April 2005
Living with and loving an aging population
By: Gail Hinchion Mancini
Resilience, quality relationships key to graceful aging
Cindy Bergeman, professor of psychology, has been charting graceful aging since graduate school. She has some heartening news about what she’s seen, some which challenges myths about growing old.
“Most people do age well and maintain a high level of functioning for a longer portion of the life span. Most are living independently. It’s a much more optimistic picture than the media paints,” she says. Clinical levels of depression are experienced only by about 15 percent of older adults, although anyone can feel down or blue for short periods of time. Though public attention to Alzheimer’s is widespread, dementia affects only about 20 percent of adults over 80.
Bergeman’s research has focused more on what’s right with the elderly than what can go wrong. What are those strengths that allow individuals to do well in the face of adversity?
“Nobody has a stress-free life. But if you’re resilient, that is, if you develop coping strategies or support networks that limit the negative effects of stress on health and well-being, you do well.”
Relience doesn’t magically develop in later life. “Successful aging no doubt starts early in the life span. Like an inoculation, if we experience life’s challenges, we enhance our mastery of skills, create additional coping resources, and develop a positive view of ourselves and our abilities. We build a resource that helps us to better deal with the next problem,” Bergeman explains.
In one study, Bergeman observed the emotional states of recently widowed women, a time period known to be one of life’s more challenging episodes. Although the study was not designed to create a blueprint for caring for older adults, some directions emerged that caregivers should know.
As much as aging adults need the support of family members, they also benefit tremendously from friendships with peers. It is speculated that grieving or otherwise emotionally challenged older adults can confide in friends—members of a book club or card group—without the worry that their emotional states will burden a fellow family member who also may be grieving. Conversations with friends proved more helpful in the grief recovery process than participation in formal support groups, Bergeman found.
In general, talking about one’s feelings was more closely associated with emotional recovery than were encounters that helped take care of business, such as transportation to a doctor or help sorting out bills. This points to an awareness that other of Bergeman’s colleagues also have noted: that caregiving of a busy, task-oriented nature, although helpful, may not nurture in the same way that allowing one to share sadness and joy does.
So how do you know if you are providing the right type of support? “Be careful not to do things they can do for themselves,” Bergeman adds. “Let them make choices. Let them have control and autonomy. Even for the very aged or ill, there still are ways to help them have a sense of control.” If you offer support, be sure that you convey that your offer is genuine. Bergeman says that in interviews with widows, one of the interesting themes that emerged was a keen awareness of offers that had a “hollow ring” to them. Participants seemed to have a clear sense of who wanted to help and who was just making a socially appropriate comment.
Older adults thrive when they can reciprocate the support. A happy prescription for caregivers: “You need to let them do things for you,” Bergeman says. One of the best predictors of successful aging is feeling like you have a purpose in life, that you are making a difference in the lives of others.
Contact Cindy Bergeman at Cindy.S.Bergeman.1@nd.edu
More on those sunny dispositions
Is there such a thing as a cranky personality, and does it affect one’s golden years?
Robert West, assistant professor of psychology, has done the research, and he believes that some older people have a positive sense of psychological well-being, and their neurological aging process may be measurably different than those with a negative outlook.
As a researcher, West has been stricken by the fact that two people of similar age and health predisposition can experience varied quality of life. He has been exploring the correlation between neurological health and what the aged report about their positive relationships or social isolation.
“We have brain data demonstrating that if you have people who report poor social relationships, their brains look different. Brain activity for those with positive relationships is much more like that of 20-year-olds than those with few quality relationships,” West says.
The finding represents good news in West’s mind, because improving one’s social life or emotional outlook “may be more promising, and less expensive, than some medical solutions.”
Certainly, it points to advice for caregivers: Older adults should be encouraged to get out and to participate in activities. West points to the work of Notre Dame Downtown, which holds social and learning events for older adults, as an example of low-cost activities that may well be having positive health benefits.
Contact Robert West at Robert.West.19@nd.edu
Maintaining steadiness and balance
Steve Boker lost his grandmother to a hip fracture. A month after falling and breaking her hip, she died from the complications that frequently beset elderly who are immobilized by broken bones.
Today, studying equilibrium and coordination represents a big part of Boker’s research as associate professor of psychology.
In a newly outfitted office in the basement of Flanner Hall, Boker tests how well two different senses—one visual, the other involving muscular sensors—work together to signal balance. Studying subjects of varying ages, he examines how those sensory systems perform throughout a person’s life.
“As we age, the senses become less acute. It’s harder to tell where our arms and legs are in space,” he says. Proprioception, the muscular signaling system, declines. The system compensates by relying more on visual clues, says Boker.
“Younger people seem to have a dual control system whose components talk to each other. For older people, it’s as though the two pieces collapse into one,” Boker explains.
Boker’s research underscores what we have long observed among our elders, a lesson emphasized by the death of his grandmother: Unsteadiness is a quality of life issue for the aged. Boker’s research could lead to therapies that help older adults maintain or reclaim a dual-control system.
While no complete set of prescriptions is available yet, Boker’s learned enough to be able to offer advice to his own mother, and to caretakers of aging adults.
- If Granny yearns to try yoga, encourage her. Early results in Boker’s experiments indicated that older adults who said they did flexibility training such as tai chi demonstrated younger-behaving control systems than others in their age groups.
- Conversely, be aware that diminished proprioception may cause an elderly friend or relative to become more still or stiff. In turn, that may further diminish their perception. Walking regularly may help both flexibility and strength in the legs, and can improve circulation.
- Deal with the visuals. Older adults begin to rely more on their vision just as it becomes less reliable. Bifocals and trifocals are common, but they distort visual information about space. “I tell my 78-year-old mother: Get separate glasses, one for reading, one for walking around. You’ll be more steady during critical times when you’re moving around.”
- High-contrast patterns such as striped wallpaper seem to give older people a better grasp of the visual landscape. If he could redesign housing for the elderly, Boker says he’d avoid all-beige environments. At the very least, high-contrast strips should be installed on the edges of stair steps.
Contact Steve Boker at Steven.M.Boker.1@nd.edu
Facing chronic illness
In his research in health psychology, Tom Merluzzi has focused on how individuals cope with chronic and terminal illness. He’s learned to understand that a physically frail person may be more psychologically strong than expected.
“I am very respectful of older people who are saying ‘I can handle things,’ ” says Merluzzi, a professor of psychology and psycho-oncologist.
Merluzzi’s research has shown that the elderly are more mentally prepared for illness than their children might expect, or than their children would be, were they to fall ill.
“As people get older, they are more psychologically able to cope with illness,” he says. “They adjust better to cancer than younger people. It’s on time in the sense that older people might be more apt to expect illness to affect them at their age. And, they’ve had a lifetime of coping to bring to bear on it.”
For elderly people who are chronically ill, the parent-child relationship can be complicated by a mismatch of support. “In cancer research, if someone does not need a lot of instrumental support, and it’s provided, the person with cancer may not do as well. You may put them in sick role and they start thinking of themselves as less capable.”
“There is a delicate balance between doing too much and not enough. So the key is listening, observing, asking questions. The need for clear communication between the adult child and the parent cannot be stressed enough. If we are good parents we do this with our children—it’s just that we are not used to doing this with our parents.”
Sometimes, an adult child willing to manage medicines, checkbooks and transportation might be wise to just sit and talk with a parent, or ensure that the parent has peers to talk with. Many times, the chronically ill elderly are more comfortable talking about their illnesses than their children can tolerate, so same-age friendships can be important for support.
Contact Tom Merluzzi at Thomas.V.Merluzzi.1@nd.edu