Gerontology reflection/respond
Write 2-3 double-spaced pages reflecting on the following case/scenario:
Using the content found in Chapters 3 & 4, describe some changes to the physical and mental well-being of an older adult and their ability to negotiate these life changes . What changes do you observe? What changes does the older adult acknowledge and what is their perceived impact? Be sure to be specific on the details, and include two outside resources to back up your reflection. One of those resources should be a personal communication with an older adult. Think of this as an observation as to how you think this person is doing in relation to what you have learned so far.
I don’t have the book, but I have the index, so do your best with it and try to understand.
the paper should be reflection and respond.
use easy language
need it in 5 hrs please
the book is aging matter, its index in the attachment.
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Nancy R. Hooyman
University of Washington
Kevin Y. Kawamoto
H. Asuman Kiyak
Aging Matters
An Introduction to Social Gerontology
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Editor in Chief: Ashley Dodge
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Library of Congress Cataloging-in-Publication Data
Hooyman, Nancy R.
Aging matters : an introduction to social gerontology / Nancy Hooyman, H. Asuman Kiyak, Kevin Kawamoto.
pages cm
ISBN-13: 978-0-205-72764-3 (student edition : alk. paper)
ISBN-10: 0-205-72764-6 (student edition : alk. paper)
1. Gerontology. 2. Aging. 3. Older peopleUnited States. I. Kiyak, H. Asuman,
II. Kawamoto, Kevin. III. Title.
HQ1061.H5826 2015
305.26dc23
2013031899
10 9 8 7 6 5 4 3 2 1
ISBN 10: 0-205-72764-6
ISBN 13: 978-0-205-72764-3
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In dedication to students, faculty, practitioners and older adults
committed to enhancing how we age across the life course
with special acknowledgment of our colleague and coauthor,
Dr. Asuman Kiyak, who died before the completion of the book
NRH, KK
With hope that my grandson Gus will inherit a world
that supports active aging
NRH
And to family and friends of all ages whose wisdom
and love have enriched the world we all share.
KK
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vii
Preface xv
An Introduction to Social
Gerontology 1
Why Study Gerontology? 2
A Life Course and Strengths Perspective 3
A Multidisciplinary Perspective 4
Key Terms 4
How Do We Define Age? 5
How Do We Study Older Adults? 6
Research Methods 6
Summary 9KeyTerms 9ReviewQuestions 9
1
The Older Population
in the United States 10
Changing Demographics of the U.S.
Population 11
Changes in Life Expectancy 12
Gender Differences in Life Expectancy 14
Racial Differences in Life Expectancy 14
Maximum Life Span 16
Population Pyramids 17
Support and Dependency Ratios 19
The Rapid Growth of the Old-Old
andOldest-Old 19
Who Are the Oldest-Old? 20
Centenarians and Super-Centenarians 21
The Role of Genes 22
The Role of the Environment 23
Increasing Diversity among the Older
Population 23
Elders of Color 24
Lesbian, Gay, Bisexual and Transgender (LGBT)
Elders 25
Geographic Distribution 25
Geographic Distribution among Elders
of Color 27
Educational and Economic Status 28
Longevity in Health or Disease? What Does
the Future Hold? 29
Summary 30KeyTerms 31ReviewQuestions 31
MediaResources 31References 31
2
Global Aging and Older
Immigrants in the
United States 34
Global Trends in Aging 35
Global Aging, Median Age, and Population
Pyramids 37
What It Means To Be Old around the World 40
Baby Boomers in Japan 42
Economic Implications for Industrialized
Countries 43
Older Europeans in the Workforce 43
Older Adults in Traditional Societies
andthe Impact of Modernization 45
Modernization Theory 47
Modernization and Elders Declining Social
Status 47
Impact of Modernization on Respect and Care
toward Elders in Asian Cultures 49
Immigrants to the United States 51
