TEST BANK for Aging as a Social Process: Canadian Perspectives 7th Edition by Andrew V. Wister.

Chapter 1

Aging as a Social Process Multiple Choice Questions 1. In 2016, what percentage of the total Canadian population did baby boomers comprise? a) 13 per cent b) 27 per cent c) 34 per cent d) 55 per cent Ans: b Page: 4 2. In 2015, what percentage of the world’s population was 65 years and older? a) 3.3 per cent b) 5 per cent c) 8.5 per cent d) 10 per cent Ans: c Page: 4 3. What happened to the number of centenarians in Canada between 2011 and 2016? a) The number stabilized b) The number increased by 25.7per cent c) The number decreased by 16 per cent d) The number increased by 41.3 per cent Ans: d Page: 5 4. Which country has the highest life expectancy? a) Japan b) Canada c) Germany d) Norway Ans: a Page: 5 5. In which country was the longest-living human born? a) The United States of America b) France Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

c) Japan d) Italy Ans: b Page: 6 6. What is the approximate lifespan for humans? a) 77 years b) 82 years c) 102 years d) 120 years Ans: d Page: 6 7. Which of the following statements is true? a) In the “baby boom echo” period, the number of “echo” births was about 70 per cent of the number in the original baby boom. b) The “baby boom echo” period occurred from 1970 until the 1980s. c) The “baby boom echo” period followed the “baby bust” period. d) The “baby boom echo” period occurred before the baby boom period.

Ans: c Page: 7-8 8. When did population aging in Canada begin to increase substantially? a) Before the baby boom period b) At the end of the baby boom period c) 10 years after the “baby bust” period d) 10 years after the “baby boom echo” period Ans: b Page: 7 9. What was the life expectancy at birth for Canadian women estimated to be in 2007–2009? a) 95 years b) 90 years c) 83 years d) 78 years Ans: c Page: 7 10. What was Canada’s birth rate in 2015? a) 5 infants per 1,000 people b) 11 infants per 1,000 people c) 20 infants per 1,000 people d) 27 infants per 1,000 people Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: b Page: 7 11. What is the “replacement rate” needed to replenish a population experiencing normal fertility and mortality rates? a) 1 child per woman b) 2.0 children per woman c) 2.5 children per woman d) 3.0 children per woman Ans: b Page: 8 12. What does “apocalyptic demography” refer to? a) The categorization of older people as a burden to society b) The view that population aging is insignificant c) The shift from contagious disease to chronic disease among older adults d) The aging experience of elderly people in eighteenth-century Europe Ans: a Page: 10 13. Which perspective examines the interplay of individual life stories, social structures, environments, and historical events at particular times in the lives of individuals or cohorts? a) The life-course transition b) The life-course perspective c) The life experiences approach d) The cumulative life-experience approach Ans: b Page: 12 14. According to your textbook, how will the growth in population aging over the next 30–40 years impact society? a) It will bankrupt the pension system. b) It will be a major contributor to escalating health-care costs. c) It will cause intergenerational conflict. d) None of the above Ans: d Page: 11 15. What is the process by which individuals in comparable situations act in different ways and make unique decisions? a) Life course construction b) Cohort flow c) Agency Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

d) Chaos Ans: c Page: 14 16. Which of the following affects aging and the status of elderly people in everyday life? a) The period of history in which they live b) The culture to which they belong c) The social structure to which they belong d) All of the above Ans: d Page: 18 17. Which of the following statements is false? a) Functional age is a more useful guideline than chronological age in determining an elderly person’s skills and abilities. b) Chronological age is the age that is represented by calendar time from one birthday to the next. c) Disability and illness are influenced by biological aging. d) Social aging is uniform across societies and cultures.

Ans: d Page: 14-18 18. A bar mitzvah, a twenty-first birthday party, a graduation from university, a wedding, or a retirement party are all examples of transitions wherein social timetables dictate that we “should” or “must” enter or leave various social positions. a) Rules b) Ceremonies c) Rites of passage d) Culture Ans: c Page: 17 19. Which of the following statements about “ageism” is false? a) It is a socially constructed way of thinking about and behaving toward older people. b) It is based on negative attitudes and stereotypes about aging. c) Both individual ageism and institutionalized (or structural) ageism exist. d) Butler considered ageism to be different than racism and sexism because none of a person’s biological factors are used to define personality or character traits.

Ans: d Page: 26-28 20. Which of the following is a multidisciplinary field of study, is the study of aging processes and aging individuals, as well as of the practices and policies that are designed to assist older adults?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

a) Geriatrics b) Structural psychology c) Gerontology d) Life-course sociology Ans: c Page: 28 21. Janet has recently turned 85 and has noticed a change in advertisements for products related to aging over the past several decades. Notably, Janet observes that advertisements no longer only depict seniors as grumpy and diseased. The ads she sees today are starting to show seniors engaging in more active lifestyles. Which of the following is the most likely explanation for what Janet has observed? a) Aging-related stereotypes are fluid and the increase in baby boomers may be driving portrayals of seniors as healthy and active. b) Aging-related stereotypes can change but only when successful social movements drive change. c) Aging-related stereotypes are static and Janet is imagining the change. d) Janet shops at stores targeting young people and therefore receives different ads from their mailing list.

Ans: a Page: 20-21 22. Fatima needs a manicure and books an appointment at a local spa in her neighbourhood. While waiting for her appointment to begin, Fatima notices that all of the brochures in the waiting room advertise anti-aging products and services. These ads promise to “turn back the clock” to give users a more youthful appearance. What is Fatima seeing evidence of in her spa’s waiting room? a) Social stratification b) The medicalization of aging c) The problematization of youth d) Gerontology Ans: b Page: 31 23. Who does aging impact most significantly because they live longer, often alone, and face more challenges in later life, such as poverty and discrimination? a) Canadians b) Baby boomers c) Men d) Women Ans: d Page: 31

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

24. Bill retired at 61 from a rewarding career as a chartered accountant. After travelling extensively for a year, he reevaluates his retirement decision and decides to go back to work full-time to earn more money and find fulfillment through employment again. After six months of searching for a new job in his field, Bill has barely had any interviews and when in the ones he has had, the employers expressed concerns that Bill may retire again in a few years and their investment in hiring him will be wasted. The one job offer Bill did receive was for a part-time position at significantly less pay than was advertised. What might Bill be experiencing? a) Sexism b) Ageism c) Gerontology d) Precarious labour Ans: b Page: 27-28 25. When do the effects of stereotypes of aging begin? a) At high school graduation b) At birth c) At retirement d) At an early age Ans: d Page: 21

True or False Questions 1. Population aging is the result of decreased fertility and longer life expectancy.

Ans: True Page: 4 2. Age cohorts are people born at a similar period in time and in the same location.

Ans: True Page: 5 3. Lifespan is the finite maximum limit of survival for a species.

Ans: True Page: 6 4. The oldest living person in the world is 144 years old.

Ans: False Page: 6

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

5. Life expectancy is the number of years that a person thinks they will live.

Ans: False Page: 6 6. A declining fertility rate is the most important factor in population aging.

Ans: True Page: 7 7. Many provinces support the development of public and private assisted or supportive housing complexes that provide only a lower level of care.

Ans: True Page: 10-11 8. Individual aging is a multi-dimensional process of growth and development that involves physical, social, behavioural, and cognitive changes over the life course.

Ans: True Page: 11 9. The life-course perspective recognizes that transitions can be reversible.

Ans: True Page: 12 10. Social structures can limit life chances.

Ans: True Page: 13 11. The influence of social structures on individuals over the life course is known as agency.

Ans: False Page: 14 12. Separate processes such as chronological aging, biological aging, psychological aging, and social aging, do not interact.

Ans: False Page: 14-18 13. The ways in which most individuals behave in a given situation at a particular age are termed “chronological age norms.”

Ans: True Page: 15 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

14. Chronological age defines what we legally can and cannot do in society.

Ans: True Page: 15 15. Functional age is often a more useful guideline than chronological age.

Ans: True Page: 15 16. Social stratification is the process whereby social attributes (age, gender, race, etc.) are evaluated differentially according to their value in society.

Ans: True Page: 18 17. Approximately one-half of Canadians were not born in Canada.

Ans: False Page: 18 18. Ageism is fostered by exaggerations of particular attributes of older people.

Ans: True Page: 19 19. Frailty is experienced by the majority of older people.

Ans: False Page: 21 20. Age identity refers to the psychological and social meaning of age rather than chronological age.

Ans: True Page: 25 21. Institutionalized ageism is the personal acceptance of negative feelings and beliefs that influence one’s thinking about older people.

Ans: False Page: 27 22. Gerontology is a sub-specialty of medicine that focuses on the physical and mental diseases of later life and on the clinical treatment and care of elderly patients by specialized physicians.

Ans: False Page: 28 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

23. Ethical issues should not question current legislation; they should only focus on future legislation.

Ans: False Page: 32-34 24. The United Nations Declaration of the Rights of Older Persons contains a call for action to improve the quality of life of older adults throughout the world.

Ans: True Page: 35-36 25. The Canadian Senate has been silent on the issue of aging.

Ans: False Page: 36

Short Answer Questions 1. What are the four processes of aging and how do they each contribute to the aging experience?

Ans: Chronological aging defines the passage of calendar time from one birthday to the next.

Chronological age is a rough indicator of physical growth and decline, social and emotional development, and anticipated patterns of social interaction. Biological aging includes genetic and environmentally induced changes in the cellular, muscular, skeletal, reproductive, neural, cardiovascular, and sensory systems. The incidence and rate of biological change affects the number of years people are likely to live and the extent to which they experience illness or disability. Psychological aging refers to the interaction of individual cognitive and behavioural changes with social and environmental factors that affects a person’s psychological state (e.g., the loss of a spouse or a change in housing). Social aging varies within and across societies and across time. It is affected by the interactions between aging individuals and others in a family, community, or subculture at a specific point in history.

Page: 14-18 2. What is the life-course perspective?

Ans: The life-course perspective enables us to understand aging individuals and older age cohorts using a historical, dynamic, and developmental approach. This perspective analyzes the interplay among individual life stories, society, and the environment, and considers the effect of specific historical events (e.g., war, economic depression, epidemics) on individuals or age cohorts. The life-course perspective investigates how the difficulties, advantages, disadvantages, requirements, and lifestyles of later life are shaped by earlier life transitions, prospects, choices, and experiences within specific historical or cultural contexts.

Page: 12-13

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

3. What are two ways in which aging be socially constructed? Your answer should drawing on what you learned about stereotypes and age identity.

Ans: While chronological age is a specific measure of the number of years a person has lived, it is rarely an accurate description of having reached a specific stage in life. Relying on chronological age, societies label those over 65 as “elderly,” “old,” or “seniors.” These labels are based on stereotypes about a particular chronological age, not on an individual’s actual abilities or health status. Labelling is institutionalized when citizens of a certain age are obliged meet certain requirements (e.g., mandatory retirement at age 65), which can influence older persons’ sense of self and how they are regarded by others. “Age identity” is the result of a subjective experience that signifies the psychological and social meaning of aging rather than chronological age. Social and age-related identities are renegotiated in different social contexts or with changes in health or visual appearance. People of the same chronological age may report a wide range of age identities (e.g., some may feel younger and report feeling like they are 55; others may feel older).

Page: 19-26 4. What is “apocalyptic demography”? In your answer, provide arguments for and against this way of thinking.

Ans: “Apocalyptic demography” refers to the labelling of older people as a burden to society.

Some analysts believe that population aging will weaken the economy, put undue pressure on the health-care system, and result in intergenerational conflict. Population aging is indeed a challenge; in particular, when baby boomers retire, the sheer size of the cohort will require some reallocation of health and social resources. However, the fear mongering is likely unwarranted as it results from a process of exaggerating or misinterpreting population statistics. Moreover, recent evidence shows that these fears are unfounded and can interfere with rational policymaking, having a negative impact on older adults.

Page: 10-11, 24 5. Why is the study of age cohorts important?

Ans: The study of age cohorts enables us to observe and analyze how different individual or societal events create variations in the aging process within and between age groups and individuals. Some events will have an impact on some age cohorts but not on others or only on specific individuals within an age cohort. For example, the feminist movement that began in the 1970s has dramatically influenced the life courses of women born just before and after the 1970s. The study of age cohorts can identify patterns in life course trajectories and link them to their causes and consequences; it can also assist in developing effective policies by utilizing integrated life-course data.

Page: 11-14 6. What are five reasons why it is important to study older adults?

Ans: It is important to study older adults in order to (1) challenge and eradicate myths about aging and older people; (2) gain a better awareness of self and of others by studying personal life journeys; (3) assist and support older family members as they move through the later stages of life; (4) serve as an informed and effective volunteer in the community; and, (5) prepare for a job Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

or career (as a practitioner, policy-maker, or researcher) in which the mandate is to address aging-related issues or to serve an older population.

Page: 5 7. What is the difference between lifespan and life expectancy?

Ans: Life span is the fixed, finite maximum limit of survival for a species (e.g., ~20 years for dogs, ~85 for elephants, and ~120 for humans). Life expectancy is the average number of years a person is projected to live at birth or at a specific age.

Page: 6 8. According to your textbook, the media have portrayed older adults in a negative light. How do the media do this? Provide several examples.

