PSY 250 Unit 6 -- Elderhood, Gerontology, and Thanatology
revised as of 10/16/06
See here for some personal reflections on death and dying.
Longevity and life expectancy
Some 3000 or so years ago, Moses wrote these famous words: "The days of our years are seventy years, or by reason of strength, eighty years" (Psalm 90:10). Apart from a drastic reduction in infant mortality, human life expectancy, even in the most economically developed and technologically advanced countries, has not increased appreciably beyond that, as the graph below (year 2001 statistics) indicate:
To read the graph, find your current age on the horizontal (X) axis. Extend a vertical line from that point up to the red line on the graph. Then extend a horizontal line from that point over to the vertical (Y) axis and read your "marginal life expectancy" from the graph. This indicates (if you are "average") how many more years you can expect to live. Add to that figure your current age, and you have a rough estimate of how old you are likely to be, all things being equal, on the day of your death. For instance, I am (almost) 49 and might reasonably expect (with no guarantees, of course!) to live about 30 more years.
The green line represents a linear (straight-line) regression function between age and marginal life expectancy for ages 0-60. Note that the red and green lines are nearly exactly overlapping for that age range. But after that, the red line deviates sharply from the regression line. For every year you live past 60, your marginal life expectancy increases relative to these linear expectations -- can you figure out why? (Hint: those who live past 60 are not a genetically random sample of their birth cohort.) However, if one extends the curve, one can see that it will cross the horizontal axis (reach zero) somewhere around age 120. This appears to be the theoretical limit of the human life expectancy even under ideal conditions. A vanishingly small number of humans have reached this age or near it. Currently, about 1.5% of the total U.S. population consists of individuals who are at or over the age of 85. Some scientists believe that a very restricted calorie (1000 calories/day or less) diet, if started in midlife or before, can extend the human lifespan by 10% to 20%. The assumption behind this is that lowering the metabolic rate prevents the generation of excessive "free radicals" (electrons that do damage to cellular integrity). Some animal research confirms this idea; a longitudinal study to test the hypothesis with humans is currently under way but, of course, will take decades to complete.
Here is a rough way to estimate how long you will live relative to these averages. Start with your current life expectancy as presented above. Then add or subtract years as follows. (Based primarily on Bee, 2004; see http://www.livingto100.com/ for another age calculator using the same general statistical paradigm.)
Factors that add to your life expectancy
Add 1/2 a year for each grandparent of yours who lived past 70.
Add another 1/2 a year for each grandparent who lived past 80.
Add 2 years if your father lived past 80 [obviously, younger students will have to wait awhile to see if this applies to you], and 4 years if your mother lived past 80.
Add 2 years if your IQ is over 120.
Add 1 year if you are a firstborn.
Add 2 years if you have an annual health exam.
Add 1 year if you eat fewer than 1500 calories a day and watch your fat and sugar intake.
Add 3 years if you exercise aerobically 3 times a week or more.
Add 2 years if you have sex at least once a week. [Don't forget that there are some ethical considerations involved here if you are not in a committed relationship.]
Add 1 year if you are a high school graduate, another year if you completed [or, when you complete] an associate degree, and another year if you completed [or, when you complete] a bachelor's degree.
Add 1 year if your job is a professional, technical, or managerial one.
Add 1 year if your income is above average for your kind of work.
Add 1 year if your work is physically active.
Add 1 year if you live in a rural area.
Add 1 year if you are currently married and living with your spouse.
Add 2 years if you are a religious person who is actively living your faith.
Add 1 year if you have a good sense of humor and laugh often.
Add 1 year if you have one or more companion animals (cats or dogs) in your life.
Factors that subtract from your life expectancy
Subtract 4 years for each grandparent, parent, or sibling who died of heart disease before age 50.
Subtract 2 years for each grandparent, parent, or sibling who died of heart disease between the ages of 50 and 60.
Subtract 3 years for each grandparent, parent, or sibling who died of diabetes or ulcers before age 60.
If you are a woman, subtract 1 year if your mother died of breast cancer before age 60, and another 1 year for each sister who died of breast cancer before age 60.
Subtract 1 year if your mother was younger than 18 or older than 35 when you were born.