Immigrant Elders Changing Roles and
Expectations 52
Financial Dilemmas Facing Immigrant Elders 53
Immigrant Elders in Multigenerational
Households 53
Additional Challenges Faced by Older
Refugees 55
Summary 56KeyTerms 56ReviewQuestions 57
MediaResources 57References 57
Contents
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viii Contents
Problems with the Intestinal System 83
Oral Diseases 84
HIV (Human Immunodeficiency Virus) or AIDS
(Acquired Immune Deficiency Syndrome) 84
Accidents 85
Older Drivers 85
Falls and Their Prevention 86
Use of Physician Services 87
Hospital Utilization 87
Medication Use 87
Health Promotion 88
Exercise as Central to Health Promotion 89
Nutrition 90
Programs That Work 90
Improving the Impact of Health Promotion
Programs 91
Summary 92KeyTerms 93ReviewQuestions 94
MediaResources 94References 94
4
Mental and Emotional
Well-Being 100
Aging and Cognitive Function 101
Intelligence and Aging 102
What Else Besides Age Affects Intelligence? 102
How Aging Affects Learning and Memory 103
Executive Function in Older Adults 105
Factors That Affect Learning in Old Age 106
Strategies to Promote Older Adults Learning 106
Age-Related Changes in Memory 106
Improving Cognitive Abilities 108
Memory Mediators 108
External Cognitive Aids 109
Physical Exercise 109
Do Chemical Aids Improve Memory? 109
Wisdom and Creativity 110
Personality in the Later Years 111
Stage Theories of Personality 111
Eriksons Psychosocial Model of
Personality 111
Trait Theories of Personality 112
Emotional Expression and Regulation 112
3
Physical Well-Being: Physiological
Changes and Health 60
Biological Theories of Aging 61
Can Aging Be Reversed or Delayed? 62
Normal Physiological Changes
withAge 63
Changes in Body Composition 63
Changes in the Skin and Hair 64
Organ Systems 64
Musculoskeletal and Kinesthetic Systems 64
Respiratory System 65
Cardiovascular Changes 65
Urinary System 66
Gastrointestinal System 66
Endocrine System 67
Immune System 67
Nervous System 67
Physiological Changes and Sexuality 68
Women and Age-Related Physiological Changes 68
Men and Age-Related Physiological Changes 68
Sleep Patterns 69
Sensory Functions 69
Vision 70
Hearing 71
Taste and Smell 73
Touch 73
Defining Health and Functional Ability 73
Are Disability Rates Declining? 75
Chronic and Acute Diseases 75
Health Disparities 76
Primary Causes of Death in Old Age 76
Common Chronic Diseases 78
Heart Disease and the Cardiovascular System 78
Strokes and Other Cerebrovascular Problems 79
Cancer 79
Arthritis 80
Osteoporosis or Weak Bones 81
Chronic Obstructive Pulmonary Disease
orRespiratory Problems 82
Diabetes 82
Problems with the Kidneys and Urinary Tract 83
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Contents ix
Disengagement Theory 145
Continuity Theory 146
Newer Social Theoretical Perspectives 147
Age Stratification Theory 147
Social Exchange Theory 149
Life-Course Perspective 150
Political Economy Theory of Aging 151
Social Constructionism 152
Recent Developments in Social
Gerontological Theory 153
Social Phenomenology 153
Feminist Gerontology 155
Summary 157KeyTerms 157ReviewQuestions 157
MediaResources 158References 158
6
Family, Friends, and Other
Informal Supports 160
We All Need Informal Social Support 161
The Benefits of Social Supports 161
Do Social Supports Change as We Age? 162
What Factors Affect Our Social
Relationships? 164
The Centrality of Family Supports 164
Families Are Changing 165
The Growth of the Multigenerational Family 166
Older Partners as Social Support 168
Older Adults and Marriage 168
Marital Satisfaction 170
Divorce in Old Age 170
Remarriage and Other Late-Life Romantic
Relationships 170
Dating in Old Age 171
Never-Married Older People 171
Childless Older Adults 171
Lesbian, Gay, Bisexual, and Transgender (LGBT)
Partners 172
What We Now Know about Older LGBT Families 173
Effects of Race, Class, and Cohort with Sexual
Identity 174
Barriers to Supports for LGBT Elders 175
