Gerontological Counseling

Osemeka Anthony


ID UAD7638HBY14286





























Gerontological Counseling

(Course Work)



























PhD in Psychology

Atlantic International University

School of Social and Human Studies





Table of Content

Table of content--------------------------------------------------------------2

Introduction-------------------------------------------------------------------3

History of gerontology------------------------------------------------------4-14

Demographics of Today's Baby Boomers-------------------------------14-15

Gerontological counseling comes of age--------------------------------16-18

Standard for gerontological counseling----------------------------------18

Counseling Theories for Use With Aging Baby Boomers-------------18-21

Ageing------------------------------------------------------------------------21-24

Causes of ageing------------------------------------------------------------24-25

Theories on the causes of ageing-----------------------------------------26-32

The ageing process---------------------------------------------------------32-39

The Evolutionary Causes of Aging and Death-------------------------39-42































1.0.Introduction

1.1. The Second World War (WWII) was fought by America’s “Great Generation” (Brokaw 1998) when the war ended, all who had been involved, both in military and civilian capacities, celebrated. Then began the task of creating the postwar nation and society. Perhaps because of their wartime challenges, the predominant values of this Greatest Generation have been identified as “responsibility, duty, honor, and faith”(Brokaw, 1998).Because they had experienced the sacrifices and the atrocities of war, their maturation processes were accelerated. In record numbers, they married and gave birth to a phenomenal number of infants, 76million in the 18years between 1946 and 1964. This group of infants, now between 40 and 58 year old, became known as the baby boomer generation. Many researchers (Moen 1998; Morgan 1998; wong, 2002) have described this generation as unique beyond its number. The year 1946, with the return of the soldiers from WWII, unstandably seen as the beginning of the baby boomer generation, whereas 1964 is viewed as the end of the “boom”. In1965, the fertility rate in America returned to pre-WWII levels. Consider, for example that member of the baby boomer generation(76million) make up over 40% of the adult population in the United states. When compared with their parents (26 million) and those who followed members of Generation X(46million). The first of the baby boomers entered their 7th decade of life in 2006, and they constituted the largest number of persons ever born in a single generation(in case only 18years) from 1905 until the end of the 20th century in the United states. Baby boomers some of whom has attended the age of 55 to 60 in the year 2006, which make up the largest 5 year of age group born in the 20th century(Morgan 1998). The appearance of such a large population bubble containing a record number of aging individual led Wong(2002) to comment “if aging was a disease in this country, public heath might declare it a national epidemic(p.3).





2.0.History of gerontology

It may be said that the history of gerontology begins with agriculture; prior to this the hunter-gatherer societies that existed could only support a marginal existence: food supply was short; frequent movement a necessity. These and other reasons meant that extremely few reached 'old age'. However, it could be argued that in a society with a life expectancy of 14 (such as 10,000 BC), being '40' was 'old'. Things changed with the coming of agriculture. A more stable food supply and the lack of frequent movement meant that humans could now survive longer, and beginning perhaps around 4000 BC, a regular segment of the population began to attain 'old age' in places such as Mesopotamia and the Indus river valleys. Agriculture didn't simply bring a steady food supply; it also suddenly made older persons an economic benefit instead of a burden. Older persons could stay and watch the farm (or children); make pottery or jewelry, and perform social functions, such as story-telling (oral tradition, religion, etc). and teaching the younger generation techniques for farming, tool-making, etc. After this change, the views of elder persons in societies waxed and waned, but generally the proportion of the population over 50 or 60 remained small. Note that in ancient Egypt, Pharaoh Pepi II was said to have lived to 100 years old. Certainly Ramses II lived to about 90; modern scientific testing of his mummy supports the written record. Ancient Greeks valued old persons for their wisdom (some reaching 80, 90, or 100 years old), while old age was devalued in Roman times. In the medieval Islamic world, elderly people were valued by Muslim physicians. Avicenna's The Canon of Medicine (1025) was the first book to offer instruction for the care of the aged, foreshadowing modern gerontology and geriatrics. In a chapter entitled "Regimen of Old Age", Avicenna was concerned with how "old folk need plenty of sleep", how their bodies should be anointed with oil, and recommended exercises such as walking or horse-riding. Thesis III of the Canon discussed the diet suitable for old people, and dedicated several sections to elderly patients who become constipated. The Canon of Medicine recognized four periods of life: the period of growth, prime of life, period of elderly decline (from forty to sixty), and decrepit age. He states that during the last period, "there is hardness of their bones, roughness of the skin, and the long time since they produced semen, blood and vaporal breath". However, he agreed with Galen that the earth element is more prominent in the aged and decrepit than in other periods. Avicenna did not agree with the concept of infirmity, however, stating: "There is no need to assert that there are three states of the human body sickness, health and a state which is neither health nor disease. The first two cover everything." The famous Arabic physician, Ibn Al-Jazzar Al-Qayrawani (Algizar, circa 898-980), also wrote a special book on the medicine and health of the elderly, entitled Kitab Tibb al-Machayikh or Teb al-Mashaikh wa hefz sehatahom. He also wrote a book on sleep disorders and another one on forgetfulness and how to strengthen memory, entitled Kitab al-Nissian wa Toroq Taqwiati Adhakira, and a treatise on causes of mortality entitled Rissala Fi Asbab al-Wafah. Another Arabic physician in the 9th century, Ishaq ibn Hunayn (died 910), the son of Hunayn Ibn Ishaq, wrote a Treatise on Drugs for Forgetfulness (Risalah al-Shafiyah fi adwiyat al-nisyan).

In medieval Europe on the other hand, during its Dark Ages, negative opinions of the elderly prevailed; old women were often burned at the stake as witches. However, with the coming of the Renaissance old age returned to favor in Europe, as persons such as Michelangelo and Andrea Doria exemplified the ideals of living long, active, productive lives.

While the number of aged humans, and the maximum ages lived to, tended to increase in every century since the 1300s, society tended to consider caring for an elderly relative as a family issue. It was not until the coming of the Industrial Revolution with its techniques of mass production that ideas shifted in favor of a societal care-system. Care homes for the aged emerged in the 1800s. Note that some early pioneers, such as Michel Eugene Chevreul, who himself lived to be 102 in the 1880s, believed that aging itself should be a science to be studied. The word itself was coined circa 1903. It was not until the 1940s, however, that pioneers like James Birren began organizing 'gerontology' into its own field. Recognizing that there were experts in many fields all dealing with the elderly, it became apparent that a group like the Gerontological Society of America was needed (founded in 1945). Two decades later, James Birren was appointed as the founding director of the first academic research center devoted exclusively to the study of aging, the Ethel Percy Andrus Gerontology Center at the University of Southern California. In 1975, the USC Leonard Davis School of Gerontology became the first academic gerontology department, with Birren as its founding dean.

In the 1950s to the 1970s, the field was mainly social and concerned with issues such as nursing homes and health care. However, research by Leonard Hayflick in the 1960s (showing that a cell line culture will only divide about 50 times) helped lead to a separate branch, biogerontology. It became apparent that simply 'treating' aging wasn't enough. Finding out about the aging process, and what could be done about it, became an issue. The biogerontological field was also bolstered when research by Cynthia Kenyon and others demonstrated that life extension was possible in lower life forms such as fruit flies, worms, and yeast. So far, however, nothing more than incremental (marginal) increases in life span have been seen in any mammalian species.

Today, social gerontology remains the largest sector of the field, but the biogerontological side is seen as being the 'hot' side.

2.1.Gerontology (old man) is the study of the social, psychological and biological aspects of aging. It is distinguished from geriatrics, which is the branch of medicine that studies the disease of the elderly. Gerontology includes these and other endeavors:

Studying physical, mental, and social changes in people as they age;

Investigating the aging process itself (biogerontology);

Investigating the interface of normal aging and age-related disease (geroscience);

Investigating the effects of our aging population on society, including the fiscal effects of pensions, entitlements, life and health insurance, and retirement planning;

Applying this knowledge to policies and programs, including a macroscopic (i.e. government planning) and microscopic (i.e. running a nursing home) perspective.

The multidisciplinary focus of gerontology means that there are a number of sub-fields, as well as associated fields such as psychology and sociology that also cross over into gerontology. However, that there is an overlap should not be taken as to construe that they are the same. For example, a psychologist may specialize in early adults (and not be a gerontologist) or specialize in older adults (and be a gerontologist).

The field of gerontology was developed relatively late, and as such often lacks the structural and institutional support needed (for example, relatively few universities offer a Ph.D. in gerontology). Yet the huge increase in the elderly population in the post-industrial Western nations has led to this becoming one of the most rapidly growing fields. As such, gerontology is currently a well-paying field for many in the West.




3.0. Baby boomer

3.1. Baby boomer is a term used to describe a person who was born during the demographic Post-World War II baby boom. The term "baby boomer" is sometimes used in a cultural context, and sometimes used to describe someone who was born during the post-WWII baby boom. Therefore, it is impossible to achieve broad consensus of a precise definition, even within a given territory. Different groups, organizations, individuals, and scholars may have widely varying opinions on what constitutes a baby boomer, both technically and culturally. Ascribing universal attributes to a broad generation is difficult, and some observers believe that it is inherently impossible. Nonetheless, many people have attempted to determine the broad cultural similarities and historical impact of the generation, and thus the term has gained widespread popular usage. In general, baby boomers are associated with a rejection or redefinition of traditional values; however, many commentators have disputed the extent of that rejection, noting the widespread continuity of values with older and younger generations. In Europe and North America boomers are widely associated with privilege, as many grew up in a time of affluence. As a group, they were the healthiest and wealthiest generation to that time, and amongst the first to grow up genuinely expecting the world to improve with time. One of the unique features of Boomers was that they tended to think of themselves as a special generation, very different from those that had come before. In the 1960s, as the relatively large numbers of young people became teenagers and young adults, they, and those around them, created a very specific rhetoric around their cohort, and the change they were bringing about. This rhetoric had an important impact in the self perceptions of the boomers, as well as their tendency to define the world in terms of generations, which was a relatively new phenomenon. The baby boom has been described variously as a "shockwave" and as "the pig in the python." By the sheer force of its numbers, the boomers were a demographic bulge which remodeled society as it passed through it. The term Generation Jones has gained popularity to distinguish those born 1954-1965 from the earlier Baby Boomers. The United States Census Bureau considers a baby boomer to be someone born during the demographic birth boom between 1946 and 1964. The Census Bureau is not involved in defining cultural generations. Influential authors William Strauss and Neil Howe label American Baby Boomers 1943 to 1960. In Canada, one influential attempt to define the boom came from David Foot, author of Boom, Bust and Echo: Profiting from the Demographic Shift in the 21st Century, published in 1997 and 2000. He defines a Canadian boomer as someone born from 1947 to 1966, the years that more than 400,000 babies were born. However, he acknowledges that is a demographic definition, and that culturally it may not be as clear-cut.. Doug Owram argues that the Canadian boom took place from 1946 to 1962, but that culturally boomers (everywhere) were born between the late war years and about 1955 or 1956. He notes that those born in the years before the actual boom were often the most influential people among boomers. For example, the Beatles, Bob Dylan, the Rolling Stones), while those born in the 1960s might well feel disconnected from the cultural identifiers of the earlier boomers. Bernard Salt places the Australian baby boom between 1946 and 1961.

