Chandler, Hardin-Simmons University
From the Author’s Chair
A genuine respect and appreciation for older adults is a value that I have adhered to since childhood. Providing assistance without compensation was taught from a very early age, and it is a rewarding experience. Therefore, it was not surprising to me that I chose a helping profession to continue to emphasize rendering services to older persons. I earned a master’s and a doctoral degree in rehabilitation counseling from the University of Pittsburgh and continued my focus on the aging population. The rehabilitation philosophy encompasses maximizing the functional capacity of individuals in all spheres of life. This philosophy is eclectic in its orientation, and it emphasizes doing whatever is appropriate to maximize the capabilities of clients. My personal philosophy and experiences are consistent with rehabilitating persons to their maximum level of functioning.
Clinical, administrative, and research experiences were obtained in a variety of formats and various organizations. However, my clinical skills were enhanced at the Western Psychiatric Institute and Clinic (W.P.I.C.) where I had the opportunity to develop my skills in individual, group, and family counseling while simultaneously working with a multidisciplinary team. It should be noted that very few inpatient psychogeriatric units existed at this time, and I was fortunate to become one of the clinicians to work on the psychogeriatric units that focused exclusively on a comprehensive approach to the treatment of older adults with mental health issues. I had a unique opportunity to co-develop, recruit, and monitor the geropsychiatry admission process and to facilitate the admissions process for older adults and their families. Additionally, research opportunities were an integral component of my employment at W.P.I.C. Interacting with various therapists in the team proved valuable in the therapeutic process with older adults. Furthermore, I managed research grants that focused on improving and enhancing the well-being of older adults in the community. Throughout all of my professional experiences, I stayed committed to working with older adults. I had the opportunity to work on inpatient and outpatient units, long-term care systems, health care systems, and in educational and consultant positions. The Benedum Geriatric Outpatient Center provided numerous opportunities for assessment and treatment for older adults and excellent supervision by personnel who specialized in gerontology, geriatrics, and geropsychiatry. This breadth of experience facilitated my completion of a master’s degree in business administration to better prepare me to understand the business aspects of the health care industry and its impact on aging services.
Currently as a professor and Gerontology Coordinator at Slippery Rock University, I have developed courses, revised curricula, managed academic programs, developed and supervised internship placements, advised students, conducted research, published articles, engaged in university governance, and provided community service. Positions included Director of a Health Services Administration program, Assistant to the Dean of the College of Health, Environment, and Science, and Gerontology Coordinator, while maintaining faculty responsibilities. Courses taught in administration included the organization, delivery, management, and financing of the health care delivery system. Courses in health included personal health, community health, and international health. Aging courses include the aging process, death and dying process, senior aging seminar, women and aging, foundations of aging, counseling older adults, career development counseling, and internship supervision.
In all of the various transitions within the university, I continue to focus on increasing awareness of aging issues and promoting the counseling and related health professions to enhance their ability to serve older clients. Elevating the status of aging as a specialty and increasing the numbers of gerontological specialists remains a high priority.
Chapter 1 Introduction
“There is a fountain of youth: it is your mind, your talents, the creativity you bring to your life and the lives of people you love. When you learn to tap this source, you will truly have defeated age.”
—Sophia Loren
Learning Objectives
After reading this chapter, you will be able to
1 Describe the basic changes that occur in the aging process
2 Analyze the various biological theories that explain aging
3 Examine the normative physical changes that accompany the aging process
4 Explain the cognitive changes that accompany aging
The aging of the population is one of the most profound and far-reaching changes affecting contemporary society. Between 2014 and 2060, the U.S. population is projected to increase from 319 million to 417 million, reaching 400 million in 2051 (Colby & Ortman, 2014). By 2030, one in five Americans is projected to be 65 and over (Colby & Ortman, 2014). In 2014, the 65 plus population is expected to grow from 15% gradually upwards to 24% by 2060 (Colby & Ortman, 2014). The baby boomers (individuals born between 1946 and 1964) largely account for the increase in this demographic, as they began turning 65 in 2011. By 2050, the surviving baby boomers will be over the age of 85.
The aging of the population has wide-ranging implications for the country. By aging, demographers often mean that the proportion of the population in the older age range increases. As the United States ages over the next several decades, its older population will become more racially and ethnically diverse. The projected growth of the older U.S. population will present challenges to policymakers and programs. It will also affect families, businesses, and health care providers (Ortman, Velkoff, & Hogan, 2014). There is a clear need for health professionals with a thorough understanding and appreciation for the experiences of this older population. With so many individuals over age 65, mental health professionals with the expertise to assess and treat the problems of later life are sorely needed (Zarit & Zarit, 2011).
People are not just living longer, but they are living better longer than ever before. Improvements in disease prevention and health promotion, the widespread availability of public and private pensions and other financial benefits, and increased educational opportunities for each successive generation have dramatically improved the lives of today’s society. The next generation of older people will have had better education and have taken better care of their health across the life span, so their prospects for successful old age are even greater (Zarit & Zarit, 2011).
These demographic and social changes mean that an increasing number of older people are in need of psychological services. The mental health field, however, has been slow to respond with adequate numbers of trained professionals who have specialized training in geriatrics. For many years, geriatric practice was a backwater, a minor field viewed condescendingly by clinicians who felt that little could be done for anyone over age 50 (Zarit & Zarit, 2011). That viewpoint was a luxury of a society that had relatively few older people. The dramatic expansion of life expectancy and growth in the proportion of people over age 65, coupled with empirical findings of the effectiveness of treatment for many problems of later life, provides a solid foundation for geriatric mental health practice. The number of clinicians with geriatric expertise, however, falls far short of the need (Zarit & Zarit, 2011).
Aging is a natural and inevitable process and a very complex one. Many changes occur in this process; however, no two persons experience these changes at the same time or at the same rate. It is a variable experience. Some elders accept the natural changes that occur as a positive experience, while others view these changes with disgust and frustration. The process of aging is also a time to explore hidden talents, engage in new activities, commit