Ans: The media often equate later life with illness, loss, loneliness, asexuality, and poverty. For example, adult cartoons portray images of older people to generate humour via references to asexuality, deafness, or forgetfulness and, in doing so, reinforce common stereotypes; newspapers focus either on the tragedies of aging or the marvels of unique but atypical longlived people who have accomplished feats unusual for their age; TV commercials displayed elderly persons in comical roles in the 1970s, with more negative portrayals in the mid-1970s and early 1980s; elderly Disney characters are sometimes portrayed negatively (grumpy, mad, threatening, highly wrinkled, etc.).

Page: 20-22 9. Why should academics pay attention to media portrayals of ageing?

Ans: When accepted as fact by the media, the public, or policy makers, negative and inaccurate images can shape public opinion about aging, influence which public programs are funded, and undermine the potential of adults as they move into the later years. For older adults, these socially constructed labels, images, and language foster a self-fulfilling prophecy whereby some older adults believe they should think and behave like the stereotypes perpetuated by the media.

This in turn can lead to a loss of self-esteem, isolation, and the labelling of oneself as “old.”

Discrimination, such as sexism, racism, or bias against sexual orientation, can also exacerbate these issues.

Page: 21 10. How can agency affect the future lives of older adults?

Ans: Elder and Johnson described agency as one of five defining principles of the life course— through agency, older adults construct their life course by making choices and taking action. As such, agency enables them to create unique identities, develop personal meanings, and decide which social groups are significant in their lives. Consequently, considerable variations in lifestyle, experience, and quality of life evolve within different age cohorts in the older population.

Page: 14 11. What is the difference between functional age and chronological age? How can both influence legal age?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: The passage of calendar time from one birthday to the next is represented by chronological age. Functional age is based on the fact that aging is a multi-faceted process in which individuals at a specific chronological age are either “older” or “younger” than age peers in terms of some relevant skill or ability. Legal age is sometimes based on chronological age norms—how most individuals at a specific age would perform a specific task or behave in a given situation. Legal age may also be influenced by functional age—how well an individual actually performs specific physical, cognitive, or social tasks. Functional age is often more useful for gauging skill-level or cognitive ability than chronological age.

Page: 15-16 12. Why is age identity important to older adults?

Ans: As opposed to chronological age, “age identity” is the result of a subjective experience that signifies the psychological and social meaning of aging. It is shaped by how individuals view themselves and how they think others view and react to them. Since many older people often report feeling and acting “younger,” it is clear that their age identity can conflict with their chronological age. This can have serious implications for decisions regarding age-related public policy. In addition, by practising “identity management” and differentiating themselves from others in the same age group, older adults can experience higher levels of life satisfaction and subjective well-being.

Page: 25-26 13. Why are ethical issues important to the study of aging? Give three examples of ethical questions surrounding population aging.

Ans: Ethical issues are important to the study of aging on many levels. The onset of population aging, along with biomedical technological developments that encourage new ways of thinking and acting, raises legal, moral, and ethical questions about aging. Some questions and issues are related to the individual; others, to society as a whole. Examples of questions that can be asked are as follows: (1) Should an older person’s driver’s license be suspended or revoked? If so, when and according to what criteria? (2) Does a physician prevent or delay death or initiate death through physician-assisted suicide? (3) Should “age” or “need” be a criterion for entitlement to economic security?

Page: 32-35 14. Should age- or need-based criteria be used for entitlement to economic security? Support your position.

Ans: Using age as a criterion for entitlement to economic security is unlikely to benefit recipients as chronological age is often an inaccurate indicator of how well an older person is able to perform physical, cognitive, or social tasks. Using age as a criterion is also likely to foster ageism and put those truly in need at a disadvantage. Therefore, need-based criteria can be used to better effect.

Page: entire chapter 15. Why, according to Gee (2000) and others (Friedland and Summer 1999; Longino 2005), is “demography not destiny”?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: “Demography is not destiny” because changes in the age structure can be managed and mitigated by policies, programs, and changes within social institutions. Despite fear-mongering by some scholars, politicians, and the media, population aging need not be viewed as a crisis.

Instead, we should look at population aging as a significant but manageable challenge. For example, the aging of the sizable baby boomer cohort will require a reorganization and reconsideration of current health-care policies and programs, as well as the creation of new ones.

Page: 11 16. What are three critical issues for an aging society?

Ans: Three critical issues for an aging society are as follows: (1) Recognizing that aging is not an illness or a disease (avoiding the “medicalization of aging” position as well as the view that aging can be reversed, or “cured”); (2) Defining aging as primarily a women’s issue (acknowledging that women live longer, often alone, and face more challenges in later life, such as poverty and discrimination); (3) Understanding that we live in and are connected to an aging world wherein much of the growth in population aging will occur in developing countries.

Page: 31-32 17. How do personal biographies interact with structural, cultural, and historical factors?

Ans: The life courses of individuals at the societal level will be different from that of younger and older age cohorts and from others of about the same age in other countries (perhaps even in other parts of Canada). These differences stem from cultural, regional, economic, or political variations in opportunities, lifestyles, values, or beliefs. The events a person experiences will vary as well because particular social or political events may affect some but not all individuals or age cohorts.

Page: 13 18. What were the three major aims of the Special Senate Committee on Aging and its final report titled Canada’s Aging Population: Seizing the Opportunity?

Ans: The three major aims were (1) to identify priority areas for political leadership and multijurisdictional coordination; (2) to provide support for research, education, and the dissemination of knowledge and best practices; and (3) to provide direct services to certain population groups for which it has direct responsibility.

Page: 36-37 19. What are three of the rights listed in the United Nations Declaration of the Rights of Older Persons?

Ans: Answers may include the right to work, the right to a decent retirement, the right to protective services when vulnerable, and end-of-life care with dignity.

Page: 34-35 20. What factors have led to population aging in Canada?

Ans: One factor that led to population aging in Canada was a significant gain in longevity achieved in the twentieth century. This gain, caused by some combination of genetics, environmental factors, diet, and lifestyle choices, is demonstrated by an increase in the average Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

and maximum lifespan of humans, in the average life expectancy at birth, and in the number of centenarians. In addition, a significant decline in the fertility rate has had the most direct and largest effect in shaping the age structure. The current, low fertility rate is below the “replacement rate” of at least two children per woman that is needed to replenish the population when normal fertility and mortality rates prevail.

Page: 7-11 21. What are the features of age-friendly communities?

Ans: In an age-friendly community, policies, services, settings, and structures support and enable people to age actively by recognizing the wide range of capacities and resources among older people; anticipating and responding flexibly to aging-related needs and preferences; respecting the decisions and lifestyle choices of older adults; protecting those older adults who are most vulnerable; and, promoting the inclusion of older adults in, and contribution to, all areas of community life Page: 19 22. “Ageism is the most widely tolerated form of social prejudice in the country.” Do you agree or disagree with this statement? Explain your position.

Ans: Perspectives will vary but should apply material related to ageism and discrimination from the chapter. For instance, students may discuss stereotypes, prejudice, institutionalized ageism, etc. In support of the statement, students may cite a new report released by senior-living company Revera and the Sheridan Centre for Elder Research that finds that one in four Canadians admit treating someone differently because of their age. Ageism does not operate in a vacuum either—other forms of oppression like racism and sexism impact how we experience ageism as well. In opposition, students may note that as the baby boomers age, conventional notions of what it means to be old are being challenged.

Page: 22, 26-28 23. What are the differences between gerontology and geriatrics?

Ans: Gerontology is the multidisciplinary study of aging processes and aging individuals, as well as of the practices and policies that are designed to assist older adults. Gerontology includes research conducted in the biological and health sciences, the behavioural and social sciences, and the humanities, as well as analyses of policies and practices developed at the global, federal, provincial, regional, or local level. Social gerontology, a subset of gerontology, employs the social sciences to study the social processes, issues, practices, and policies associated with aging and older people. Geriatrics is a sub-specialty of medicine that focuses on the physical and mental diseases of later life and on the clinical treatment and care of elderly patients by specialized physicians.

Page: 28 24. What are the three life-course conceptual dimensions to understanding aging that are listed in your textbook?

Ans: The first dimension directs us to consider life histories and pathways of individuals as they age. The second and third dimensions entail dichotomies that represent a dimension with two Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

extremes: agency and social structure; and the micro (individual) and macro (structural) elements of daily life. While the textbook separates these dimensions out to explain them conceptually, they refer to different aspects of social life that are complex, interrelated and interdependent Page: 30-31 25. How might current biomedical, social, technological, and policy development raise legal, moral, philosophical, and ethical questions about aging and older adults? Illustrate your answer with an example.

Ans: Answers will vary here depending on the example chosen by the students. Some issues will raise questions related to the level of the individual; others, at the level of society. Students should recognize that there will be individual differences of opinion but should apply material from the chapter to support their perspective. Popular topics might include legalization of assisted suicide, increased use of social media amongst aging population, elder abuse, the legalization of marijuana, etc.

Page: entire chapter

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Chapter 2

Historical and Cultural Perspectives on Aging Multiple Choice Questions 1. According to 2016 census estimates, approximately how many Canadians reported an ethnic identity as one of the Indigenous Peoples of Canada, including First Nations, Métis, and Inuit? a) 2,103,760 b) 1,673,785 c) 205,170 d) 130,080 Ans: b Page: 43 2. Approximately how many immigrants were admitted to Canada between January 2011 and May 2016? a) 10.6 million b) 5 million c) 1.2 million d) 500,000 Ans: c Page: 43 3. Which of the following statements is false concerning the responsibility of families to care for older adults in Eastern and Western societies? a) In Western cultures, economic assistance, housing, and health care for older adults is common. b) In Eastern cultures, older family members often move in with one of their children. c) In Western cultures, a daughter or daughter-in-law is usually responsible for caring for elderly parents. d) Filial piety is deeply embedded in both Eastern and Western societies.

Ans: d Page: 44 4. What is the name for the phenomenon whereby members of a society regard their mainstream culture as superior to all others? a) Assimilation b) Acculturation c) Marginalization Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

d) Ethnocentrism Ans: d Page: 46 5. Which of the following is true regarding the primitive hunting-and-gathering societies that existed before the Industrial Revolution? a) The oldest members were considered to have a valuable source of knowledge concerning rituals and survival skills. b) The oldest members were considered to be a burden on the rest of the tribe and were given minimal power and responsibility. c) The knowledge of the younger members was viewed as a source of power. d) The knowledge of the older members was viewed as outdated and no longer needed.

Ans: a Page: 48 6. According to Hendricks (1982), where does modernization first occur? a) In areas where there are more working men b) In the core areas of a country c) In peripheral (rural) regions d) In areas where there is a larger number of affluent families Ans: b Page: 50 7. How did the “before and after modernization” explanation account for the changing status of elderly people? a) Older adults lost power and status because they no longer played essential roles and were no longer the primary source of knowledge. b) Since adult children lived in the family home, some believed they could afford better health care. c) Older adults lost power and status even in societies where they continued to perform valued functions. d) Older people gained power and status in all societies because they had fewer children.

Ans: a Page: 50 8. What did the Industrial Revolution lead to in terms of the social and economic systems of a society? a) The emergence of extended families and the breakup of the nuclear family b) The skills of older people becoming more useful than ever before c) An increase in life expectancy d) The end of mandatory retirement Ans: c Page: 49 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

9. Which lens has recently been applied to understanding how minority-group status and marginalization shape the experiences and identity of individuals based on the interaction of culture, age, gender, social class, and other salient domains that influence inequality? a) Intersectionality b) Marxist c) Democratic d) Centenarian Ans: a Page: 48 10. Anthropologists categorize societies into one of three types, according to their level of industrialization and modernization. Which if the following is not one of these categories? a) Actuarial societies b) Primitive hunting-and-gathering societies c) Pre-industrial societies d) Post-industrial and postmodern societies Ans: a Page: 47 11. According to research into preliterate societies, in which kinds of tribes did elderly people tend to have the lowest status? a) Risk-taking tribes b) Highly skilled tribes c) Nomadic tribes d) Illiterate tribes Ans: c Page 53 12. Which of the following statements is true regarding Ancient Greece? a) Power was associated with wealth more than with age. b) Power was associated with health more than with age. c) The Greeks looked forward to old age. d) Greek gods were often depicted as old.

Ans: a Page: 54 13. Which of the following is false regarding shared elements of traditional Indigenous cultures? a) Their members tend adhere to traditional healing practices and beliefs b) Their members exhibit a respect for elders as a source of wisdom. c) Their members prefer formal care from public services over informal support from relatives. d) Their members value close-knit communities and strong family ties.

Ans: c Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 58 14. Ethnic subcultures are groups that do not necessarily share which of the following elements? a) Language b) Beliefs c) Religion d) Occupation Ans: d Page: 62 15. According to a study conducted by Chappell and Kusch (2007), what percentage of Chinese seniors in Canada live either with their spouse and a child or, if widowed, with a child? a) 73 per cent b) 50 per cent c) 21 per cent d) 15 per cent Ans: a Page: 64-65 16. Which of the following statements is false regarding recent elderly immigrants to Canada? a) They are often widowed. b) They often embrace their children’s busy “Western” way of life. c) They have arrived to be cared for by adult children who have lived in Canada for many years. d) They are more likely to be women than men.