3.1.0. Characteristic


3.1. 1.Size and economic impact

Seventy-six million American babies were born between 1946 and 1960, representing cohorts that would be significant on account of its size alone. These cohort shares characteristics like higher rates of participation in higher education than previous generations and an assumption of lifelong prosperity and entitlement developed during their childhood in the 1950s. The age wave theory suggests an economic slowdown when the boomers start retiring during 2007-2009.

3.2.0.Cultural identity

3.2.1.Boomers grew up at a time of dramatic social change. In the United States, that social change marked the generation with a strong cultural cleavage, between the proponents of social change and the more conservative. Some analysts believe this cleavage has played out politically since the time of the Vietnam War, to some extent defining the political landscape and division in the country. In 1993, Time magazine reported on the religious affiliations of baby boomers. Citing Wade Clark Roof, a sociologist at the University of California at Santa Barbara, the articles stated that about 42% of baby boomers were dropouts from formal religion, a third had never strayed from church, and one-fourth of boomers were returning to religious practice. The boomers returning to religion were "usually less tied to tradition and less dependable as church members than the loyalists. They are also more liberal, which deepens rifts over issues like abortion and homosexuality." It is jokingly said that, whatever year they were born, boomers were coming of age at the same time across the world; so that Britain was undergoing Beatlemania while people in the United States were driving over to Woodstock, organizing against the Vietnam War, or fighting and dying in the same war; boomers in Italy were dressing in mod clothes and "buying the world a Coke"; boomers in India were seeking new philosophical discoveries; American boomers in Canada had just found a new home and escaped the draft; Canadian Boomers were organizing support for Pierre Trudeau. It is precisely because of these experiences that many believe those born in the second half of the birth boom belong to another generation, as events that defined their coming of age have little in common with leading or core boomers. The boomers found that their music, most notably rock and roll, was another expression of their generational identity. Transistor radios were personal devices that allowed teenagers to listen to The Beatles and The Motown Sound. In the 1985 study of US generational cohorts by Schuman and Scott, a broad sample of adults was asked, "What world events over the past 50 years were especially important to them?" For the baby boomers the results were:

3.2.2.Baby Boomer cohort no,1 (born from circa 1946 to 1955), the young cohort who epitomized the cultural change of the sixties Memorable events: the Cuban Missile Crisis, assassinations of JFK, Robert Kennedy, and Martin Luther King, Jr., political unrest, walk on the moon, risk of the draft into the Vietnam War, anti-war protests, social experimentation, sexual freedom, drug experimentation, civil rights movement, environmental movement, women's movement, protests and riots, Woodstock, mainstream rock from the Beatles to Jimi Hendrix experimentation with various intoxicating recreational substances Key characteristics: experimental, individualism, free spirited, social cause oriented Key members: Former UK Prime Minister Tony Blair, U.S. Presidents Bill Clinton and George W. Bush

3.2.3.Baby Boomer cohort no.2 or Generation Jones (born from circa 1956-1964)

Memorable events: Watergate, Nixon resigns, the Cold War, lowered drinking age in many states 1970-1976 (followed by raising), the oil embargo, raging inflation, gasoline shortages, Jimmy Carter's imposition of registration for the draft, punk or new wave from Deborah Harry and techno pop to Annie Lennox and MTV Key characteristics: less optimistic, distrust of government, general cynicism Key members: Douglas Coupland who initially was called a Gen Xer but now rejects it and Barack Obama who many national observers have recently called a post-Boomer, and more specifically part of Generation Jones.



3.2.4.Aging and end of life issues

As of 1998, it was reported that as a generation boomers had tended to avoid discussions and planning for their demise and avoided much long term planning. However, beginning at least as early as that year, there has been a growing dialogue on how to manage aging and end of life issues as the generation ages. In particular, a number of commentators have argued that Baby Boomers are in a state of denial regarding their own aging and death and are leaving an undue economic burden on their children for their retirement and care.

3.2.5. Impact on history and culture

An indication of the importance put on the impact of the boomer was the selection by Time magazine of the Baby Boom Generation as its 1967 "Man of the Year." As Claire Raines points out in ‘Beyond Generation X’, “never before in history had youth been so idealized as they were at this moment.” When Generation X came along it had much to live up to and to some degree has always lived in the shadow of the Boomers, more often criticized (‘slackers’, ‘whiners’ and ‘the doom generation’) than not.

3.3. Differences in the Baby Boomer Generation

Differences exist between the baby boomers and previous generations. We--one of us born in the late Depression and one an early baby boomer--were able to have a candid dialogue about these significant differences and how they will likely affect the ways that the members of the different generations will respond to growing older and to the challenges associated with extended life expectancies. Baby boomers are unlike their parents in the following ways:

• Baby boomers are in better physical health than the generation that preceded them (Zapolsky, 2003).

• Baby boomers are more highly educated with different quality-of-life expectations.

• Baby boomers hold worldviews vastly different because they have been raised in a country at relative peace and have not faced a global war. Furthermore, unlike any prior generation, their worldviews have been expanded by mass media, technological advances, and world travel.

• Baby boomers have not experienced the same struggles, including the deprivations wrought by the early Great Depression, as their parents did.

Fewer tragedies and family sacrifices were the goals set by their parents for the baby boomers, and all this was believed possible because their parents were America's Greatest Generation--strong, courageous, and self-reliant (Brokaw, 1998). Did America's Greatest Generation pass this legacy to its children? The baby boomers did grow up differently than their parents did. They are more affluent than their parents, perhaps because of their education, their courage, or their ingenuity, or a combination of these (Vaillant, as cited in Chesser, 2003). Although the previously cited differences make them unique, these same differences will affect the needs of those baby boomers who will reach their 60s in this decade and the future concerns of the baby boomers who are still in their 40s.

3.4.Current Challenges and Issues Facing Baby Boomers

A few of the challenges facing the baby boomers are similar to those facing the entire United States. In 2003, the United States was at war against terrorism. The country was beginning to emerge from the worst economy in almost a half century and was experiencing changes in traditional (nuclear) family structure. More than 60% of the American public saw the bulk of their retirement savings and investments dwindle. A great number of these Americans with disappearing savings are baby boomers. This is the generation that is "reconfiguring the nature of work, family and retirement" (Moen, 1998, p. 43). These workers will be among those affected by the move to delay payments of Social Security benefits to individuals 67 years or older. Even when the benefits begin, these individuals will almost certainly be unable to depend on Social Security as anything more than a supplement to other resources necessary for the financial demands resulting from increasing life expectancies.

Baby boomers are changing the shape and scope of retirement (Simon-Rusinowitz, Wilson, Marks, Krach, & Welch, 1998). Many will be more affluent than their forebears; some will start new and different careers or jobs when they reach "retirement age." Some baby boomers, because of choice, need, desire, or boredom, will remain in their current positions. Unlike those eligible for retirement in the late 1980s and throughout the early 1990s, Simon-Rusinowitz et al. found that the majority of baby boomers will not be financially secure even at age 67. With the stock market collapse in 2000, along with the tragic events of September 11, 2001, conditions necessary to allow baby boomers to retire will be different.

3.5.Baby Boomers Are Encountering Economically Driven Social Issues

For those baby boomers struggling with finances and unable to consider early retirement, additional concerns are becoming apparent both in the workplace and the greater global economy. One issue is age discrimination. "Fueled by charges from workers in their 40s and 50s, the number of age bias complaints filed with the U.S. Equal Employment Opportunity Commission (EEOC) increased by 41% between 1999 and 2002" (Nicholson, 2003, p. 10). Sixty-four percent were complaints from litigants between the ages of 40 to 59. This discrimination is particularly noteworthy for baby boomers because they see themselves as the generation that fought for the equality of all workers and against ageism in the workplace. As children and teenagers, baby boomers experienced the civil rights movements that occurred in the United States during the 1960s and 1970s. As young adults, they helped develop some of the core values of U.S. society that prohibit discrimination against any minority group.

Regarding the issue of age discrimination, common sense would suggest that as the economy tightens, businesses, industrial organizations, and even educational institutions will find reasons to give incentives to their highest paid employees to retire or resign--or ultimately will force them to do so. The vacancies created by these forced retirements or resignations are often not filled, and the responsibilities of the individuals who held those jobs are assumed by younger, lower paid employees. This action is already causing older adults to seek counseling for problems and concerns related to stress at work (Valliant, as cited in Chesser, 2003).

Two other issues for baby boomers that parallel age discrimination are (a) health care and its escalating cost and (b) the impending potential demise of Social Security benefits (Simon-Rusinowitz et al., 1998). Baby boomers, historically the largest population group, may watch Social Security funds disappear because of their sheer numbers. This is yet another reason to believe that the baby boomer generation will seek counseling more than has any previous generation.



