Tuesday, July 13, 2010

Discuss depression, dementia, and Alzheimer Disease and their impact on the cognitive functioning in late adulthood.

Question: Discuss depression, dementia, and Alzheimer Disease and their impact on the cognitive functioning in late adulthood.

Answer:
Depression
• The “common cold” of mental disorders.
• The individual is deeply unhappy, demoralized, self-derogatory, does not feel well, loses stamina easily, has a poor appetite and unmotivated.
• Causes: biological, psychological, social, experiential.
• 80 % of older adults receive no treatment at all.
• Treatment: Combinations of medications and psychotherapy.
• Improvements in 4 out of 5 elderly adults.
• Suicidal tendencies: 25 %.
• Lonely males are most likely to commit suicide.

Dementia

• A global term for any neurological disorder.
• A deterioration of mental functioning.
• 20 % of individuals over the age of 80 have dementia.

Alzheimer’s Disease

• The most common form of dementia.
• A progressive, irreversible disorder.
• Deterioration of memory, reasoning, language, and physical functioning.
• Prevalence: 4 million people over the age of 65.
• Will triple in the next 50 years due to increase in old age.
• Early-onset (younger than 65 years).
• Late-onset (after 65 years of age).
• Early onset is rare (10 percent of all cases).

Causes of Alzheimer's Disease

• A deficiency in the brain messenger chemical acetylcholine.
• Increasing number of tangles or tied bundles of protein.
• Plaques (deposits that accumulate in the brain’s blood vessels).
• An abnormal gene.

Stages of Alzheimer’s Disease

• Early stage: memory loss, decline in intellectual functioning.
• Later stage: hospitalization in a vegetative stage.
• Live 8 years after symptoms first appear.
• Care of patients and the burden on caregivers.
• Depression in 50 % of family caregivers.
• Respite care can relieve the caregiver.

Treatment

• Early Detection and treatment can delay the cognitive decline.
• Aricept: the main drug for the treatment.
• Spaced retrieval technique
• Computerized speech rehabilitation programs
• Diet: more fruits, vegetables, less red meat.
• Cholesterol lowering drugs

Multi-Infarct Dementia

• Progressive loss of intellectual functioning.
• Caused by repeated temporary obstruction of blood flow in cerebral arteries.
• A series of mini strokes.
• Symptoms: confusion, slurring of speech, other impairments.
• Treatment: exercise, diet, drugs.
• More common among men with high blood pressure.
• Individuals can recover from multi-infarct dementia.

Answer 2:
As answer 1 explained, people with depression are deeply unhappy, demoralized, bored, loses stamina easily and unmotivated. These all contribute to the inactivity in cognitive functioning as depressed people refuse not only to engage in physical activity, but are also in a state of emptiness cognitively, thus suppressing cognitive functioning. In late adulthood, research shows that men are more likely to experience depression than women because they usually experience more dramatic role shift as they retire. This a very interesting piece of fact for me because my dad, who is always very tough is depressed for the first time in his life as he turned 60, whereas my mom is not depressed, but is only dealing with PTSD. Knowing this helps not only me but my dad in understanding his mood swing, which actually help with his mood as well.


Further thoughts:
As a psychologist, what would you propose to resolve the social issue?
Please elaborate on the dramatic role shifts in males and how you would counsel your male late adulthood client if he came to you for therapy?

Answer 3:
Many people can't afford therapy. It is very expensive and many people don't have the financial support to be able to pay for it.

Some may have an aversion to therapy. The ol, 'I made it this far without it, why do I need it now.' Perhaps misunderstandings of its benefits. Often this is the age of those who grew up with the concept of the "loonie bin." (a home for people with serious emotional needs)

Some psychologists aren't very 'user friendly' to senior clients. Perhaps the client has tried therapy and wasn't warmly received.

How to solve? Perhaps there could be therapists who were known and welcomed to see aged clients. Perhaps a special focus.

Answer 4: Medical expenses to psychologists are pretty expensive. Maybe government subsidy could help? Personally, I also feel that when people see psychologists, they see themselves as having "problems" which is also an issue...many people, especially chinese people, I guess...would rather solve their own issues without outsider assistance...What do you think, fellow Hong Kong students?