Ans: b Page: 64-66 17. Which of the following groups is part of the fastest-growing minority group in Canada? a) Muslims b) Anglicans c) Chinese d) Japanese Ans: a Page: 63 18. Currently, what percentage of all Canadians over the age of 65 were born outside of Canada? a) 5 per cent b) 10 per cent c) 30 per cent d) 60 per cent Ans: c Page: 63 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

19. Which of the following is not a major barrier to accessing health-care services for ethnic elders? a) Immigration status b) Linguistic needs c) Discomfort with having children present at medical appointments d) Limited knowledge of the health-care system Ans: c Page: 66 20. Which term refers to subcultures, such as the Old Order Mennonites or Hutterites, that maintain a totally separate and unique identity, lifestyle, and place of residence, often in rural areas? a) Persistent subcultures b) Dynamic subcultures c) Northern subcultures d) Ritualistic subcultures Ans: a Page: 57 21. In a multicultural society like Canada, there is an urgent need for new studies on the experiences of many ethnic and religious groups that are what? a) Visible in aging b) Invisible in aging c) Aging in isolation d) Aging in exurban communities Ans: b Page: 62-63 22. Carlos is conducting a study of elderly citizens in the Atlantic provinces. After several months of interviewing, Carlos realizes that his research participants speak about their experiences in distinct ways. For instance, he notices that men can differ from women, recent immigrants can differ from second-generation Canadians, and seniors with higher retirement income can differ from those with low-incomes. When conducting his analysis, Carlos explains to his supervisor that in order to more fully understand the status of older people within and between cultures and over time, he needs to examine levels of social support in cultures flowing to older adults and how this support is shaped by gender, social position, religion, etc. Which perspective is Carlos most closely aligned with? a) Before and after b) Positivism c) Intersectionality d) Elitism Ans: c Page: 51 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

23. According to Sharon Koehn’s unpublished findings (2002–4), a case worker helped Mr S deal with isolation and cultural dislocation by referring him to whom? a) A female physician and moving him to another care home in a more urban area b) A male physician and moving him to another care home in a warmer city c) A Punjabi-speaking physician and moving him to another care home where there were other Punjabi-speaking residents d) An older physician and moving him to another care home where there were other male residents Ans: c Page: 63 24. The grandmother of Charlie’s friend attends religious gatherings where they drink poison and handle dangerous snakes. Charlie thinks that these practices are not normal and doesn’t understand why others would want to practise such strange rituals. What concept is reflected in Charlie’s feelings? a) Cultural diffusion b) Ethnocentrism c) Globalization d) Cultural relativism Ans: b Page: 46 25. Which of the following terms refers to the respect and a feeling of responsibility for one’s parents? a) Unilineal piety b) Filial piety c) Paternalism d) Patricide Ans: b Page: 44

True or False Questions 1. Filial piety refers to the belief that the extended family is a burden.

Ans: False Page: 44 2. Over the past 40 years, the Canadian immigrant population has become less diverse, coming mostly from two or three countries of origin.

Ans: False Page: 44 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

3. Values are the internalized criteria by which people judge behaviour.

Ans: True Page: 46 4. Beliefs are a statement about what is thought to be true as opposed to what is real or desirable.

Ans: True Page: 46 5. Norms represent an individual’s conception of the world.

Ans: False Page: 46 6. People who regard their own culture as superior can be called ethnocentric.

Ans: True Page: 46 7. In agrarian-peasant societies, the oldest citizens had no control of the land and were generally lacking in power.

Ans: False Page: 49 8. Modernization theory suggests that the Industrial Revolution led to a decline in the status of older adults.

Ans: True Page: 50 9. The status of older adults was the lowest in preliterate societies that had a surplus of food.

Ans: False Page: 53 10. The status of older adults was highest in preliterate societies in which older people had knowledge of rituals and customs.

Ans: True Page: 53 11. In 2016, 27 per cent of the Indigenous population was under 15 years of age.

Ans: True Page: 58 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

12. About 7 per cent of Indigenous people are 65 years of age or older.

Ans: True Page: 57 13. The life expectancy of Indigenous is about six years less than the national average.

Ans: True Page: 58 14. Indigenous elders have the advantage of quality home care systems if they live on reserves.

Ans: False Page: 61 15. Indigenous elders fare equally well whether they live on or off a reserve.

Ans: False Page: 57-61 16. Assimilation is a process whereby subcultures retain their own identity.

Ans: False Page: 57 17. A racial subculture is a subgroup within a larger society in which physical appearance and cultural commonality define the boundaries of membership.

Ans: True Page: 62 18. Kobayashi (2000) found that, among second- and third-generation Japanese Canadians, few had a strong commitment to filial duty.

Ans: False Page: 65 19. The situation of elderly Chinese people is often related to whether they spent their childhood in China or in Canada.

Ans: True Page: 64 20. Elderly people who have lived in Canada most of their lives are just as likely as recent elderly immigrants to feel isolated and marginalized.

Ans: False Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 63-66 21. Acculturation is a process whereby individuals from one cultural group learn and internalize the culture of another group.

Ans: True Page: 46 22. Social scientists have always studied the diversity within a society and the structural factors that influence the experiences and opportunities of aging adults.

Ans: False Page: 47 23. An intersectionality lens considers disadvantage (and privilege) as fundamentally tied to the intersection of multiple inequalities that are fluid over the life course and reinforced in social structures.

Ans: True Page: 48 24. Intersectionality has been useful in understanding how minority-group statuses and related forms of inequality are formed, sustained, and how they can be changed over time.

Ans: True Page: 48 25. Increased interventions through federal health and financial assistance programs have largely improved unemployment rates, living conditions, levels of physical and mental health, and poverty levels for Indigenous peoples in Canada.

Ans: False Page: 59

Short Answer Questions 1. What are the similarities in Eastern and Western societies’ treatment of elderly persons?

Ans: The similarities of Eastern and Western cultures regarding their treatment of elderly persons include the following: the family is the primary support system in the daily lives of elderly persons; a growing number of older adults are economically dependent on the state and/or their families for survival; fertility rates are declining and smaller families are more typical than in the past; and, debates about the relative responsibility of the state and the family for providing support to older adults are common.

Page: 44

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

2. What are the differences between Eastern and Western societies’ treatment of elderly persons?

Ans: The differences between Eastern and Western cultures regarding their treatment of elderly persons include the following: filial piety (respect and a feeling of responsibility for one’s parents) is embedded in Eastern cultures; such a general guiding principle is not found in the West; rapid population aging occurred in modernized Western societies in the twentieth century; it will occur in developing Eastern societies in the twenty-first century (it has already happened in Japan); in Eastern cultures, the eldest son and his wife are usually responsible for caring for his parents (often in a multi-generational household); in Western cultures, a daughter or a daughter-in-law is more likely to be responsible; in Western cultures, state-supported economic assistance, housing, and health care for older adults are common; these programs are just beginning to appear in Eastern cultures.

Page: 44 3. What is the modernization hypothesis? What are four critiques of this perspective?

Ans: The modernization hypothesis refers to the notion that modernization and its accompanying social, political, and economic changes led to a decline in the status of older people. It was assumed that older adults no longer played essential roles and were no longer the major source of knowledge. It was also assumed that adult children no longer felt obliged to support their aging parents. Some challenges to this perspective were made in the 1980s and beyond: (1) the onset and degree of industrialization differed considerably by region and industry; (2) the social status of older people in pre-industrial societies was not always as high as assumed; (3) the status of older persons in modern societies is no lower and may indeed be higher than it was before industrialization; (4) as societies modernize, changes in family structure and in traditional values weaken the informal social support network previously supplied by the family.

Page: 50-51 4. How are Indigenous elders in Canada viewed by their communities? What have they done that has had a positive effect on their status?

Ans: Indigenous elders are still respected to some degree because of their experience, their past contributions to the community, and their knowledge of traditions. They have the essential task of cultural transmission and are still thought to contribute to their communities in a vital way.

Collecting proactively to form outreach groups and provide leadership, Indigenous elders have dynamically maintained a unique position in their communities.

Page: 59 5. From a structural perspective, what are some of the inequalities faced by Indigenous peoples?

Ans: From a structural perspective, Indigenous people face inequalities and a difficult lifestyle, characterized in general by the following: high levels of unemployment or irregular employment; low average incomes, economic deprivation, and a dependence on government subsidies, with many living below the poverty line; one in five Indigenous people live in housing requiring major repair (Statistics Canada 2017e); few retirement residences, nursing homes, or geriatric-care facilities in remote communities; poor health, including a high incidence of chronic diseases related to lifelong malnutrition, alcoholism, and misuse of drugs, and to inadequate health-care Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

services and facilities, including a lack of hospitals and health-care workers in the community; higher incidence of being victims of crime, especially violent crime, and of spousal or child abuse; lack of formal community-based social and welfare services, such as home care, and under-use of formal services even when they exist, owing to a preference for support from relatives.

Page: 59 6. What are four common research approaches used to understand the cultural basis of aging?

Ans: Four research approaches typically used to examine the cultural basis of aging in a global context are (1) a historical comparison of early and later societies; (2) a comparison of two or more somewhat similar societies at the same point in time; (3) a comparison of Eastern versus Western societies; and (4) a comparison of developed versus developing regions or countries.

Page: 44 7. What are three developments in the study of aging from a comparative perspective?

Ans: The first development in the comparative approach to understanding aging occurred when historians, anthropologists, and sociologists identified patterns of thought and behaviour by older people that are repeated in many cultures, as well as those that are found only in a specific culture, subculture, or historical period. A second development was the study of aging from a cultural anthropological perspective, employing mainly observational ethnographic techniques to investigate how culture shapes the social and economic status of older people in a society. A third development was the “unpacking” of meanings of old age as reflected in historical accounts.

Page: 46-47 8. What is the intersectionality lens and how can it shed light on aging?

Ans: An intersectionality lens is a theoretical lens used to examine experiences of inequality and privilege through analysis of the intersections of ethnicity, race, gender, socio-economic status, etc. Understanding the intersectionality of cultural inequalities can shed light on the ways that culture interacts with other salient dimensions of aging to affect a range of experiences of aging at the individual level, the ways in which these are embedded in our social institutions, and how identities are formed and reshaped. It has also brought into question the use of social categories to slot individuals into groups because of the potential for negative labels (termed “anticategorical complexity”).

Page: 48 9. Why is ethnocentrism a problem for older adults in a multicultural society? Illustrate your answer with an example.

Ans: Ethnocentrism is a phenomenon in which members of a society regard their mainstream culture as superior to all others. Ethnocentric beliefs can influence how people behave toward members of other cultures as well as members of subcultures in their own societies. This attitude can foster insensitivity to those who are different and influence a variety of practices that affect older people—for example, the kind of food served in long-term-care settings that primarily house those from mainstream society. Student examples may vary.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 46 10. What are three ways in which the Industrial Revolution changed the lives and status of older people?

Ans: Some of the ways in which the Industrial Revolution affected the lives and status of older people are as follows: (1) A shift from home to factory production meant that the family was no longer the centre of economic production (as it had been on farms). The result was a dramatic increase in the number of people, including the elderly, who became dependent on non-family employers for economic security. (2) A breakup of the extended family and the emergence of the nuclear family resulted in the separation of children from older parents, who often lived in a different community. (3) The rise of large organizations and the creation of new occupations requiring skills that young people could acquire through apprenticeship/formal schooling meant that many of the skills possessed by older people became obsolete.

Page: 49 11. What are five types of respect that Asian cultures express towards elders?

Ans: Student responses will include five of the following 14 types of respect (Sung 2001) that Asian societies display towards elders: care respect; victual respect; gift respect; linguistic respect; presentational respect; spatial respect; celebrative respect; public respect; acquiescent respect; salutatory respect; preferential respect; funeral respect; consulting respect; ancestor respect.

Page: 52 12. What is an ethnic subculture? Compare and contrast how two different subcultures in Canada treat older adults.

Ans: Ethnic subcultures are groups that share cultural characteristics, such as language, beliefs, religion, or national origin. Student examples will vary as there are many examples throughout the textbook.

Page: 57, 62-63 13. Compare and contrast the social and economic conditions of elderly people within two ethnic subcultures in Canada.

Ans: Student responses will vary as there are many examples throughout the textbook.

Page: 64-65 14. In what ways do Indigenous elders experience health disadvantages in Canada?

Ans: Older Indigenous persons face a number of barriers in terms of access to health services, including the loss of traditional approaches, geographic isolation, and legal divisions with Indigenous communities. The prevalence of self-reported chronic conditions such as heart disease, hypertension, diabetes, and arthritis is often two or three times the rate reported by their Canadian counterparts. These conditions are compounded by the fact that many Indigenous elders are not eligible for extended health plans that cover vision and dental care, prescription drugs, and new health technologies. Furthermore, most reserves and many communities do not have nursing homes. Thus, elderly people who need continuing care must enter a nursing home Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

away from their community where they rarely receive the kind of food they prefer and are far from friends and family.

Page: 60-61 15. What are the challenges facing health-care workers and policy-makers in Canada’s multicultural society?

Ans: Over the past 40 years, a larger and more diverse immigrant population has presented a number of unique challenges for health-care workers and policy-makers. A one policy “fits all” approach based on broad labels (e.g., “Asian”) is no longer adequate due to considerable withingroup diversity. Language barriers, varying rates of assimilation, and lack of knowledge about social or health-care services must all be taken into account. Moreover, dietary restrictions and specific cultural beliefs about health care, death and dying customs, and the responsibility of the family versus the state in supporting older people, can all cause adaptation problems in hospitals or long-term-care facilities. These factors are especially challenging when trying to reduce or eliminate gender inequality.