Working with LGBT Elders 176
Self-Concept and Self-Esteem 113
Successful, Robust, Resilient, or Positive Aging 114
Mental Disorders among Older
Persons 115
Depression 116
Risk Factors for Depression 116
Diagnosing Depression 116
Therapeutic Interventions 117
Suicide 118
Anxiety 118
Paranoia and Schizophrenia 119
Older Adults Who Are Chronically or Severely
Mentally Ill 119
Dementia 120
Reversible and Irreversible Causes of Dementia 121
Alzheimers Disease (AD) 121
Differentiating AD from Normal Age-Related Memory
Changes 121
Potential Causes of and Risk Factors for Alzheimers
Disease 121
The Importance of a Thorough Diagnosis 122
Stages of Alzheimers Disease 123
Drug Therapy 124
Behavioral Treatment and Environmental
Interventions 124
Parkinsons Disease 125
Substance Use 125
Alcoholism 125
Drug Abuse 127
Summary 128KeyTerms 129ReviewQuestions 130
MediaResources 130References 131
5
Social Theories of Aging 138
The Importance of Social Theories
ofAging 139
Social Gerontological Theory before 1961:
Role and Activity 141
Role Theory 141
Activity Theory 144
The Next Stage of Theory Development:
Disengagement and Continuity
Theory 145
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x Contents
Modifying the Home Environment 210
Respite Care 210
Electronic Supports 211
Future Service Directions 211
When Caregiving Becomes
Too Much 212
Placement in Long-Term Care Facilities 213
Elder Mistreatment 213
Financial Abuse and Exploitation 215
Reporting and Other Legal Requirements 215
Underpaid Caregivers: Direct Care
Workers 217
Economic and Health Disparities Faced by Direct
Care Workers 218
Future Demand 219
Summary 220KeyTerms 221ReviewQuestions 221
MediaResources 221References 222
8
Productive Aging: Leisure,
Spirituality, and Civic
Engagement 226
Defining Productive Aging 227
Leisure 228
Religious Participation, Religiosity,
andSpirituality 229
Defining Religion, Religiosity, and Spirituality 229
Religious Affiliation: Age, Gender, and Race 230
Religiosity 232
Benefits of Religious Participation and Religiosity
forOlder Adults 232
Other Factors to Consider regarding Religion
andHealth 233
Spiritual Well-Being 233
Implications for Health Care Providers 235
Stages of Spiritual Growth 235
Civic Engagement 236
Civic Engagement: Toward What End? 237
Membership in Voluntary Associations 237
Patterns of Membership 237
Senior Centers: Are They Prepared for Changing
Demographics? 238
Sexuality, Intimacy, and Emotional
Support 176
What We Know about Older Adults and
Sexuality 177
Other Types of Family Supports 178
Relationships with Adult Children 178
Sibling Relationships 179
Grandparenthood and Great-Grandparenthood 179
Friends and Neighbors as Social Supports 182
Programs to Strengthen or Build Neighborhood and
Community Supports 183
Intergenerational Programs 184
The Unconditional Love of Pets 185
Summary 186KeyTerms 187ReviewQuestions 187
MediaResources 188References 188
7
Informal and Family
Caregiving 193
What is Informal Caregiving? 194
What Kind of Informal Care Do Some Older Adults
Need? 194
Who Are Informal Caregivers? 196
Losses and Gains of Informal Care 197
Costs of Informal Caregiving 197
Benefits of Informal Caregiving 199
Adult Children as Caregivers 200
The Gendered Nature of Caregiving 200
Women in the Middle 201
Spouses/Partners as Caregivers 202
Family Caregivers of Color 202
Friends as Caregivers 204
Caregiving for Persons with Dementia 204
Grandparents as Primary Caregivers 204
Legal Issues Related to Grandparent
Caregiving 206
Legislation and Policies to Support Family
Caregivers 207
Services and Support for Caregivers 208
Why Dont Caregivers Use Services? 209
Effective Evidence-Based Interventions 209
Psychoeducational Groups, Skills Training, and
Treatments 210
Support Groups 210
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Contents xi
10
Economic Well-Being: Retirement,
Employment, and Poverty 283
Retirement 284
Baby Boomers and Changing Expectations