Answer 5:

Yes I think seeking therapists help is becoming a new field in HK, and starting to gain acceptance, however for the aging population, I would think this would be even more of a stretch. A very large barrier. I know young working professionals who have sought help from the gov't services and so it seems they don't always see the same doctor and the waiting list is so long. It seems that there isn't enough therapists to go around. However, is affordable. Some more doctors in the government system could be very helpful, but there would need to be some advertising or promotions on 'getting help is ok.'

Answer 6:
Researchers (Hultsch et al, 1999) find that older adults, who engage in cognitive activities, especially challenging ones, have higher cognitive functioning than those who don’t use their cognitive skills. In late adulthood, individuals are easily depressed due to cumulative loss (death of a spouse and friends), declining health and loss of control. They will feel listless and unmotivated. Their cognitive functioning deteriorates as they prefer to stay away from any kind of activities.


Dementia is a set of disorders that occur mostly in old age. It usually accounts for cognitive defects in late adulthood. Individuals with dementia suffer serious memory loss and mental functioning deterioration, impairing daily activities and behaviors.


The leading cause of dementia in the United States is Alzheimer's disease. It happens when neurons in the sub-cortical regions deteriorate, leaving symptoms of tremors, shuffling gait, loss of facial expression, rigidity of limbs, poor balance and stooped posture. Recent memory deteriorates first, then older memories. Patients are eventually incapable of communicating or recognizing family and friends.

I also came across an interesting reading on the new development of detection of Alzheimer's from New York Times. Enjoy!

Gina Kolata (June 23, 2010). The vanishing Mind: Promise Seen for Detection of Alzheimer's. New York Times.

http://www.nytimes.com/2010/06/24/health/research/24scans.html?src=me&ref=homepage

Answer 7: I will first pay close attention to listen to their concerns of adapting to the new life style, and their understanding of their mood swings. Then I will share with them some research statistics to show how common it is for anyone to experience difficulties when facing role shift in lives. It would be also helpful to let them know why his wife does not experience as dramatic the mood swing as he does. Not only is every individual different, even though they are a couple, their life role shifts have different time line.

My friend, male, 30s, experiences some frustration as to why he doesn't feel the need to take it easy in career and start a family as his female friends in the same age have done. I explain to him that female has a different time line due to the mere fact that we will have an interruption in our career when we are having children. This life-event interruption prompts us to think more about our role and make adjustment psychologically. Yet our husbands, even though they also experience significant role shift to become a father, but the fact that there is not interruption in their career, and that the child-rearing responsibility is not as burdensome for male than female even in today's society makes them less likely to experience the role shift as dramatically as in female.

Thus male's role shift becomes more dramatic as they retire, usually in their older age, thus experience more stress than the well-trained female in shifting role since the first time they become mother.


Answer 8: To add to those excellent examples above, some do not believe in the therapeutic process. Hollywood often portrays therapy in a negative light or therapist as incompetent, and many people who are only exposed to the process through the TV or movies believe that is what therapy is like. Additionally, many cultures feel it is inappropriate to discuss family matters outside of the family unit and therefore do not allow family members to seek therapeutic services.

I have done advocacy work at the California state capital on behalf of the field of psychology. I believe it is our duty to fight for the rights to mental health services for our patients. If we don't, who will? It was an exciting experience and I encourage all of you to get involved to make a difference and positive social changes.

Has anyone known anyone or watched someone who has suffered from Dementia or Alzheimer's? It can be really sad and painful to watch those who love fade away.

It is often believed that only those who can contribute are the ones we place value and worth too. However the needs of those struggling with mental health issues are also important. Mental health does carry a stigma and it is such a great need.

Answer 9:
I have a paternal aunt with severe Alzheimer's and my great aunts twin sister has an even more severe case of Alzheimer's. Yes, it is very difficult. I just went to visit her a few days ago and it was obvious my aunt's cognitive function is rapidly declining. Most often it is the family who suffers more emotionally as the patient is unaware of his/her surroundings or situation.

Three most important influences on cognitive functioning in late adulthood

Question:
Why is education, work, and health the three most important influences on cognitive functioning in late adulthood?

Answer:

In late adulthood, people tend to do some kind of "Life review" which involves looking back on one’s life experiences and evaluating them. Interestingly, older adults report experiencing more positive emotion and less negative emotion... Hence, I guess they often review on their level of education, their working experience and having good health keeps their life sustained...I think health is the most important aspect, not just for them, but for all ages.

