E. B. Douglass, R. C. Atchley, D. D. David, & P. F. Wendt (Eds.), Standards and guidelines for gerontology programs (3rd ed.). Washington, DC: Association for Gerontology in Higher Education.

Cornman, J. M., & Kingson, E. R. (1996). Trends, issues, perspectives, and values for the aging of the baby boom cohorts. In J. Hendrickson (Ed.), Symposium: Where are the new frontiers in aging theory? Gerontologist, 36 (1), 15–26.

Foner, A. (2000). Age integration or age conflict as society ages? Gerontologist, 40 (3), 272–276.

Gubrium, J. F., & Holstein, J. A. (1994). Analyzing talk and interaction. In A. Sankar & J. F. Gubrium (Eds.), Qualitative methods in aging research. Thousand Oaks, CA: Sage.

Hendricks, J. (1996). Qualitative research: Contributions and advances. In R. H. Binstock & L. K. George (Eds.), Handbook of aging and social sciences (pp. 52–72). San Diego, CA: Academic Press.

Hendricks, J. (1996). The search for new solutions. In J. Hendricks (Ed.), Symposium: Where are the new frontiers in aging theory? Gerontologist, 36 (2), 141–144.

Hoyer, W. J., Rybash, J. M., & Roodin, P. A. (1999). Adult development and aging. Boston: McGraw-Hill.

Peterson, D. A. (1995). Claiming boundaries: Professionals in the field of aging should be credentialed. Generations, 19 28–30.

Silverstone, B. (1996). Older people of tomorrow: A psychosocial profile. Gerontologist, 36 (1), 27–32.

Tornstam, L. (1992). The quo vadis of gerontology: On the scientific paradigm of gerontology. Gerontologist, 32 (3), 318–326.

Uhlenberg, P. (2000). Why study age integration? Gerontologist, 40 (3), 261–272.