"ANNALS of the American Academy of Political and Social Science, The"

RILEY, JOHN W.; RILEY, MATILDA WHITE

doi: 10.1177/0002716289503001001pmid: N/A

RILEY, MATILDA WHITE; RILEY, JOHN W.

doi: 10.1177/0002716289503001002pmid: N/A

This article addresses the central dilemma of the mismatch between the strengths and capacities of the increasing numbers of older people in the United States, on the one hand, and the inadequate social-role opportunities to utilize, reward, and sustain these strengths, on the other. In order to enhance the quality of aging, interventions are needed, both in the ways individuals grow older and in the environing matrix of families, work organizations, political institutions, health care systems, and all the other social structures in which people's lives are embedded. Examples of interventions in both lives and role structures demonstrate the potential for improvement. Looking toward the future, these interventions are seen to affect people of all ages and call for ultimate gradual redesign of the life course from birth to death. An analytical framework of the relationship between aging and broad changes in society is presented as a guide in designing small-scale interventions that can accumulate to benefit—rather than to impair—the well-being of older people now and in the future.

RODIN, JUDITH

doi: 10.1177/0002716289503001003pmid: 10293090

A substantial amount of research has demonstrated that the sense of control is associated with numerous positive outcomes, including good health. Many aspects of the personal and social conditions of old age influence the control-health relationship. Environmental events associated with old age often place limits on the range of outcomes that are attainable by older people. Moreover, the association between control and indicators of health status may be altered by old age. Finally, old age may influence the relationship between control and various health maintenance behaviors. Aspects of the sense of control can be altered with small interventions that can enhance health specifically and the quality of aging in general. Given the relationship between control and health in old age, several possible factors may help explain or mediate this relationship including mechanisms of behavioral and cognitive change, and physiological adaptations. Despite the largely positive outcomes associated with increased sense of control, negative outcomes are also possible, especially when control is not desired or entails too much responsibility or other demands.

STAUDINGER, URSULA M.; CORNELIUS, STEVEN W.; BALTES, PAUL B.

doi: 10.1177/0002716289503001004pmid: N/A

The aging of intelligence features a paradox including both growth and decline in performance, as well as latent potential and aging-related limits to further growth. Two resolutions to the paradox are offered. First, because of the dual-process nature of intelligence—fluid mechanics versus crystallized pragmatics—there is the possibility of differing life-span trajectories characterized by a decline in the mechanics and select growth in the pragmatics. Second, because of the facilitative and enriching effect of knowledge-based pragmatics, highly effective cognitive performances in old age are possible despite an aging-related loss in cognitive mechanics. A model of selective optimization with compensation is presented to elucidate various interventional strategies that allow for intellectual efficacy and growth despite increased biological vulnerability and decreased intellectual reserve capacity. A visionary social policy for old age needs to recognize this double-edged nature of the aging mind: limits and potential.

ORY, MARCIA G.; WILLIAMS, T. FRANKLIN

doi: 10.1177/0002716289503001005pmid: 10293091

Rehabilitation to restore and maintain functioning in older people is relatively new. Traditionally, ageist prejudices and the medical preoccupation with cure have led to neglect of chronic disabilities in older people. With a focus on an aging population, however, a new approach to rehabilitation is taking shape at the confluence of geriatric and psychosocial approaches. Significant components of this emerging approach are: setting small goals as incentives for motivating the patient, the timing of the disability within the individual's life course, coping behavior and the way the disability is defined, the importance of social support to the recovery potential, and the incorporation of sustained interventions into daily routines and life-styles. This article illustrates this approach with examples from common disabling conditions, proposing that the quality of aging can be markedly enhanced for older people suffering from functional disability.

MANTON, KENNETH G.

doi: 10.1177/0002716289503001006pmid: N/A

This article examines the evidence for two propositions: that health and ability to function can often be sustained into advanced old age through interventions that (1) control risk factors among people already old and (2) improve lifelong health behaviors and life-styles starting with people currently still young. Beginning with a general model of age-related changes in health, function, and survival, the article shows how the interrelationship between the three varies between two extreme types of diseases: the fast, lethal type, where death occurs early and rapidly, with few years spent in unhealthy or disabled conditions; and the slow, degenerative type, where prolonged survival allows for added years in unhealthy or disabled conditions. Since this latter type is predominant among older people in the United States today, interventions to prevent morbidity and functional loss are of critical importance. The need for an improved research base to guide such interventions is strongly urged.

MECHANIC, DAVID

doi: 10.1177/0002716289503001007pmid: 10313067

Western values have long emphasized an interventionist approach to problems of health and health care. Yet, as medical technology becomes increasingly expensive and as the number of older people grows, proposed changes often are now governed more by considerations of cost than by quality of services. This tension between cost and quality also affects public willingness to invest in social components of health care despite their importance in enhancing quality of life. The tension emerges in sharpest contrast as scarce resources are allocated by gatekeepers in health maintenance organizations and in the arrangements for long-term care. With respect to financing, what seems to be needed is a creative mix of voluntary inputs from the community, private initiatives, and new programs of public entitlements. With respect to quality of care, what has often been overlooked is the recognition that gains in the quality of life require programs that encourage older people's continued involvement and participation in social life and in active and healthy life-styles. This article discusses the evolving balance between these two types of interventions: the medical and the social.

CANTOR, MARJORIE H.

doi: 10.1177/0002716289503001008pmid: 10293092

The growing number of elderly is bringing about dramatic changes in family life, in the nature and extent of interventions necessary to support an aging population, and in our notions about respective roles of family and community in providing for these needs. Although most older people manage independently with only the ordinary assistance family members provide each other, growing numbers of the oldest old and persons suffering from frailty and incapacity require more extensive social care. The term “social care” is often used synonymously with “formal community services,” but the concept is broader, also encompassing informal family care. Social care is directed toward needs critical to independence: socialization and self-development, help in tasks of daily living, and assistance with personal care. At present, older people prefer that social care be provided within a family context, turning to formal community interventions only when families are unable to provide the required assistance. But given increases in numbers of working women, the restructuring of the family, and changing attitudes about the community's role as service provider, a more carefully articulated partnership between family and community will be required in the future.

SCHRANK, HARRIS T.; WARING, JOAN M.

doi: 10.1177/0002716289503001009pmid: N/A

Ambivalent attitudes toward older workers are to be found in society at large, in the organizations where they work, and among older workers themselves. This article explores the nature and scope of this ambivalence on these three levels and concludes that the primary need is for age neutrality in the workplace. It is at this level that interventions designed to enhance age neutrality are most feasible, resulting in improvements in the quality of aging as well as in the lives of workers of all ages. Several types of specific interventions are described and discussed, ranging from performance appraisals to postretirement employment opportunities.

CZAJA, SARA J.; BARR, ROBIN A.

doi: 10.1177/0002716289503001010pmid: N/A

A coincidence of two trends—the current technological revolution and the rapid increase in the size of the U.S. older population—has created an urgent need to consider the characteristics, capacities, and limitations of older adults in relation to new technologies. This article proposes that older adults should be perceived as active users of these technologies rather than as passive recipients. Everyday interactions with technology at work, in the home arena, in medical and health care settings, and on the highway are identified. Characteristics of older adults relevant to these environments are discussed. Both positive and negative potential consequences of technological change for older people are identified.