Dementia, Aging, Gerontology: Theories and Care

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Three of the Most Important Major Theories used to explain Dementia, Aging, or Gerontology

Aging is one of the most challenging phases of human development due to several reasons. The period comes with various physical, psychological (emotional), and social problems that if not handled well may adversely affect an individual. Among the most compelling complications that are witnessed during this critical stage of life include dementia, a problem that affects a large fraction of the aging population. In a bid to determine, explore, and explain aging or gerontology, researchers have developed various theories that take diverse viewpoints. As this section reveals, three of the most comprehensive and insightful theories that have attempted to account for dementia among other problems experienced during old age include the disengagement theory, activity theory, and continuity/dialogical theory.

The Disengagement Theory

The disengagement theory posits that aging is a process that extricates people from the social world. Proponents of the theory, Elaine Cumming and William Henry take the psychosocial perspective in explaining the unhealthy collective relationships the aging person’s experience in the latest phases of their lives (Comer, 2015). In this theory, it is believed that aging is an inevitable mutual withdrawal from the social system by a person.

It is imperative to note that the data that was used to formulate this theory was generated from a study in Kansas City (First, Frances, & Pincus, 2015). This longitudinal study traced the life changes observed among hundreds of people, as they moved from middle age to old age. The findings from the group of researchers were used to create nine assumptions about aging. One of the assumptions is that as people approach old age, they tend to lose social ties apparently due to their anticipation of death. They begin to live a life of isolation, which implies that they disengage with intimate or non-intimate relations (Silverstein, Bengtson, Putnam, Putney, & Gans, 2008). As this happens, they begin to lose touch with social norms, a situation that deteriorates their life in isolation.

As the theory reveals, throughout the process, gender roles assume the center stage of the isolation and disintegration with social norms. The process is spurred by the aging people’s unwillingness to maintain their social reputation amid these changes. Simultaneously, the theory believes that younger adults are socially prepared to take on the roles of those who hit the detachment stage. From a sociological point of view, total disentanglement takes place when the person going through the change and the community are prepared to face it. However, the disengaged person must be able to adopt the new social roles for the process to be successful. Failure by either the society or the people changing to alter their lifestyle by assuming new roles may lead to several physical, psychological, and social problems, including dementia. The disjunction may also bring other problems such as identity crisis among others.

Activity Theory

Given that disengagement theory was the first sociological perspective to explain aging, other theorists came up to respond to the argument is expressed. One of the significant theories to have responded to the disengagement perspective is the activity theory. While contrasting disengagement theory, this viewpoint posits that aging people tend to form healthy relationships, which keep them vigorous and functional. The theory postulates that strong and healthy relationships among elderly persons are beneficial in the establishment of stability in society. For one to be satisfied with his or her late life, he or she needs to create a working and healthy social system.

Besides, the theory takes a rather psychological perspective in addressing some of the issues that face the elderly people. For instance, it recognizes that old age comes with numerous socio-emotional and physical challenges that one can only address if he or she takes a positive view (Arkowitz, 2008). To the proponents of this theory, people in their old age must be encouraged to stay active, repeat their life-long habits such as dancing, and/or create positive relationships with the society and people around them. Happiness is considered the ultimate goal of every person living in his or her latest age. The society is more stable, secure, and satisfying when the elderly persons are given a chance to enjoy their lives just like other members of society.

It is worth noting that various perspectives of productive and successful aging that were generated from this theory have been criticized for various reasons (Arkowitz, 2008). However, while the theory is deemed successful in challenging the disengagement perspective, it also faces criticisms. One of the shortfalls that skeptics cite in their attempt to disregard the theory is that it overlooks certain problems that emerge during the old age stage of life. For example, some old people encounter various traumatic events that significantly challenge their ability to stay active in the social arena. The activity theory ignores the stated fact, a case that also fuels criticisms. Moreover, skeptics of the theory also cite that it ignores the health and economic disparities that may curtail or diminish the desire and opportunities for some elderly persons. To this perspective, professionals such as recreational therapists must endeavor to encourage the senior generations to get out of their comfort zones and engage in meaningful activities to achieve healthy lives.

Continuity/Dialogical Theory

Central to the arguments presented by the continuity theory is that aging involves maintaining or preserving the same activities a person enjoyed in his or her early years (Comer, 2015). In other words, healthy aging is witnessed when people display the same behaviors they exhibited during their youthful age. Additionally, people need to respond to old age challenges just as they did during their early lives. The continuity is created by establishing new experiences that interconnect with the past. Based on the theory, aging is all about reliving the life one had in the past. For instance, aged persons may decide to listen to the same music they used to listen to while they were young. They may also visit the same social places such as museums just as they did in their past life.

