Gerontology and The Relationship to The Human Civilization

Gerontology is a relatively unexplored field in relationship to the entire human civilization. Because we are in the demographic infancy of old age, we are said to be still in a societal and cultural exploration phase of old age. Therefore, what we witness today, as old age, has not yet settled into a stable culture or environment. Instead, in the years and decades to come, the facts and processes of old age are likely to undergo rapid changes to both cultural and behavioural representation. Although some individuals have reached old age before the twentieth century, today close to 50% of the population reach the age of 75. Like the rest of the developing world, Australia is experiencing a rapid increase in the proportion and absolute number of older persons. Taking the traditional retirement age of 65 as a reference point marking the beginning of the 'old age', about 12.1 percent of Australia's population or 1.85 million people fall into this category, with the group aged 80 and over growing most rapidly. (Baltes &Graf, 1996; Browning, Gething, Helmes, Luszcz, Turner, Ward & Wells, 2000)

Ageing is not merely a biological phenomenon experienced identically by all people, neither is it necessarily separate stages or states of being which just 'arrive' The ageing process needs to be represented as a social, physical, psychological and spiritual process in which individuals have created for themselves or have imposed upon them. Older people both experience and give meaning to their ageing within the constraints of specific material conditions (e.g. issues such as housing, income and access to relevant services) and social conditions (e.g. issues such as ageism and age discrimination; gender, race and empowerment; cultural and linguistic diversity). Experiences of past and future cohorts are likely to be very different from today's cohorts so care must be taken when communicating current data to future populations. Older people have many experiences in common with other age groups, and share many of their interests. For example, people can experience homelessness, poverty or are homeowners in various cohorts.

Current studies of ageing show that aged care and rehabilitation policies and practices reflect a pessimistic and negative view of old age - a form of ageism characterising older people as useless and dependant, allowing the younger generation to see older people as different from themselves, thus they subtly cease to identify with their elders as human beings. Ageism, like all prejudices, influences the self-view and behaviour of its victims. The elderly tend to adopt negative definitions of themselves and perpetuate the stereotypes directed against them, thereby reinforcing society's beliefs. Social expectations regarding old age and the elderly tend to be negative, and elders are particularly vulnerable to the expectations expressed by others in interactions. Research on conversation addressed to the elderly indicates that caregivers tend to modify their speech more in terms of stereotyped communication needs than in terms of the real, individual needs of specific older individuals. In turn, the tendency to over accommodate one's speech is exaggerated when individuals exhibit signs of disability or dependence. Although elders who are institutionalised or suffering from cognitive confusion are the most likely recipients of patronising or infantilising speech, healthy older adults in the community also complain of this type of behaviour. (Ryan, 1991)

Pratt & Norris (1994) provide that the evidence regarding the comprehension of language sounds across adulthood generally suggests that healthy older adults do as well as younger groups on such tasks under optimum conditions. However, one important issue in elderly populations concerns the role of sensory impairment, in particularly, both hearing and visual impairment increases sharply in later adulthood. There are also a number of physiological changes in the speech apparatus which accompany ageing, as well as changes in rate and clarity of speech, which may be the basis for this identification. Thus, the production of speech sounds in the elderly is somewhat distinctive, particularly for those in poor physiological condition. However, there is little evidence that this seriously impairs a listener's comprehension of older adult speakers. On the other hand, there is considerable evidence that younger listeners judge those speakers with 'older' voice characteristics to be less competent, probably due to stereotypic expectancies about ageing. (Pratt & Norris, 1994, Ryan, 1991)

Human Service Professionals and Older Persons Organizations play key roles in developing strategies that reflect and advocate positive ageing approaches being careful to avoid the dangers of advocacy that reinforce negative stereotypes, such as the old being 'sick and frail' and the young being 'normal' as if they were universal. Previous studies carry a negative effect of comparing older persons as normal versus disability. Fontaine & Solomon (1995) reflect that as people live longer and fuller lives, negative views of ageing and old age are being replaced by appraisals of the ageing process and that older people are emphasizing alternatives and choices. The concept of ageing well does not ignore the fact that many older people do experience disability, disease, poverty and isolation - a person may age well in spite of adverse circumstances. Understanding how people acquire needed services, maintain social support, and create a subjectively positive reality in the face of adversity can lead to public policies, programs, services, and a social environment in which more people can age well. (Fontaine & Solomon, 1995; Browning et al, 2000)

Ryff & Essex (1991) argues of an implicit negativism in many previous approaches to psychological well being in later life and that this research has been conducted with measures of 'illness' rather than measures of wellness. Current research equates more to 'well being' with the absence of 'illness' (subjective research as compared to objective research). In reinforcement, the Australian Psychological Society (APS) provides a positive paper (Browning et al, 2000) as a contribution to the International Year of the Older Person reflecting how to promote successful ageing in the older individual. The APS paper elaborates on the impact of, and policy responses to population ageing, independence and self-provision, healthy ageing and attitudes, lifestyle and community support. (Browning et al, 2000; Ryff & Essex, 1991)