ofRetirement 285
The Timing of Retirement 287
Employment 289
Unemployment 289
Barriers to Employment 291
Economic Status 292
What Are the Major Sources of Income
forOlderAdults? 293
Social Security 293
Assets 295
Pensions Other Than Social Security 295
Earnings 296
Public Assistance 297
Social Class and Poverty in Old Age 297
Are Older Adults Poorer Than Other Age
Groups? 298
Limitations of Official Poverty Statistics 299
Poverty Variations by Race, Gender, and Sexual
Orientation 300
Hunger Is Increasing among Older Americans 301
Changing Conceptions of Work
andRetirement 302
Summary 304KeyTerms 305ReviewQuestions 305
MediaResources 306References 306
11
Community Well-Being: Living
Arrangements and Social
Interactions 309
The Aging Experience in Rural, Urban,
andSuburban Areas 310
How and Where Elders Live Affects
Their Well-being 310
Relocation 312
Volunteering 240
Benefits of Volunteerism 242
Race, Social Class, and Volunteering 243
Lifelong Learning Programs 244
Political Participation 245
Do Older Adults Become More Politically Conservative
with Age? 245
Voting Behavior 246
Are Older Adults a Powerful Political Constituency? 247
AARPThe Largest Membership Organization
in the Country 248
Looking toward the Future of Productive Aging 250
Summary 250KeyTerms 251ReviewQuestions 251
MediaResources 252References 252
9
Loss and Grief in Old Age 256
Loss and Grief within the Context
ofAging 257
The Nature of Grief 259
Typical Losses Faced by Older Adults 259
Relocation 260
Retirement 261
Caring for a Relative with Chronic Illness
orDisability 262
Caring for Adult Children with Chronic Illness
orDisabilities 263
Living with Chronic Illness or Disability 265
Death of Loved Ones 265
Death of a Partner 265
Death of Siblings 268
Death of Friends 269
Approaching Ones Own Death
and the Dying Process 269
The Dying Process 271
Desire for a Good Death 272
End-of-Life Care: Palliative Care and Hospice 272
Culturally Appropriate End-of-Life Care 273
The Right to Die 275
Hastened Death and Physician Aid-in-Dying 275
Patients Legal Options regarding Their End-of-Life
Care 277
Summary 278KeyTerms 279ReviewQuestions 279
MediaResources 279References 280
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xii Contents
Technology in the Workplace 346
Technologies to Help Aging
in Place 347
Universal Design and Smart Homes 347
Can Computer Games Promote Elders
Well-Being? 352
Computer Games and Physical
Exercise 353
Summary 354KeyTerms 354ReviewQuestions 354
MediaResources 355References 355
13
Policies to Promote Older Adults
Well-Being 357
Understanding Policies, Programs,
andRegulations 358
Separating Fact from Fiction about Age-Based
Policies 359
Criteria by Which Policies Vary 359
Factors That Influence the Development
of Public Policies 360
Values Affecting Social Policy 360
Intergenerational Inequity versus
Interdependence 361
Historical, Economic, and Political
Context 362
The First Policies to Benefit Older Americans
1930s1950s 362
Expansion of Age-Based Programs in the 1960s
and1970s: Compassionate Stereotypes
aboutOlder Adults 363
Cost Efficiency and Program Reductions
in the 1980s and 1990s 363
Since 2000: Market and Personal Responsibility
and Reduced Government Spending 364
Social Security: An Income Security
Program 364
The Goals of Social Security 365
The Cross-Generational Nature of Social
Security 365
Housing Patterns of Older People 314
Independent Housing 314
Aging in Place 316
Age-Friendly/Livable Communities 316
Flexible Housing and Universal Design 317
Additional Innovations for Aging in Place 318
Planned Retirement Housing 320
Continuing Care Retirement Communities 321
Assisted Living 322
Private Homes That Offer Long-Term
Supports 323
Skilled Nursing Facilities (SNFs) 324
Culture Change in Long-Term Care 325
Social and Health Services to Promote
Aging in Place 327
Home Care 328
Adult Day Care and Adult Day Health Care 328
Housing Policy and Growing Housing
