MODULE 3

LIFE CHANGES AND EVENTS IN OLD AGE

INTRODUCTION

 Growing old maybe complex and complicated because the older individuals may need to face many life
transitions like retirement, reduced income, possible housing changes, frequent losses through deaths
of significant persons, and a declining ability to function. In addition, these life events can be
accompanied by role changes that can influence behavior, attitude, status, and psychological integrity.
 Therefore, the gerontological nurse is faced with the challenge in providing holistic care to older adults
as they go through the complex and arduous adjustments involved aging and their achievement of
satisfaction and wellbeing during later years.

LEARNING OBJECTIVES
After reading this chapter, you should be able to:

1. Discuss ageism and its consequences

2. Discuss changes that occur in aging families in terms of:
3. Discuss the impact of aged related changes in health and functioning on roles
4. Describe cumulative effects of life changes and events: shrinking social world, awareness of mortality
5. Describe the responses of the older adults to life changes and events: life and life story, self-reflection,
strengthening inner resources

TERMINOLOGIES

AGEISM: Applying prejudices to older adults due to their age.

INNER RESOURCES: Strength within the person that can be drawn upon when needed.

LIFE REVIEW: A process of reminiscing or reflecting one’s life.

RETIREMENT: The period in which one no longer works.

AGEISM

 The prejudices and stereotypes that are applied to older people sheerly on the basis of their
age…."(Butler, Lewis and Sutherland, 1991.) Rather than showing appreciation for the vast
contributions of older adults and their wealth of resources and wisdom, society is best with prejudices
and lacks of adequate provision for them, thus derogating their dignity.
 Ageism may have consequences as follows:
o It leads to lack of understanding of older people by the younger people.
o It reduces the opportunities for the younger people to gain realistic insights into aging.
o It predisposes aging persons to disappointments because they may believe stereotypical views
that old age is a time of purposefulness and decline.
o It may be detrimental to achieving an opportunity for freedom, growth, and contentment during
old age.

