Qualitative research aims to understand the richness and complexity of social experience by attending closely to the actions, interactions, and social contexts of everyday life. It involves systematically ??watching people in their own territory?? (Kirk and Miller, p. 9) or speaking with them in depth about their thoughts and feelings. In some instances, this will lead to descriptions of multilaye…
??Quality of life?? (QOL) subsumes two distinct domains in gerontological research. One is health-related quality of life (HRQOL); the other, nonhealth or environment-based quality of life (Spilker and Revicki). HRQOL encompasses domains of life directly affected by changes in health. Jaschke and colleagues provide a good thumbnail test of whether a domain falls within the category of health-relat…
The phrase ??quality of life?? is almost always controversial. The basic idea behind the concept of quality of life is that some characteristics of the person and his or her surrounding environment are better than others from the point of view of the human good or human flourishing. Nearly all the major thinkers of the Western tradition, from Plato and Aristotle through Jeremy Bentham, Immanuel Ka…
Rehabilitation is one of the basic elements of comprehensive geriatric care. Rehabilitation is indicated when someone is not functioning at their full potential. It involves an assessment of the underlying causes of activity limitation, treatment of the primary impairment to the extent possible, prevention of further disability, and interventions to promote adaptation of the person to their disabi…
The United States is a nation of religious believers. National surveys consistently find that nine in ten Americans affiliate with a religion or religious denomination. This is true regardless of age. Older adults, however, participate on average in certain religious activities more frequently than younger individuals. Religion also appears to represent a more salient influence in the lives of old…
Older adults have become an attractive market for retailers and marketers. People over the age of fifty-five, a fast-increasing part of the population, have a growing amount of spending potential. They are rather affluent in terms of discretionary income, and many have both time and resources to devote to shopping. In the past, older adults? spending habits were more conservative than their younge…
Retirement communities are age-homogeneous living environments for older persons, almost all of whom are retired. The communities usually have defined boundaries, and often have age restrictions. Retirement communities come in many varieties and sizes, and no one type fits all older adults. The variety occurs because older Americans are a heterogeneous population, and those who choose living in re…
Early literature on retirement focused almost exclusively on men. More recently, researchers have recognized that women may make the decision to retire somewhat differently from men due to differences in caregiving responsibilities, employment opportunities and cultural expectations. In addition to the economic and health factors, recognition of these differences reminded researchers that, in addi…
The pattern of retirement at the end of the work career is shaped less by aging per se than by institutional mechanisms that provide incentives and support structures for workers? exits from the labor force. The origins of retirement institutions across industrial societies have been traced to emergent economic and governmental conditions in the late nineteenth century. These institutions develope…
The vast majority of individuals and couples in the United States can look forward to their retirement—that period later in life when they are no longer working full-time and are supported by financial resources accumulated during their working years. The average retirement age in the United States, based on data from the 1998 Survey of Consumer Finances, is 62.7 years. At this age, in 1998…
Retrogenesis is the reversal of normal developmental biologic processes during the course of disease. The retrogenic process has been described clearly for the brain diseases known as the dementias. The most common form of dementia is Alzheimer?s disease (AD), and retrogenesis has been demonstrated in striking detail in this common disorder of the elderly. It is well established that normal human …
Ischemic heart disease is the commonest form of heart illness. It increases in frequency with increasing age, and outcomes are much worse in elderly patients. Ischemia is caused by narrowings or blockages in the coronary arteries, resulting in an inadequate blood supply to the heart. The disease spectrum ranges from subclinical disease (no symptoms) to angina, and, finally, to a heart attack (myoc…
As people age, the chances increase that some conditions (e.g., disability) or events (e.g., retirement, loss of spouse) may alter their financial status. Risk management is a field that seeks to reduce the economic costs that would otherwise be associated with those conditions and events. These costs may be reduced both by reducing the probability or severity of the event (e.g., adding safety rai…
Rodents are members of the order Rodentia, a large group of biologically similar animals that includes rats, mice, and beavers. Two of these species, rats and mice, are the most commonly used animal models for aging research. Many types of aging research cannot be conducted with human subjects. In situations where the research requires a living organism, and humans are not suitable, investigators …
Description of the life circumstances of older people living in remote or rural areas is complicated by different definitions of rural residence and by the lack of variability within residential categories. The U.S. Bureau of the Census, for example, classifies residence based solely on the size of the population living in a predetermined geographical area. An ??urbanized area?? refers to one or m…