3.6.Boomers Are Reconfiguring Their Work and Their Retirement Patterns

Consultant David Corbett (2003) wrote, "there is an extended middle age these days, and retirement may be delayed by many to age 80 to 85, not necessarily at 60 to 65" (p. A6). This can give pause to those who have thought of aging and "retirement" in a traditional sense. Baby boomers have been the focus of several studies on persons planning to work longer than have members of previous generations ("Boomers at Midlife," 2003; Corbett, 2003; Skorupa, 1999; "Work Life," 2000). Following is a summary of several facts mentioned in the above studies that are common to baby boomers.

• Between 70% to 75% of baby boomers enjoy their work, and only 15% reported that they would quit entirely if they could.

• Members of households with incomes that exceed $70,000 had more plans for working into their 70s than did members of households with incomes less than $30,000.

• Reasons given most frequently for working a longer time included enjoyment of work, need for money, security, feeling useful, and health insurance coverage.

• Although 80% of the younger baby boomers (ages 38 to 48) indicated that they were concerned about the amount of their savings, they also indicated a confidence in their abilities to set reasonable financial goals and obtain them. According to AARP ("Boomers at Midlife," 2003), "Do boomers think their advancing age might keep them from accomplishing stuff?. Don't even go there" (p. 62).

• Seventy-three percent of baby boomers hope to pursue hobbies or other interests when they do finally retire, unlike members of earlier generations who did not have specific plans.

3.7.Relationship Difficulties Are Prevalent Among Baby Boomers

An issue of concern for some baby boomers is the significant increase in the divorce rate among married couples in their generation in the United States. According to the Bureau of Population Statistics, the divorce rate in the United States has changed from 28% of marriages (within the first 20 years of marriage) in 1960 to 56% of marriages in 2000, a 100% increase (Schmitt, n.d.). A partial cause of this increase may be attributed to changes in societal conditions, which include (a) no-fault divorce laws, (b) increased abilities of women to support families alone, (c) changing social norms (adjustment to changing gender roles may cause stress and uncertainty in marriages), and (d) improved access/methods of contraception/abortions (Schmitt, n.d.).



3.8.Demographics of Today's Baby Boomers

Noteworthy is the fact that although there were only two gerontological counseling programs in the United States in 2003 that were accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), the "popular" media are conducting studies almost monthly about the needs, concerns, issues, and statistics regarding these emerging "gerocenes" (Cole, Van Tassel, & Kastenbaum, 1992, p. 126). Newsweek (Heinz Family Philanthropies/Newsweek Poll, 2000) reported on one study involving 1,501 adults. The following demographics, based on results from the poll, describe today's baby boomers.

Work

• Seventy-one percent of baby boomer households had both spouses working in 1999.

• In 23% of the households, only the husbands worked; in 4% of the households, only the wives worked for a wage or salary.

• Thirty-two percent of boomers ages 35 to 44 worked from the home, as did 20% of those ages 45 to 54.

• In 1999, 39% of baby boomer households made more than $60,000 annually.

3.9.Finances

• Seventy-one percent of baby boomers owned their home in 1999.

• Ninety-two percent of boomers ages 35 to 44 had financial assets (other than home ownership) averaging $12,000 in 1995.

• Eighty-two percent of those between the ages of 45 to 54 had savings in excess of $25,000.

3.10.Health

• Thirty-seven percent of baby boomers polled in 1997 reported suffering from chronic muscle aches and pains.

• Coincidently, 48% of men and 67% of women, ages 30 to 49 reported rarely or never exercising.

• In 1998, baby boomers who said they were in excellent health included 60% of those ages 30 to 49 and 30% of those ages 50 to 59.

When one considers recent research reporting a significant relationship between mental and emotional health and physical exercise (American Medical Association, as cited in Myers, 2003), baby boomers are urged to pay attention.

The demographics presented previously are meant to support the contention in an earlier section of this article that baby boomers are a unique generation. The fact that so few engage in physical exercise as a life priority will surely affect their future health care. Furthermore, "related to their finances, boomers are not saving for their retirement years" (Morris, 1996, p. 89). As baby boomers face the demands normally associated with growing older, their sheer members will the future of the United States in the areas of both health care and the economy.

3.11.Tomorrow's Challenges and Opportunities for Baby Boomers

More than 76 million baby boomers are approaching retirement (or transition) beginning in 2006; the generation that follows only numbers approximately half as many. These individuals, born between 1965 and 1983, are called the "baby bust" (Morgan, 1998) because they number only 46 million people. This major difference in population numbers alone has serious implications in terms of benefits and services programs operated by the federal government, including Social Security, Medicare, and Medicaid. Although it may be futile to prioritize the challenges facing the baby boomers who are in their 40s and 50s, we have cited issues that will cause stress and strife and, therefore, will increase the need for counseling help, a phenomenon not experienced by earlier generations.

Blanchette and Valcour (1998) stated, "boomers present the potential to redefine aging. They can become the healthiest, most productive, and most innovative group of older people the world has ever known" (p. 80). Although this may be a positive outlook for the baby boomers, it is a prediction that engenders potential problems, one of which is baby boomers' life expectancy. All of the above are reasons to encourage and support the growth of such professions as geriatric health and geriatric psychiatry, as well as the field of gerontological counseling.







4.0. Gerontological Counseling Comes of Age

4.1. Brief Reflection on Aging in History

According to Cole et al. (1992), in ancient Greece, older individuals (geron or presbys) knew nothing of retirement age nor of retirement benefits. Greek men worked as long as they were able. However, even in those early days of Greece, age 60 was an unspoken but useful marker for "slowing down," although life spans were shorter. Military obligations ended at age 59. Men tended to marry around age 30, and women married around age 15. The Greek view of old age was quite negative (Bremmer, 1987). "An idle life is good for old men, especially if they are simple in their ways or prone to be stupid or tall nonsense, which is typical of old men" (Cole et al., 1992, p. 330). Yet, the rhetorician Sophicles is said to have lived and been productive to 110 years. Additionally, Socrates was defending himself and his clients in court at age 70, and Plato was still writing at age 83 (Cole et al., 1992). In Rome, the Senate was described by Baldwin (as cited in Cole et al., 1992) as "100 'patres,' a few select old men, physically weak, but intellectually vigorous" (p. 301). Also in Rome, according to Baldwin (as cited in Cole et al., 1992) and Finlay (1981), men and women worked until they were no longer physically capable. The median age for death was age 34 for women and 46 for men (McAlindon, 1957).

The early Christian view of older individuals is also interesting. "Old age requires the acceptance of bodily deterioration, viewed as the opportunity to grow in virtue, for the loss of health and bodily firmness eventually forces a withdrawal from past activities and can open new horizons" (Post, 1992, p. 127). Post also noted that "the myth of Ageism is in itself ageist, for it denies those who grow old their genuine alternative to despair" (p. 127). Staying active, working, reaching out to others, volunteering, creative endeavors appear to be a "secret to longer, fuller life" (p. 130). Reinforcing Post's claim is the work of John Wesley, the founder of Methodism who was "renowned for his evangelical activities while a white-haired man in his eighties" (Post, 1992, p. 130).

5.0.Important Considerations

In a 2003 CACREP review, mentioned earlier, only two programs in gerontological counseling were accredited by CACREP. Although some universities provide an occasional course or two in aspects of gerontological counseling, if practitioners are to meet the rapidly growing needs of the baby boomers, more attention will need to be given to training these professionals. With more than 40% of the adults in this country belonging to the baby boomer generation, counselors must become more knowledgeable about this population. Counselors will need to confront their own stereotypes about the aging process before they can help these older persons to age positively and full of hope for their present and future.

6.0.What Counselors Should Know

It will be the baby boomers themselves, as well as theft counselors, who can bring a positive "spin" to life's later years. In the literature on aging, one encounters key words like creativity (Kastenbaum, 1992), attitude (Chesser, 2003), positivism (Ponzo, 1992), and wellness (Myers & Schwiebert, 1996, 2003). Kastenbaum (1992) described creativity in the mature years. In refuting the claims that creativity must be assessed and evaluated as abilities, Kastenbaum asked, "Why do we not see creativity as multi-dimensional instead of limited to achievement through abilities? What are the meanings and functions of creativity in the later years?" (p. 291).

Chesser (2003) referred to aging well as a matter of attitude. In her interview with George Vaillant, she concluded that "Growing old gracefully isn't about a plastic surgeon, a happy childhood or even a whopping IRA, its about attitude" (p. 96). In a landmark longitudinal study of human development (Vaillant, as cited in Chesser, 2003), 824 men and women were followed from their teens into their 80s. The study concluded that "whether we die or are disabled between 50 and 85, which is when most of us die or are disabled, is far more under our own control than we have ever believed in the past" (p. 99). The results of this study may prove to be an incentive for baby boomers who expect to live well as they age. These men and women, especially those currently older than baby boomers, are known as the "late bloomers" (Goldman, 1988), many of whom are entering, by self-description, the most exciting, creative, and positive phase of their lives after "retirement."

7.0.Promoting Self-Empowerment Through Gerontological Counseling

Ponzo (1992) wrote that successful aging is described as "staying vital longer by reaching for and emphasizing the positive aspects of life, of seeing what is possible, instead of what is typical or expected" (p. 210). It is important to help people appreciate, and accommodate to, the changes of aging, just as people accommodate to other changes throughout the life span.

Rowe and Kahn (1987) stated that "the effects of the aging process have been exaggerated and the modifying effects of diet, exercise, personal habits and psychosocial factors underestimated" (p. 143). Self-empowerment is as crucial in the aging process as it is at any other time in life.

According to Callahan (1987), "we must envision a health span revolution that brings full functioning to almost the end of life: a revolution that will be fueled by coordinated research, clinical and educational efforts of professionals in the behavioral, social and biological sciences" (p. 101). Counselors must be prepared to help people resolve the issues they see related to aging, and as Ponzo (1992) said, "counselors can play a key role in helping people strive for and live out a vital, enjoyable and fruitful long life" (p. 213).

8.0.Standards for Gerontological Counseling

CACREP (2001) has provided the standards for gerontological counseling programs that are necessary for counselors to possess when working with older clients. These standards are based on broad foundations in the areas of history, philosophy, and the existing trends in social contexts that highlight gerontological counseling. The standards promote a counseling approach that advocates life span wellness and empowerment of older persons.