Needs 329
Homelessness: Aging in Place
on the Streets 329
Aging in Place among Older Prisoners 331
Summary 331KeyTerms 333ReviewQuestions 333
MediaResources 333References 334
12
Enhancing Older Adults
Well-Being through
Technology 336
Information and Communication
Technologies 337
Intergenerational Communication 339
Lifelong Learning 340
News and Information 341
Managing Health Online 342
Health Information on the Internet 342
Health Plans Online 344
Telehealth 345
Health Consultation Online 346
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Contents xiii
14
Careers in Aging 391
Why Consider a Career in Aging? 392
The Wide Range of Jobs in Aging 396
Preparing for a Career in Aging 397
Academic Programs in Aging 398
Workforce Initiatives in Medicine, Nursing,
and Social Work 399
Interdisciplinary Teams 399
Internships and Other Training Opportunities 400
Journaling as a Self-Discovery Tool 401
A Multidisciplinary, Multigenerational
Outlook 401
Summary 405KeyTerms 405ReviewQuestions 405
MediaResources 406References 406
Glossary 407
Credits 417
Index 421
The Future of Social Security 366
Proposed Changes to Social Security 367
Proposals to Reduce Gender Inequities in Social
Security 368
Social Services through the Older
Americans Act 369
Medicare and Medicaid 372
Medicare 372
Medicare-Funded Home Health Care 375
Medicare Reform and Prescription Drug
Coverage 376
The Future of Medicare 377
Medicaid 378
Medicaid-Funded Skilled Nursing Home Care 379
Medicaid-Funded Home Health Care 380
Directions in Long-Term Services
andSupports 382
Long-Term Care Insurance 382
Policies to Promote Innovative Health
and Long-Term Care Services 383
Benefits of Health Care Reform for Older Adults 384
Summary 386KeyTerms 387ReviewQuestions 387
MediaResources 388References 388
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xv
Preface
Why This Introductory Text
forUndergraduates?
Since 1987, Nancy R. Hooyman and H. Asuman Kiyaks
textbook Social Gerontology: A Multidisciplinary Perspective
has impacted thousands of students learning about aging.
It is always rewarding to hear from students and faculty in
different colleges and universities nationally and interna-
tionally about how the textbook changed their knowledge
and attitudes toward older adults, fostered the personal
rewards that come from gaining insight into older peoples
lives, influenced career choices, or provided a compre-
hensive resource for future reference. It is deeply gratify-
ing to have created a text that both undergraduate and
graduate students find helpful and even inspiring, both
personally and professionally. Indeed, it was that type of
feedback that encouraged and motivated Drs. Hooyman
and Kiyak to complete nine editions of Social Gerontology:
A Multidisciplinary Perspective.
Along with the positive feedback, we would often
hear comments such as I would love to use your textbut
it is too dense, heavy, or long for my undergraduate
class, I wish you had a user-friendly undergraduate
version of your text, or When are you going to do an
undergraduate version of your text? Even though we
knew that SocialGerontology was used by some instruc-
tors for upper-division courses, we consistently received
feedback that it is not always appropriate for lower-
division or community college courses. This book, Aging
Matters: An Introduction to Social Gerontology, specifically
responds to this criticism by attempting to meet the
need for a user-friendly, readable, and evidence-based
undergraduate social gerontology text. It also reflects
our knowledge from teaching undergraduatesas well
as research on changing attitudes toward agingthat
exposing undergraduates, especially those in their early
twenties, with content on aging and experiences with
elders, can promote their positive attitudes, beliefs, and
values about older adults. It may even influence them
to consider a career working with older adults and their
families.
