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Define “double jeopardy” and describe how it affects various elderly minority groups

Week 5: Overview

Introduction

This week we’ll cover four topics: minority issues, women’s issues, family relationships, and long-term care.

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Learning Outcomes

· Define “double jeopardy” and describe how it affects various elderly minority groups

· Describe cycle of insular poverty

· Identify issues particular to older women and their longer life expectancy

· Chart the pattern of marital satisfaction over the average life span

· Describe how caregiving affects the “sandwich generation”

· Identify the five types of grandparenting from the study by Neugarten and Weinstein

· Compare and contrast the advantages and disadvantages of various forms of long-term care

· Week 5: Lecture

· Minority Issues

· You likely will become familiar with some of the discriminatory practices toward various minorities through the reports of your classmates and your own research. Here we will briefly address “double jeopardy,” a somewhat controversial concept that has general application to various minorities. Double jeopardy is the tendency for a member of a minority to be discriminated against, first by virtue of being a member of a racial or ethnic minority, and to be further disadvantaged by being older. Some would add that being female is a third dimension of jeopardy. Women’s issues will be discussed shortly.

· Although some researchers have viewed the concept of double jeopardy as being overemphasized, many more have maintained its significance.  Clearly, most minorities experience hardships (lower income, substandard housing, etc.) that are less prevalent among native born, White Anglo-Saxon Protestants, or even among most Whites in general.

· One of my objectives in this course is to urge you to become more sensitive to the additional hardships faced by the majority of minority elderly. In his book titled The Other America, Frank Harrington asserts that most poverty in the United States is insular poverty, i.e., pockets of poverty in which one generation of poverty begets another. As an example, a poor Hispanic child grows up in a neighborhood where education is not emphasized, attends a substandard school, ends up with a relatively low-paying job, and retires with relatively low retirement income. One’s offspring continues the cycle and has the additional burden of helping provide for aging parents that may need financial and other assistance. If you say that there are many exceptions to my example, you are absolutely right. However, Harrington and others would likely say that we may hear too much of the Horatio Alger stories and lose sight of the norm.

· Week 5: Lecture

· Women’s Issues

· Robert Butler, geriatrician and former Director of the National Institute on Aging, and Myrna Lewis have written extensively about the plight of the older woman. In recent decades the life expectancy of older women has been 5 – 7 years longer than that of older men. This fact alone presents many additional problems for older women, even though most of us value a longer life.

· Whereas over the past 20 years plus, generally more than 70% of older men (65 and older) are married and living with their spouses at any given point in time, less than half of older women are married and living with their spouses. This underscores the likelihood that most older females will spend a substantial part of their later years living alone. Older men are likely to have a spouse as a caregiver in later life but older women likely will have to find a different source of assistance. Living alone also has significant implications related to income, housing (especially upkeep), social life, etc. Butler once asked why the women’s movement focused so little attention on the plight of the older woman. It appears that little headway has been made in this area since Butler drew so much attention to it in the 1970’s. Issues of older women remain an area that lends itself to discussion and creative improvement.

· Week 5: Lecture

· Family Relationships

· In discussing family life and aging, four areas will be discussed briefly: spousal relationships, caregiving, grandparenting, and intergenerational equity. As anyone might expect, family life is a primary factor related to happy and successful aging for most.

· Roger Gould, a University of California at Los Angeles researcher, noted an inverted bell shape (or u-shaped) pattern of marital satisfaction. According to him, marriage tends to be very happy in the early years, begins gradually declining into the early middle years and then begins to increase again sometime in the middle years through later life. It appears that for those who survive the challenges of the middle years (roughly ages 35-55), marriage is very satisfying.

· There does not appear to be widespread consensus on what gender role patterns lend themselves best to happy and successful marriages. However, Robert Atchley, a noted author in gerontology, stated that egalitarian marriages tend to fare best. By this he meant that marriages that have flexible, rather than rigid, male and female roles tend to be most satisfying.

· Another major factor related to happiness in later life is the health of one’s spouse. The Rand Corporation conducted a study of what tended to contribute most to high morale and life satisfaction among older persons. Of the three factors that were concluded to contribute most, not surprisingly, one’s good health and adequate finances were identified. The third factor, and what may be sometimes overlooked, is the health of one’s spouse. One may tend to have somewhat more control over one’s own health and finances than on the health of one’s spouse.

Week 5: Lecture

Caregiving

The family remains the greatest single source of caregiving for older adults. Often to provide optimal care, there needs to be coordination between primary caregivers (family) and the aging network (the system of community resources for older adults such as homecare agencies, day care centers, senior centers, health clinics, etc.).

Of course, sometimes caregiving for older persons falls on the shoulders of the children of older persons, the so-called “sandwich generation” that may have the dual role of raising their own children while caring for their aging parents. The Health and Retirement Study that began in 1990 and has continued into this century reported that as many as two-thirds of the middle-aged sample had parents or parents-in-law in need of some form of caregiving.

Many researchers have emphasized the importance of what is referred to as a “continuum of care,” the provision of vital services as they are needed. Older people usually do not go from a state of full independence to a state of complete dependence. More frequently, there is a gradual need for increased services. Most researchers advocate facilitating the older person to remain as autonomous and independent as possible. Transitioning from the role of child to parenting one’s own aging parents can be done too abruptly and completely.

Some researchers also caution observers from concluding that the offspring of older persons are usually the “givers” and older persons are usually the “takers.” This point is made quite clear in the attached, titled “ Intergenerational Equity or the New Ageism?

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“. In the article, the Commonwealth Fund reported in its study that older persons are four times more likely to provide assistance to their children than vice versa.