In the section of the CACREP (2001) Standards titled "Contextual Dimensions of Gerontological Counseling," the standards require that counselors become familiar with the network of service providers who assist mature clients. The continuum of community care often includes adult day care, senior centers, recreational and wellness programs, and residential and long-term care. Social services address needs that include education, employment, and retirement.

9.0.Counseling Theories for Use With Aging Baby Boomers

Weiss (1995) suggested the application of cognitive therapy and life review therapy for gerontological counseling. He pointed out that these theories, when used to counsel more mature adults, have vast potential in the emerging field of gerontological counseling. According to Dychtwald and Hower (1989), life expectancy in 1930 was 58 years. By 1988, it had increased to 75 years (Smolak, 1993). In 2003, average life expectancy was expected to exceed 80 years. Capuzzi and Gross (2002) suggested several group theories and approaches to working with aging baby boomers. They include (a) reality orientation, (b) milieu therapy, (c) reminiscence groups, and (d) re-motivation therapy. Along with different theoretical models and different counseling methods suggested for use with older clients, one might ask, "What are other counseling implications that might exist for those gerocounselors?"

First, the very issues of living longer tend to reinforce the need for a specialty in the counseling of older adults. Second, the standards cited by CACREP (2001) suggest the need for skills, techniques, and practices beyond the scope of the "generalist" counselor. The fact that the fastest growing segment of the U.S. population will live to be 85+ years of age indicates that counselors may need additional training and preparation. Third, the specialized needs of these soon-to-be older adults--the boomers--suggest that the principles and competencies required to serve them will need to be unique to this population of clients (Capuzzi & Gross, 2002). These authors described the need for counseling applications specific to older adults, both individually and in group settings. Altekruse and Ray (1998) also identified principles and recommendations important for use in the counseling of older adults. They included the following recommendations:

• Counselors need to demonstrate the benefits of counseling to the baby boomers and should be cautious in the use of tests with this population.

• Counselors must respect and enhance the dignity and worth of older persons and be sensitive to the possible age differences.

• Counselors must attend to the "physical environment" of counseling more so than with a younger client.

• Counselors might serve more actively in the role of client advocate and attend to the dependence/independence issue while working with older adults.

• Counselors might focus on short-term goals and emphasize the present life situation of the client.

• Counselors need to be aware of the cultural, environmental, and value orientation differences between themselves and their clients and to have some perspective on the clients' "place in history."







10.0.Competencies Necessary for Working With Aging Baby Boomers

Jane Myers has conducted several studies involving older clients. Her research and competencies for gerontological counseling are both comprehensive and specific. More important is the fact that she is one of the few researchers who takes a wellness approach to working with older adults. Myers and Schwiebert (1996) recommended 16 specific "Minimal Essential Competencies" (skills) for a gerontological counseling specialist. Ten pertinent skills are presented in the following list.

• Demonstrates and actively advocates for positive, respectful, wellness-enhancing attitudes toward older persons and a concern for empowerment of persons throughout the lifespan.

• Demonstrates skill in applying extensive knowledge of human development for older persons, including major theories of aging, the relationship between physical and mental health and aging, the difference between normal and pathological aging processes, gender-related developmental differences, and coping skills for life transitions and losses.

• Demonstrates skill in applying extensive knowledge of social and cultural foundations for older persons, including characteristics and needs of older minority subgroups, factors affecting substance and medication misuse and abuse, recognition and treatment of elder abuse, and knowledge of social service programs....

• Demonstrates skill in recruiting, selecting, planning, and implementing groups with older persons.

• Demonstrates skill in applying extensive knowledge of career and lifestyle options for older persons, age-related assets and barriers to effective choices, and resources for maximizing exploration of career and lifestyle options....

• Demonstrates skill in applying extensive knowledge of current research related to older persons and the implications of research findings for helping relationships.

• Demonstrates skill in applying extensive knowledge of the intellectual, physical, social, emotional, vocational and spiritual needs of older persons and strategies for helping to meet those needs.

• Demonstrates skill in applying appropriate intervention techniques, in collaboration with medical and other care providers, for physical and mental impairments common to older persons, such as acute, chronic and terminal illness, depression, suicide, and organic brain syndromes....

• Demonstrates skill in the use of a wide variety of specialized therapies to assist older persons in coping with both developmental and non-normative issues such as creative art therapies, pet therapy, peer counseling, and family counseling.

• Demonstrates skill in applying extensive knowledge of ethical issues in counseling older persons, their families, and care providers. (pp. 12-13)

These competencies address some of the unique needs and issues that face the 76 million members of the baby boomer generation in the next 20 years.

11.0.Ageing

11.1.Ageing is the accumulation of changes in an organism or object over time. Ageing in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline. Reaction time, for example, may slow with age, while knowledge of world events and wisdom may expand. Research shows that even late in life potential exists for physical, mental, and social growth and development. Ageing is an important part of all human societies reflecting the biological changes that occur, but also reflecting cultural and societal conventions. Age is usually measured in full years and months for young children. A person's birthday is often an important event. Roughly 100,000 people worldwide die each day of age-related causes. The term "ageing" is somewhat ambiguous. Distinctions may be made between "universal ageing" (age changes that all people share) and "probabilistic ageing" (age changes that may happen to some, but not all people as they grow older, such as the onset of type two diabetes). Chronological ageing, referring to how old a person is, is arguably the most straightforward definition of ageing and may be distinguished from "social ageing" (society's expectations of how people should act as they grow older) and "biological ageing" (an organism's physical state as it ages). There is also a distinction between "proximal ageing" (age-based effects that come about because of factors in the recent past) and "distal ageing" (age-based differences that can be traced back to a cause early in person's life, such as childhood poliomyelitis). Differences are sometimes made between populations of elderly people. Divisions are sometimes made between the young old (65-74), the middle old (75-84) and the oldest old (those aged 85 and above). However, problematic in this is that chronological age does not correlate perfectly with functional age, i.e. two people may be of the same age, but differ in their mental and physical capacities. Each nation, government and non-government organization has different ways of classifying age. Population ageing is the increase in the number and proportion of older people in society. Population ageing has three possible causes: migration, longer life expectancy (decreased death rate), and decreased birth rate. Ageing has a significant impact on society. Young people tend to commit most crimes, they are more likely to push for political and social change, to develop and adopt new technologies, and to need education. Older people have different requirements from society and government as opposed to young people, and frequently differing values as well. Older people are also far more likely to vote, and in many countries the young are forbidden from voting. Thus, the aged have comparatively more political influence.

11.2.Life divided into various ages

An animal's life is often divided into various ages. Historically, the lifespan of humans is divided into Eight ages; because biological changes are slow moving and vary from person to person, arbitrary dates are usually set to mark periods of life. In some cultures the divisions given below are quite varied. In the USA, adulthood legally begins at the age of eighteen, while old age is considered to begin at the age of legal retirement (approximately 65).

• Pre-conception: ovum, spermatozoon

• Conception: fertilization

• Pre-birth: conception to birth (pregnancy)

• Infancy: Birth to 1

• Childhood: 1 to 12

• Adolescence: 13 to 19

• Early adulthood: 20 to 39

• Middle adulthood: 40 to 64

• Late adulthood: 65+

• Death

• Post-Death: decomposition of the body





11.3.Ages can also be divided by decade:

Term Age (years, inclusive)

Denarian 10 to 19

Vicenarian 20 to 29

Tricenarian 30 to 39

Quadragenarian 40 to 49

Quinquagenarian 50 to 59

Sexagenarian 60 to 69

Septuagenarian 70 to 79

Octogenarian 80 to 89

Nonagenarian 90 to 99

Centenarian 100 to 109

Super centenarian 110 and older

People from 13 to 19 years of age are also known as teens or teenagers. The casual terms "twenty something", "thirty something," etc., are also in use to describe people by decade or age.

12.0.Cultural variations



In some cultures (for example Serbian) there are four ways to express age: by counting years with or without including current year. For example, it could be said about the same person that he is twenty years old or that he is in the twenty-first year of his life. In Russian the former expression is generally used, the latter one has restricted usage: it is used for age of a deceased person in obituaries and for the age of an adult when it is desired to show him/her younger than he/she is. (Psychologically, a woman in her 20th year seems older than one who is 19 years old.)

Considerable numbers of cultures have less of a problem with age compared with what has been described above, and it is seen as an important status to reach stages in life, rather than defined numerical ages. Advanced age is given more respect and status.

East Asian age reckoning is different from that found in Western culture. Traditional Chinese culture uses a different ageing method, called Xusui with respect to common ageing which is called Zhousui. In the Xusui method, people are born at age 1, not age 0, because conception is already considered to be the start of the life span.





13.0.Legal

There are variations in many countries as to what age a person legally becomes an adult. Most legal systems define a specific age for when an individual is allowed or obliged to do something. These ages include voting age, drinking age, age of consent, age of majority, age of criminal responsibility, marriageable age, age of candidacy, and mandatory retirement age. Admission to a movie for instance, may depend on age according to a motion picture rating system. A bus fare might be discounted for the young or old. Similarly in many countries in jurisprudence, the defence of infancy is a form of defence by which a defendant argues that, at the time a law was broken, they were not liable for their actions, and thus should not be held liable for a crime. Many courts recognize that defendants who are considered to be juveniles may avoid criminal prosecution on account of their age, and in borderline cases the age of the offender is often held to be a mitigating circumstance.

13.1.Causes of ageing

Ageing occurs because natural selection gets weaker after our reproductive life starts. Once we are able to have children, we can give our genes to a future generation. If a gene has not killed you, or otherwise prevented you from having a child, then that gene will be passed on. The genes that don't act until late in life are also transmitted to our children, so they escape the force of natural selection. Natural selection cannot get rid of the genes that express harmful effects when we are old. Humans are the longest-living mammals. The maximum human life-span is 120 years, but the length of life varies a lot from place to place.

Overall, we know a lot about the human population. Yet although we know how long a newborn baby is statistically expected to live, we cannot predict how long each individual newborn will actually live. An accident or self-destructive life-style can suddenly end the life of any person, independent of their genes.