Page: 44-45 16. As an older person, is it better to have been born in Canada or outside of Canada? Explain your choice.

Ans: Student responses will vary but should apply material from throughout the chapter, but students may touch on physical features (colour of skin or shape of eyes), or cultural characteristics (language, beliefs, religion, or national origin) that distinguish them from the dominant culture. Other students may refer to Intersectionality theory as a high level lens that suggests that no single defining characteristic. Other students may discuss some of the known structural barriers (e.g., struggle between adhering to traditional as opposed to mainstream practices with respect to the use of health-care services or the use of family as opposed to formal support systems).

Page: 48, 62-66 17. What are values, beliefs, and norms?

Ans: Values are the internalized criteria by which members select and judge goals and behaviour in society. Values are trans-situational and are found in most social institutions. Beliefs represent an individual’s conception of the world. They are a statement about what is thought to be true as opposed to what is real or desirable. Beliefs are unique to a given culture or subculture and are learned through socialization processes via parents, teachers, peers, and the mass media. Norms define acceptable or expected behaviour in specific social situations. Many norms concerning how we dress and act, how we spend our leisure time, or how we select living arrangements are related to our stage in life or our social position.

Page: 44 18. How has modernization affected care of the elderly in Japan?

Ans: Japan’s modernization began in the Meiji era (1868–1912) and intensified during post– World War II reconstruction. A number of changes are redefining traditional cultural ideology.

First, young adults are moving to large cities, away from their rural roots, where traditional Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

norms and values prevail. Second, traditions such as respect for older people and caring for one’s parents are weakening. Third, a shortage of special housing for older people has resulted in the construction of retirement communities for affluent persons seeking an independent lifestyle. Fourth, the role of Japanese women is changing as more young women earn university degrees and work full-time—leaving little room to care for an aging parent or parent-in-law. All of these factors combine to shift the burden of care for the elderly from adult children to the state.

Page: 56 19. What is the difference between convergent and persistent subcultures? Illustrate your understanding by providing examples.

Ans: Convergent subcultures are subcultures that are eventually assimilated into the larger culture.

An example would be the descendants of Italian immigrants who arrived in Canada after the Second World War and were assimilated over two or three generations. Other subcultures, such as the Old Order Mennonites or Hutterites, are persistent subcultures because they maintain a totally separate and unique identity, lifestyle, and place of residence, often in rural areas. In the following sections, issues of aging and the status of elderly people are examined for indigenous, racial, ethnic, and religious subcultures.

Page: 57 20. What were the six functions performed by elderly people in preliterate societies identified by Maxwell and Silverman (1970)?

Ans: The six major functions performed by elderly people in preliterate societies—according to Maxwell and Silverman (1970)—are as follows: (1) hosts of feasts, games, or visiting groups; (2) consultants about survival skills or rituals; (3) decision-makers for the group; (4) entertainers; (5) arbitrators of disputes; and, (6) teachers of the young.

Page: 53 21. What are Achenbaum’s (2010) archetypes of age?

Ans: Achenbaum identifies a number of archetypes of age that have prevailed in historical accounts of old age, including the following: (1) physical features of old age; (2) differences between old and younger members of a society; and (3) the relevance of gender in constructing old-age imagery. Achenbaum shows that older persons have been typified in negative imagery in historical accounts in terms of physical deterioration and weakness (such as missing teeth, wrinkled faces, and small stature). This has been balanced by positive images of wisdom and mystical or spiritual traits. The archetype of older women has been particularly negative in historical accounts, with the exception of older women being portrayed as healers.

Page: 47 22. What was the status of older people in preliterate societies?

Ans: In preliterate societies, knowledge, beliefs, and survival skills were accumulated by the elders. The economic system was based on production and consumption within domestic kinship groups, and the dependence of children on parents was linked to a degree of obligation toward the oldest people in the family or tribal unit. The status of elderly people was highest in Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

societies that had a surplus of food where the oldest members controlled property, possessed special cultural knowledge, or held religious roles. In societies where food was scarce, where property was nonexistent, or where leadership was based on ability rather than on longevity, older people were sometimes abandoned or put to death.

Page: 52-53 23. What was the status of older people in literate pre-industrial societies?

Ans: The status of older people in literate pre-industrial societies varied according to living conditions, religious beliefs, cultural values, and the degree to which they were nomadic. Elderly people appeared to have high status in early Hebrew, Roman, and North American societies.

The higher status of older people due to religion was particularly pronounced during the Dark Ages—a time when the Christian Church was dominated by senior clergy. However, this privilege did not extend to women, who were excluded from positions of power.

Page: 53-54 24. How has the status of the Anishinabe Elders of Georgian Bay shifted?

Ans: Originally, the Anishinabe (“original people”) elders played a traditional role by transmitting knowledge and culture to the children of the tribe. However, with the arrival of Christian missionaries and the creation of schools on the reserves, missionaries and teachers took control of the knowledge and culture transmitted to younger generations. Skills needed for survival in the “modern” world (English, mathematics, etc.) were taught. By the 1960s, the prestigious role of elder had disappeared. In the 1970s, however, Native elders regained some degree of importance when the federal government created Native Cultural/Educational Centres across Canada. In one instance, Native elders of the Anishinabe were recruited by the staff of a centre on Manitoulin Island to record and transmit elements of their traditional culture. The oldest-surviving members became “volunteer elders” in the traditional sense.

Page: 54-56 25. What are the impacts of language and cultural barriers in health care? Illustrate your understanding by providing an example.

Ans: Many students will rely on information from Highlight 2.7 “The Influence of Language and Cultural Barriers in Health Care.” Most health and social welfare policies and services are designed for members of the majority group. In fact, some racial or ethnic groups underutilize the social services available in a community because they do not know what services are available or because their language, customs, or beliefs make it difficult for them to access or use the services, especially in long-term-care institutions (see Parts I, III, and IV in Whitefield and Baker 2013). Highlight 2.7 illustrates how cultural values and family dynamics influenced the understanding of disease and access to health care. Specifically, the box tells the story of how two elderly Punjabi men experienced aging and healthcare. Mr S, who was originally placed in a care facility where few inhabitants spoke his language or shared his culture, began to thrive when offered health care in his own language and placed in a facility where the opposite was true.

Likewise, the box also describes how language and culture led to a miscommunication about the number of support services and care options available to Mr G and his family.

Page: 63 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Chapter 3

Integrating Physical, Psychological, and Social Change across the Life Course Multiple Choice Questions 1. Which term refers to the co-occurrence of chronic conditions, such as arthritis or diabetes, which can become serious in later life? a) Co-mortality b) Co-morbidity c) Multimortality d) Multimorbidity Ans: d Page: 70 2. Approximately what percentage of Canadians aged 65 and over report at least one disability which influences their daily activities? a) 7–12 per cent b) 15–18 per cent c) 23–25 per cent d) 33–40 per cent Ans: d Page: 70 3. What percentage of Canadians aged 65–74 experience some form of diagnosed dementia? a) 2 per cent b) 8 per cent c) 20 per cent d) 30 per cent Ans: b Page: 70 4. Which of the following would not be considered a disability? a) Influenza b) Chronic joint pain c) Using a wheelchair d) An inability to walk Ans: a Page: 71 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

5. What is the most common disability reported among people aged 65 and up related to? a) Hearing b) Sexual functioning c) Mobility d) Dental issues Ans: c Page: 71 6. Which of the following would be considered an instrumental activity of daily life (IADL)? a) Dressing b) Cleaning the house c) Grooming oneself d) Using the toilet Ans: b Page: 71 7. Which of the following statements is false? a) Frailty is a disease state that can be reversed in some cases. b) Frailty is strongly related to an increased risk of falling, social isolation, cognitive decline, and hospitalization. c) The main causes of frailty can include genetic predisposition, sedentary lifestyles, the onset of disease, and poor nutrition. d) Frailty is an inevitable consequence of aging.

Ans: d Page: 71 8. Which of the following is a characteristic of sarcopenia? a) A decrease in water content and an increase in fat cells in relation to muscle cells b) A decrease in bone mass and minerals c) A decrease in muscle mass, strength, and elasticity d) A deterioration in the flexibility and composition of joints Ans: c Page: 74 9. What is the cause of body weight decline for many adults over the age of 60? a) A change in body metabolism b) The inability to chew c) Loss of appetite d) Lack of access to nutritious food Ans: a Page: 73 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

10. Which of the following would not be evidence of the central nervous system slowing down with age? a) Longer response or reaction time b) The earlier onset of fatigue c) Forgetfulness d) Hand tremors Ans: c Page: 75 11. What kinds of physiological changes occurring with age are the most visible? a) Those in the central nervous system b) Those in the musculoskeletal system c) Those in the cardiovascular system d) Those in the respiratory system Ans: c Page: 75 12. Which of the following statements is false? a) Physical activity is positively associated with mental and physical health. b) There is an inverse relationship between physical activity and mortality rates. c) Physical inactivity is especially common in later life. d) There are fewer benefits of physical activity for older people.

Ans: d Page: 75 13. Robert has been visiting his physician for an annual physical every spring since he retired a decade ago. This year, Robert tells his doctor that he has taken up several new hobbies in an effort to ward off “old age.” He then tells his doctor all about his winter schedule, which included curling, learning Spanish, knitting, and yoga. Upon hearing about these new activities, Robert’s doctor tells him that his decreased systemic blood pressure and increased muscle mass, endurance, and strength make sense now. What is the most likely explanation for these changes in Robert’s health? a) Robert’s doctor misinterpreted his chart. b) Learning a language has an impact on physical health. c) Robert is experiencing the benefits of increased social activities. d) Robert is experiencing the benefits of regular physical activity.

Ans: d Page: 76 14. Which of the following refers to the motivation, confidence, physical competence, understanding and knowledge that individuals develop in order to maintain physical activity at an appropriate level throughout their life? a) Physical literacy b) Functional literacy Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

c) Boomer syndrome d) Age norming Ans: a Page: 78 15. According to the textbook, why do the mass media periodically report the accomplishments or unusual athletic feats of aging adults? a) These accomplishments are commonplace and news media reports on routine events. b) The increased interest in physical activity and sport among the general population. c) Aging adults buy more newspapers. d) Sports-related news draws more advertising profits.

Ans: b Page: 78 16. If a job demands speed in decision-making and performance, an older worker may be disadvantaged more by which of the following than if the job merely requires physical strength? a) Faster neurons b) Faster cognition c) Slower reaction time d) Slower social cues Ans: c Page: 82 17. Which of the following statements is false regarding presbycusis? a) It affects 80 per cent of older adults. b) It is a major type of hearing loss that results in the inability to hear higher-frequency sounds. c) It starts to appear after the age of 50. d) It is more common in men.

Ans: a Page: 84 18. Which of the following statements regarding sexuality in later life is false? a) Physical changes, chronic illness, and some prescription drugs may reduce sexual desire in later years. b) As they age, men experience increased sexual desire while women experience a decrease. c) Reduced sexual activity in later life can be explained by psychological or social problems. d) It may take longer to become aroused and reach satisfaction in later years.

Ans: b Page: 85 19. What percentage of dementia is classified as the Alzheimer’s type? a) 10 per cent b) 20 per cent Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

c) 40 per cent d) 70 per cent Ans: d Page: 87 20. Which of the following statements regarding intelligence is false? a) Fluid intelligence is the ability to adjust one’s thinking to the demands of a specific situation. b) Crystallized intelligence is a product of education, experience, and acculturation. c) Fluid intelligence is not susceptible to age-related declines. d) Crystallized intelligence increases with age, even into the mid-70s.

Ans: c Page: 88 21. Which of the following activities cannot enhance memory? a) Practising b) Relying more on recognition than on recall c) Using non-meaningful material to be learned and remembered in experimental situations d) Reducing interference during the learning process Ans: c Page: 91 22. Regarding cognitive styles, what is true of “field-dependent” individuals? a) They are more aware of their social environment. b) They are more analytical. c) They are more internally directed. d) They are less constrained in their behavior by tradition.

Ans: a Page: 92 23. Which of the following statements regarding creativity is true? a) Creativity involves the ability to produce work that is novel, high in quality, and taskappropriate. b) Creative potential often peaks at around the age of 20 and begins to decline around the age of 40. c) Creativity and wisdom are thought to function at similar ends of the life course. d) Creativity is easy to measure.

Ans: a Page: 92 24. What does Erikson’s definition of generativity (1985) describe? a) A process in which individuals become less concerned with leaving a legacy to the next generation. b) A process in which individuals become less concerned with self-identity.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

c) A process in which individuals begin to focus more on themselves. d) The fact that individuals expect reciprocity.

Ans: b Page: 95 25. Which of the following tends to occur with regards to the “big five” personality traits later in life? a) An increase in agreeableness and conscientiousness b) An increase in neuroticism and extroversion c) An increase in neuroticism, extroversion, and openness d) An increase in openness Ans: a Page: 95

True or False Questions 1. Environmental factors have no bearing on those who are predisposed to disease states and malnutrition.

Ans: False Page: 70-71 2. The 2006 Participation and Activity Limitation Survey and 2012 Canadian Survey of Disability showed consistent reporting of disabilities for older Canadian populations.