Answer 2:
Education has important influence on cognitive function in late adulthood because research evidence shows that higher cognitive ability in 79-year-olds was linked to more years of education (Gow & others, 2008). There are many reasons as to why older adults seek further education, most of which involves helping them to cope with or adapting to the ever-changing society, which means through education they learn how tow effective use their limited resources on selective tasks.

Work is another important influence as research suggests that exposure to complex environments increases intellectual functioning (Kempermann, Kuhn, & Gage, 1997). The increasingly complex and technology oriented demand in jobs today help with cognitive functioning in older adults, as the old saying goes, practice makes perfect. As people delay their retirement, in order to compete in the job market, continuous training in different disciplines on the job help with cognitive functioning.

Lastly, health is important to cognitive functioning in older adults because some of the diseases more common among older adults, such as hypertension and diabetes are linked to cognitive dropoffs, though not mental decline (Santrock). Some other disease related to life-style preference, such as overeating, inactivity and stress, are related to mental decline, so is mental disorders. These diseases are inter-related, as people get older and also get sick more frequently or severely, people tend to get more gloomy, which leads to inactivity and stress. This inhibits one's cognitive ability as one feels stuck and cannot engage in more meaningful cognitive activities, such as enjoying a game of chess or go golfing.


Further thoughts: If late adulthood populations report experiencing less negative emotions, how do you account for males in that population having the highest suicidal success rates? Do all cognitive functions decline with age? Are there some functions that increase?


Answer 3:
Although for some aging adults there can be a decline in language skills, however for many, knowledge of words and word meanings continues unchanged or may even improve in late adulthood.

It is imperative that the aging population 'use it or loose it.' As they continue to read, attend lectures, do crossword puzzles, and engage in other intellectual endeavours it will be to their advantage, enhance their well being.


Answer 4: The older adult most likely to commit suicide is a male who lives alone, has lost his spouse, and is experiencing failing health. (pg 575) Men typically don't do well alone or widowed. In one study widows showed depressive states two years after the spouse had died. Add poor health to that with minimal support it isn't surprising they are taking their life. However, if you add good social support and being socially integrated into the community the person does much better.

Even when we looked at those who retired with healthy well-being, were those who had good health, good social network, good finances, good satisfaction with their lives before retiring.


Further question: What could be done for old people who are reserved and anti-social?

Answer 5:
Family members could play a positive role here. If the person didn't have family, ideally there would be a network in place that could check up on the newly widowed to see how they are doing. They could build a relationship with and advise accordingly. Does Hong Kong social services offer anything like this? I know the social workers are overloaded but just wondering.

Social support is very important in late adulthood, especially when "children" leave home. We may experience empty-nest syndrome later!

I don't think that Hong Kong Government do a good job for the elderly. However, many churches form fellowships for them, which I think, providing a good social gathering and network for the elderly.

Social services in Hong Kong is overloaded, but as more people live longer, the aging problem in Hong Kong population will become more serious. I know that recently, there are new options such as better-equipped nursing homes run by non-profit or religious organizations for taking care of older adults who need special attentions. Some of them provide home-life environments instead of the traditional institutional setting, so to make it more comfortable for older adults to enjoy community life and necessary medical attention in familiar, friendly environments. This expansion of the scope and nature of services to older adults is beneficial to the society as a whole. The fact that most Hong Kong people have long working hours, it is difficult for them to provide sufficient social and physical support to older adults at home. This new type of nursing home provides an economic option for middle-income families to fulfill their duties at work and with their children while provides good care to the older adults.

Do you know of any other social support models available worldwide that can be applicable to Hong Kong?


Word knowledge stays the same and often increases with age because we are continually exposed to and use language, and as language is evolving (new technology words for example: internet, blog, webcam, online etc.) our vocabulary evolves. Knowing your community social support systems will be imperative if working with this population. There are many support models in the USA. Two that come to mind in the US are Medicaid and Medical. They are government programs that assist retired and disabled individuals with aspects of their medical concerns (hospital, prescriptions, doctor visits, etc). They can be limiting with many restrictions, but for many it is the only medical assistance available due the high cost of purchasing insurance without employment insurance plans.