CHANGES IN FAMILY ROLES AND RELATIONSHIPS

 PARENTING
o The dynamic parental code changes to meet the growth and development needs of both parent
and child. During middle and later life, parents must adjust to the independence of their
children as they become responsible adult citizens and they leave home.
 o However, this lessening of the parenting role and the changes in family function are not
necessarily negative. Most children do not abandon or neglect their aging parents, they
maintain regular contact. Separate family units may help the parent child relationship develop
on a more to more adult basis, to the mutual satisfaction of both the young and the old. If older
adults adjust to their new role as parents of independent adult children, they may enjoy the
freedom from previous responsibilities and the new developments in their family relationships.
 Grandparenting
o Filipinos’ extended life expectancy enables more people to experience the role of the
grandparent and spend more years in that role than previous generations.
o Most baby boomers, a great number are likely to be college educated and employed than
previous generations to grandparents.
o They are spending more on grandchildren than previous generations. (Metlife, 2011)
o Grandparenthood is a learned role and some older individuals may need guidance to become
effective grandparents. Older adults may need to be guided in thinking through issues such as:
o Respecting their children as parents and not interfering in the parent-child relationship.
o Calling before visiting
o Establishing rules for babysitting.
o Allowing their children to establish their own traditions within their family and not expecting
them to adhere to the grandparents’ traditions.
o In addition to fulfilling grandparenting role, many older adults may assume primary child
rearing responsibilities for their grandchildren.
 Loss of Spouse
o The death of a spouse is a common event that alters a family life for many older persons. The
loss of that individual with whom one has shared more love and life experiences and more joys
and sorrows than anyone else may be intolerable.
o The death of a spouse affects more women than men. In fact, most women, will be widowed
by the time they reach their eight decades of life. Unlike many today’s younger women, who
have greater independence through careers and changed norms, most of today’s older women
have led family-oriented lives and have been dependent on their husbands.
o On the part of the gerontological nurses, they may facilitate adjustments to widowhood by
identifying sources of friendships and activities such as club, volunteer organizations, or groups
of widows in the community and by helping the widow understand and obtain all the benefits to
which is she entitled. This may require reassuring the widow that enjoying her new freedom
and desiring relationship with another individual is no reason to feel guilty and may help her to
adjust to the loss of her husband and the new role of a widow.
 RETIREMENT
o Retirement is another of the major adjustments of an aging individual. This transition brings the
loss of a work role and it is often an individual’s first experience of the impact of aging. Ind
addition, retirement can require adjusting to reduced income and consequent changes in
lifestyle.
 Loss of the Work Role
 Retirement is especially difficult in urban areas, in which worth is commonly
measured by an individual’s productivity. Work is often viewed as the dues
required for an active membership in a productive society. Many of today's older
persons, raised to value a strong work ethic, hold the attitude that
unemployment, for whatever reason, is an undesirable state.
 When one’s work is one’s primary interest, activity, and source of social
contracts, separation from work leaves a significant void in one’s life. Aging
individuals should be urged to develop interests unrelated to work. Retirement is
 facilitated by learning how to use, appreciate, and gain satisfaction from leisure
time throughout an employed lifetime. In addition, enjoying leisure time is
therapeutic outlet for life stresses throughout the aging process.
o Phases of Retirement by Robert Atchley
 Preretirement Phase
 When the reality of retirement is evident preparation for leaving one’s job
begins, as does fantasy regarding the retirement role.
 Retirement Phase
 Retirees attempt to do everything they never had time for simultaneously.
 Disenchantment Phase
 As life begins to stabilize, a letdown sometimes a depression, is experienced.
 Reorientation Phase
 As realistic choices and alternative resources of satisfaction are considered, the
disenchantment with the new retirement routine can be replaced by developing a
lifestyle that provides some satisfaction.
 Retirement Routine Phase
 An understanding of the retirement role of achieved, and this provides a
framework for concern, involvement, an action in the older person’s life.
o Termination of Retirement
 The retirement role is loss as a result of either the resumption of a work role or
dependency due to illness or disability. (Atchley, 1975, 2000.)
 Different nursing interventions may be required during each phase of retirement.
 Assisting aging individuals with their retirement preparation during preretirement phase
is a preventive intervention that enhances the potential for health and wellbeing in late
life.
 Counseling regarding the realities of retirement.
 Being supportive of retirees during the disenchantment phase.
 Appreciating and promoting the strengths of the stability phase may reinforce an
adjustment to retirement.
 The tactful management of dependency and the respectful appreciation of losses are
extremely important.
 Gerontological nurses’ evaluation of their own attitudes toward retirement are beneficial.
 Reduced Income
o A reduction in income is a significant adjustment for many older persons because it triggers
other adjustments.
o Financial resources are important at any age because they affect our diet, health, housing,
safety, and interdependence and influence many our choices in life. Retirement income is less
than half of the income earned while fully employed.
o Few older persons have accumulated enough assets during their lifetime to provide financial
security in old age. Some of them are asset rich but cash poor.
 Changes in Health and Functioning
o The changes in appearance and bodily function that occur during the aging process make it
necessary for the aging individual to adjust to a new body image.
o Colorful soft hair turns gray and dry, flexible straight fingers become bent and painful, body
contours are altered, and height decreases.
o Stairs once climbed several times daily demand more time and energy to negotiate as the years
accumulate.
o As subtle, gradual, and natural as these changes may be, they are noticeable, and,
consequently, affect body image and self-concept.
 CUMULATIVE EFFECTS OF LIFE CHANGES AND EVENTS IN OLD AGE
o SHRINKING SOCIAL WORLD
o NURSING IMPLICATIONS IN HELPING OLDER PERSONS MAINTAIN SOCIAL CONNECTIONS
o AWARENESS OF MORTALITY
 RESPONDING TO LIFE CHANGES AND EVENTS IN OLD AGE
o When faced with ageism and multitude changes affecting relationships, roles, and health, older
adults may respond in a variety of ways. The older adult's ability to cope and adjust to life
changes determines whether they reach a stage of integrity or fall to despair.
o Nurses can help older adults respond to life changes and events by facilitating life review and
eliciting a life story, promoting self-reflection, and strengthening older adults’ inner resources.
 LIFE REVIEW AND LIFE STORY
 SELF REFLECTION
 STRENGTHENING INNER RESOURCES
 THE HOLISTIC SELF MODEL