It is important to note that this theory uses life course perspectives to create a substantial argument about aging (Silverstein et al., 2008). Just as the other two theories mentioned above, the continuity theory is derived from the psychosocial school of thought in which issues that relate to social relationships and their influence on people’s behavior are taken into account. For instance, goal setting and adaptation form one of the issues that this theory focuses on in its explanation of old age. It is postulated that the majority of aged people recreate their experiences and feelings as a way of adapting to their new roles and responsibilities. In line with Silverstein et al.’s (2008) sentiments, the interconnection between the internal and external structures helps in harnessing these elements. The internal foundations help them in making plans that in turn assist aged people in attaining social and psychological satisfaction (Comer, 2015).

Why the Three Theories Are the Most Compelling

As evidenced by the arguments presented in this paper, the three theories strikingly stand out as the most appropriate among the long list of aging theories because they all capture the psychosocial aspects of people’s well-being as they struggle to live in the challenging environment. According to Silverstein et al. (2008), the behaviors of the old are heavily influenced not only by biological or internal states but also by the social environment. Although the theories differ in several aspects, the central theme that they all discuss regards the social and psychological interplay that creates individuals’ behavior during old age. The decisions, perceptions, and reactions of the seniors are highly influenced by most issues discussed in the three selected theories. It is important to conclude that people working with elderly persons must take into consideration most of the elements highlighted above.

Additionally, the three models were developed by scholars who were open-minded in their approach to both social and psychological issues that are associated with development. Although it was inflexible in its reason, the disengagement theory formed the antecedent that benchmarked every single offspring’s psychosocial perspectives. It also initiated the debate about the challenges that affect old people, including ways in which they can best be addressed (Silverstein et al., 2008). Similarly, continuity and activity theories address social and psychological issues that directly affect human reaction and behavior.

How Various Areas of Social Work, Sociology, Long Term Care, and/or Communication Disorders Help in Understanding Aging, Dementia, and/or Gerontology

Sociology and Dementia

Sociology refers to the study of human behaviors and their social relations at the individual and the societal level. To understand dementia, one needs to approach it from a sociological point of view. The view is informed by the fact that the environment in which dementia patients reside largely influences their wellbeing. If the patients are well connected to the society in which they reside, the severity of the dementia symptoms may be reduced. Additionally, the available research indicates that the disease is less severe if the victims are actively involved in communal activities (Silverstein et al., 2008).

The understanding of dementia from a sociological perspective requires a good understanding of the symptoms. One of the symptoms of dementia is poor self-esteem and a feeling of worthlessness. This feeling results in poor involvement in communal activities. The problem of low self-esteem often escalates if the concerned person faces stigmatization from society. In severe cases of dementia, the victim may avoid intimate and non-intimate relations, a situation that may lead to a feeling of alienation. According to Saxena (2006), alienation is one of the factors that lead to the escalation of dementia. The connection between alienation and the worsening of dementia is supported by the functionalist theory. The mentioned theory states that any kind of isolation leads to a chain of reactions, which manifest in the form of various dysfunctions. In contemporary society, old people seem to be alienated from society since the young often perceive them as less important. Additionally, seniors often suffer discrimination because of the negative stereotypes about them. This situation leads to poor participation in communal activities, thus further worsening the dementia symptoms.

The association between sociology and dementia may also be used to explain the reason for the increased cases of the disease in developed countries. Based on the recent World Health Organization’s statistics, developed countries have the highest number of patients suffering from dementia (First et al., 2015). The high number of dementia patients in such countries is largely associated with familial and social alienation. In most developed countries, traditional family structures have been eroded due to various reasons. Saxena (2006) claims that one of the reasons why traditional family structures have been eroded is the increased embracement of family planning, which results in fewer children. This situation, which leads to a reduction of the number of family members, exposes the aging parents to the risk of poor care during old age. Based on the arrangements of traditional families, children are expected to take care of their old parents. Therefore, without children, old parents are exposed to the danger of lack of care. Given that dementia is more common in old age, the lack of care from children during such times may lead to the escalation of the disease. The rate of divorce in developed countries has also increased tremendously. The case has attracted the risk of loneliness among old people. Loneliness is closely related to the escalation of the dementia symptoms. Hence, familiar dissociation may contribute to the worsening of the problem.

Long Term Care and Dementia

Another approach to understanding aging, dementia, and/or gerontology involves examining the patient’s need for long-term care. Since dementia mostly manifests among the seniors, it is appropriate for them to receive the necessary care to reduce the effects of the symptoms on their health. Two types of long-term care, namely, assisted living facility and skilled nursing facility (nursing home) are available for seniors who suffer from dementia (Macdonald & Cooper, 2007).

