Chapter 4

Life Transitions and Story

Role Changes
• Children leave the home.
– Freedom from responsibilities and worries of child
rearing; more free time.
– Loss of meaningful, satisfying activities associated
with child-rearing.
Role Changes (cont.)
• The woman aged during a period of tremendous changes
in women’s roles.
– Woman’s role as homemaker vs. woman’s role in
workplace.
• The older male also witnessed changes in the male’s role.
Ageism
• Definition
– The prejudices and stereotypes that are applied to
older people on the basis of their age.
• Consequences
– People are less likely to see the similarities between
themselves and older adults.
– A lack of understanding of the elderly.
– Reduced opportunities for the young to gain realistic
insights into aging.
Misconceptions of Old Age
• Old people are sick and disabled.
• Most old people are in nursing homes.
• Senility comes with old age.
• People either get tranquil or cranky as they age.
• Old people have lower intelligence and are resistant to
change.
• Old people are not able to have sexual intercourse.
• There are few satisfactions in old age.
Challenges to Caring for a Grandchild
• The effect on health, marriage, and lifestyle.
• Existing health conditions interfering with child care.
• Having the energy to care for an active child.
• Being able to afford to care for the child.
• Rights and responsibilities of the child’s parents.
• Having the legal right to serve as a surrogate.
Grandparent Issues
• Respecting their children’s roles as parents and not
interfering in the parent–child relationship.
– Calling before visiting.
– Establishing rules for baby-sitting.
• Allowing children to establish their own traditions.
Nursing Implications for Grandparents
• Help families locate resources that can assist in meeting
the challenges of grandparenting.
• Suggest activities that can help grandparents be
connected with their grandchildren.
• Encourage elders to keep diaries, scrapbooks, and
notebooks of family recipes and customs to provide
insights into ancestors.
Adjusting to Widowhood
• Developing alternative roles.
• Dealing with income issues.
• Adjusting to loss of sexual partner.
• Choosing a new lifestyle.
• Obtaining benefits.
Reasons Women Adjust to Widowhood
More Easily than Men
• Availability of friends who share similar problems and
lifestyles due to the high proportion of older women who
are widowed.
• Revival of old friendships providing sources of activity
and enjoyment.
• Freedom from certain responsibilities associated with
partner’s death (cooking, laundering, etc.).
Challenges in Retirement
• Dealing with threatened identity.
• Judging worth by an individual’s productivity.
• Overcoming attitude that unemployment is an
undesirable state.
• Finding a new source for activities, interests, and social
contacts.
Phases of Retirement (Atchley)
• Remote phase
• Near phase
• Honeymoon phase
• Disenchantment phase
• Reorientation phase
• Stability phase
• Termination phase
Nursing Interventions for Retirement
• Near Phase: counseling regarding the realities of
retirement.
• Honeymoon Phase: helping retirees place their new
freedom into proper perspective.
• Disenchantment Phase: being supportive without
fostering self-pity.
Nursing Interventions for Retirement
(cont.)
• Reorientation Phase: helping to identify new sources of
satisfaction.
• Stability Phase: appreciating and promoting the
strengths of this phase.
• Termination Phase: managing dependency tactfully
and respectfully appreciating losses.
Signs of Reality of Mortality
• Renewing interest in fulfilling dreams.
• Developing deeper religious convictions.
• Strengthening family ties.
• Providing for the ongoing welfare of family.
• Leaving a legacy.
Advantages of Reminiscence and Review
• Interprets and refines past experiences as they relate to
self-concept.
• Helps the individual understand and accept life.
• Connects the young listener with the past.
Elder Self-Concept
• Reactions to changes in self-concept:
– Deny body changes and make same demands on
bodies as when younger.
– Resist body changes by investing in endeavors that
diminish the budget but not the normal aging
process.
– Exaggerate these effects and impose an
unnecessarily restricted lifestyle on self.
Nursing Interventions
• Help aging persons understand and face the common
changes associated with advanced age.
• Encourage factors that promote optimum function (such
as, diet, paced activity, physical examination, etc.).
• Offer assistance with attention to preserving as much of
the individual’s independence and dignity as possible.
Retirement Income
• Retirement income is less than income during working
years. Aging people must:
– Determine whether retirement income plans are
keeping pace with inflation.
– Obtain benefits and manage money.
– Be aware of the impact of economic welfare on
health status.
Shrinking Social World
• Loneliness and desolation emphasize all the misfortunes
of people who are growing old.
• Isolation can occur in sparsely populated rural areas as
well as urban areas.
• Hearing and speech deficits and language differences can
foster loneliness.
Nursing Interventions for Social Isolation
• Provide telephone reassurance or home visits.
• Contact the person’s faith community to provide
assistance.
• Help the elder locate and join social groups.
• Change the housing to provide a safe environment.
• Relocate the elder to an area in which members of the
same ethnic group live.
• Use pets as companions for the elderly.