Theoretical perspectives on positive psychological functioning of the elderly include Maslow's (1968, cited in Ryff & Essex, 1991) conception of self-actualisation being the final phase of development; he describes this phase as strong feelings of empathy and affection for all human beings and capable of greater love, deeper friendship, and more complete identification with others. Adult developmental theories such as Erikson's (1959, cited in Ryff & Essex, 1991) also emphasise the achievement of intimacy with others and the guidance and directions of others. The importance of positive relations with others is repeatedly stressed in these conceptions of psychological well being. Life span theories also give explicit emphasis to continued growth and the confronting of new challenges or tasks at different periods of life. Thus, continued growth and self-realisation is also a prominent theme in the aforementioned theories. The integration of these theories points to converging aspects of positive psychological functioning. (Ryff & Essex, 1991)

The current approach to ageing advocated by the Australian government and conveyed as a major theme of the International Year of the Older Person (IYOP) is that of 'successful ageing'. Successful ageing involves the maintenance of mental, physical and social health. It is closely linked with quality of life. Butler (1991, cited in Browning, 2000) defines it in terms of four forms of fitness: physical, intellectual, social, and purpose fitness. Physical fitness refers to bodily strength, resilience, and ability. Intellectual fitness refers to keeping the mind engaged and active. Social fitness involves forming and maintaining significant personal relationships. Purpose fitness refers to having positive feelings of self-esteem and control over one's own life. Battersby (1998, cited in Browning, 2000) also agrees with Butler's definition for conveying the importance of taking a positive view about ageing and growing old. Previous cohorts were largely willing to accept unequal relationships between 'expert' professionals and 'passive' clients or patients. But many older people now are less willing to be passive recipients of care, and strongly believe that service providers have a responsibility to listen to them. They believe they are entitled to opportunities for choice and control over their lives, and in theory this belief is supported by government policy emphasising consumer rights. (Browning et al, 2000)

The failure to listen to consumers has been shown to negatively impact on their well-being. For example, research conducted by Gething, Fethney, & Blazely (1998, cited in Browning, 2000) at a major Sydney rehabilitation hospital for older people revealed that older people and health professionals were unaware of the client's goals. Older people reported that they felt unconsulted about their needs, and that the treatment they received did not me7et these needs or prepare them for a successful return to community life. It is important to recognise the impact on well being and freedom of choice of government policies and professional practice whose methods appears to be in the interests of the older person, but which, if implemented without consideration for each individual's particular life situation, can inhibit empowerment and well being. (Browning et al, 2000)

There is more diversity within any age cohort than there is between cohorts. Australian legislation and policy acknowledges diversity by recognising minority groups whose well being is to be promoted through provision of services tailored to meet their needs. Examples of such groups are Aboriginal and Torres Strait Islanders, people with disabilities and people form non English-speaking backgrounds. Strategies that take into account such diversity are important, but should avoid the danger of assuming that all people within a given group are the same. Stoller & Gibson (1994, cited in Browning, 2000) argue that older people from minority groups often experience obstacles constructed earlier in life that can become handicaps to well being in later life. For example, the 'baby boomer' cohort is the first to contain substantial numbers of people with long standing disabilities. These people have had many life experiences that affect their attitudes towards service provision, their ability to negotiate service systems and their ability to exercise freedom of choice. This generation has experienced deinstitutionalisation, and has been active in the human rights movement. Previous experiences with service systems and service providers have made many wary, but have provided them with practice in questioning the authority of 'experts' and a willingness to challenge the system. (Browning et al, 2000)

I have included the following to sum up and describe my position in life at the tail end of the baby boomers cohort (i.e. aged 45yrs).

In her description of the 'older people of tomorrow', Silverstone (1996, cited in Browning, 2000) noted that the areas in which baby boomers appear to be particularly at risk in regard to ageing are: income, security, productivity, health and disability, and social supports. She concluded that they are likely to be more confident about being old and more aware of their health needs, but more uncertain economically. Silverstone (1996, cited in Browning, 2000) expects that such trends will necessitate changes to practice, in terms of consumer rights, professional skills, long-term care, clinical assessments, and skills in community organization. Older people are becoming increasingly likely to fight for their rights, and will be more assertive consumers with higher expectations than previous cohorts. Their anticipated resistance to existing policies, practices and behaviours will demand major changes in approaches to service provision if society is to preserve the rights and dignity of older people while meeting needs within limited resources. (Browning, 2000)

The use of psychological services may be affected by the readiness of older people to seek treatment. The current cohort of older people has a reputation for being more focussed on physical than psychological concerns than younger age groups. There is a stigma around mental health for this age group: some fear they will be labelled crazy for consulting a psychologist, yet many use their general practitioner as an informal counsellor. Older general practitioners themselves are a part of this cohort that may be less familiar and comfortable with psychological services. This paper suggests that there are noticeable levels of optimism in psychological research in the field of ageing. There are important gaps in policy and education of older people about ageing. However, the Australian Psychological Society position paper demonstrates the robustness of Australian research in gerontology. (Browning et al, 2000)