Use the following tables to subtract points if you are overweight.
If you are a woman:
| Your weight is 10% to 30% over the ideal | Your weight is more than 30% over the ideal | |
| You are under 30 | Subtract 5 years | Subtract 7 years |
| You are between 30 and 50 | Subtract 4 years | Subtract 5 years |
| You are 50 or older | Subtract 2 years | Subtract 4 years |
If you are a man:
| Your weight is 10% to 30% over the ideal | Your weight is more than 30% over the ideal | |
| You are under 30 | Subtract 10 years | Subtract 13 years |
| You are between 30 and 45 | Subtract 4 years | Subtract 6 years |
| You are 45 or older | Subtract 2 years | Subtract 4 years |
Subtract 2 years if you smoke, another 5 years if you smoke 1 pack a day or more, and another 5 years if you smoke 2 packs a day or more.
Subtract 3 years if you drink alcohol (more than one glass of wine or equivalent per day) and another 5 years if you drink heavily.
Subtract 5 years if you have a chronic health condition.
Subtract 4 years if you work at an unskilled occupation.
Subtract 1 year if your income is below average for your kind of work.
Subtract 1 year if you have lived in urban areas for most of your life.
If you are widowed, separated, or divorced, separate 4 years if you are a woman, 7 years if you are a man.
If you have never married, subtract 1 year for each decade past 25. If, in addition, you are male and you live alone, subtract an additional 1 year for each decade past 25.
Subtract 2 years if you are a chronically angry person who frequently vents your anger.
Subtract 2 years if you sleep more than 10 or less than 6 hours on an average night (over the long term).
Unfortunately, this algorithm can lead to some ridiculously high estimates of life expectancy. By these criteria, I can expect to live to be 99. Given my current retirement savings plan, I hope this doesn't turn out to be true! But the variables above do at least suggest some empirically verified ways you can modify your chances of living a long life.
Socioemotional development in elderhood
Erikson -- the integrity stage (65+ yr.)
Developmental crisis: Looking back over my entire life, am I pleased with how I have lived it?
Extreme resolutions: (1) Premature withdrawal from life, or "giving up on life too early"; (2) Holding on too tightly to life, or failing to accept the realities of aging and mortality.
Balanced resolution: Continuing to engage life until you die, but in a realistic way that "lets go of the reins" and is willing to pass power and control on to the next generation, shifting increasingly from an activity-based to a reflection-based way of life, or from the cultural center (at least in terms of economic productivity and social status) to its periphery. (Note that modern American culture, which is perhaps the most obsessively youth-worshipping culture that has ever existed in human history, does not make this easy, as compared to prototypical cultures that view the elderly as a valued repository of wisdom and cultural values and traditions.)
Dependence on previous stage: One's ability to look back with contentment on one's entire life obviously depends on how one has lived in all the previous stages, but most notably on the extent to which one has achieved ego transcendence and a "psychological legacy" in the generativity stage.
Note: many analysts believe that there should be a ninth stage in this model (to differentiate between the "young old" and the "old old"). To date, there is not.
Butler -- the "life review"
In the words of Turner and Helms, "Many older people reminisce about the past as death draws nearer [a phenomenon that probably begins for many in midlife]... a process known as the life review and described as a looking-back... to relive past experiences and deal with persisting conflicts". However, evidence for the universality of this process among elder adults is decidedly mixed. While a general tendency toward self-reflection (correlated with the longitudinal shift towards E- as noted in the previous unit) does appear to exist, Bee notes that while "there are several studies that show that a process of structured reminiscence may increase life satisfaction or self-esteem among older adults... at this point we do not know if reminiscence is actually more common among the elderly than among the middle-aged" nor whether reminiscence in elderhood necessarily has the "integrative and evaluative" component required by Butler's model.
Predictors of adjustment to elderhood
A complex but interesting longitudinal question has to do with the statistical ability to predict, in midlife, the likelihood of "positive" versus "negative" adjustments to elderhood. Folk wisdom recognizes that midlife is a time when seeds of one's elderhood are being sown, a crop that will be harvested for good or ill in 20-30 years, or as octogenarian author Avis Carlson (who wrote a best-seller about elderhood, In the Fullness of Time, when she was 81) puts it, "Old age is when the chickens come home to roost." (Now there's a rural metaphor for you!)