And Thou Shalt Honor

Now watch the film, “And Thou Shalt Honor.” Again, use the  form

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provided to record the important points in the film for your own use.

· Click here to open the video “And Thou Shalt Honor”

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Another area that is replete with misconceptions is related to older adults and their grandchildren. Before we go on to discuss grandparenting in the next section, take a few minutes to complete the Older Adults and Grandchildren discussion.

 

Week 5: Lecture

Grandparenting

Below are important data from one of the most widely reported studies on grandparenting and aging (Neugarten and Weinstein, 1968). Five types of grandparenting are reported in the study:

1. Formal:  Grandparents of this style usually enjoy getting together with their grandchildren on holidays and other special occasions.  They are careful not to encroach on parenting which they leave to the parents.

2. Fun Seeker:  A key characteristic of this style is mutuality.  The grandparents actually enjoy very much doing activities with their grandchildren and often are younger grandparents.

3. Surrogate Parent:  These grandparents, usually females, actually take over the parenting role much of the time for their grandchildren.

4. Reservoir-of-family-wisdom:  Often the grandfather, these grandparents pride themselves in being a resource to their grandchildren, passing on both family and educational  information.

5. Distant-figure:  These grandparents are very atypical of the stereotype that most people have of grandparenting:  They don’t particularly value their time with their grandchildren.

 

The study probably helps us to counter the tendency to stereotype the role of grandparent. There are many different approaches to implementing the grandparenting role, and there also are many different sources of significance for being a grandparent. See some of the original data from the Neugarten and Weinstein study below.

Study on Grandparenting and Aging Grandmothers (N = 70) Grandfathers (N=70)
Significance of Grandparenting Role    
Biological Renewal 42% 23%
Emotional Self-Fulfillment 19% 27%
Resource Person to Child 4% 11%
Vicarious Achievement 4% 4%
Remote 27% 29%
Insufficient Data 4% 6%
Style of Grandparenting    
Formal 31% 33%
Fun-Seeking 29% 24%
Parent Surrogate 14% 0%
Reservoir of Family Wisdom 1% 6%
Distant Figure 19% 29%
Insufficient Data 6% 8%
Ease of Role Performance    
Comfortable / Pleasant 59% 61%
Difficult / Discomfort 36% 29%
Insufficient Data 5% 10%
Source: Neugarten and Weinstein, 1968

One of the major changes between the original Neugarten and Weinstein study and the more recent Health and Retirement Study is the percent of grandparents who are implementing the “parent surrogate” role. The Health and Retirement Study reports that more than 40 percent of the grandmothers in their 50’s and early 60’s are devoting 15 or more hours per week caring for their grandchildren. Even if this number of hours may not technically qualify as a “surrogate parent,” it does seem very substantial.

Week 5: Lecture

Long Term Care

In the previous textbook for this class, Diana Harris (The Sociology of Aging, 2007) defines long-term care as follows:

“Long-term care refers to an array of health-care, personal care, and social services provided over a sustained period of time to persons with chronic conditions and functional limitations.”

Harris adds that there are three major providers of long-term care: assisted living facilities, home health care, and nursing homes.

Harris compares and contrasts the advantages and disadvantages of the various forms of long-term care. Note that the bulk of community-based long-term care is provided by families or friends. We have already observed that is the preference of older persons. Even when health care is needed, older persons would prefer to receive it in their own homes. However, many older persons will reach a time when chronic conditions and functional limitations are so extensive that assisted living or nursing home care may be the most appropriate setting for care.

Three laws have done much to shape long-term care in the U.S.

1. The Social Security Act of 1935 helped provide the income for older persons to pay for private long-term care.

2. OBRA 87 helped to reform nursing homes by establishing provisions aimed at improving their quality of care standards.

3. Medicare / Medicaid laws of 1965 helped fund nursing home care.

It is very important to remember that Medicare provides very limited funding for nursing home care following hospitalization; Medicaid is a major source of funding for nursing home care, but it is means-tested and kicks in only after depleting most of one’s assets and having very limited income. You’ll learn more about the major government programs and provisions in a later class.

Harris emphasizes that although nursing homes are often viewed very negatively, they may be very positive and the best setting for some older persons. For example, on the negative side, Dr. Robert Butler and others have observed that many older persons view nursing homes as a place where one goes to die. However, Harris’ example in Chapter 13 of an older couple who fared well in a nursing home and a number of examples from the videos shown in class (e.g. Eden Alternative) help show the positive side of nursing homes.

On a more personal note, your instructor heaps much praise on those who work in nursing homes. He too has heard the common complaint of nursing home staff mentioned by Harris: “overworked, underpaid, and under-appreciated.” Many of the staff in nursing homes are doing what so many of us are unwilling or unable to do and are paid very little in return. The ones who are dedicated and who provide quality care are clearly heroes to me. Keep these issues in mind when we discuss careers in aging later in the course.

Week 5: Activities

Readings

· Aging and the Life Course:  Chapters 8, 12, and 15

· Handouts

· Intergenerational Equity or the New Ageism?

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· Video Viewing Form

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Discussions

During this week, you should participate in the following discussions:

· Older Adults and Grandchildren

· Minority Reports

· Annual Editions Presentations

To receive participation points, you must post at least one substantive comment or reply for each discussion question in the week it’s assigned. Substantive comments do not include simple statements of agreement or disagreement. Support your statements with references to class materials. Comments must be in complete sentences with correct grammar and spelling. Just as you would in person, participating in online discussion requires you to read and respond to your classmates’ comments.

Assignments

Assignments are due at the end of week 5:

· Retirement Plan

· When I Grow Old Survey

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