Answer 6:
People are living longer and I too believe that this will become a larger problem in HK. As many HK people have their parents living with them, I wonder if there will also be a movement for people to put their parents in longer term care facilities. I know the Jockey Club in HK has sponsored one in Aberdeen that is considered to be quite good. It is along term care for the aged. But yes knowing what is available to us is vital for referral, as Donica has mentioned. I know in Canada, there is medical support for people to receive help from nurses. They make home visits. It is believed to helpful as it allows the aged to remain at home but also get the help they need. Does anyone know if there is this type of help available in Hong Kong?

Answer 7:
I also know that there is a Bradbury Hospice Nursing Home, which is run by the Hospital Authority of Hong Kong, yet the development was sponsored by Bradbury Foundation and built by the Society for the Promotion of Hospice Care in Hong Kong. Although it is only for terminally ill patients, but most terminally ill patients are elderly, so it serves a fragment of the older population in Hong Kong.

Below is the website of the Bradbury Hospice.

http://www.ha.org.hk/bbh/introhist.htm

Various Forms of Memory in Cognitive Development in Late Adulthood

Question:
Discuss the various forms of memory and which decline or are sustained in the late adult stage of development (and why).

Answer:
The various forms of Memory are
1) Working Memory
The Working Memory holds and process new information. It decreases in respective to age. The ability to remember lists reduced especially when distracted. The ability to perform tasks while remembering lists are also impaired.
2) Long-term Memory
The Long-Term Memory provides knowledge base to all the things that we can know. Again, it decreased when one ages.
3) Explicit Memory
The Explicit Memory can hold facts such as words, concepts, dates, places, events, etc. Most people usually able to recall when required and the ability to recall decreases in aging
4) Implicit Memory
This is also know as the unconscious, automatic memory that is difficult to retrieve verbally. It is recalled through recognition, performance, less affected by aging. Older people make less rapid responses (Slower reactions compared to younger people)

Reasons for memory deficits are
1) Self-fulfiling prophecy
Old people acknowledge/assume the fact that their memory is declining which already contributes to it. Secondly, they often exaggerate their past abililities, thereby believing that their loss is relatively greater than it is...

2) Culture
The culture in different countries often contributes to the acknowledgement of the decline of memory of old people.
Eg: respect for aging associated with abilities in aging...In China, great respect for abilities of the elderly

3) Prescribed Drugs
Old people over 65 years old take 50% of all prescribed drugs...hence dosage maybe too much for the elderly and lead to memory loss in elderly.

When speed of processing is involved, older adults do more poorly than younger adults. Older adults do more poorly in most areas of memory.
However, wisdom (expert knowledge about practical aspects of life) may increase with age ...


Answer 2:
I'd like to also add to answer one that there are also (1) episodic memory, (2) semantic memory, (3) source memory, (4) prospective memory.


(1) episodic memory is memory about personal facts, either chronologically or temporally dated recollection of personal experience. E.g. where have to travel to last trip; what happened on your last birthday, etc.


(2) Semantic memory is memory of general fact that is not tied to time when the information was stored. E.g. Christmas is 25th December; Beijing is the capital of China; human is mammal, etc.


(3) Source memory is the ability to remember where one learns something. The failure to locate the source of a memory is more prevalent on subject that does not matter personally to the person than something that has personal meaning to the person.


(4) Prospective memory involves remembering to perform actions in the future, such as going to the doctor’s appointment next Wednesday or attending Church on Sunday morning.


Episodic memory declines as one ages, it is interesting there is a phenomenon called “reminiscence bump” which describes how one can remember more events from the second and third decades of their lives than from other decades.


Semantic memory declines in the sense that it takes longer for older adults to retrieve information than younger adults, but the degree of decline is smaller than episodic memory.


Source memory declines with age, but it is not as severe on subject that matters to the person than subject that doesn’t matter much. This is because older adults get more selective in how they use their resources, including storing and retrieving memory.


Prospective memory also declines as one ages, but the age-related deficits occur more often in time-based matter, such as remember exactly what time is the doctor’s appointment, than event-based, such as going to doctor’s appointment.

Answer 3:
Episodic memory and semantic memory are two types of declarative memory. Episodic memory is recall of personal facts. Remembering what happened in the wedding or when went to university uses episodic memory. Semantic memory is recall of general facts. Remembering the capital of China and the regulations for using a lab library uses semantic memory. Since episodic memory and semantic memory are conscious, intentional remembering of information, they are also termed as explicit memory. It is well-documented that explicit memory deteriorates with age (Salthouse, 1982). A recent research (Mormino et al, 2008) believes that episodic memory loss is related to hippocampal-mediated β-amyloid deposition in elderly people. Another research proposes (Association for Psychological Science,2008) that the lack of imagination in older adult results in memory declining.