Existing models in the literature are complex and require a statistical analysis of path analysis (which I do understand, but don't intend to try to explain here, since it would require a one-year detour into the world of multivariate statistics including matrix algebra). Here are some of the predictive factors:
Internal (Dispositional or Attitudinal) Factors
External (Situational or Sociocultural) Factors
Ageism
Compared to the vast sweep of world cultural history, ours may be the most obsessively youth-oriented culture of all time. Negative stereotypes about the elderly, most of which have minimal basis in fact, abound in our culture. Watch a night's worth of television commercials and count how many people over 55 you see pictured there (not counting ads for motorized power chairs, denture creams, medic alert services and such like). Compare this to the actual percentage of the current U.S. population that is 55 or older (about 21%, and likely to increase dramatically as the latter half of the Boomer generation, now aged 45-50, and including almost-49-year-old me, enters late midlife).
Consider the following impressive accomplishments of some famous elders as a counterpoint to the usual cultural stereotypes:
Are these exceptions? Perhaps (some studies indicate that the peak of a person's intellectual and vocational contributions comes, on average, around age 49; however, this is partly a function of the sociology of organizations and cultural expectations about career trajectories). Yet there is every reason to question many of the harshly negative social stereotypes about elderhood that are rife in our society. If Strauss and Howe's model is correct, these stereotypes should soon be fading as elderhood again becomes "trendy" (as they say happens once a saeculum, when an Idealist generation matures into elder "Grey Champions" during the saecular Crisis).
Theories of retirement (I): Atchley
Atchley proposes a seven-stage longitudinal theory of retirement as follows:
Theories of retirement (II): Hornstein and Wapner
On the assumption that moving to retirement can involve either a continuous or a discontinuous path -- a seamless transition to a life similar to the one had before, or a radical "quantum leap" transformation to something very different -- and also that the result can be experienced as primarily positive or primarily negative -- these theorists posit four quadrants (continuous-positive, continuous-negative, discontinuous-positive, discontinuous-negative) that represent four retirement styles or types:
Thanatology (the study of death and dying)
Death is universal, and learning how to cope with the end of life is a person's final developmental task. The tendency in Western cultures to isolate most people, during most of their lives, from intimate contact with the dying (which was certainly not the case as recently as a century ago), and to view death as abnormal rather than a natural part of the life course, probably makes the task more difficult for many. (It wasn't that long ago that family members, not professional morticians, prepared dead bodies for internment; or that most people died at home, not in a hospital.)
Death, and the knowledge of one's own inevitable death, has many meanings. It gives urgency to how we spend our life (because the clock is ticking); it forces us to ask about the ultimate meaning of our existence. In the words of Steindl-Rast, "Death... is an event that puts the whole meaning of life into question. We may be occupied with purposeful activities, and then along comes the phenomenon of death... [which] confronts us with the fact that [contingent or temporal] purpose is not enough. We live by meaning." Note the connection to Frankl's ideas (previous unit).
Interestingly, studies of the fear of death indicate a curvilinear relationship between fear and age within adulthood: midlifers, as a group, show more fear of death than those younger or older than themselves. This is probably because, in the words of one author, "one of the central tasks of midlife is to come to terms with the inevitability of death. The greater awareness of body changes and aging that is part of this period, coupled perhaps with the death of one's own parents [who are a sort of illusory or imaginary shield between the self and death], combine to break down defenses... In these years, many adults grope toward new ways of thinking about death, eventually accepting it in a different way, so that the fear recedes in old age." There also appears to be a rather paradoxical curvilinear relationship between religiosity and the fear of death, with both highly religious and highly irreligious individuals showing less fear than those of moderate religiosity (although the highly religious group showed the least fear overall). In terms of the Big Five, not surprisingly, N+ individuals show more fear of death as a group since this personality trait is correlated with general anxiety and worrisomeness.