Ans: False Page: 71 3. Older women, more than older men, report one disability or more.

Ans: True Page: 71 4. It is estimated that the incidence of dementia in Canada will decrease by the year 2038.

Ans: False Page: 70 5. Clinicians often label someone as “frail” if they have one of the following characteristics: muscle weakness, fatigue, unintentional weight loss, or unsteady gait.

Ans: False Page: 71-72

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

6. Most people experience serious functional loss by the time they are 65.

Ans: False Page: 72 7. Body weight tends to increase until about 50–60 years of age, and then it begins to decline.

Ans: True Page: 73 8. Aging entails a decrease in muscle mass and elasticity.

Ans: True Page: 74 9. Research shows that declines in cognitive processes are more rapid and more severe than declines in motor, physiological, and sensory systems.

Ans: False Page: 87 10. Aging results in a decrease in bone mass, especially among women.

Ans: True Page: 74 11. Crystallized intelligence peaks during adolescence whereas fluid intelligence increases with age.

Ans: False Page: 88 12. For aging people, lack of physical activity can result in early fatigue and long recovery periods during stressful situations.

Ans: True Page: 76 13. Recent studies have found that more physically fit older people score higher on tests of cognitive functioning.

Ans: True Page: 77 14. “Field-dependent” and “field-independent” are terms that refer to the ways in which individuals practice physical activity.

Ans: False Page: 91-92 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

15. There is an inverse relationship between the amount of physical activity at work or play and mortality rates.

Ans: True Page: 77 16. Physical activity is becoming more socially acceptable and desirable among baby boomers.

Ans: True Page: 78 17. The “self” is only influenced by current social circumstances and not cultural or social circumstances from earlier in life.

Ans: False Page: 95 18. Adults aged 18 to 39 are less likely to meet the guidelines for moderate-to-vigorous physical activity than those aged 40 to 79.

Ans: False Page: 77 19. Age grading can be entrenched when role models for physical activity are absent in a society.

Ans: True Page: 78 20. Longitudinal studies suggest that after early adulthood, people demonstrate reasonable consistency in attitudes, values, temperament, and traits.

Ans: True Page: 94 21. Impairment in sensory systems cannot be compensated for through other means.

Ans: False Page: 91 22. Sexual activity occurs more often in old age than in middle-age because of a dramatic increase in the use of medications like Viagra.

Ans: False Page: 86 23. Baby boomers define sexuality similarly to earlier cohorts of older adults.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: False Page: 86 24. Nursing home personnel are increasingly grappling with how to accommodate the sexual needs of married and unmarried older residents.

Ans: True Page: 86 25. Research has yet to examine why some individuals live to an extreme advanced age.

Ans: False Page: 96

Short Answer Questions 1. What are the benefits of physical activity for older adults? What are some of the reasons for inactivity in later life?

Ans: Some of the benefits of physical activity for older adults include the slowing of cellular degeneration, increased blood flow through the capillaries, increased muscle mass, endurance, and strength, decreased body fat and a lower body weight, increased flexibility and coordination, and increased cardiovascular endurance. Some of the reasons for inactivity in later life include negative attitudes towards physical activity and myths surrounding the inability of older adults to exercise, or the lack of benefit that regular exercise can bring.

Page: 76–78 2. How do learning and memory change in later life? What are five ways to enhance memory in later years?

Ans: Older adults can learn new skills, ideas, and concepts if adequate personal and situational conditions are present. Learning potential may be restricted because of a decreased ability to distinguish relevant from irrelevant information so it is important to eliminate distractions in the environment. In terms of memory, older adults are more likely to have the ability to remember distant events than recent happenings. While a progressive decline in memory performance is not inevitable, older people do need more time to retrieve information from both their shortand long-term memory, especially if there are many competing stimuli in the environment. Some techniques for enhancing memory include the following: (1) learning and adopting strategies to facilitate memorization, such as direct training and instruction; (2) practising; (3) providing more time for acquiring, rehearsing, and retrieving information; (4) using meaningful material to be learned and remembered in experimental situations; and, (5) relying more on recognition than on recall.

Page: 89–91 3. How does personality change across the life course?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: Two patterns of personality change may be noted at or beyond middle age in some people.

First, most members of a cohort exhibit changes over time in some traits, but a person’s relative position in the group does not change. Secondly, all members of a cohort change on some trait but some people change much more than others. Personality changes can also be initiated at any stage in life by agency, when people actively seek to bring about behavioural changes in themselves; by the interaction of genetic factors with social or physical environmental factors; or by transitions or traumatic life events. Another (relatively recent) concept of personality change is Erikson’s theory of generativity, which describes a process in which individuals become less concerned with self-identity and more concerned with leaving a legacy to the next generation.

Page: 93–96 4. Is aging a disease? Explain your position.

Ans: As we age, we all experience some decline in health and gradual losses of physical, motor, and cognitive efficiency and ability. While some diseases, such as Alzheimer’s disease, Parkinson’s disease, and strokes are more prevalent in later life, aging itself—a natural process with both positive and negative aspects—should not be considered a disease. In addition, since both genetic and environmental factors can speed up or slow down changes in health or aging, the process varies greatly from person to person. As such, it is not possible to diagnose a specific set of “disease” symptoms at a particular point in time.

Page: 70–72 5. What is frailty? Explain using examples.

Ans: Frailty is neither well defined nor well understood. It is not an inevitable consequence of aging but rather a disease state that is susceptible to intervention and, in some cases, reversal.

Frailty is characterized by impairments across physiological systems that often entail imbalances, such as weaker lung capacity and loss of leg strength. The causes include genetic traits related to the metabolic, cardiovascular, and immunologic systems; the onset of disease or injuries that limit physical activity; poor nutrition; and lack of regular physical activity. Common symptoms are as follows: muscle weakness, especially in the legs; fatigue and diminished energy reserves; decreased physical and social activity; unintentional loss of weight; poor posture; and a slow or unsteady gait.

Page: 71-72 6. What are the most significant external changes that occur when aging?

Ans: The external changes associated with aging occur in the skin, the hair, and in the shape and height of the body. In later life, the skin becomes wrinkled as it loses thickness, elasticity, and subcutaneous fat. Similarly, hair becomes thinner and loses its original colour. While body weight usually increases up to about 50–60 years of age, there is often a decline thereafter because of changes in the body’s metabolism. In addition, a shortening stature that begins in late middle age is caused by changes in the structure and composition of the spine. These changes are seen with an increased “bowing” of the spine, rounded or stooped shoulders, and back pain.

Page: 73-74 7. What are the most significant internal changes that occur when aging?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: The internal changes associated with aging include a decrease in muscle mass (sarcopenia), strength, and elasticity; a decrease in water content and an increase in fat cells in relation to muscle cells; a decrease in bone mass and minerals so that bones become more brittle, which increases the likelihood of fractures; and a deterioration in the range, flexibility, and composition of the articulating surfaces and joints, which enhances the likelihood of fractures or arthritis.

Many of these changes lead to decreased mobility, changing leisure activities, and the inability to perform household tasks. They can also increase the incidence of accidents or falls.

Page: 74-76 8. What is reaction time? How do changes in reaction time affect people in later life? Is there anything that can be done to offset the negative effects?

Ans: Reaction time is the period from perception of a stimulus to reaction. The slower reaction time that often comes with age has been explained as a physical problem resulting from a number of physiological processes (e.g., a decline in signal strength as neurons and nerve cells die, an increase in reflex time for skeletal muscles, etc.). Many older workers who cannot continue to perform because speed and accuracy have decreased end up leaving their jobs (either voluntarily or involuntarily). In the social domain, a slowing of reaction time and decisionmaking reduces the frequency, quality, and type of interaction that elderly people have with others and with the environment. A loss of reaction time can be offset by practice and a strong desire to succeed at the task and by spending more time monitoring the input stimuli before a response is made.

Page: p. 81–82 9. What is impairment? Explain using examples.

Ans: Impairment refers to the loss of some physical or mental function. Impairment can occur in a singular sensory system while global sensory impairment refers to an aging-related decline that affects all five of the sensory systems. With age, greater stimulation is needed in order to send information to the brain. The quality and quantity of information processing is reduced when age-related changes occur in the major sensory receptors and processors. If the receptors become less efficient, a person’s interest in communicating and in their capacity to understand information is reduced. The changes in these systems are referred to as “impairment.”

Page: 82-85 10. What happens to taste, smell, and touch as we age?

Ans: By about the age of 60, individuals experience a higher taste threshold for all five taste sensations: salt, sweet, bitter, sour, and the recently discovered umami (monosodium glutamate).

In addition, they produce less saliva and lose some of their taste buds. These changes are compounded by smoking, wearing dentures, and the regular use of certain prescription drugs.

Sensory problems tend to be minimal until the advanced ages of 75–80, at which point they increase substantially. The ability to detect or identify odours declines with age; many also experience a loss of sensitivity to touch and/or vibration in some parts of the body.

Page: 84-85 11. How does sexuality change with age? Is there an inevitable decline in sexual desire or sexual function?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: Research shows that a great number of older people are sexually active and continue to experience sexual desire. While the meaning of sexuality typically shifts from an emphasis on the importance of sexual intercourse to a greater appreciation for companionship, affection, and intimacy, older adults continue to be sexually active, given the right conditions (e.g., privacy, good physical health, the availability of an interested partner, etc.). Contrary to a once-popular belief, lack of interest in sex on the part of older adults is not the norm. While hormonal changes in women and the general neuro-muscular slowing with age among men may affect the sex lives of older adults, the decline is not as fast (nor does it reach as low a level) as early research or popular belief have implied. Moreover, psychological or social problems have a greater effect on sexual activity in later life than physiological deficiencies.

Page: 85–86 12. What is the difference between fluid and crystallized intelligence? How does each change with age?

Ans: Fluid intelligence, influenced by neurological capacity, represents incidental learning that is not based on culture. Fluid intelligence is the ability to adjust one’s thinking to the demands of a specific situation and to organize information to solve problems. It is measured by performance tests that are scored according to accuracy and speed and peaks during adolescence. Therefore, it is susceptible to age-related declines. Crystallized intelligence, a product of education, experience, and acculturation, is based on learning and experience. Consequently, there are individual differences that vary by level of education, socio-economic status, and gender. Crystallized intelligence is measured by verbal comprehension tests that stress vocabulary and the continual addition or restructuring of information and knowledge within the cognitive system. This type of intelligence increases with age, and is therefore relatively resistant to aging effects.

Page: 88 13. What are five factors that can influence intelligence-test performance in old age?

Ans: Differences in intellectual performance can be accounted for by a variety of past and current social and environmental factors, such as the following: experience, motivation, and training concerning material in the tests (+); higher levels of education completed and fewer years since leaving school (+); the absence of stress and fatigue in test situations (+); the presence of stereotypes that define older people as incompetent, thereby lowering expectations and the level of test motivation (–); a decreased emphasis on speed of performance (+); the onset of personal crises, including major changes in job, marital, financial, or health status (–).

Page: 89 14. How do problem solving styles change as people age?

Ans: The ability to solve problems declines with age because of a slowing down of behaviour and because of an unwillingness (or inability) to use newer, more efficient strategies that might lead to a solution or decision. However, declines are related, as well, to education and to the type of task involved. The decline in ability is lower among better-educated older people and for tasks similar to those used in a person’s occupation. A cohort effect may therefore be present because of changes in educational and occupational experience that improve cognitive skills, such as computer use or the use of other technologies.

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Page: 92 15. What is “disability”?

Ans: A disability is a “reported” difficulty in performing the activities of daily life (ADLs), such as dressing, getting out of bed, grooming oneself, or using the toilet, or in performing instrumental activities of daily life (IADLs), such as shopping, banking, cleaning and maintaining a home, and driving a car. A disability can also be a physical or mental condition, or a health problem, that reduces the kind or amount of activity that can be completed. A reported disability can range from a backache to an inability to walk even with an assistive device such as a cane or a walker. Older people report more disabilities than younger people; and older women, more than older men, report one disability or more.

Page: 71 16. What are the ways in which hearing loss can affect older people?

Ans: An older person who is unaware that his or her hearing is declining may have communication problems and experience stress in social situations. This can decrease the quality of social interaction, inhibit communication, cause fear and embarrassment, or lead to depression. A spouse may have to change communication patterns and the frequency and type of interaction with a partner who has hearing impairment. Some older people who experience hearing loss also begin to avoid social events and experience isolation.

Page: 83–84 17. What are some of the changes to the muscular system that occur with age? How can they impact daily life for older adults?

Ans: Age-related changes in the muscular system result in a decrease in strength and endurance, although the rate and degree of loss depend on the frequency and intensity of physical activity.

Sarcopenia (a major loss of muscle mass and loss of muscle function) is a major cause of disability and morbidity among older people. Furthermore, a decrement in the muscular-skeletal system increases the likelihood of falls: there may be reduced leg lift when walking, which increases the chance of tripping, or there may be greater difficulty in regaining balance after stumbling. In addition, the time required for a muscle to relax or contract, and the time required before it can be re-stimulated, increases in later life. This occurs partly because of changes in the contractile tissue in the muscle and partly because of neurological changes. A decline in muscular endurance also reduces the efficiency of other body functions, such as the respiratory system.

Page: 75-76 18. What is meant by cautiousness in relation to motor performance?