Implicit memory is an unconscious, nonintentional form of memory. Learning how to drive is an example of implicit memory. Typing on a keyboard and swimming in the pool also use implicit memory. Implicit memory is less likely correlated with aging than explicit memory ( Kessels, Boekhorst, & Postma, 2005)



References




Association for Psychological Science (2008). Lack Of Imagination In Older Adults Linked To Declining Memory. ScienceDaily. http://www.sciencedaily.com­ /releases/2008/01/080107110352.htm


Kessels, R. P. C., Boekhorst, S. T. & Postma, A. The contribution of implicit and explicit memory to the effects of errorless learning: a comparison between young and older adults. Journal of the International Neuropsychological Society, 11(2), 144-151.


Mormino, et al (2008). Episodic memory loss is related to hippocampal-mediated β-amyloid deposition in elderly subjects. Brain, 132; 1310–1323.


Salthouse, T. A. (1982). Adult cognition — An experimental psychology of human aging. New York, Berlin, Heidelberg: Springer.

Further Questions:
How are memory stored?

Answer 4:
That would be episodic memory, the retention of information about the where and when of life's happenings. This is a memory that young people are able to 'pull out from what seems to be nowhere." You may hear them say, "yes we were here before, remember that was when you spilt coffee all over your bag?" I often find myself amazed at the details of what seems to be random events.

We have hardware "cognitive mechanics" and we have software "cognitive pragmatics." Essentially our brain is a computer of sorts, and it is busy storing data. Our experiences, our encounters, what we see, what we learn it is being stored.

I know of an 8 year old who has just finished his second brain surgery in two weeks for a tumour. Days after surgery still nonverbal and taking it all in, apparently language etc will return.

Answer 5:
Intellectual changes in late adulthood do not always result in reduction of ability.

Fluid intelligence is the ability to perceive, remember and think about a variety of basic information. It includes speed with which information can be analyzed, and also includes attention and memory capacity.


Crystallized intelligence is the ability to accumulated information and vocabulary acquired in daily life. It also encompasses the application of skills and knowledge to solving problems.


While fluid intelligence does decline in later years, crystallized intelligence has been shown to rise slightly over the entire life span. Willis & Schaie (1986) reported that a decline in cognitive performance could be reversed in 40% to 60% of elderly people who were given remedial training.

Forced Visitation Rights for Grandparents in order to attain healthy psychological well-being

Question:
It has been acknowledged that there is an importance of grandparenthood on healthy psychological well-being. Do you think forced visitation rights for grandparents are in the child’s best interest? Is it feasible in the society of Hong Kong?

Answer:
Under enormous financial burden, Hong Kong parents have no other choice than leave their children to grandparent. On one hand, people of same bloodline are dependable. On the other hand, grandparent usually retires and rests at home. They have more time to look after children. Owing to the above reasons, I don’t think that forced visitation right is necessary. Parents in Hong Kong welcome grand-parenting.


Answer 2:
As we have learned there are three prominent meanings attached to being a grandparent. It can be a) a source of biological reward and continuity b) a source of emotional self-fullfillment, generating feelings of companionship and satisfaction that may have been missing in earlier adult-child relationships c) a remote role.

I think it is true, "the grandparent role may have different functions in different families, in different ethnic groups and cultures, and in different situations."

The grandparent relationships that I have observed in Hong Kong have been through my friends, so I am really an outsider looking in. However, the relationships I observed seem to fit into category c, a remote role. Although the grandparents may live with the family, due to finances, in terms of their role in the home it seems that they are observers and occupants of the flat. It seems more of a dutiful, expected relationship and less of an involved engaged relationship. Again these are my friends, I am not making a statement regarding all of Hong Kong.

I do know of some grand-parenting relationships that could fit into b category, satisfaction which may have been missing in earlier adult-child relationships. In those cases they may have worked and not cared for a small child and grand-parenting allows them to do this.