Life expectancy has increased dramatically in the industrialised world during the 20th century - from almost 50 years to now nearly 80 years. The longest-living group are Japanese women, who are expected to live 83 years. The additional years of life have been gained by 'traditional' methods, such as improved food supply, hygiene and medicine. In that sense living longer is a human creation. Wild animals hardly ever have the chance to age, because the weaker ones will eventually be eaten up by their natural enemies.

The same dramatic increase in life expectancy is now taking place in developing countries. This is mainly due to improvements in the food supply, medicine and hygiene. By 2020 almost three quarters of the world's elderly people (i.e. those over 60) will live in developing countries.

For people in the industrialised world to now gain a further dramatic increase in life expectancy is extremely unlikely by lifestyle changes alone.

Only by finding a way to modify the ageing process, and by making this discovery available to the entire population, might life expectancy exceed 100 years.

There is no single cause or mechanism found for ageing, only some good candidates.

It has been suggested and most scientists agree, that free radicals or oxygen radicals injure cells and promote ageing. Free radicals are one of the by-products of our breathing.

Scientists don't know to what extent the free radicals are responsible for our death, and what contributions they may have to our life.

A second suspected chemical reaction behind our ageing process is the 'browning reaction'. It is the same transformation that happens when we toast a slice of bread. In cellular life the 'browning reaction' happens between glucose and proteins. It causes changes and damage to protein function and to the expression of genes.

A third suspect for ageing is that our cells lose their ability to divide. This, amongst other things, makes our immune system weaker. The ageing process might be pre-programmed in our genome, but exactly how is still not known.

Scientists have been successful in prolonging the life of some animals. On a near-starvation diet rodents can live up to 40% longer, so long as they have the required vitamins and minerals.

Scientists have also been able to identify some of the genes related to ageing. Modifying these genes can lengthen the life of yeast, worms, mice and fruit flies. Yet, would these longer-living or slower-ageing animals prosper in the real world? Evolutionary theory predicts that longevity would come at a cost. Many of these mutants have been infertile.









14.0.Theories on the Causes of Aging

14.1.Theoretical Disclaimer

While thinking about these theories, one must remember the differences between cause and effect. Some are based on observations of aging cells. While the following theories may be valid causes of aging, they may also simply note an effect of the aging process. For example, gray hair is found primarily in the elderly, but does not play an active part in the aging process. Also keep in mind that individually, these explanations do not account for the complex process of biological aging. Thus, aging may be most accurately described by the synthesis of several of the following theories.

14.2.Current theories can, in general, be separated into two groups:

DNADamageTheories

Aging is caused by accumulated damage to DNA, which in turn inhibits cells' ability to function and express the appropriate genes. This leads to cell death and overall aging of the organism.

• DNA Damage/Repair Theory

• Free Radical/Oxidation Theory

• Mitochondrial DNA Theory

• Radiation Theory

Built-InBreakdownTheories

Aging is a direct consequence of genetic programming. The causes for aging are directly built into the genome and cellular structure, as a sort of molecular clock.

• Disposable Soma Theory

• Genetic Theory

• Immunological Theory

• Telomere Theory

14.3.DNA Damage/Repair Theory

DNA damages occur continuously in cells of living organisms. While most of these damages are repaired, some accumulate, as the DNA Polymerases and other repair mechanisms cannot correct defects as fast as they are apparently produced. In particular, there is evidence for DNA damage accumulation in non-dividing cells of mammals. These accumulated DNA damages probably interfere with RNA transcription. It has been suggested that the decline in the ability of DNA to serve as a template for gene expression is the primary cause of aging. Most damage comes in the form of oxidative damage, and hence is likely to be a prominent cause of aging.

14.4.0.Free Radicals & Anti-Oxidants

14.4.1.Free Radicals

In general, a free radical is any molecule with one or more unpaired electrons in its valence shell. In the discussion of aging, the free radicals of importance are oxygen-based molecules such as superoxide (O2-), hydroxy radical (OH), singlet oxygen (O), hydrogen peroxide (H2O2), and hypochlorous acid (HOCl). Free radicals, though attractive and charming, are damaging to the body because they are extremely reactive; they tend to rip electrons off of other molecules in order to pair off their lone electrons. In other words, free radicals are strong oxidizing agents.

Unfortunately, free radicals cannot be avoided since they are byproducts of essential reactions in the body, such as the process of metabolizing oxygen. Free radicals can also be found in abundance in the environment: air pollution, tobacco smoke, radiation, toxic waste, and certain chemicals.

14.4.2.Free radicals wreak havoc at a cellular level since they are able to:

• break off cell membrane proteins, thereby destroying cellular identity.

• fuse membrane lipid & proteins, hardening the cell membrane and leading to brittle and nonfunctional cells.

• disrupt the nuclear membrane. Free radicals may expose genetic material in the nucleus, leaving the DNA open for mutation or destruction.

• burden the immune system by damaging immune cells.

• cause chronic diseases.

These effects are known as oxidative stress, and may lead to DNA mutations, cell death, and disease, all of which contribute to the overall effects of aging. To prevent oxidative stress, one should reduce environmental burdens in the body (chemicals/heavy metals), reduce stress, improve the quality of one's food supply, and (if possible) increase one's antioxidant mechanisms.

14.5.Antioxidants

Antioxidants are the body's solution to oxidative stress. These molecules neutralize free radicals by supplying them with extra electrons. This exchange results in lowering the reactivity of the free radical and leaving the antioxidant itself with an unpaired electron. The structure of an antioxidant, however, is not damaging to the body since it is stabilized through chain reactions with other antioxidants.

14.6.Known antioxidants include:

• enzymes such as glutathione peroxidase, catalase, superoxide dismutase.

• nutrients including vitamins C and E, beta carotene, selenium, cystene, uric acid.

• synthetic molecules such as DSMO, BHT, and BHA.



14.7.The Free Radical / Oxidation Theory

This, perhaps one of the most respected and well-studied theories, rests on the fact that oxidants induce a variety of distinct biochemical changes in target cells. Hydrogen peroxide is considered one of the more troublesome oxidants, as it diffuses into target cells where site-directed hydroxyl radical formation injures specific targets. DNA is particularly sensitive to hydroxyl radical-induced damage: both DNA strand breakage and base hydroxylations can be detected. The breakage of the DNA strand activates a DNA binding protein (poly(ADP-ribose)polymerase), which forms polymers of ADP-ribose bound to various nuclear proteins using NAD as its substrate. NAD turnover under these circumstances increases so dramatically that it affects ATP synthesis, to the point where high enough concentrations inactivates mitochondrial ATP synthesis.

If the concentration of hydrogen peroxide is high enough, these pathways will lead to cell death, and, therefore, hydrogen peroxide-induced alterations will not be passed on to future generations. If, however, cells are exposed to sub-lethal concentrations of hydrogen peroxide, the ensuing injury could cause permanent and transmissible cellular alterations which could be biologically detrimental. For instance, if hydroxyl anion-induced DNA damage fails to be repaired or is improperly repaired, this DNA damage could lead to genetic alterations such as mutations, deletions, and rearrangements. Moreover, if these genetic alterations occur in critical genes that are involved in cell growth and differentiation, they could lead to deregulated cell growth and differentiation and ultimately contribute to the malignant transformation of cells. Hence, the growing number of free radical diseases includes the two major causes of death, cancer and arteriosclerosis.

Since hydrogen peroxide easily defuses through cell membranes, hydroxyl anion formation may occur extra- or intracellularly, depending on the availability of transition metals. Because of its high reactivity, the hydroxyl radical will always cause site- directed damage at the site of its formation. However, the body does possess some natural antioxidants in the form of enzymes which help to curb the dangerous build-up of these free radicals, without which cellular death rates would be greatly increased, and subsequent life expectancies would decrease.

14.8.Mitochondrial DNA Theory

This theory suggests that the loss of effectiveness of one of the cell's key organelles paves the way for age-related degenerative diseases. The mitochondria, which are the energy-producing bodies within a cell, have their own genome (mtDNA). This mtDNA is synthesized at the inner mitochondrial membrane near the sites of formation of highly reactive oxygen species. Mitochondrial DNA seems unable to counteract the damage inflicted by these by-products of respiration because, unlike the nuclear genome, it lacks advanced repair mechanisms. Thus, the cell loses its ability to produce energy, and gradually dies. This theory is supported by observations confirming the genomic instability of mitochondria, as well as widespread mtDNA deletions and other types of injury to the mitochondrial genome.

14.9.Radiation Theory

This theory is focused primarily on the aging of skin cells, as they are most directly affected by external sources of radiation. Radiation can create free radicals in cells, as the radiation strikes surrounding water molecules and other proximal targets. Thus the aging process goes back to the free radical theory on aging mentioned above, with radiation serving to increase its rate. Experimental studies have recently shown that the shorter, more energetic spectrum of the ultraviolet range (UVB) is responsible for the dermal connective tissue destruction observed in photoaged skin. Also, it has been shown that UVA and infrared radiation contribute significantly to photoaging, producing, among other changes, severe elastosis. Thus, even small amounts of radiation is enough to accelerate the aging process, although this theory is, as they say, only skin-deep.

14.10.Disposable Soma Theory

Soma, or somatic cells, are all the cells in the body except gametes and cells involved in gamete formation. This theory suggests that because of the requirement for reproduction, natural selection favors a strategy that invests fewer resources in maintenance of somatic cells than are necessary for indefinite survival. Therefore, energy will be spent to ensure minimum damage to molecular structures such as DNA, and to ensure that the animal remains in sound condition through its natural life expectancy in the wild, where accidents are the predominant cause of death. Since longevity is costly energy- wise, and since with age there is no longer any ability to reproduce and hence pass genetic material onto subsequent generations, there is simply no reason to keep an organism alive past its time of procreation.

14.11.Genetic Theory

Experiments have shown that human cells will divide less than 100 times outside the body. Also, there is an inverse correlation between the number of cell divisions and the age of the person from which the cells were taken. This theory suggests that cell senescence is an active process, as even though they are unable to divide, senescent cells are actively metabolizing. It has been suggested that senescence is genetically programmed, and that its phenotype is dominant, illustrated by the fact that when normal and immortal human cells were fused, they showed limited division potential. Senescent cells express highly abundant DNA synthesis inhibitory mRNA's and produce a surface membrane associated protein inhibitor of DNA synthesis not expressed in young cells. Thus, this theory suggests that aging is predetermined in the genome, and that it is a dominant condition, although the onset of the phenomenon is still unknown.