Ans: Changes in motor performance in later life include loss of speed in making decisions and a concomitant increase in reaction time. Moreover, the loss is compounded if the situation is stressful, such as driving under dangerous conditions. With advanced age, there may be a slowing of speed to ensure accuracy—a generalized tendency to respond to stimuli slowly or not at all because of the possible consequences of a mistake—which is referred to as “cautiousness.”

This slow response (or lack thereof) occurs in many situations when a quick decision must be made, such as while driving in heavy traffic.

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Page: 81 19. What is the concept of “wisdom”?

Ans: Based on the Berlin Wisdom Paradigm, wisdom is defined as expert knowledge in the basic pragmatics of life that facilitate exceptional insight, judgment, and skilled advice about complex life situations. The acquisition of wisdom is not guaranteed, and not all older persons are viewed as possessing wisdom. Some studies have suggested that wisdom involves some balance of advanced cognitive ability and creativity. It may also be related to personality and to being “open” to new experiences. It is assumed that wisdom increases to a maximum in the older years because of experience, education, and creative energy, and many seeds of wisdom are planted in adolescence and early adulthood.

Page: 93 20. What is a self-concept and how does it change with age?

Ans: A self-concept is a subset of personality that is the outcome of our motivations, attitudes, feelings, and behaviour relevant to our self-definition (how we define and present ourselves to others) and our personal meaning of life. There is both stability and change in the self-concept as we age. We use our physical, cognitive, and social resources to maintain or change our selfconcept as social or cultural situations change over the life course. Life-course events shape the self, and the content of the self influences life-course experiences. Moreover, the self is influenced not only by current social circumstances but also by culture and our place in the social structure earlier in life.

Page: 95 21. What do we know about cognitive vitality and quality of life issues for those who reach extreme ages?

Ans: Cognitive vitality refers to particular personality and/or cognitive traits that are more common among those who reach extreme ages. That said, quantity of life is not necessarily translated into quality of life. Furthermore, although the pathways to longevity are complex, we do know that (1) there is positive selection for psychological factors (i.e., those with poor psychological health die earlier and vise versa) such that certain psychological traits likely contribute to longevity; (2) even those who outlive others in their cohort and exhibit aspects of vitality can be challenged by significant reductions in energy and physical strength, resulting in the need for adaptive coping strategies; (3) the measures that we currently use to examine cognitive and other types of vitality among the very old are not well developed to date; and (4) we require longitudinal data, such as those collected in the Canadian Longitudinal Study on Aging, to understand the biopsychosocial complexities underlying the connections between longevity and vitality (Smith and Ryan 2015).

Page: 96-97 22. What were the findings of the Canadian Health Measures Survey from 2012 and 2013? Given what you have learned in the textbook so far, do you think these findings will stay the same or change when the survey is conducted 5–10 years from now? Explain your reasons.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: Results from the 2012 and 2013 Canadian Health Measures Survey (CHMS) indicate that adults aged 18 to 79 accumulated an average of about 12 minutes per day of moderate-tovigorous physical activity in bouts of 10 minutes or more, or 84 minutes per week. As such, about one in five adults achieved the recommended 150 minutes of moderate-to-vigorous physical activity (in 10-minute bouts) set out by the Canadian Physical Activity Guidelines for adults and older adults. The percentage of adults meeting the guidelines was lower in older age groups. Adults aged 18 to 39 (32 per cent) were significantly more likely to meet the guidelines than those aged 40 to 59 (18 per cent) or 60 to 79 (12 per cent). Student response to the latter question will vary according to their perspective and ability to apply material from previous chapters and elsewhere in the current chapter. For instance, students may note that an aging boomer generation is changing social and individual attitudes about aging and physical activity or bring in material from later in the chapter that describes how media cover physical accomplishments by older citizens.

Page: 77, 78-81 23. How does obesity impact aging persons or populations?

Ans: For many adults, body weight increases up to about 50 to 60 years of age, although there is often a decline thereafter because of a change in body metabolism. Obesity in later life has both physical and psychological effects. Research indicates that obesity is associated with a heightened risk of several chronic illnesses, including cardiovascular disease, type 2 diabetes, and hypertension; however, these associations are stronger among middle-aged persons and weaken among those aged 65+ and especially 75+. Today, aging adults also face a cultural ideal of a youthful body and an active life so obesity may feel like a form of stigma.

Page: 73-74 24. How did the reporting of prevalence rates of disability change in Canada between 2006 and 2012?

Ans: Prevalence rates of disability are the percentage of seniors with a disability measured at one point in time. The 2006 Participation and Activity Limitation Survey found that 40.5 per cent (about 1.5 million) of Canadians 65 and over reported having at least one disability (Statistics Canada 2007). However, a different definition was used in the more recent 2012 Canadian Survey of Disability, which resulted in 33.2 per cent of persons aged 65 and over, and 43 per cent among those aged 75 and over reporting a disability (Statistics Canada 2015a). Regardless of the measure used, a significant proportion of the older population have one or more disabilities, and the incidence increases with advanced age. Among people over 65, the disabilities reported most often were pain, mobility problems (80 per cent of those with a disability), and flexibility (difficulty getting dressed or reaching above their head) (Statistics Canada 2015a).

Page: 71 25. What is physical literacy and why does it matter for aging adults?

Ans: Physical literacy refers to “the motivation, confidence, physical competence, understanding and knowledge that individuals develop in order to maintain physical activity at an appropriate level throughout their life” (Whitehead 2010). Researchers are beginning to study and apply this concept to older adults by focusing on understanding and fostering greater physical activity over the life course for all individuals. There has also been a concomitant spread of physical activity Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

programs specifically targeting baby boomers and older adults to maintain and/or enhance their physical activity levels. For examples of application, students may refer to material from Highlight 3.3 which illustrates the range of possible involvement in sport and physical activity by older people, and Highlight 3.4 which showcases a Canadian marathoner who broke the world record for his competitive age group (85 to 89), or Highlight 3.5 which demonstrates how people can adopt new physical activity patterns during their senior years.

Page: 78-81

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Chapter 4

Population Aging:

A Demographic and Geographic Perspective Multiple Choice Questions 1. What does the demographic transition refer to? a) The rapid increase of older people b) A transition in morbidity and mortality from acute to chronic illness c) A transition in morbidity and mortality from chronic to acute illness d) A shift from high fertility and mortality to low fertility and mortality Ans: d Page: 104 2. Which of the following occurs as a result of an epidemiological transition? a) An increase in life expectancy at birth and the leading causes of death becoming chronic and degenerative diseases later in life b) A decrease in life expectancy at birth and the leading causes of death becoming infectious, parasitic, and acute illnesses c) An increase in fertility and a decrease in mortality due to the technoplosion d) A decrease in fertility and the development of an aging population Ans: a Page: 104 3. Which phase of demographic transition sees a country modernize and experience a rapid spread of new technological developments, creating major changes and improvements in public health (such as disease control, public sanitation, and health promotion), individual health and longevity, work and leisure lifestyles, and quality of life? a) Technoplosion b) Population explosion c) Population implosion d) Demoplosion Ans: a Page: 104 4. Which of the following is comprised of a set of individual birth cohorts? a) Cohort b) Baby boomer cohort c) Generation d) Period Ans: c Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 105 5. Which of the following is not considered a generation? a) Millennials b) Generation X c) Generation P d) Baby Boomers Ans: c Page: 105-106 6. Approximately what percentage of the Canadian population do baby boomers comprise? a) 5 per cent b) 12 per cent c) 27 per cent d) 54 per cent Ans: c Page: 112 7. Approximately what percentage of Canadian baby boomers were born outside of Canada? a) 57 per cent b) 47 per cent c) 37 per cent d) 17 per cent Ans: d Page: 106 8. By 2040, what percentage of the world’s older population will live in less developed countries? a) 75 per cent b) 15 per cent c) 25 per cent d) 45 per cent Ans: a Page: 111 9. Which group is predicted to more than triple its population between 2015 and 2050, making it the fastest-growing segment of the world population? a) The 80+ population b) The 70+ population c) The 60+ population d) The 50+ population Ans: a Page: 111 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

10. In which of the following countries is the highest percentage of the population over age 65? a) Germany b) Greece c) Japan d) Belgium Ans: c Page: 113 11. In which of the following countries is the lowest percentage of the population over age 65? a) Kuwait b) Afghanistan c) Rwanda d) United Arab Emirates Ans: d Page: 113 12. What is median age? a) The chronological age at which the population divides into equal numbers of younger and older people b) The functional age at which the population divides into equal numbers of younger and older people c) The chronological age at which the population divides into larger numbers of younger people than older people d) The chronological age at which the population divides into larger numbers of older people than younger people Ans: a Page: 113 13. Which of the following refers to the average number of years a person can expect to live without chronic disability? a) Independent life expectancy b) Active life expectancy c) Healthy life span d) Functional life expectancy Ans: b Page: 115 14. What was the sex ratio for Canadians aged 65 and up in 2016? a) 29 males per 100 females b) 34 males per 100 females c) 67 males per 100 females d) 83 males per 100 females Ans: d Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 118 15. At which point in history did the total dependency ratio for Canada peak? a) During the early 1970s b) During the early 1980s c) During the late 1990s d) During the baby boom Ans: a Page: 118 16. What is the old-age dependency ratio? a) The number of people aged 19 to 64 divided by the number of people aged 65 and over b) The number of people aged 85 and over divided by the number of people aged 19 to 84 c) The number of people aged 65 and over divided by the number of people aged 19 to 64 d) The number of people aged 65 and older, or who are considered dependent, divided by the number of people aged 64 and younger, or who are considered independent Ans: c Page: 119 17. By 2056, what is Canada’s projected total dependency ratio? a) 77 dependents for every 100 people of working age b) 94 dependents for every 100 people of working age c) 68 dependents for every 100 people of working age d) 84 dependents for every 100 people of working age Ans: d Page: 119-120 18. Which of the following is not a phase of the demographic transition? a) Agroplosion b) Population implosion c) Population displosion d) Technoplosion Ans: a Page: 104 19. Which of the following is not an example of an “older” Canadian community? a) Elliot Lake, ON b) Kelowna, BC c) Barrie, ON d) Parksville, BC Ans: c Page: 122 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

20. In 2016, which Canadian province or territory had the highest percentage of older adults? a) Nunavut b) Ontario c) Québec d) Nova Scotia Ans: d Page: 101 21. In 2016, which Canadian province or territory had the lowest percentage of older adults? a) Alberta b) Northwest Territories c) Nunavut d) British Columbia Ans: c Page: 101 22. Which of the following statements regarding sex ratios is true? a) The sex ratio over the next 30 years is projected to decrease in developing countries. b) The sex ratio will not change in the next 30 years. c) The sex ratio over the next 30 years is projected to increase in developed countries and decrease in developing countries. d) The sex ratio over the next 30 years is projected to decrease in developed countries.

Ans: c Page: 117 23. Which of the following statements regarding immigrants to Canada is false? a) Until the 1970s, most immigrants came from European countries. b) In the past decade, immigrants were more likely to come from Asia. c) Most recent immigrants settled in Winnipeg, Calgary, and Saskatoon. d) An increasing proportion of new immigrants are identified as “allophones.”

Ans: c Page: 122-123 24. What is the most likely explanation for the aging of rural areas and small towns in Canada? a) It is the result of immigration and migrant workers seeking out permanent residency. b) It is the result of youthful migration to obtain employment in urban areas while older people stay or others return to the hometown from urban areas if they have left. c) It is the result of small town idealism—retirees seek out charming communities to leave the stress of cities and work behind them. d) It is the result of a global trend toward urban–rural population migration.

Ans: b Page 121 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

25. What is the median age of the population in Toronto? a) 9 b) 19 c) 29 d) 39 Ans: d Page: 122

True or False Questions 1. Globally, around 2016, people aged 65 years and over outnumbered children under five years old.

Ans: True Page: 101 2. The “youngest” country in the world is Kuwait.

Ans: False Page: 101, 113 3. In the 1800s, the average life expectancy at birth was 30 years.

Ans: True Page: 104 4. Canada is the “oldest” country in the world.

Ans: False Page: 101 5. Apocalyptic interpretations that argue older people are fast-becoming a burden to society are the most accurate type of explanations for population aging.

Ans: False Page: 107 6. Globally, 8.5 per cent of the world’s population is 65 years old and over.

Ans: True Page: 109 7. By 2050, the proportion of persons aged 65 and over, globally, will increase to 47 per cent.

Ans: False Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 109 8. “Generation X” refers to the “back-end” boomers.

Ans: False Page: 106 9. Population explosion is the second phase of the demographic transition.

Ans: False Page: 104 10. The demographic transition is when a society shifts from high fertility and mortality to low fertility and mortality.

Ans: True Page: 104 11. Population displosion is the phase in demographic transition when the population of a specific geographic area becomes increasingly diverse due to migration flows.

Ans: True Page: 104 12. Epidemiological transition occurs when a population ages and is the result of a shift from infectious diseases to chronic diseases.

Ans: True Page: 104-105 13. A generation is comprised of a set of individual birth cohorts that share particular experiences at a particular stage in life and share characteristics that distinguish them from other cohorts or generations.

Ans: True Page: 105 14. The United Nations reported at the Second World Assembly on Ageing that population aging is unprecedented, pervasive, profound, and enduring.

Ans: True Page: 107-108 15. The aging of the baby boomers will create a serious economic burden on society and will ruin the health-care system.