Answer 3:
I also do not have statistic that shows us which type of grandparenting is most common in Hong Kong. Nonetheless, it is indisputable that grandparenting is a role that can bring not only biological continuity (which was extremely important in ancient China, but losing much of its importance in modern society), but also emotional self-fulfillment when older adults are gradually retiring from their other roles and duties such as bread winners.


Answer 4:
I absolutely believe that grand-parenting plays a significant role in helping grandparents feel connected and fulfilled, but also strengthening the relationship between generations. There could be a great sense of self-worth and opportunity to help extend the next generation, but also great reward for the grandchildren. I see grandparents doing so many things with their grandchildren. For example picking the children up from school, meeting the school bus, taking the children to the park, taking the children to school. I know even for us, my mom has spent significant amount of time in Hong Kong with us and it has been wonderful having the children spend time with her doing many of the things listed above.

My grandparents were involved in my life growing up, not to the same extend as we see today in Hong Kong but we saw them regularly.


Answer 5:
Thanks for the above sharing...It is wonderful that your grandparents were quite involved with you in your childhood. My grandparents held a more remote role in this sense. I do not even remember any conversation I have had with my grandpa, who passed away when I was 15. But we actually lived together for the last couple years before he's gone. One reason was probably he got many grandchildren, especially a tons of grand-daughters, but only two grand-sons, I know he was a little closer to my two male cousins. It is interesting how people have different relationships with their grandparents. We can't assume that those we see on the street will recall relationships with their grandparents either.

"The cumulative personality model states that with time and age personality becomes more stable”. Do you agree with this statement?

Question :
"The cumulative personality model states that with time and age personality becomes more stable”. Do you agree with this statement? Please illustrate your answer with an example. It can be your own development or your observation of your friend or family member’s development.

Answer:

In a way, I agree with this statement. Emotions are less extreme and more enduring later in life. They tend to experience life more evenly...the good things don't make them overly happy nor bad things drag them down completely...perhaps through life experiences, at this juncture, one will know his/her limits and on the other hand, knowing what skills or abilities needed to achive certain things. I guess at this stage, how one thinks or relate will correlate with how one reflects on his/her past...is he/she satisfied with what he/she has done? Or will he/she look at his/her life with regret ?

Observing one of my uncles, he would often tell me how regretful that he didn't do this/that when he was younger... On the other hand, he would tell me what he has achieved at his previous jobs...repeatedly... So in a way, they balance off...

This reminds me of the reminiscence therapy that is usually used with older adults. By discussing they past, both regrets and achievements, it helps improve the mood of older adults. (Santrock P 590)


Middle-age adults in many respects may have 'softened.' They have perhaps learned from their mistakes, major on the majors not the minors, and are perhaps more realistic in their pursuits and expectations.

The cumulative personality model indicates that people become more adept at interacting with their enviornment in ways that promotes increased stability and personality. They become more confident, warm, responsible and calm, in short they become more 'socially mature.' I wonder if it could be said that when people get 'older' they are becoming more comfortable in their own skin." They are learning to accept who they are.

How have I seen this in others? What I have noticed, is with women at this stage is that they are now 'free' to embark upon their career. They know who they are, who they aren't and usually they pursue an interest/career that is a culmination of all the activities, passions and pursuits that they have been apart of over the years. I think perhaps there is a more focus to who they are and what they are about.

There is an alternative interpretation of the cumulative personality model.


People attempt to achieve stability within oneself through selective information sampling to minimize cognitive coherence. In another word, as people grow older, they are more comfortable in their own skin (as Michelle said), more confidence in their instinct, sometimes may be even over-confidence and prone to jump to conclusion, thus easily discard values, beliefs and opinions different from their own.


For example, sometimes I find it more difficult to convince older adults than the young ones on a great variety of subjects, regardless of whether they have expert knowledge in it or not. I believe this maintenance of stability in older adults is adaptive because cognitive incoherence is minimized, thus encounter less inner frustration. But it is maladaptive in personality development as well as intellectual learning, because they refute too easily any ideas that are inconsistent with their own limited knowledge, thus they become their biggest enemy in the pursuit of knowledge or becoming a better person. What do you think?

Answer 2:
When we reach middle adulthood, we think we are not as energetic as before. "Those were the days" is the usual expression when we recall the achievement in the past.

When we come across some downturns in life, we will say "let it be". It sounds a bit permissive. This is only one side of the story. My friends choose to have "stability" in career and relationship but they challenge themselves in other field such as rock-climbing and sky-diving.