14.12.Immunological Theory

It is well documented that the effectiveness of the immune system peaks at puberty and gradually declines thereafter with advance in age. This seems to be based primarily on T-cells, and it is generally associated with an increase in susceptibility to infections as well as in incidence of autoimmune phenomena in the elderly. T-cells lose effectiveness in early life due to the decay of the thymus gland. In other words, the quality and quantity of T-cells begins to decline after puberty. Therefore, as one grows older, certain antibodies lose their effectiveness, and fewer new diseases can be combated effectively by the body, which causes cellular stress and eventual death.

14.13.Telomere Theory

This theory suggests that cell death is caused by the shortening of telomeres, which are "caps" on the ends of chromosomes. It has been observed that with each cell division the telomeres are shortened by approximately 65 base-pairs. Telomeres function by permitting complete replication of eukaryotic chromosomes, and by protecting chromosome ends from recombination. It has been shown experimentally that cell strains with shorter telomeres undergo significantly fewer doublings than those with longer telomeres. These observations suggest that telomere length is a biomarker of somatic cell aging in humans and is consistent with a causal role for telomere loss in this process. When the telomeres get too short, the cell stops replicating at an appreciable rate, and so it dies off, which eventually leads to the death of the entire organism.

15.0.Is the Aging Process Variable?

15.1.Diseases Involving Accelerated Aging

Several diseases have the effect of rapidly increasing the rate at which the carrier ages. For example, patients afflicted by progeria suffer from arteriosclerosis, coronary artery disease, congestive heart failure and non-healing fractures by the age of seven. Degeneration of hair follicles leads to balding. Most progeria sufferers die by the age of 30. Several other diseases are known to have similar effects, including Cockayne syndrome and Werner's syndrome.

15.2.Possibilities of Increased Lifespan

As things stand, the maximum human lifespan is about 120 years. As a whole, human knowledge is increasing at an exponential rate. By this logic, some scientists believe the human lifespan could be increased to between 400 and 1,000 years within the next 20 years. (Of course, we wouldn't really know for 400 more years...)

The following are some theories on increasing the human lifespan:

By increasing the amount of antioxidants in one's system, one will have less damaging free radicals in the body. The necessary antioxidants can be found in several sources:

• Multivitamin pills, especially Vitamins C and E.

• Beta cerotene

• Zinc

• Selenium

• Calcium

• Magnesium

• Chromium Picolinate

• Coenzyme Q-10

Telomerase has been discovered in some germs and cancer cells, but not in most normal organisms. This enzyme replaces/repairs shortened telomeres such that the cells are able to replicate (theoretically) forever. If the telomerase gene could be activated or spliced into regular human cells (assuming telomere theory is correct), human longevity would be greatly increased.

A mutant form of the gene age-1 in the worm C. elegans caused the worm's lifespan to double. The gene apparently codes for an enzyme important in the mediation of cellular communication and signal transmission. Increased lifespan was observed when the age-1 gene was nonfunctional.

Injection of growth hormone into men seemed to reverse some signs of aging. Experiments with other hormones, such as estrogen and testosterone, are ongoing.

16.0.The ageing process

As we age, our bodies change in many ways that affect the function of both individual cells and organ systems. These changes occur little by little and progress inevitably over time. However, the rate of this progression can be very different from person to person. Research in aging is beginning to find out the reasons for these changes and the genetic and environmental factors that control them.

• Genetic and Environmental Factors

• Cellular Changes Associated with Aging

• Bodily Changes Associated with Aging

• Other Changes with Aging

• Normal Aging and Disease

• Changes in the Regulation of Body System

16.1.Genetic and Environmental Factors

The aging process depends on a combination of both genetic and environmental factors. Recognizing that every individual has his or her own unique genetic makeup and environment, which interact with each other, helps us understand why the aging process can occur at such different rates in different people. Overall, genetic factors seem to be more powerful than environmental factors in determining the large differences among people in aging and lifespan. There are even some specific genetic disorders that speed up the aging process, such as Hutchinson-Gilford, Werner’s, and Down syndromes. However, many environmental conditions, such as the quality of health care that you receive, have a substantial effect on aging. A healthy lifestyle is an especially important factor in healthy aging and longevity (see Prevention). These environmental factors can significantly extend lifespan.

Behaviors of a Healthy Lifestyle

• Not smoking

• Exercising

• Getting adequate rest

• Eating a diet high in fruits and vegetables

• Coping with stress

• Having a positive outlook



16.2.Cellular Changes Associated with Aging



Aging causes functional changes in cells. For example, the rate at which cells multiply tends to slow down as we age. Certain cells that are important for our immune system to work properly (called T-cell lymphocytes) also decrease with age. In addition, age causes changes in our responses to environmental stresses or exposures, such as ultraviolet light, heat, not enough oxygen, poor nutrition, and toxins (poisons) among others.

Age also interferes with an important process called apoptosis, which programs cells to self-destruct or die at appropriate times. This process is necessary for tissues to remain healthy, and it is especially important in slowing down immune responses once an infection has been cleared from the body.

Different diseases that are common in elderly people can affect this process in different ways. For example, cancer results in a loss of apoptosis. The cancer cells continue to multiply and invade or take over surrounding tissue, instead of dying as originally programmed. Other diseases may cause cells to die too early. In Alzheimer’s disease, a substance called amyloid builds up and causes the early death of brain cells, which results in a progressive loss of memory and other brain functions. Toxins produced as byproducts of nerve-cell transmissions are also thought to be involved in the death of nerve cells in Parkinson’s disease.

16.2.0.Bodily Changes Associated with Aging

Our bodies normally change in appearance as we age.

16.2.1.Changes in Height

We all lose height as we age, although when the height loss begins and how quickly it progresses vary quite a bit among

different people. Generally, our height increases until our late forties and then decreases about two inches by age 80.

The reasons for height loss include the following:

• changes in posture

• changes in the growth of vertebrae (the bones that make up the spine)

• a forward bending of the spine compression of the discs between the vertebrae

• increased curvature of the hips and knees

• decreased joint space in the trunk and extremities

• joint changes in the feet

• flattening of the arches



The length of the bones in our legs does not change much.

16.2.2.Changes in Weight

In men, body weight generally increases until their mid-fifties; then it decreases, with weight being lost faster in their late sixties and seventies. In women, body weight increases until the late sixties and then decreases at a rate slower than that of men.

People that live in less technologically developed societies do not show this pattern of weight change. This suggests that reduced physical activity and changes in eating habits may be causes of the change in body weight rather than the aging process.

16.2.3.Changes in Body Composition

The proportion of the body that is made up of fat doubles between age 25 and age 75. Exercise programs may prevent or reverse much of the proportional decrease in muscle mass and increase in total body fat. This change in body composition is important to consider in nutritional planning and level of activity. The change in body composition also has an important effect on how the body handles various drugs. For example, when our body fat increases, drugs that are dissolved in fatty tissues remain in the body much longer than when our body was younger and more muscular.

17.0.Other Changes with Aging

Normal aging in the absence of disease is a remarkably beginning process. In other words, our body can remain healthy as we age. Although our organs may gradually lose some function, we may not even notice these changes except during periods of great exertion or stress. We may also experience slower reaction times.

17.1.Normal Aging and Disease

Aging and disease are related in subtle and complex ways. Several conditions that were once thought to be part of normal aging have now been shown to be due to disease processes that can be influenced by lifestyle. For example, heart and blood vessel diseases are more common in people who eat a lot of meat and fat. Similarly, cataract formation in the eye largely depends on the amount of exposure to direct sunlight. We should remember that there is a range of individual response to aging. Biologic and chronologic ages are not the same. In addition, body systems do not age at the same rate within any individual. For example, you might have severe arthritis or loss of vision while the function of your heart or kidneys is excellent. Even those aging changes that are considered "usual" or "normal" are not inevitable consequences of aging.

17.2.Changes in the Regulation of Body Systems

The way our body regulates certain systems changes with age.

Some examples are listed below.

• Progressive changes in the heart and blood vessels interfere with your body’s ability to control blood pressure.

• Your body cannot regulate its temperature as it could when you were younger. This can result in dangerously low body temperature from prolonged exposure to the cold or in heat stroke if the outside temperature is too high.

• There may be aging-related changes in your body’s ability to develop a fever in response to an infection.

• The regulation of the amount and makeup of body fluids is slowed down in healthy older persons. Usual (resting) levels of the hormones that control the amount of body fluids are unchanged, but problems in fluid regulation commonly develop during illness or other stress. Also, elderly people don’t feel as thirsty after water deprivation as they did when younger.

17.3.What do these age-related changes in our body systems mean?

• First, with advancing age, we become less like each other biologically, so our health care needs to be more individualized.

• Body systems that can be minimally affected by age are often profoundly influenced by lifestyle behaviors such as cigarette smoking, physical activity, and nutritional intake, and by circumstances such as financial means.

Finally, it’s helpful to consider ahead of time our possible choices in case certain situations arise. For example, if you become less physically able to take part in an athletic activity you did before, is there a different activity you might enjoy? Are there things you might like to do to keep your mind active? More serious situations to consider might include death of a spouse, or if you find your abilities becoming more and more limited. Have you discussed how you would like to handle such situations and your wishes with your family? It is important to remember that the ability to learn and adjust continues throughout life and is strongly influenced by interests, activities, and motivation. With years of rich experience and reflection, we can rise above our own circumstances. Old age, despite the physical limitations, can be a time of variety, creativity, and fulfillment.



18.0.Slowing the ageing process



Everybody (Rich Man, Poor Man, Beggars, Thief), all will go through the aging process. However, how well we endure that process will depend on the individual. Remember the old adage," Take The Bull By The Horns" means we must do everything in our power to slow down the aging process. By slowing down the aging process, we are extending our life expectancy.

Many factors are involved in the aging process. All these factors impact the Respiratory, Cardiovascular, Nervous, Musculoskeletal, and the Immune Systems. Each system reacts to it's own physiological makeup. Therefore, how we treat these systems, and the environment in which we live in directly will determine the response to the aging process.