Ans: False Page 107-109 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

16. The absolute number of older people in China will rise to over 25 per cent by 2050.

Ans: True Page 109 17. The speed of population aging in China will have a particularly pronounced effect in rural regions.

Ans: True Page: 110 18. The impact of HIV/AIDS has no bearing on the roles of older adults in various African countries.

Ans: False Page: 111 19. Life expectancy in Canada has finally begun to decrease.

Ans: False Page: 114-115 20. The life expectancy gap between men and women in Canada is closing.

Ans: True Page: 114 21. Active life expectancy refers to the number of years people engage in regular physical activity throughout their lives.

Ans: False Page: 115 22. Globally, there is a clear trend of reverse aging in the largest cities in the world.

Ans: False Page: 121 23. Most immigrants arrive in Canada before they are 30 years old.

Ans: True Page: 123 24. At the height of the baby boom, Canadian women were averaging about eight children each, concentrated in a shorter period than for previous generations.

Ans: False Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 106 25. There are significant differences among the provinces and territories in terms of aging populations.

Ans: True Page: 121

Short Answer Questions 1. How has the baby boom generation influenced social systems of the past and how does it continue to affect the economy today?

Ans: On a societal level, population aging is posing significant challenges for the labour force, the economy, the health-care system, and the family, all of which must adapt to an age structure that is becoming older. History has shown that the school and university systems adapted when the baby boom entered school and that, later, the labour force absorbed this large birth cohort.

Now, society must adapt as the baby boomers leave the labour force and enter the later years of life. In addition, in later life, baby boomers will likely consume more products than prior generations because they have always been avid consumers. As such, entrepreneurs might do well to develop new products targeted at the baby boomers.

Page: 102-103 2. What are some of the questions debated by government to address economic and social problems arising from population aging?

Ans: The questions debated by government to address issues arising from population aging include the following: Should the retirement age be raised or eliminated? Should some healthcare needs be privatized and paid by individuals who use these private services? Should public pension benefits be reduced? Should pension contributions be increased? Should the number of immigrants be increased? Should incentives be created to encourage couples to have more children?

Page: 102 3. What is demography? Why is it an important concept to understand?

Ans: Demographers study why and how populations change over time and become smaller, larger, or older, due to the interrelationships among fertility, mortality, and migration patterns.

To analyze these issues, demographers develop profiles of a nation, region, or community; explain past, current, and future trends; and, based on varying assumptions, make projections— but not predictions—about the future size, composition, and location of the population. Often, these projections include crucial economic, social, and policy issues to be addressed or the possible consequences, positive or negative, of demographic changes for a society or community.

Page: 103

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4. What is demographic transition and how does it influence population growth? How have less developed countries experienced this transition?

Ans: A demographic transition is a gradual process (usually taking about 100 years) in which a society moves from having high rates of fertility and mortality to low rates of fertility and mortality. Typically, mortality rates drop faster than fertility rates, which results in significant population growth. Less developed countries have been experiencing this transition at a faster pace than did more developed countries, largely because of the global distribution of food, medicine, and technology.

Page: 104 5. What are the four phases of demographic transition? Briefly describe each.

Ans: (1) population explosion: rapid population increase. (2) population implosion: concentration of a population in a relatively small area. (3) Population displosion: population becomes increasingly heterogeneous owing to in- or out-migration and immigration. (4) technoplosion: the rapid spread of new technological developments.

Page: 104 6. What is the difference between population explosion and implosion phases of demographic transition?

Ans: Population explosion is the first phase of the demographic transition. In this stage, the world’s population increased from about one billion in 1800 to about six billion at the beginning of the twenty-first century. It is projected that if fertility rates remain constant in most developed countries and decline in developing countries, the world population will rise from about 7.3 billion in 2015 to 9.4 billion by 2050 (He et al. 2016). Of this total, 25 per cent will live in the more developed countries and 75 per cent in the developing countries. A second phase of the demographic transition was population implosion; that is, the population of most countries became concentrated in a relatively small area, primarily when young adults migrated to cities in search of work and an urban lifestyle.

Page: 104 7. What is the epidemiological transition?

Ans: In the later stages of a demographic transition, there are often improvements in the health of a nation—a health transition. As a population ages, the leading causes of death usually change from infectious, parasitic, and acute illnesses to chronic and degenerative diseases. This phenomenon, known as an epidemiological transition, begins once there are improvements in food distribution, nutrition, water quality, personal hygiene, public sanitation, education, and economic development. As a result, life expectancy at birth rises, and the leading causes of death become the chronic and degenerative diseases of later life.

Page: 104–105 8. What is the relationship between a generation and a cohort?

Ans: A generation is comprised of a set of individual birth cohorts (e.g., boomers born from 1946 to 1965). It includes individuals who share particular life experiences at a particular stage in Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

their life course. It typically exhibits characteristics or “watersheds” that distinguish it from other generations—characteristics that are related to the size and composition of the cohorts comprising the generation and the attributes of the individuals it contains. While a generation is made up of birth cohorts, these terms are not necessarily synonymous. According to Wister (2005): “The age at which individuals of a particular birth cohort (age effects), who share social experiences at the same point in life as their age peers (cohort effects), are exposed to particular historical events (period effects) will define a generation.”

Page: 105 9. What are the differences between the experience of “front-end” and “back-end” boomers?

Ans: Those born in the late 1940s, the “front-end” boomers, have always had an economic and social advantage, since they moved through the workforce during longer periods of economic stability and growth. The “back-end” boomers were born between 1961 and 1965. When these younger boomers were ready to enter the labour force in the late 1970s and early 1980s, Canada was in a major economic recession, and they experienced high rates of underemployment and unemployment. Out of economic necessity, many of these adult back-end boomers (boomerang children) returned to live with their parents at some point (Mitchell 2006), and they may seek to retire later in life to make up for lost income.

Page: 106 10. What are three examples of commonly-used definitions of generations?

Ans: The textbook describes the following examples: the “baby boom,” born between 1946 and 1965; Generation X, born between the mid-1960s and about 1980 (1965–1981 used by some researchers); the Millennials (also known as Generation Y), born between the early or mid-1980s and the late 1990s or early 2000s; Generation Z (also known as the iGeneration or Plurals)— born after the Millennials, up to 2007; and, Generation A (Alpha)—born after 2008.

Page: 106 11. What is the “double whammy” facing health-care systems in developing countries?

Ans: In developing countries, survival rates in the early years are increasing dramatically with improvements in nutrition, sanitation, and access to food and medicine. But, at the same time, their health-care systems are facing a “double whammy”—they must prevent and treat noncommunicable diseases and eradicate infectious diseases such as AIDS/HIV, SARS, and tuberculosis while at the same time introducing community care and long-term-care services for the increasing number of citizens who survive into later life.

Page: 105 12. What is the United Nations’ position on population aging?

Ans: The United Nations (2002b) reported at the Second World Assembly on Ageing (there has not been a third, as yet) that population aging (1) is unprecedented in the history of humanity, and the number of older people in the world will exceed the number of young people for the first time by 2050; (2) is pervasive, globally, and will have an impact on every citizen regardless of age; (3) is profound and will have an impact on all aspects of human life— economic, social, political, health, housing, and migration; and (4) is enduring and likely irreversible.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 107-108 13. What are four ways in which global aging can positively affect economic performance?

Ans: (1) Declining fertility has led to, and will continue to lead to, greater female labour force participation. This will counterbalance age-related labour force declines associated with population aging. (2) Fewer children generally mean healthier, smarter, and better educated children as parents divide their resources among fewer offspring—this translates into higher adult productivity. (3) Demographic projections indicate further gains in longevity, including gains in healthy life expectancy. Increased longevity should boost savings, which translates into investment. Investment will drive economic growth. (4) People generally respond to longer lifespans by planning on longer work lives. Tight labour markets in the future should provide a strong impetus for countries to increase legal retirement age and change pension policies to entice longer work lives, which will increase the absolute size of the workforce.

Page: 108 14. Why should media and policymakers be cautious of alarmist or apocalyptic interpretations?

Ans: Sometimes facts are manipulated by the press, which uses alarmist headlines to increase newspaper sales; by politicians, to justify increasing taxes, reducing pension or health-care spending, or transferring more elder-care responsibilities from the state to the family; or by the health-care system, to justify requests for larger budgets and more facilities. The use of demographic statistics for these purposes has been called “alarmist” (Friedland and Summer 1999) or “apocalyptic” or “voodoo” demography (Peterson 1999; Gee and Gutman 2000; Longino 2005). Alarmist or apocalyptic interpretations argue that older people, as the fastestgrowing segment of the population, are becoming a burden to society (Dychtwald 1997; Lascelles 2004; Chappell and Hollander 2011). However, others argue that a negative and unrealistic view of aging is being created by these catastrophic fear-based projections. If the elderly are blamed for the current social and economic problems facing society, older people may be marginalized to an even greater extent than at present. Such projections, and the resulting media headlines, fuel the argument that generations are being treated unequally or that there is “generational inequity.”

Page: 107 15. Why will less-developed countries experience population aging at a faster rate compared to more developed countries?

Ans: The rate of population aging is higher in developing nations—and compressed into a shorter period—because fertility rates are rapidly declining. At the same time, life expectancy in these countries is projected to increase, on average, from 40 to 76 years, but with extreme variations per country. As such, less developed regions of Africa, Latin America, Asia, etc., are aging more rapidly than the more developed regions of the world, where these demographic changes are not as sharp.

Page: 109 16. What is compression of aging? What are the reasons for the urgency of the compression of aging for less-developed countries?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: Compression of aging refers to the speed of population aging. Less-developed regions are aging much more rapidly than the more developed regions of the world. These rapid demographic changes do not allow for much time to create policies and an infrastructure to meet the health and social needs of older citizens. China, for example, may be ill-prepared to cope with the speed at which its population is aging due to its lack of formal pension system and the unevenness of its economic development, especially across regions.

Page: 109-110 17. Why might China be ill-prepared to cope with the changes associated with population aging?

Ans: China’s economic development is uneven, especially across regions. The country has no formal pension system. It has no comprehensive health-care system. The population is less educated, in general, than in the developed countries. Young adults are emigrating from China to developed countries (Canada, Australia, European countries) or migrating to urban regions (Beijing, Shanghai, and the new economic regions) and are not available to care for their aging parents. Jobs previously held by older people, often until near the end of their lives, will be eliminated, and as a result there will be economic hardship for older people without pensions.

Page: 110 18. What are the characteristics of aging in Sub-Saharan Africa? How does it compare to other parts of the less-developed world?

Ans: In stark contrast to the rapidity of aging in other parts of the less developed world, most of sub-Saharan Africa remains in an intermediate stage of demographic transition. Fertility and mortality rates are quite high by global standards, and the regional age structure is changing only gradually. Women in sub-Saharan Africa still bear over five children on average, compared with under three in North Africa and just over two in Asia. Although infant and maternal mortality rates are comparatively high, the large number of babies born each year ensures that the base of the population pyramid will remain quite broad. At the same time, life expectancy at birth for the region is approximately 50 years, 13 years below the average for all less developed countries. The scourge of HIV/AIDS has pushed the average life expectancy below 40 years in some subSaharan nations. The proportion of older people in Africa is expected to increase only modestly in the coming decades, although the absolute number of older people will rise steeply. While aging as a socio-political issue is not a high priority, there are unique features of many African societies that bear directly on older people. One is the impact of HIV/AIDS, which thrusts older adults back into the role of primary child-care providers (while also dealing with poverty).

Another is the rapidly growing number of widows and the role that polygamy may play in their well-being or lack thereof. Also, sub-Saharan Africa is rapidly urbanizing, and the implications of migration patterns for the well-being of older Africans in rural areas are not well understood.

Page: 111 19. Why is it important to modulate measures of life expectancy with measures of active life expectancy?

Ans: Life expectancy is the average number of years of life remaining for an individual at a given age. It is determined by applying current age–sex specific death rates to a hypothetical cohort of individuals to construct “life tables,” which are typically calculated for men and women separately because of their different mortality rates. An improvement in life expectancy does not Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

necessarily mean, however, that the health or quality of life of the population has improved.

Rather, ill or disabled people may experience a prolonged illness and a delayed death. Thus, life expectancy should also be measured by qualitative indices that gauge disability-free, healthy, or active life expectancy to assess quality rather than quantity of life.

Page: 113–115 20. What is the pattern of sex ratios across age? What is the significance of this pattern for gerontology?

Ans: The sex ratio is the number of males per 100 females in a population. A ratio of 1 indicates an equal number, and a ratio of less than 1 indicates that there are fewer males than females in a particular age group. Although males outnumber females at birth (about 105 male births per 100 female births), females outlive males as chronological age increases. This changing sex ratio results from a higher incidence of mortality among men, primarily because of fatal accidents before middle adulthood, degenerative diseases in the middle and later years, and events such as wars or natural disasters. This is particularly significant for gerontology because it is an indicator of the shifting gender composition in later life, which affects virtually all dimensions of aging.

Page: 116-117 21. What are dependency ratios? Why has the use of dependency ratios been criticized?