Sarcopenia, from a Greek word meaning ??poverty of flesh,?? is the loss of muscle mass and strength caused by normal aging. It is distinct from muscle loss caused by inflammatory disease (cachexia), and from the weight loss and attendant muscle wasting caused by starvation or advanced disease. Compared to young, healthy, physically active young adults, reduced muscle mass and strength are evident …
Savings, from the perspective of the individual, comprises money set aside for future use. Savings, from the perspective of the economy, includes all of the money set aside by all individuals, employers, governments, and other groups. Savings are important to the individual because they enable people to make purchases in the future and to be prepared for unforeseen financial needs. Savings are imp…
Self-employment has greater importance among older workers. The self-employed in 1994, for example, numbered 1.5 million at ages 55 to 64 and 1 million at ages 65 and older (Bregger, Table 4). Although a tenth of workers in the labor force was self-employed in the 1979 to 1996 period, the self-employment rate at ages 55 to 64 was about two and one-half times that at ages 25 to 34 (Manser and Picot…
The modern-day senior center traces its roots back to the early 1940s when one of the earliest centers (the Hodson Center in New York City) focused on meeting the needs of lower income older people (Gelfand). The number of senior centers has grown to between twelve thousand and fourteen thousand depending on what one considers a senior center to be (Krout, 1989b; Wagner). Three White House Confere…
Siblings are family members who are ascribed by birth (full siblings), by law (adopted siblings) or by marriage (half-siblings, step-siblings, and siblings-in-law). Full siblings have two biological parents in common, whereas half-siblings have one biological parent in common. Legal siblings and step-siblings have no biological parents in common, but their parents are married. A sibling-in-law is …
In some industrialized communities smoking prevalence in elderly people is as high as 30 percent, and smoking prevalence is highest in low socioeconomic groups so that those older people with smoking-related diseases may also have other poverty-related social and medical problems. In the United Kingdom the smoking-related disease epidemic has probably passed its peak in men but is reaching its pea…
The Social Security Old-Age, Survivors and Disability Insurance (OASDI) programs play an important role on both the individual level and in the overall United States economy. The most visible influence of the programs is as a source of income when workers retire, or in instances of death or disability. Less visible, but equally important, are its effects on the national economy. Social Security…
Speech consists of the sounds that humans produce, most often for the purpose of expressing language orally. Speech is just one mode of expressive language; other modes are writing and the production of manual signs. Very generally, language is a system of symbols that humans use to communicate. (See ??Language Disorders?? entry in this volume.) Although most of the time speech sounds are produced…
The nineteenth and twentieth centuries were marked by sweeping technological advances and rapid social transformations, particularly in Western Europe and North America. The proportion of older people in national populations grew, slowly at first, and then more rapidly as fertility behavior changed and public health measures contributed to increases in longevity. These socioeconomic and demographi…
It is commonly believed that it was rare to live to old age in the preindustrial west. This misconception arises from confusion between average life expectancy at birth and the actual life spans of those who survived the high mortality years of early life. For example, in England life expectancy at birth averaged around thirty-five years between the 1540s and 1800. But those who survived the hazar…
To anthropologists, a tribal society is an uncentralized grouping of autonomous local communities linked by common cultural features and associations. These social entities are connected by kin-based organizations such as clan, or associations based on age grading or special activities such as ritual, which cross-cut kinship and territorial boundaries (Haviland). Households tend to be egalitari…
The concept of stress as a change in the environment that results in an internal response in living organisms can be traced to the nineteenth-century ideas of the physiologist Claude Bernard (1813–1878). Initially, the stress response involves important adaptive changes throughout an organism that are necessary to restore homeostasis, a term coined by Walter Cannon (1871–1945) to des…
Stress and coping with stress have been among the most popular research topics in the social and behavioral sciences over the past twenty years. Despite a long history and a substantial amount of literature on stress and coping, less attention has been paid to stress and coping processes among older adults than in younger persons. This is unfortunate because research on stress and coping in later …
A stroke is defined as a sudden loss of brain function due to a blocked or burst blood vessel. There are two classifications of stroke, ischemic and hemorrhagic. Ischemic strokes account for approximately 80 percent of all strokes and result from blockage of the blood supply to the brain. Hemorrhagic strokes account for the remaining 20 percent of all strokes and result from bleeding in the brain.…