The respiratory system can severely be impacted by environmental influences such as exposure to smoke, toxic chemicals and air pollutants. These influences cause a progressive deterioration of the functioning structures of the lungs and bronchial tubes. Added to this are age related changes that increase the respiratory effort. Those are the changes in the other systems of the body that also directly affect the respiratory system.

The musculoskeletal system, comprised of the muscles, tendons, ligaments, connective tissues, and the fascia are the glue that binds the body together. It is here in these tissues that the individual is apt to notice the progressive changes of aging. Basically, these connective tissues lose water and start to dry-up, as we grow older. This drying out process of the tissues causes them to lose the elasticity we enjoyed in earlier years. They will become more brittle and injuries are more likely to occur. Our flexibility is reduced, so we move, walk and bend with increased difficulty. The respiratory system is affected due the loss of flexibility of the muscles involved in the breathing process, therefore affecting all the chest structures.

The impairment of the respiratory system can in turn affect the cardiovascular system. The cardiac output is lowered due to the increased resistance of the blood vessels in the musculature. This reduction in the blood flow decreases the oxygen uptake, making the body less able to deliver the necessary oxygen to the body tissues, because of the decreased lung capacity. This vital capacity diminishes after age 20 and is on a steady decline thereafter, unless the individual takes the proper steps. As we get older and become more sedentary in our habits, the decline increases.

The nervous system acts as a communications coordinator between the various systems and organs of the body. Should there be any breakdown or glitch in the nervous system there will a disharmonious reaction in the structures that relate to the body's normal function, simply because they cannot carry on the work they normally do. For example there will be disruption of the metabolic processes that in turn can cause other breakdowns as in the digestive system causing a variety of other problems. These problems are too numerous to go into because there can be thousands and thousands of volumes written, and still not scratch the surface. But, I think you will see that one thing leads to another. In other areas the heart rate may be lowered, thus reducing the cardiac output and further lowering the oxygen uptake.

Aging, per se, is not just the effects of chronological time, but the inactivity we impose on our body. The former Surgeon General of the United States put it very bluntly: "More people die of a sedentary lifestyle than from smoking". Much of what we consider normal aging is due to our sedentary lifestyle. A prime example would be when an individual fractures a bone, let us say in the arm, and the arm is placed in a cast. After 6-8 weeks of wearing the cast and the cast is removed, the muscles of the arm will be thinner (atrophied) and have become weaker due to the inactivity. If the cast was over a joint, that joint will have stiffened and normal range of motion (ROM) will be greatly restricted. By this example you can perceive how important it is for us to keep our body moving. "If you don't move it you lose it".

That is why the process of aging, other than is normally due to "Father Time", can be directly related to our sedentary lifestyle. Inactivity, due to the lack of exercise, affects the architectural structures and thus speeds-up the "aging process". It is inevitable that we all grow old, but it is not inevitable to grow old in such a manner as not to be able to bend down and tie our shoelaces, or do the everyday ordinary chores without the resultant aches and pains.

18.1.Slowing the "aging process" therefore depends on the individual and what steps they employ to do this. With the proper steps you can turn back "Father Time". In other words you can reduce your "real age" to your "chronological age". A realistic plan to best achieve this goal would be as follows:

• Start a regular exercise program and stick to it. It has been found that 50% of the people who start an exercise program will stop it in 3 to 6 months.

• Stop smoking.

• Control your diet. Eat less fat, especially animal fat and dairy fat. Eat more fruits and fresh vegetables. Reduce your sodium and sugar intake. Omit eating white processed flour and rice.

• Take proper diet supplements, including antioxidant vitamins such as C (500-1000 mgs), E (400 IU), A (5000 mgs) and calcium (1000-1600 mgs).

• Limit your exposure to the sun. But 15 minutes at least three times weekly is advisable because the body manufactures vitamin D from the sun exposure.

• Watch your weight, avoid obesity and limit your calories. Lose weight if you are overweight. Drugs to lose weight should not be taken unless the individual is morbidly obese.

• Limit your consumption of alcohol and caffeine. Alcohol should be limited to no more than one or two drinks daily, and caffeine to no more than one or two drinks daily. Avoid cola sodas entirely.

• Reduce and avoid stress as much as possible. Try to get at least 30 minutes of quite time, where you can put your feet up, relax and think good thoughts.

• Instead of driving, walk when you can. When you do drive, drive within the speed limits and drive defensively. Walk up and down stairs when possible.

• Go to sleep the same time each night. Do not watch television in the bedroom. Keep the bedroom airy and darkened.

• Flossing your teeth on a daily basis and visiting your Dentist once or twice a year to prevent gum disease can prolong your life. Gum disease has been shown to contribute to heart disease and other diseases.



By following these 11 steps, the individual can reduce their real age from their chronological age, by as much as 6 years and possibly even more. The single most important step is starting your exercise program.



19.0.The Evolutionary Causes of Aging and Death



One of the core ideas of the Principia Cybernetica ethics is that "cybernetic" immortality is an essential long-term goal we (or evolution) should strive for. However, when asssuming that immortality is "good" in an evolutionary sense, we must justify why we are not immortal as yet, being the products of evolution.

A useful way to look at this problem is Dawkins's "Selfish Gene" picture of evolution, where the fundamental unit to be maintained by natural selection is not the individual, nor the group or the species, but the gene. Individuals are merely disposable vehicles for the replicating information contained in the genes. As long as the genes survive (that is, are replicated in offspring before the individual dies), the survival or death of the individual is not very important. This leads to the "disposable soma" (disposable body) theory of aging, which we will summarize below.

Though some theories assume that aging (and hence death) are preprogrammed in the genes, thus implying some kind of evolutionary necessity of individual mortality, more recent theories explain aging without such special assumptions. The main idea is that every evolutionary adaptation has a cost: using genes for one specific activity or function implies that resources (matter, energy, time, neguentropy) are wasted, which thus can no longer be invested in another function. In practice there is always a trade-off, and it is impossible to simultaneously maximize two different functions (e.g. reproduction and survival).

For a gene, the main criterion that must be fulfilled or maximized in order to be naturally selected, is that its vehicle (individual organism) should survive long enough to be able to produce (numerous) offspring. Now, one might argue that the longer the organism lives, the more offspring it can produce, and the more copies of its genes will be made. Hence, the genes of organisms that do not age, and thus live longer, would be naturally selected. However, mortality depends on at least two different factors: (internal) aging, and (external) perturbations (accidents, diseases, predation, starvation, ...). Though a gene can make its vehicle or carrier stronger, smarter and more resistent, it can never completely eliminate all possible perturbations causing death.

On the other hand, we might imagine genes stopping the process of aging. There are enough examples of self-repair mechanisms in cells and organisms to suggest that this is possible. Moreover, the fact that genes themselves are immortal should be sufficient to counter any arguments based on uncontrollable deterioration because of the second law of thermodynamics. Indeed, it is well-known that primitive organisms (e.g. bacteria, algae, protozoids, ...) are in a sense immortal. That is, when they reproduce (by mere splitting of cells) there is no difference between "parent" and "offspring": both splitted cells continue to survive, and undergo further splits, without any apparent aging or senescence. Our own process of reproduction (meiosis) is merely a more complicated version of this, in which just a few cells (sex-cells or germ-line cells) can indefinitely reproduce, while the other cells die after a while. Even the increase of thermodynamic entropy can be counteracted indefinitely in an open system with a constant input of neguentropy. So there is no a priori reason why living systems would not be able to indefinitely maintain and repair their structural organization.

But the question is whether it is worthwhile for a gene to invest lots of resources in counteracting the effects of aging. The factor of death because of external perturbations could be measured as some kind of average probability for an individual to be killed in a given lapse of time due to external causes. This would make it possible to compute an average life expectancy, not taking into account internal aging. The normal life expectancy for primitive people living in a natural environment (unlike our own highly protective environment) seems to be about 20-30 years.

Now, if you are likely to die around the age of 25 by external causes, there is little advantage in spending a lot of resources on combating the effects of aging, so that you might theoretically live for 1000 years. That is why we might expect that in the trade-off between early reproduction and long-time survival the genes would tend towards the former pole, making sure that sufficient off-spring is generated by the age of 25, rather than trying to extend the maximal age beyond 120 years (the apparent maximum for humans).

This implies that if our present environment, where the probability of being killed by predators, starvation or diseases before reaching old age is much smaller than in the original human environment, would continue to exist for a million year or so, natural selection would promote genes that would make us live longer. (when we are speaking about an evolution towards cybernetic immortality, however, we mean a quite different phenomenon, on a much shorter time scale. This evolution would take place on the level of memes rather than genes. ) In fact, a similar evolution has been artificially produced in fruit flies: by only allowing the fruit flies to reproduce at an advanced age, there was a selection for longevity instead of a selection for quick reproduction. Thus, in a few years, time researchers were able to double the (very short) life span of the flies. This is an experimental confirmation of the disposable soma theory.

In conclusions, such genetic theories of aging seem to imply that death is not necessary for evolution: it is only a side-effect of the fact that a gene can spread more quickly by early reproduction than by long-term survival of its carrier, depending on the average life-expectancy (and reproduction expectancy) in the given environment. From the point of view of the selfish gene, there is no reason whatsoever why it should destroy older copies of itself in order "to make room for the newer ones" (a quote from our Cybernetic Manifesto). This is merely an anthropomorphization of "Nature" as an intelligent agent, looking ahead and concluding that the new generation should be promoted at the expense of the older generation. All genes are selfishly striving for survival, and the only thing that would make one of them give up the fight is because it is less fit than its rivals, not because it is "older".

From that point of view, I would even reject the more careful formulation that mortality "may be useful for genetic evolution". The only reason for mortality would be that not having it (i.e. maintaining the necessary apparatus for unlimited self-repair of cells and organisms) would take away many resources from reproduction, for a very small return in terms of reproductive fitness. But I would hardly call that "being useful".