The classic Kubler-Ross model that suggested five linear stages in coming to terms with death (denial, anger, bargaining, depression, acceptance) still plays a significant role in many counseling circles, but empirical evidence for the linearity of this sequence is very mixed. It is probably better to describe these stages as like "layers of an onion" that recur in a rather unpredictable way, even though there is general movement from the outer surface (denial) to the inner core (acceptance). Some studies of "saying goodbye" suggest a stagelike process of "getting one's house in order" with respect to close relationships as death nears, but again evidence is equivocal.
The near-death experience (NDE)
With recent advances in the ability to respond to conditions like cardiac arrest in such a way that restores people to life after the heart has stopped beating for a minute or two, and even in some cases after measurable brain activity has seemingly ceased for a comparable period of time, there has been an explosive increase in the percentage of those brought back from the brink of the grave who report a cluster of experiences that collectively might be called the near-death experience (NDE). In the most systematic studies of this phenomenon, from 10% to 20% "temporarily dead" individuals (by standard measures of death including both cardiac death and brain death) report NDE's. There are a number of reasons why it is at least conceivable that NDE's are universal but that many people fail to report them, including the possibility that, as with dreams, memories of NDE's are fragile and only loosely linked to the normal autobiographical or episodic memory system (hence many people may be subsequently amnesiac about NDE experiences, just as many people are amnesiac about the vivid dreams they experience nightly). It is also possible that some individuals may consciously or unconsciously choose not to report such experiences, and/or to repress or to explain away their memories of them especially if negative or traumatic -- which some NDE's are, although the majority of reported NDE's are emotionally positive in tone.
Of course, science as such cannot tell us the nature of NDE's or what causes them. Those who are predisposed to view them as some kind of evolutionary adaptation, or as an artifact of how the physical brain reacts under conditions of stress or anoxia, can find ways to support their views (along with some anomalies that are difficult for this theory to explain). Those (including myself) who are predisposed to view them as being, at least in some if not in all instances, authentic glimpses of another mode of existence can find ways to support their views as well (along with a different set of anomalies that do not fit neatly into this view). The dispute is more philosophical than scientific, having to do with (among other things) the presumed nature of consciousness itself, and is not resolvable by scientific experiment as such.
It is interesting, however, that NDE's show the same features across a wide variety of cultures (from very secular to very religious cultures) and thus do not appear to be a product of acculturation or socialization as such; that people who do not believe in a life after death have reported NDE's (and some, surprisingly, remain unconvinced that there is a future life even in the wake of such experiences, which adds credibility to the reports themselves since they run counter to these subjects' philosophic expectations); that NDE's can be experienced during times when all measurable brain activity has ceased (which calls into question standard views of psychophysical parallelism); and that most who experience NDE's (especially emotionally positive ones) undergo a measurable personality transformation towards increased altruism, increased tolerance, increased serenity, and decreased self-aggrandizement (that is, becoming more O+, A+, and N-... a cluster of traits that are morally laudable but perhaps a mixed blessing in a competitive culture such as ours).
Within American culture, surveys reliably indicate that from 70% to 80% of respondents affirm a belief in some kind of individual existence after death, with fewer than 4% believing firmly that death is the end of conscious existence in any form (the remainder are uncertain or inconsistent in their responses, or define a form of post-death existence that is not fully individual or not fully conscious). Cross-cultural survey data is scanty, although as a general point of comparison, the most reliable data suggests that about 85% of the world's population adheres (at least formally and outwardly) to a religion whose official tenets include some form of post-death experience (with an unknown percentage having internalized and assimilated those views personally as opposed to giving superficial outward consent to them). True reductionistic materialism, while it has certainly been philosophically influential in academic circles over the past 150 years, appears to be a very rare point of view among the general world population (and does not appear to be increasing in prevalence over the past eight decades, either in the general population or within the formal scientific community). Europe is about four times as "secularized" as is the United States by this rough criterion (at a minimum, about 18% of Europeans are reductionistic materialists, compared to about 4% of Americans).
Study Guide
1. Discuss influences on longevity and life expectancy.
2. Discuss Erikson's and Butler's views of elderhood.
3. Discuss determinants of positive psychological adjustment to elderhood.
4. Discuss ageism.
5. Summarize lecture material related to thanatology, including material on NDE's.