??Do people get less happy as they get older??? This question has been addressed by researchers who focus on aging and subjective well-being (SWB). SWB is used to describe the subjective experience, as opposed to the objective conditions, of life (Okun and Stock). What matters most in this regard is how people perceive life rather than the actual circumstances of their lives. SWB has both an affec…
In Africa south of the Sahara, many older persons (especially women) are illiterate and do not know their birthdate or chronological age. African cultural definitions of old age usually are functional: people are ??old?? when they lose their strength, and also, for women, when they no longer menstruate or give birth to children. The United Nations defines older persons as those age sixty and over …
Contemporary exploration of the ethical issues concerning suicide and assisted suicide has focused almost exclusively on a single form of suicide: physician-assisted suicide in terminal illness. Ethical issues concerning suicide in old age, independent of illness, are rarely if ever openly Controversial assisted suicide advocate Jack Kevorkian (right) speaks at a press conference held with hi…
The term sundown syndrome, also known as sundowning, refers to an increase in agitation during the late afternoon and evening hours in individuals with Alzheimer?s Disease and related dementias. Agitation is a class of behavior problems that include disruptive vocalization, physical aggression, and motor restlessness. This syndrome is said to affect between 10 and 37 percent of dementia patients.…
Surgery on elderly people was once uncommon, but as the population has aged it has become much more frequent. There has also been a change in who is thought of as old, and studies based on someone sixty-five years old provide incomplete insight into the issues surrounding appropriate therapies for the ??new?? geriatric patient. The traditional view of risk for surgical procedures has focused more …
Most surveys have several common characteristics (Fowler). Their purpose is to generate information that statistically summarizes issues of interest in the study population. This information is collected by asking people (respondents) questions, either in person or over the telephone. In most cases, a sampling strategy is used to select only a fraction of the population that is actually interviewe…
Swallowing allows people to eat and drink, thus providing nutrients for growth and maintenance of body tissue. Saliva is regularly swallowed while awake and during sleep. Though swallowing usually occurs automatically, it involves a complex sequence of nerve and muscle coordination managed by the brain. Normally, food and drink are formed into a mass by the mouth and channeled by the tongue to the…
The sense of taste influences food preferences and food choices. When people describe how food tastes, they are actually talking about food flavor, and not just the basic tastes of sweet, sour, salty and bitter. The range of flavor experiences also includes aroma, texture, and mouth ??feel??—and, some would say, even the pleasantness of foods. Much of food flavor is perceived through taste …
Elderly persons are treated very well by the U.S. federal tax system and by the tax systems of many states and localities. They get an extra federal standard deduction, Social Security benefits are taxed lightly or not at all, pensions get special relief, and state and local property tax burdens are often offset by income tax relief. It is not, however, easy to provide a simple, widely accepted ph…
The term ??technology?? embodies a broad variety of concepts. In The New Industrial State, John Kenneth Galbraith described technology as the ??systematic application of scientific or other organized knowledge to practical tasks.?? Within this broad definition technology may intersect with the lives of older persons in a variety of ways. Technology may include new knowledge gained through basic re…
Senescence and ageing are processes that affect all organisms and have been described as the diminishing probability of survival accompanied by a reduction of fecundity with increasing age (Partridge, 2001). The disposable soma theory was proposed in an attempt to ascribe an evolutionary framework to understand the existence of, and variations in, the universal process of ageing (Kirkwood, 1977; K…
The idea that DNA damage may be a major factor in aging has been popular since 1974, when Ronald Hart and Richard Setlow demonstrated a direct correlation between life span and capacity for DNA repair. The idea is still largely unproven, although much data supporting it have been obtained. DNA damage includes altered bases, mismatched base pairs, strand cross-linking, and both single- and double-s…
The error catastrophe theory of aging was proposed by Leslie Orgel in 1963 and it was originally a very popular theory because it made a great deal of sense. Although the theory per se has by now been largely discarded due to a lack of experimental supporting evidence, elements of the theory are still being investigated as possible factors in aging. The genetic blueprint for each biological specie…
In the past, many investigators tried to develop a unified theory of biological aging. Evidence that environmental factors can induce mutations and damage cells, and that repair processes are a normal part of cell function, led to development of error and damage theories of aging. According to these theories, accumulation of damage eventually outstrips the ability of the cells to repair themselves…
A theory is defined, minimally, as a statement (or more typically a set of interrelated statements) that explain or account for a phenomenon of interest. In formal terms, such statements generally have two elements. The explanandum refers to the phenomenon or event of interest— the outcome to be explained. The explanans is the statement that provides the postulated explanation (Hempel, 200…
