1. Adulthood and Aging, 6e
John C. Cavanaugh
Fredda Blanchard-Fields
CHAPTER FOURTEEN
Successful Aging
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2. Demographic Trends and Social Policy
Learning Objectives
• What key demographic changes will occur by 2030?
• What are the challenges facing Social Security and
Medicare?
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3. Demographic Trends and Social Policy
Demographic Trends: 2030
• Potential for intergenerational conflict exists.
– Controversy over the rate and growth of Medicare and Social
Security
– Future issues when the last baby boomer reaches 65 (2030)
• The proportion of older adults will have nearly doubled.
• Older adults will be politically sophisticated and organized.
• Will want to keep their affluent lifestyle, Social Security benefits,
health care, comfortable retirement
• Ratio of workers to retirees will fall from 3:1 to 2:1.
• Lowered sense of obligation toward elderly parents
• Rapid increase of ethnic minority older adults
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4. Demographic Trends and Social Policy
Social Security and Medicare
• Political Landscape
– 1970s: older adults began to be portrayed as scapegoats
concerning government resources
• Because of tremendous growth of federal dollars expended on them
• Older adults portrayed as highly politically active, fiscally
conservative, and selfish.
– 1983: Congress made considerable changes in the name of
intergenerational fairness.
• Changes in Social Security, Medicare, the Older Americans Act, and
other programs and policies
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5. Poverty Rates
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6. Social Security & Medicare
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7. Demographic Trends and Social Policy
Social Security and Medicare
Social Security
– 1935: initiative by FDR to “frame a law which will give some
measure of protection to the average citizen and to his family
against the loss of a job and against poverty-ridden old age.”
– Revisions to the law have changed SS so it now represents the
primary financial support after retirement to many Americans.
– In the 21ST century, other plans, 401(k), 403(b), 457, mutual funds,
IRAs, savings option, may change SS back to being the supplement
it was supposed to be.
– Primary challenge to SS is the large cohort of baby boomers
drawing benefits and a smaller generation paying into the system.
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8. Demographic Trends and Social Policy
Social Security and Medicare
Medicare
– 40 million U.S. citizens depend on Medicare for medical insurance.
– Eligibility for Medicare
• Over 65
• Be disabled
• Have permanent kidney failure
– Consists of three parts
• Part A – inpatient hospital services, etc.
• Part B – outpatient services, etc.
• Part D – some coverage for prescription medications
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9. Health Issues and Quality of Life
Learning Objectives
• What are the key issues in health promotion and
quality of life?
• What are the major strategies for maintaining and
enhancing competence?
• What are the primary considerations in designing
health promotion and disease prevention programs?
• What are the principle lifestyle factors that influence
competence?
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10. Health Promotion and Quality of Life
Changing Unhealthy Habits Increase Functional Capability
• Little research on health programs specifically for the
elderly, however:
– Taking possibility of injury into account, exercise is key to health
– Health education programs minimize effects of emotional stress
– Health screening programs are effective in identifying chronic
diseases that impact quality of life
• Quality of Life
– One’s well-being and life satisfaction
– State of health has major influence
– Best studied from the point of view of the person
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11. Health Promotion and Quality of Life
A Framework for Maintaining and Enhancing Competence
• Use of computers is one way in which technology can
enhance competence of older adults.
– Websites dedicated to older persons.
– Email as a way to keep in touch with friends and family.
• Considering the life-span perspective, changes occur with
age result from:
– Multiple biological, psychological, sociocultural, and life-cycle forces
• Mastering tasks of daily living contributes to a sense of
competence.
– Key is to apply the three adaptive mechanisms for aging:
• Selection – Optimization – Compensation (SOC)
– Differentiate usual or typical aging from successful aging.
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12. Health Promotion and Quality of Life
Health Promotion and Disease Prevention
• No magic potion or set of steps to successful aging but table
14.1 suggests a strategy.
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13. Health Promotion and Quality of Life
Health Promotion and Disease Prevention
U. S. Department of Health and Human Services created a national
initiative to improve health of all Americans.
– U.S Government allocates funds appropriated by the Older
Americans Act through the Administration on Aging (AoA) to
support programs such as:
• Health risk assessments and • Health promotion programs on
chronic disabling conditions
• screening
Nutrition screening and education • Counseling regarding social
• Physical fitness services
• Home injury control services • Follow-up health services
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14. Health Promotion and Quality of Life
Health Promotion and Disease Prevention (cont.)
Issues in Prevention
– Primary prevention
Intervention that prevents a disease or condition from occurring
– Secondary prevention
Instituted after a condition has begun
– Tertiary Prevention
Efforts to avoid complications or secondary chronic conditions
– Quaternary prevention
Aimed at improving functional capacities of people with chronic conditions
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15. Health Promotion and Quality of Life
Lifestyle Factors
• Exercise
– Aerobic exercise: places moderate stress on the heart by
maintaining a pulse rate between 60 and 90% of the person’s
maximum heart rate
• Nutrition
– Metabolism: how much energy the body needs
Metabolism and digestive process slow down with age.
– Low-density lipoproteins (LDL): cause fatty deposits to
accumulate in arteries
– High-density lipoproteins (HDL): help keep arteries clear by
breaking down LDLs
– Body mass index (BMI): ratio of body weight and height (w/h2)
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16. Overweight & Obesity
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17. Successful Aging
Learning Objectives
• What is successful aging?
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18. What is “Successful Aging?”
The absence of disease and disability makes it easier to
maintain mental and physical function. And maintenance of
mental and physical function, in turn, enables (but does not
guarantee) active engagement with life.
It is the combination of all three—avoidance of disease and
disability, maintenance of cognitive and physical function,
and sustained engagement with life—that represents the
concept of successful aging most fully
(Rowe & Kahn, 1998, p. 39).
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19. Successful Aging
Vaillant (2002) proposes three criteria related to health:
1. No physical disability at age 75
2. Good subjective health
3. Length of undisabled life
and three related to social and productive activity:
– Good mental health
– Objective social support
– Self-rated life satisfaction in eight domains
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20. Successful Aging
Vaillant’s eight domains of life satisfaction:
1. Marriage
2. Income-producing work
3. Children
4. Friendship and social contacts
5. Hobbies
6. Community service activities
7. Religion
8. Recreation/sports
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21. Successful Aging
Successful Aging Theories
The Selection, Optimization, and Compensation (SOC) model
Selection
The choosing and developing goals
Optimization
The refinement of goal-related actions
Compensation
the substitution of means when previous ones are no longer available
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22. Successful Aging
Successful Aging Theories
• Successful aging requires that people:
– Have the resources to live a healthy life
– Have access to health care
– Have life experiences that support individual decision
making
• Negatives
– Poverty, widowhood, differential social expectations based
on gender influence
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23. Successful Aging
When you are old, will you be able to
look back and say,
“I lived long and prospered”
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