skills including self-awareness, so that they can counsel older adults on a variety of issues. Staying aware of the older adult client as a unique individual with a combination of racial, ethnic, gender, sexual orientation, cultural, religious, and socioeconomic identities will prevent professional and emerging practitioners from viewing the client primarily in terms of age (Zeiss & Kasl-Godley, 2001). This awareness will further develop the client–counselor relationship.
Many factors, such as coping mechanisms, influence how older persons address changes in later life. Coping has been defined as a person’s “cognitive and behavioral efforts to manage (reduce, minimize, master, or tolerate) the internal and external demands of the person—environment transaction that is appraised as taxing or exceeding the resources of the person” (Folkman, Lazarus, Gruen, & DeLongis, 1986, p. 572). Adaptive coping, or managing the demands of life relatively well, is at the heart of achieving and maintaining optimal health and wellness. This is certainly true at any age, but perhaps even more so in old age, when the threat of overtaxed resources and the need to tolerate limitations become inevitable. Life involves gains and losses; it is naïve to assume that everyone can and will maintain a high quality of life right up to their death. On the other hand, unnecessarily pessimistic views of old age, fueled by negative stereotypes of the elderly, restrict the ways people choose to adapt to aging and limit their sense of control over their lives.
Helpers who are knowledgeable about and skilled in understanding coping mechanisms can promote healthy adaptation, regardless of client age. Sources of concrete information about how to cope with getting older, how to understand the perspective of elders (Pipher, 1999), and how to deal with dementia can help clinicians build their foundations of knowledge. Whitbourne (1989) summarizes the task:
The main point that a clinician must keep foremost in mind, when working with an aging client, is the need to be flexible. The aging process involves multiple physical, psychological, and social demands that can all potentially impact on the individual’s ability to function. Clinicians may be called upon to perform advocacy services, environmental interventions, and interdisciplinary consultations, which they would not ordinarily regard as falling within the domain of “psychotherapy.” It is only by maintaining an open approach to the multiple needs of the aged client that the clinician can hope to bring about successful change. Helping professionals assume multiple roles when working with older clients and should remain open and flexible in their encounters. (p. 168)
Remaining Flexible and Open
Stereotypes, myths, and erroneous information regarding aging and the abilities of older adults is pervasive within the American culture. Henderson, Xiao, Siegloff, Kelton, and Peterson (2008) found that first year nursing students’ attitudes toward aging tended to be positive; however, the students did not aspire to work with geriatric patients. The reasons for not wanting to work with older adults were difficulty in relating or communicating with older people, feelings of the work being boring, and inexperience in caring for older people. However, students who had previously worked with elderly patients reported more positive attitudes, suggesting that positive exposure to such persons diminished negative feelings about aging.
Similarly, social work students’ negative attitudes toward older adults regarding their productivity, adaptation, independence, and optimism were a result of little previous contact with elderly individuals and minimal knowledge about aging prior to graduate school (Gellis, Sherman, & Lawrence, 2003). While Gellis and colleagues (2003) did not find experiences to predict attitudes toward older people among nursing, gerontology, and health science students, attitudes toward elderly adults changed as a result of ongoing exposure to and meaningful intergenerational exchanges with such persons (Butler & Baghi, 2008).
Older clients are capable of personal growth in the latter stage of life, unless there exists diseases that negatively impact their cognitions. While an individual’s basic personality is usually formed by around age 30, personality traits of older men and women take on a different pattern. For example, in later life, women may become more assertive and aggressive (when needed), and older men may become more nurturing. Therefore, the idea of being inflexible and rigid is questionable, at best. Both the older client and helping professional need to maintain openness to what can be accomplished within the therapeutic encounter.
Counselors help people with issues of career and sexual development well before they are fully active in these areas. Similarly, work to promote successful aging must begin before old age. Successful aging can involve adjusting to life transitions (such as from work to retirement), which can be thought of as turning points that occur between periods of stability within one’s life (Goodman, Schlossberg, & Anderson, 2006). Transitions often require a person to journey into the unknown, take risks, adapt, and cope with fears. They can therefore be challenging times in one’s life, often experienced as a crisis. Transitions can also create opportunities for personal discovery, renewal, and transcendence to heightened levels of existence.
Promoting Successful Aging
The process of helping to promote successful aging can be implemented by counselors in individual counseling, group counseling, workshops, or courses. The underlying philosophy or theme for these endeavors has been stated by Bortz (1990):
Aging is a self-fulfilling prophecy. If we dread growing old, thinking it is a time of forgetfulness, and physical deterioration, then it is likely to be just that. On the other hand, if we expect to be full of energy and anticipate that their lives will be rich with more adventures and insights, then that is the likely reality. We prescribe what we are to become. (p. 55)
Three key concepts anchor the development and implementation of promoting successful aging work. The first concept assumes that older people can prescribe their future and that counselors can effectively help them with this process. The second concept assumes that although general knowledge of developmental stages and sociocultural background is helpful in formulating working or guiding hypotheses, it is no substitute for developing a comprehensive understanding of the client. Third, each person uniquely interacts with and creates his or her own environment. Different cultures might have distinct views on the aging process, but individuals vary in their awareness and interpretation of these views. It is likely, however, that almost all people have concerns regarding aging and can be helped to age more successfully. Guided Practice Exercise 3.9 provides the opportunity to examine cross-cultural aging, which will be valuable in understanding older clients who seek counseling services.
Guided Practice Exercise 3.9
Individuals from various cultures experience aging differently. It may be welcomed or viewed with disdain. Identify two older adults from different ethnicities and examine their views of aging, the ways older persons are treated in their society, and their use of professionals for personal problems. Share the similarities and differences with your colleagues. Are you surprised by your findings?
Optimizing the Vision for Aging
At varying levels of consciousness, people imagine what it means to grow older. These imaginings need to be evaluated in terms of their accuracy and whether they represent how the person wants to age. Discussion, art therapy, relevant print and audiovisual materials, and interviewing are ways of making older people more conscious of their own thoughts and feelings about aging, expanding their notions as to what is possible, and then enlightening them on what they could be doing to achieve it. Gerontological counselors should take some of the following concerns into account when working with older adults. These concerns include losing their health, their ability to care for themselves, and their mental capacity; running out of money; finding meaning in older age; managing loss and grief; navigating sex and impotency; and sustaining marriage in the later years.
A key element is helping people realize what later life will be is highly