19.1.Different causes of aging



As to the process of aging, there seems to be a multitude of effects involved, so that we should not expect any single genetic mutation to solve the problem. One of those is the production of "free radicals" (a type of oxidizing agents, damaging proteins necessary for the functioning of the cell) during energy production. Much of the damage done by free-radicals is repaired by the cell, but in the long term damage tends to accumulate. One of the suggested therapies to increase life-span (life-extension) is to combat free radicals by antioxidant chemicals such as selenium, Vitamin C and Vitamin E, or to minimize their production by calorie restriction diets.

Another one is an apparently inbuilt limit on the number of times a cell can divide (mitosis). This so-called Hayflick limit (of the order of 50 divisions) is well beyond the one that is reached during normal life, and should thus not be interpreted as a preprogrammed death. The hypothesis is that it functions to limit the risks for the development of cancer or tumors (characterized by unrestricted reproduction of cancerous cells). The mechanism seems to be that during each splitting of a cell, the chromosomes are copied incompletely, with a small stretch of DNA on the outer extremum being cut off during the split. The outer stretches of DNA (telomeres) for a young cell are not functional, so that losing them does not impair function. But after a sufficient number of divisions, the process would start to cut off functional DNA, thus making it impossible for the cell to survive. The cutting off does not happen during cell divisions (meiosis) producing sex cells (sperm or egg cells). Otherwise each subsequent generation would have less DNA than the previous one. This reminds us of the fact that the loss of DNA is not an unavoidable effect of increase of entropy or a similar physical principle leading to aging.

Very recently, researchers have managed to synthetically produce the enzyme telomerase, which is capable of produce new telomeres. This open up new avenues to combat those forms of again linked to the Hayflick limit.



20.0.Summary/Conclusion

This paper has revealed the facts and figures that make the baby boomer generation unlike any other in terms of sheer numbers, and also highlighted the unique characteristics of this large population and the differences from previous generations. Challenges and issues for baby boomers' present and future were discussed. Results of several studies described the concerns of these baby boomers.

A brief reflection on historical views of aging and ageism suggests the need for altering stereotypes in order to be of greater counseling assistance to this population. Four keys to self-empowerment in aging were noted and described: creativity, attitude, positivism, and wellness. We discussed applicable theories and standards for both individual and group work and defined recommended principles and specific competencies for gerontological counseling. As baby boomers move into their 60s the face of counseling will become more complex. Increasing numbers of highly skilled professionals will be needed to meet the mental, physical, social, emotional, career, and leisure needs of this population.

Bortz (1990) stated a theme or philosophy for growing older:

Aging is a self-fulfilling prophecy. If we dread growing old, thinking of it as a time of forgetfulness and physical deterioration, then it is likely to be just that. On the other hand, if we expect it to be full of energy and anticipate that our lives will be rich with new adventures and insight, then that is the likely reality. We prescribe who we are. We prescribe what we are to become. (p. 55)









References



Achenbaum, W. A., (1995). Crossing frontiers: Gerontology emerges as a science. Cambridge, UK: Cambridge University Press.

Altekruse, M., & Ray, D. (1998). Counseling older adults: A special issue. Educational Gerontology, 24,303-307.

Bortz, W. (1990). Use it or lose it. Runner’s World, 25, 55-58.

Brokaw, T. (1998). The greatest generation. New York: Random House.

Bass, S., & Ferraro, K., (2000). Gerontology education in transition: Considering disciplinary and paradigmatic evolution. The Gerontologist, 40, 97-106.

Bengtson, V. L., Parrott, T. M., & Burgess, E. O., (1996). Progress and pitfalls in gerontological theorizing. The Gerontologist, 36, 768-772.

Biggs, S., Lowenstein, A., & Hendricks, J., (Eds.) (2003). The need for theory: Critical approaches to social gerontology.

Birren, J. F., & Bengtson, V. L., (Eds.) (1988). Emergent theories of aging. New York: Springer Publishing Company.

Bramwell, R. D., (1985). Gerontology as a discipline. Educational Gerontology, 11, 201-210.

Bass, S.A. (2006). Gerontological Theory: The Search for the Holy Grail. The Gerontologist, 46, 139-144.

Bath, P.A. (2003). Differences between older men and woman in the Self-Rated Health/ Mortality Relationship. The Gerontologist, 43 387-94

Bitterman KJ, Cohen HY, et al (2003). "Small molecule activators of sirtuins extend Saccharomyces cerevisiae lifespan". Nature 425 (6954): 191–6.

Charles, S.T., Reynolds, C.A., & Gatz, M. (2001). Age-related differences and change in positive and negative affect over 23 years. Journal of Personality and Social Psychology, 80, 136-151.

Capuzzi, D., & Gross, D. (2002). Counseling the older adult. Introduction to the counseling profession (3rd ed.). Boston: Allyn & Bacon.

Chesser, M. (2003). Aging well: Surprising guide posts to a happier life. Spirit, 96-100.

Crary, D. (2004).Standards manual. Alexandria, VA: American Counseling Association. Ageism:

de Grey, Aubrey; & Rae, Michael (2007). Ending Aging: The Rejuvenation Breakthroughs that Could Reverse Human Aging in Our Lifetime. New York, NY:

Dobbs, L. (2004, April 24). Changes in the workforce. CNN News Network.

Estes, C. L., Swan J. H., & Gerard, L. E., (1982). Dominant and competing paradigms in gerontology: Towards a political economy of ageing. Ageing and Society, 2, 151-164.

Effros RB (April 2005). "Roy Walford and the immunologic theory of aging". Immun Ageing 2 (1):

Fentleman, D.L., Smith, J. & Peterson, J. (1990). Successful ageing in a postretirement society.

Guarente L, Picard F (2005). "Calorie restriction the SIR2 connection". Cell 120 (4): 473–82.

Gilleard, C., & Higgs, P., (2000). Cultures of ageing: Self, citizen, and the body. Harlow, England: Prentice Hall.

Gilleard, C.& Higgs, P.(2005). Contexts of ageing: Class, cohort and community. Cambridge, UK: Polity.

Howe, M., & Strauss D. (2001). Millenials rising: The next generations. New York:

Hagestad, G. O., & Dannefer, D.(2001). Concepts and theories of aging: Beyond microfication in social science approaches.

Howell, Trevor H. (1987), "Avicenna and His Regimen of Old Age", Age and Ageing 16

Jones, Landon (1980), Great Expectations: America and the Baby Boom Generation, New York:

Katz, S. N., (1996). Disciplining old age: The formation of gerontological knowledge. Charlottesville, VA: University Press of Virginia.

Kastenbaum, R. (1992). The creative process: A lifespan approach. Generations, 22(1), 285-306.

Kaeberlein M, Powers RW, Steffen KK, et al (2005). "Regulation of yeast replicative life span by TOR and Sch9 in response to nutrients". Science 310 (5751): 1193–6..

Longino, C. F., Jr. (2005). Exploring the connections: Theory and research. Journal of Gerontology: Social Sciences, 60B, S172.

Moen, P. (1998). Recasting careers, changing reference groups, rests, and realities. Generations, 22(1), 40-41

Morgan, D. (1998). Facts and figures about the baby boom. Generations, 22(1), 10-15.

Myers, J. (1996). Competencies for gerontological counseling. Alexandria, VA: American Counseling Association.

Myers, J. (2003). Wellness in later life. Paper presented at the annual meeting of American Counseling Association, Anaheim, CA.

Maddox, G. L., & Campbell, R. T., (1985). Scope, concepts, and methods in the study of aging. Handbook of aging and social sciences, 2nd edition (pp. 3–28). New York: Van Nostrand Reinhold.

Marshall, V., (1999). Analyzing social theories of aging. Handbook of theories of aging (pp. 434–455). New York: Springer Publishing Company.

Minkler, M., (1996). Critical perspectives on ageing: New challenges for gerontology. Ageing and Society, 16, 467-487.

Mather, M., & Carstensen, L. L. (2005). Ageing and motivated cognition: The positivity effect in attention and memory. Trends in Cognitive Sciences 9, 496-502.

Moody, H. R.(1988). Toward a critical gerontology: The contribution of the humanities theories of aging. Emergent theories of aging (pp. 19–40).

Myers, G. C.(1996). Aging and the social sciences: Research directions and unresolved issues. Handbook of aging and social sciences, 4th edition (pp. 1–11).

Noveck, Jocelyn (2009), "In Obama, many see an end to the baby boomer era".

Owram, Doug (1997), Born at the Right Time, Toronto: University Of Toronto Press.

Ponzo, Z. (1992). Promoting successful aging: Problems, opportunities, and counseling guidelines. Journal of Counseling Development, 7, 210-213.

Parsons, T., (1997). Social systems and the evolution of action theory. New York:

Phillipson, C.(1998). Reconstructing old age: New agendas in social theory and practice. London: Sage Publications.

Rowe, J.D. & Kahn, R.L. (1987). Human ageing: Usual and successful. Science, 237, 143-149

Rowe, J.D. & Kahn, R.L.(1997). Successful ageing. The Gerontologist, 37 (4) 433-40

Strawbridge, W.J., Wallhagen, M.I. & Cohen, R.D. (2002). Successful ageing and well-being: Self-rated compared with Rowe and Kahn. The Gerontologist, 42, (6)

Savage, S. P.(1981). The theories of Talcott Parsons: Social relations in action.

Settersten, R. A., Jr., (2005). Linking the two ends of life: What gerontology can learn from childhood studies. Journal of Gerontology:

Salt, Bernard (2004), The Big Shift, South Yarra, Vic.: Hardie Grant Books,

Schuman, H. and Scott, J. (1989), Generations and collective memories, American Psychological Review, vol. 54, 1989, pp. 359-81.

Walker, A., (1999). Public policies and theories of aging: Constructing and reconstructing. Handbook of theories of aging. New York:

Weiss, R. S., & Bass, S. A., (Eds.) (2002). Challenges of the third age: Meaning and purpose in later life. New York: Oxford University Press.

Weiss, J. (1995). Cognitive therapy and life review therapy: Theoretic and therapeutic implications for mental health counselors. Journal of Mental Health Counseling, 10, 157-171.

Wong, F. (2002). Preparing to meet the needs of an aging American public. Nation’s Health, 32(8), 3

Zacks, R.T., Hasher, L., & Li, K.Z.H. (2000). Human memory. The Handbook of Ageing and Cognition (pp. 293–357).









































.