Largely because of the visibility and influence of
aging baby boomers, the issues of aging are increasingly
attracting the attention of the media, politicians, busi-
nesses and industry, and the general public. Accordingly,
a growing number of colleges and universities now offer
coursework in gerontology. The goal of many of these
courses is to prepare students to understand the process
of aging and the diversity among older people, and to be
able to work effectively with older adults and their families.
These courses also attempt to enhance students personal
understanding of their own and others aging. Frequently,
students take such a course simply to meet a requirement,
but they quickly learn how relevant the aging process is to
their own or family members lives.
We recognize that only a small proportion of students
who read Aging Matters may pursue a specialized career in
aging. But all of them are living in an increasingly older and
more diverse society. Indeed, no matter what career path
or work setting they choose, they will be interacting with
older adultseven if they say that they dont ever want to
work with those older people. As citizens of our aging
society and world, they need to see the connection between
learning about the aging process and understanding their
own behavior, the behavior of their parents, grandparents,
neighbors, and work colleagues, and eventually the behav-
ior of their clients, consumers, or patients across all work
settings and fields.
Despite the increased visibility of more positive
images of older adults, we live in an ageist society and
many of us have internalized ageism. Undergraduates
are not immune to holding negative views, myths and
stereotypes about aging, and these need to be countered
with factual information. Many undergraduates have not
had positive opportunities to interact with older adults,
particularly if their grandparents or great-grandparents
were at a geographic distance when they were growing
up. Given this likely context, we try to provide a bal-
ancedapproach of both the gains and losses that often
accompany the aging process. It is important for under-
graduates to know that there are growing numbers of
healthy active older adults and that a relatively small
proportion of our societys elders is homebound or
in skilled nursing homes. For example, we frequently
remind the reader that we are all aging and that people
can, to some extent, influence their own experience of
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xvi Preface
Aims and Focus
Aging Matters is intended to be useful to a wide range of
disciplines, including nursing, social work, sociology, psy-
chology, health education, architecture, psychology, human
services, and the allied health professions. Accordingly, we
present the study of social gerontology from a multidis-
ciplinary perspective. We illuminate the diversities of the
aging experience related to the cultural, biological, physi-
ological, emotional, cognitive, economic, and social aspects
of aging so that students readily see how all these multiple
facets interact to influence our social functioning and phys-
ical and mental well-being. We hope to convey that aging
is a fascinating process (and subject to study), because these
changes occur differently in each one of us. It is important
for students to understand how changes within the aging
individual, such as sensory modifications or issues of loss
and grief, affect elders daily interactions with social and
physical environments. Through research evidence, case
studies, personal illustrations, and timely excerpts from the
media, we illustrate how dramatic increases in the num-
bers and proportion of older people in our population and
worldwide have numerous implications for families, the
neighborhood, and communities; the workplace; housing;
health and social services; political processes; educational
and recreational services; religious institutions; volun-
teerism; and the use of technologyand that these changes
occur across multiple generations and the life course.
Similarly, we emphasize that effectively addressing these
complex changes requires a multidisciplinary approach.
Throughout this book, a unifying theme is the impact
of these dynamic interactions between older people and
their environments, including inequities based on age,
gender, race, social class, and sexual orientation, on their
quality of life and physical and mental well-being. But we
also emphasize the remarkable resilience of older adults,
many of whom have faced lifelong inequities. The differen-
tial effects that these changes have on three rapidly growing,
but historically underserved, populationswomen, LGBT
adults, and elders of colorare frequently recognized, as
well as the inner strength and resilience of these groups
acknowledged. Culturally competent approaches to under-
stand and respectfully meet the needs of an increasingly
diverse older population are also identified.
We have tried to present up-to-date content, drawing
upon current research, government reports, and Web sites.