I have a different point of view towards your example. My father-in-law won't listen a word from me about cooking style and some health concerns. However, he will sit tight and pay attention to me when I teach him how to use a computer. Cheers!


As it models a teachableness of my father-in-law. He could have easily passed criticism on technology, as a way of dismissing himself from it, but instead he willingly wants to learn. There is humility in that. As they say, "You can teach old dogs new tricks."

Sometimes, it seems that when people get older people seem to yield to those who are older, and a sense of entitlement develops. It can be a huge learning curve to have had many people working for you and now you don't. Big adjustments

Factors that characterized the contemporary life-events approach

Question:
Please describe the different factors that characterized the contemporary life-events approach. Look at a friend or an acquaintance’s life and illustrate his/her middle-adulthood development, and how these factors interact that influence his/her development.

Answer:
I have a friend by the name of J (name hidden for confidentiality). He's 60 years old. He is a professional singer at this age.The reason is that he started to become professional at his late 50s. Probably that's due to Erikson's idea of either one provide unconditional guidance to younger people or being self-absorbed, engaging in meeting one's own personal affairs and desires. In the case of J, he desires to be a professional singer even at this age. But he really sings well... much better than the Hong Kong singers that made it based on connections nor looks.

When I speak with him, or observe how he communicates with others, in terms of "being young vs being old", when he is in front of younger people (like me...haha), he will say that he is old...but when he is talking with people around his age group, he will tell them that he is still young and super energetic. And that is true too, because I play racket games with him and he goes for every ball, sometimes diving to ensure he hits the shuttle before it reaches the ground. So in a way, he is pretty masculine, in the sportive sense. For "being attached to others vs being separated from them", this is very interesting because he has been married 3 times. He has separated a few times with his ex-wives, yet he is still attached to his latest wife (3rd marriage)...


Comments:
Thank you so much for sharing. This is quite an interesting example. I wonder did J mention the reason why he become a professional singer in his late 50s? What was his career before and is there a special life event that prompt him to make such a big change?

Answer 2:
The contemporary life-events approach emphasizes that how life events influence the individual’s development depends not only on the life event, but also on mediating factors (physical health, family supports), the individual’s adaptation to the life event (appraisal of the threat, coping strategies), the life-stage context, and the socio- historical context.(p. 504) As usual, it has some imperfections . Critics claim that the approach ignores stability and daily stresses.

John (Name hidden for confidentiality) is my ex-boss. His diligence wins the fastest promotion to the director position. He has good relationships with family and grades his marriage as satisfaction. With the consent of his wife, he decides not to have any offspring. However, his desire to do something for the next generation is so strong that he does not hesitate to teach everything to his subordinates. His dedication inspires many colleagues.


The most stressful event he experiences in life is his parent’s divorce in his young adulthood. His mother initiates the divorce. Being the only son in the family, he has tried every effort to salvage but in vain. The life-stage and socio-historical context may make this event less disastrous. John is an adult and divorce become more common in HK society. However, he still perceives it as highly stressful and suffers depression over a year. With strong support from his wife, he finally overcomes and returns to normal.

Comments:

Your example is very interesting. As you said John was quite devastated by his parent's divorce, though he recovered from it, I am curious if his parent's divorce had anything to do with his decision to not having children? Sometimes life event may have longer lasting impact on one's life-span development and subsequent life decisions than we can imagine.


Answer 3:

For me this is very vivid within my family. My dad died suddenly at the age of 40 of a heart attack, 5 days before Christmas. My mom was essentially widowed with three kids and little job skills. In time she sold the farm, moved to northern Canada and started a new life for herself. She went to college, got a degree and has had an amazing career in media -tv, radio and newspaper. Her situation plunged her into drastic but wonderful changes for her personal and professional development. My dads sudden death also had impact on those in the community who then looked at their life and wondered what they wanted it to look like.

These types of crisis can help to re-route people into making positive healthy changes for themselves. I know people who used this as an opportunity to reflect on their life and some quit their high pressure jobs and started to work in fields they actually liked. THe desire for money and prestige lessened and the desire for happiness entered.

Comments:
Your mom served as a great model for everyone. Life events can sometimes be devastating, but at the same time it presents us with the opportunity to look at our lives from a different perspectives, which help us to learn to become stronger, better person. It all depends on our perception of the events and how effectively we cope with the stress and trauma of these life events. Life events sometimes impact one's life so deep that subsequent decisions will be affected. Do you have one?