Sensations of touch arise by the activation of sensory receptors located in the skin that are responsive to mechanical stimuli. Proprioception, the perception of the position and movement of the limbs of the body, arises as a result of neural activity in sensory receptors located in and around the muscles underneath the skin. Advancing age is associated with diminished functioning of sensory syste…
Tremors are involuntary, purposeless movements of a body part around a fixed plane in space. A tremor can be classified on the basis of whether it occurs with a certain posture, at rest, or during movement. It can be localized to the affected body part and characterized by what makes the tremor better or worse. A physiological tremor is a variation of what is normal while a pathological tremor is …
Tube feeding is an optional medical treatment to deliver nutrition when a patient lacks the ability to eat or swallow independently. The most common device used for long-term tube feeding in the institutionalized older population is the percutaneous endoscopic gastrostomy (PEG) tube. A PEG tube is placed directly into the stomach through a small hole in the skin during a simple procedure requiring…
Twitches are brief, sudden, and fine contractions caused by electrical impulses that stimulate muscle fiber activity. Some twitches are under voluntary control, but most are involuntary. Twitches have been called muscle jerks, spasms, and fasciculations, and these terms are often used interchangeably. Fibrillation is a contraction of a single muscle fiber. It occurs when the muscle fiber loses ele…
Infections of the urinary tract are the most frequent bacterial infections identified in older adults. The variation in illnesses that these infections produce is quite wide, and can range from bacteria present in the urine without symptoms (asymptomatic bacteriuria) to infections producing chiefly bladder symptoms (symptomatic urinary tract infections, or UTIs) that spread to the blood (sepsis) a…
Since the 1970s, the U. S. Department of Veterans Affairs (VA) has responded to a vital demographic trend: Although the total number of veterans is declining, the proportion of older veterans is increasing dramatically. In addition, the proportion of older persons in the veteran population far exceeds the proportion of older persons in the U.S. population in general. Anticipating the needs of a ra…
Perceiving is a constructive act. Using the data supplied by the senses and his knowledge of the world, the perceiver constructs his reality of the moment. Since the sensory systems have a limited capability for acquiring information, the constructed reality will reflect not only the present data but the person?s interpretation of the information and its context. The perceiver does not simply reco…
Older adults have been represented surprisingly often in the visual arts. Over half of Rembrandt?s works represent an elderly person. This includes fifty-five drawings, etchings, and paintings taken from the single biblical story of the elderly blind man Tobit and his wife Anna. Rembrandt?s other important images of aging persons include the famous series of self-portraits recording his own aging …
A vitamin is defined as a chemical (organic compound) present in variable small quantities in natural foodstuffs and essential for the normal processes of growth and maintenance of the body. Vitamins do not furnish energy, but are essential for the transfer of energy and regulation of metabolism (chemical processes) involved in the normal growth and maintenance of the body (Parker). The word vitam…
Volunteering may be defined as unpaid work that is willingly performed. In the academic and professional literature, the term is usually restricted to describe unpaid work that is done for formal organizations. In some cases, the term volunteering is used more broadly to include informal assistance to neighbors and strangers or discretionary tasks performed on behalf of relatives. This discussion …
The term welfare state originated in the wartime Britain of the 1940s. The term initially contrasted the ideals of the British ??welfare state?? with those of Nazi Germany?s ??Warfare State.?? First used by William Temple, Archbishop of York, it signified a commitment to ensuring basic social protections for all citizens, rather than a commitment to waging war. The most basic definition of the wel…
The population of western Europe—presently most of the countries of western Europe are part of the European Union (EU)—grew strongly during the twentieth century, with the last major growth period occurring during the post war era and lasting into the 1960s. Following these years, fertility declined while life expectancy continued to rise. As elsewhere, the aging population of wester…
The wheelchair is made from many components ideally chosen to meet the needs of the person using the chair. The reasons to choose a wheelchair and the options available are as varied at the people who will use them. The most important thing before purchasing or renting a wheelchair is to make sure it will best fit the needs of the individual who will be using it. The best way to do this is to work…
The concept of a long-term care workforce is of relatively recent origin. Throughout much of the history of the United States, only a small proportion of the population was old and infirm, and dependent aged persons were almost always cared for by family members. Institutional care was virtually unknown, with the exception of almshouses for the truly isolated and destitute. The professional provis…
The yeast Saccharomyces cerevisiae, known popularly as bakers? or brewers? yeast, has been used extensively in aging research. Since 1990, it has emerged as an important model organism for the dissection of the biological aging process at the genetic and molecular levels. Its distant cousin, Schizosaccharomyces pombe, or fission yeast, was shown in 2000 to undergo a very similar aging process. Th…