But because the fieldand especially social, health, and
long-term care policies and programschanges so rapidly,
aging. Our lifestyles during young adulthood can affect
our health, cognitive and emotional well-being, and
social lives in later years. We refer to recent research that
demonstrates the role of individual choices and behav-
iors in whether we age in a healthy, active manner, or
with multiple chronic diseases and without supportive
social networks. But we also point to the necessity of
policies, programs and communities to support aging in
a healthy manner.
To help counter negative stereotypes, we emphasize
that the majority of older adults continue to live in and
be an integral part of their communities and contribute
substantially to our cultural, family, and work lives. Recent
research findings are presented on extending both years
and quality of life by preventing or managing chronic
diseases, enhancing active aging, and maintaining pro-
ductivity (i.e.,contributing to society in a wide range of
ways) through both paid and unpaid activities. Examples
of older adults vital roles as family members as well as
their civic engagement and volunteer activities, includ-
ing cross-generational alliances related to solving social
problems, are included.
But we also remind the reader that not all groups
in our society, particularly those that are historically
disadvantaged, low-income, or with limited education,
have opportunities to experience healthy or active aging;
instead, they face societal and economic barriers to pro-
ductivity and civic engagement, to health promotion
initiatives, even to having adequate food on the table.
Therefore, we do not gloss over the very real problems
of poor health, chronic illness, poverty, hunger, or inad-
equate housing that face many older adultsespecially
women, elders of color, immigrants, the oldest-old, and
those living aloneand the social and health inequities
and social structures that create such problems. Aging
Matters includes numerous examples of how the eco-
nomic and social well-being of older adults has been
negatively affected by the worldwide recession while
social and health services to support elders well-being
are cut nationwide and basic policies such as Medicare
and Social Security are threatened. Growing numbers of
older people must continue to be employed, or return to
work, because of lost retirement income, the high cost
of health care, unexpected rises in their housing costs, or
even home foreclosures. Quite simply, students learn that
aging matters as a social justice issue as well as a demo-
graphic challenge and that fundamental policy-level
changes are needed to ensure well-being in old age.
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Preface xvii
Points to Ponder for students to respond indi-
vidually or in small groups to questions about the
content
Reflection Breaks for students to think about issues
privately or explore them with others
Easily readable and updated tables, charts, and
graphs
An increased number and mix of color photos con-
veying positive and negative images of older adults
Discussion questions at the end of each chapter
to promote a review of key concepts and critical
thinking
A list of key terms defines key terms introduced in
that chapter along with a comprehensive glossary at
the end of the book
The book is designed to be completed in a semester, but
readers can proceed at a faster or slower pace and select
only the chapters most relevant to their focus of study.
Consistent with the multidisciplinary nature of
gerontology, this book is organized in sections that
first address demographic changes within the United
States, other countries, and other cultures, and then the
biological, psychological, and social aspects of aging.
The Introduction briefly reviews the books underly-
ing themes, key terms, and research methods used to
study aging and older people. Chapter 1 encompasses
the changing demographics of the U.S. population, with
attention to gender and racial differences in life expec-
tancy and the increasing diversity of the older population
by race, sexual orientation, age, and social class. Chapter
2 discusses the demographic characteristics and eco-
nomic implications of aging globally and the distinctive
challenges faced by older immigrants and refugees in the
United States. Chapter 3 covers normal age-associated
biological and physiological changes, including sensory
functions, that affect older peoples daily functioning
as well as their risk of chronic diseases, disability, and
accidents; how they cope with the most common chronic
health conditions; and their use of health and long-
term services and supports services, including models
of chronic disease management, care transitions, and
health promotion. It also addresses older adults sexuality
and intimacy, a topic that may alter many undergradu-
ates conceptions of older adults. Chapter 4 deals spe-
cifically with normal age-related changes in intelligence,
learning, memory, and personality as well as increases
in creativity and wisdom that often occur with age. It
some of the issues raised in this edition will inevitably be
out of date by the time the text is published. And statistics
on demography, diversity, and social-economic stat