Answer 4:

Luckily, so far there isn't any traumatic life event like death of close relatives or divorce, happen to me. But I realize minor stressful experiences one encounter can quite add up and mold one's personality into a specific direction. As I shared earlier, my mom used to yell at me quite severely when I was young if I keep making the same mistakes in writing Chinese character; if i don't get a perfect 100 on my dictation, even 98, she would be very upset; and for many times, she would run crying and dash out of the apartment as if it was the biggest fault anyone can commit and I am a big disappointment to her. This all adds up that made me very nervous about exams and grades when I was in high school and got over-worried with my future career.

Socioemotional Development in Middle Adulthood

According to Erikson’s seventh stage of development, the psychosocial crisis is generativity vs stagnation. In this stage, the key challenge is to acquire a genuine concern for the welfare of future generations, which results in providing unconditional guidance to younger people. On the contrary, if one fails to tackle the challenge, one will experience stagnation or self-absorption, which is characterized by self-indulgent concerns with meeting one’s personal needs and desires.


According to Levinson’s seasons of a man’s life, adult male in their middle adulthood are faced with four major conflicts: 1) being young vs being old, 2) being destructive vs being constructive, 3) being masculine vs being feminine, 4) being attached to others vs being separated from them. It is important to note that Levinson’s theory drew on interviews exclusively with middle-aged males, which may or may not apply to female adults as Levinson’s work included no statistical analysis.



Life-events approach relies on life events to conceptualize adult development. This approach takes into the account not only critical life events, such as death of a spouse, divorce, marriage, etc. and their influences, but also the individual’s adaptation (coping strategies) to life events, the life-stage context and sociohistorical context. This approach is criticized of neglecting the stress from day-to-day hassles.

Social historical context (cohort effects) is important in understanding life span development. Social expectation, values, attitudes and behaviors are by-products of the social historical context we live in. Elder people who had experienced WWII have a very different perspective on the daily hassle that bothers the younger generation today. Divorce was a taboo in the 60s for people living in China, it is undoubtedly a very special events than today.


There are also differences between female and male in terms of their adult stage development. As the sociohistorical context changes, the cohort effect on female is even more far-reaching. As career opportunities increases for women, we are juggling both traditional roles, such as childrearing and child bearing, and non-traditional roles by helping to pay the rent.


As for the debate on the extent to which there is stability or change in adult development, a few longitudinal studies are conducted. Some conclusions include people show more stability in their personality when they reach midlife than when they were younger adults. These findings confirm the “cumulative personality model”, which states that as we grow older we become more adept at interacting with the environment in ways that foster stability in personality.


Midlife crisis is over-hyped by the media. Vaillant conducted a study called the “Grant Study” maintained that only a minority of adults experience a midlife crisis. Various studies on the sociopsychological well-being of mid-life adulthood found that mid-life crises are characterized more so by negative life events than aging. Studies also found that adults experienced a peak of personal control and power in middle age, and with high internal locus of control. In general, personality traits across adulthood occur in positive directions.


It is important to note that there are individual variations of middle life development that may or may not fit the age related stages/ crisis as prescribed by Erikson or Levinson or the life-event/daily hassle approach.


During middle adulthood, there are several aspects of close relationships. In terms of love and marriage, affectionate or companionate love increases in midlife. Rocky early adulthood marriages turn out to be better during midlife because either the issues are resolved or the marriage is dissolved by midlife. Some midlife parents may experience “empty nest syndrome”, which means parents experience decline in marital satisfaction after children leave home.

But most parents actually enjoy better marital satisfaction because they are free from child rearing responsibility and have more time for each other.


Some people become grandparents when they are in their middle adulthood. Being a grandparent is a source of biological reward and continuity, it is also a source of emotional self-fulfillment and satisfaction. Younger grandparents tend to be characterized to be the fun-seeking style when interacting with grand children.


Middle-aged adults are described as the “sandwich”, “squeezed” or “overload” generation because of their responsibilities both for the adolescents and the elderly. They are also the bridges for intergenerational relationship. It is interesting to note that daughter-mother is amongst the closest inter-generational relationship, more so than son-father, daughter-father or son-mother.