The assisted living facility refers to intervention for people suffering from dementia. This form of care is suitable for seniors whose illness is at the initial stages. Such seniors can perform Instrumental Activities of Daily Living (IADLs) independently or with minimal help from a caregiver (Macdonald & Cooper, 2007). Therefore, despite being somehow independent, a senior placed in this intervention requires little assistance. On the other hand, the skilled nursing facility enrolls seniors whose illnesses have already deprived them of their ability to perform IADLs. Such facilities ensure that the concerned patient is under continuous monitoring from skilled caregivers.

The two types of care described above are critical to the understanding of dementia. One of the lessons that one can gain from the interaction with the long-term care options is that dementia in old age deprives victims of the power to take care of themselves (Silverstein et al., 2008). For the care-giving systems described above, victims are assisted in performing basic daily activities. Although other seniors without dementia also require assistance, those with the illness require more care.

The other lesson that can be learned from this analysis is that dementia intensifies with time. At the earlier stage, the affected seniors are not fully deprived of their ability to take care of themselves. However, they must be assisted by a person to make certain decisions, especially those revolving around savings. However, as the disease advances to the next stage, the affected senior is deprived of the ability to perform even the smallest tasks. Patients in this stage must rely on a caregiver for support in every task they intend to accomplish. The establishment of such care facilities also confirms the view that young people have neglected the old. If the traditional family structures still existed, probably there would be no need for such facilities. Lastly, the long-term care concept helps one to understand the relationship between dementia and old age. The two types of care target the old people, as opposed to the young. Hence, dementia mostly affects old people. Dementia among the old is attributed to various factors among them a stroke or other types of illnesses that affect the brain (Macdonald & Cooper, 2007). Given that the old are less active compared to the young people, the impact of the illness on them is severe.

Communication Disorders

The other factor that may help people to increase their knowledge regarding dementia is communication disorders, which are associated with the illness. The most common language disorders associated with dementia include the inability to construct sentences (Lin et al., 2011). Poor sentence construction skills lead to miscommunication, which reduces their ability to communicate their problems. Other than poor sentence structure, seniors who suffer from dementia tend to have reduced grammar skills.

Communication disorders presented by dementia help one to understand the reason why many old people usually exhibit low levels of self-esteem. The stated observation is based on the view that people with poor verbal communication skills tend to face stigmatization from eloquent individuals. In this regard, they tend to exhibit a sense of worthlessness, which causes them to experience poor self-esteem levels. The problem is compounded by the fact that seniors who suffer from dementia cannot understand euphemisms, sarcasm, double meanings, puns, or another wordplay (Silverstein et al., 2008). If a person uses such language, seniors may misinterpret the message to think they are being negatively targeted. This situation increases their hatred for the youths and hence their (seniors) lower self-esteem.

In addition to low self-esteem, the analysis of the communication disorders sheds light on the reasons why most old people in the society are reluctant to participate in communal activities. Such relations might require the concerned seniors to communicate their views verbally, a scenario that may be challenging. Their inability to communicate denies them the opportunity to contribute their views during such activities for fear of being laughed off (Lin et al., 2011). Old people who suffer from dementia are unable to speak out their problems with ease (Lin et al., 2011). Without communicating their problems, it is hard for them to secure the necessary support from prospective caregivers. Therefore, the inability to speak may be the reason why youths and relatives fail to offer the necessary care. This claim discredits the assertions that youthful individuals have deliberately neglected the old.

Conclusion

Not many theories of aging have been comprehensive and insightful in their analysis and postulations about dementia, aging, or gerontology compared to the three that have been highlighted in this paper. Concisely, the three theories are undeniably a revelation in the issue of aging. In as much as the young are said to have neglected their parents, the analysis of the speech disorder gives another dimension to the assertions. As stated previously in this paper, the old tend to face stigmatization from the young people due to their incapacitation. The inability to speak may cause young people to stigmatize them and hence the need to understand the best approach that can be adopted to take care of the aged class of people.

References

Arkowitz, H. (2008). Motivational interviewing in the treatment of psychological problems. New York, NY: Guilford Press.

Comer, R. (2015). Abnormal psychology student workbook. New York, NY: Worth Publishers.

First, M., Frances, A., & Pincus, H. (2015). DSM-V-TR handbook of differential diagnosis. New York, NY: American Psychiatric Publishers.

Lin, F., Metter, E., O’Brien, R., Resnick, S., Zonderman, A., & Ferrucci, L. (2011). Hearing loss and incident dementia. Archives of Neurology, 68(2), 214-220.

Macdonald, A., & Cooper, B. (2007). Long-term care and dementia services: An impending crisis. Age and Ageing, 36(1), 16-22.

Saxena, D. (2006). Sociology of aging. Delhi, India: Concept Publishing Company.

Silverstein, M., Bengtson, V., Putnam, M., Putney, N., & Gans, D. (2008). Handbook of theories of aging. New York, NY: Springer Publishing Company.

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