Ans: Dependency ratios calculate the number of non-workers who are supported directly or indirectly by members of the labour force. These ratios have been criticized for supporting apocalyptic demography by suggesting that an aging and dependent population will break the health, pension, and social-service systems; underestimating or ignoring the contributions of persons on the “dependent” side of the equation and overestimating those on the nondependent side; ignoring the financial contributions of the so-called dependent population through spending, taxes, savings, investments, capital accumulated, and voluntary unpaid labour; and, masking underlying or systemic problems, such as large national or provincial debts, changes in transfer payments supporting health care, etc.

Page: 118-120 22. What are two examples of the differences in the growth ratio among the provinces compared to the territories in Canada?

Ans: In Alberta, the senior population is projected to increase by 200 per cent (doubling), whereas New Brunswick’s senior population could increase by 118 per cent. The greatest proportional increases in seniors should occur in the northern regions due to high fertility rates in the past (similar to compression of aging in developing countries). For instance, population aging should occur at a faster rate in the Northwest Territories, increasing by 355 per cent between 2012 and 2036. Still, most older people will continue to live in the four largest provinces: Ontario, Québec, British Columbia, and Alberta.

Page: 121 23. What are the differences between baby boomers and their parents, according to Easterlin (1996)? How will these differences affect the later lives of baby boomers?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: Easterlin (1996) stressed that lifestyle and value differences between the baby boomers and their parents are quite significant: boomers spend more of their income; fewer of them marry; more of them experience divorces and remarriages; they have fewer children; more of them are childless couples and people who have never married; more of them are dual-career families; and some will inherit vast amounts of money or property from their frugal parents or grandparents.

Consequently, as the baby boomers enter later life, some will have only limited savings, whereas others will have large inheritances; they will have fewer children or in some cases none at all to look after them; and a larger percentage will live alone because they are divorced, were never married, or do not live in a common-law relationship.

Page: 103–104 24. What characterizes immigration patterns among older people in Canada? How do these patterns influence aging processes?

Ans: Immigration has contributed to population growth in Canada, but the effect on total population aging is modest because most immigrants arrive before they are 30 and then age along with the rest of the population. About 31 per cent of Canadians aged 65 and older were born outside Canada; most of them immigrated as young adults (see Chapter 2 for additional patterns). At first, they increased the proportion of people under 65, but as they have grown older, they have contributed to the growth in size of the oldest-age cohorts. Many older immigrants come to Canada to join their children, and most come from developing countries.

Page: 123 25. What does the term “allophone” mean? Describe the demographic trends related to allophones in Canada.

Ans: The term “allophone” refers to immigrants whose native language is neither English nor French. In the 2016 census, Canadians (of all ages) reported more than 200 languages under the category “mother tongue,” and about 7.3 million (21 per cent or more than one out of five living in non-collective dwellings) were identified as using non-English or non-French languages (about 23 per cent for persons aged 65 and over). After English and French, the most commonly spoken languages in Canada in 2016 were, in order, Chinese, Punjabi, Spanish, German, Italian, and Arabic. The country/region of origin has also been changing dramatically and is projected to continue, with increasing numbers immigrating from Asia, Africa, and the Americas and decreasing numbers from European countries (Statistics Canada 2017e).

Page: 123

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Chapter 5

Theories and Research in Explaining and Understanding Aging Phenomena Multiple Choice Questions 1. According to your textbook, which of the following refers to a formal, specific explanation for some facet of the social world? a) Theory b) Model c) Perspective d) Framework Ans: a Page: 132 2. Which of the following is based on the assumption that individuals search for social situations in which valued outcomes are possible, and in which their social, emotional, and psychological needs can be met? a) Structural functionalist perspective b) Interpretive perspective c) Social constructionist perspective d) Social exchange perspective Ans: d Page: 136 3. According to Ray (1996), what might the term “caregiving” mean to a postmodern feminist? a) The care is offered freely to meet the needs of another person. b) Care is hard work performed for remuneration. c) Care begins because of a sense of duty or responsibility. d) Families are required by law to provide care.

Ans: a Page: 137 4. Which of the following accurately describes the life course perspective? a) There is limited variability between older adults in the experiences that they have had over the life course. b) Opportunities, experiences, and decisions made earlier in life can influence one’s situation later in life. c) Advantages and disadvantages experienced throughout the life course tend to cancel each other out and, therefore, do not impact our aging experience.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

d) Events that happen early in life, such as education, work history, leisure, and family circumstances, have no impact on what happens to a person later in life.

Ans: b Page: 140 5. In which of the following perspectives did the activity theory originate? a) Symbolic interactionism b) Functionalism c) The conflict approach d) Modernization theory Ans: a Page: 142 6. Which of the following theories supports the hypothesis that well-adjusted older adults have high-quality interactions with significant others, and therefore enjoy more positive self-images? a) Continuity theory b) Activity theory c) Social exchange theory d) Labelling theory Ans: b Page: 142 7. Which of the following statements is false? a) The disengagement theory argues that change and adaptation in the later years of life are necessary, both for the individual and for society. b) The activity theory argues that individual adaptation in later life involves continuing an active life. c) The continuity theory argues that as people age, they strive to maintain continuity in their lifestyles. d) The social exchange theory argues that people enjoy interacting with one another and exchanging ideas about certain phenomena.

Ans: d Page: 136-7, 142-4 8. Which of the following theories supports the hypothesis that lost roles must be replaced by new roles for successful aging to occur? a) Activity theory b) Social learning theory c) Disengagement theory d) Exchange theory Ans: a Page: 142 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

9. According to continuity theory, which of the following is false? a) Continuity involves adapting to changes in attitudes, values, and beliefs. b) Continuity involves adapting to changes activities and environment. c) Continuity implies an absence of change. d) Continuity involves coping with discontinuity because of illness or disability.

Ans: c Page: 145 10. According to Riley and the aging and society paradigm, which of the following is not one of the main age strata? a) Childhood and adolescence b) Young and middle adulthood c) Middle and later adulthood d) Later years Ans: c Page: 145 11. Which of the following refers to a situation in which women seeking career advancement find that economic institutions block their opportunities? a) Cohort-centrism b) The feminist perspective c) Structural lag d) Institutional inequity Ans: c Page: 147 12. Which of the following statements regarding evaluation research is false? a) Its purpose is to assess needs before a policy or program is started. b) Its purpose is to determine whether any progress has been made towards a specific goal. c) Its purpose is to measure cost-effectiveness at a particular state of a program or policy after it has begun. d) Its purpose is to determine what is right or wrong.

Ans: d Page: 155-156 13. Which of the following statements regarding participatory action research is false? a) Participants are partners in the research process. b) The research process is done with people rather than on or for people. c) The search to understand specific contextual factors is as important as understanding general patterns. d) This type of research cannot lead to changes in programs or policies.

Ans: d Page: 156 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

14. Which of the following types of studies is best used for specifically addressing issues with the same people at different points in time? a) Cross-sectional study b) Trend study c) Cohort study d) Panel study Ans: d Page: 159 15. According to Locher et al., which of the following ethical issues may arise when conducting research with homebound older persons? a) The researcher may experience interpersonal conflict. b) The caregivers of older people may not want their patients or loved ones involved in the research. c) Researchers may not understand what it is like to be an older person. d) Older people may mistakenly believe that they are to receive some form of treatment or cure for an ailment.

Ans: d Page: 162 16. Which of the following is not possible with cohort analysis? a) Observing cross-sectional age differences b) Studying age changes within a cohort over time c) Completely separating age/period/cohort effects d) Compare patterns exhibited by cohorts of the same chronological age at different points in history Ans: c Page: 160 17. What do survey researchers strive to be? a) Objective b) Close to study participants c) Included in the research d) Astute observers and listeners Ans: a Page: 154 18. Which of the following is characteristic of qualitative research designs? a) Key informants are added until no new information can be gleaned. b) Data are analyzed after being collected. c) They utilize large random samples. d) The sample size is predetermined.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: a Page: 160 19. Which of the following depends on a sample comprised of readily available and visible older people? a) A random sample b) A genealogical sample c) A probabilistic sample d) A non-random sample Ans: d Page: 161 20. What must the research process protect participants from? a) Physical or mental harm b) Sharing information c) Acquiring knowledge d) Other participants Ans: a Page: 162 21. Who uses well-defined concepts and theoretical perspectives to guide their thinking, coupled with rigorous and standardized scientific methods to help them reach their conclusions? a) Journalists b) The public c) Scholars d) All of the above Ans: c Page: 131 22. Which perspective views aging as a process in which an individual adjusts to inevitable new roles, such as a “retiree” or “widow,” and argues that an individual’s failure to adapt to role changes (from worker to retiree) represents an inability to fit into the existing social structure, not that the structure is ineffective or unsuitable for that individual or period in history? a) Participatory action research b) Structural functionalism c) Symbolic interactionism d) Social construction Ans: b Page: 133 23. Which theory contends that privilege and disadvantage needs to be examined at the intersections of major systems of inequality embedded in society along age, gender, sexuality, social class, race, and ethnicity lines? a) Structural functionalism Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

b) Symbolic interactionism c) Intersectionality theory d) Critical gerontology Ans: c Page: 149 24. Which theory challenges the status quo, including prevailing myths and assumptions about pervasive and unacceptable social conditions and the hidden interests and goals of power groups? a) Structural functionalism b) Symbolic interactionism c) Intersectionality theory d) Critical gerontology Ans: d Page: 148 25. A weakness of which method is that it may not work with people who are very reserved, not very articulate, not highly educated, or not very fluent in English, or who have lost some of their memory? a) Participant observation b) Narrative gerontology c) Literary analysis d) Survey research Ans: b Page: 153

True or False Questions 1. The most crucial goal of research is to explain observed relationships or patterns and to interpret the meaning of a social phenomenon observed in everyday life.

Ans: True Page: 131 2. Hypotheses and theories are the same thing.

Ans: False Page: 131-132 3. The interpretive perspective views individuals as social actors who actively construct their reality.

Ans: True Page: 134 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

4. The critical perspective argues that the social structure is inherently equitable.

Ans: False Page: 135 5. Postmodern thought challenges the concept of positivism.

Ans: True Page: 137 6. Feminist studies of older women almost never focus on the economic and power relations between women and men.

Ans: False Page: 138 7. The life-course perspective bridged individual and structural dynamics of the process of aging.

Ans: True Page: 139 8. The idea of agency is that individuals are best understood as the result of institutional norms and structures.

Ans: False Page: 133 9. Activity theory posits that older people should relinquish their earlier roles in order to be happy.

Ans: False Page: 142-143 10. Cohort flow accounts for the aging of cohorts in a dynamic world characterized by social, economic, and political changes.

Ans: True Page: 145 11. The political economy of aging approach assumes that older people, as an age group, are impoverished and lack power.

Ans: True Page: 148 12. We need both theory and research to fully understand the social world.

Ans: True Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 149 13. Researchers who study the aging process should only use quantitative research methods.

Ans: False Page: 151 14. Secondary analysis of data sets typically produces unreliable information.

Ans: False Page: 151-152 15. One advantage of qualitative approaches is that they produce reliable and reproducible results.

Ans: False Page: 151, 160-161 16. Narrative research sometimes includes collecting biographical information and stories.

Ans: True Page: 153 17. Rates of chronic illness are best collected using participant research methods.

Ans: False Page: 155-156 18. Action research attempts to improve the situation of disadvantaged people and communities.

Ans: True Page: 156 19. A cross-sectional design collects information on the same people at multiple points in time.

Ans: False Page: 158 20. Cohort analysis helps us understand aging processes linked to age, period, and cohort.

Ans: True Page: 159-160 21. Non-random sampling can introduce significant bias and non-representativeness into a research study.

Ans: True Page: 161 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

22. Survey research uses random or purposive samples, employs face-to-face or telephone interviews or questionnaires that are mailed, accessed through the Internet, or delivered to a respondent.

Ans: True Page: 154 23. Ethical concerns are less of an issue when studying older adults.

Ans: False Page: 162 24. Quantitative research employs small, non-random samples in which key informants are added until no new information can be gleaned.

Ans: False Page: 160 25. A theory is a general or global view, which often encompasses one or more perspectives or frameworks that take a similar approach to the study of social phenomena.

Ans: False Page: 132

Short Answer Questions 1. What are the major goals of scholarly research? Provide examples for each.

Ans: The major goals of scholarly research are: to satisfy a need to know about some question, pattern, problem, or observation (e.g., why and how does a social pattern or problem occur?); to refute myths or verify assumptions (e.g., that the elderly are a burden to society); to identify inequities in the social world and suggest how they might be reduced or eliminated (e.g., the poverty of elderly widows or the lack of adequate health care and housing for older people); to produce reliable and valid information for the development, implementation, and evaluation of policies and programs (e.g., those in the health-care system); and, to explain observed relationships or patterns and to interpret the meaning of a social phenomenon observed in everyday life.

Page: 130-131 2. How does theory contribute to knowledge as a research tool? List five ways in which this contribution occurs.

Ans: Theory contributes to knowledge as a research tool by (1) providing a common set of assumptions, definitions, and meanings for key concepts and variables, and hypotheses; (2) summarizing, connecting, and synthesizing many existing facts, empirical findings, or observations to help build a coherent, systematic, and cumulative body of knowledge; (3) Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

providing a critical awareness and a focus on large, highly relevant research questions or issues facing society; (4) guiding and stimulating thinking by introducing new research questions and identifying gaps or flaws in the existing state of knowledge; and, (5) stimulating the search for more complete or alternative explanations.

Page: 131 3. How does theory contribute to knowledge as a product of scholarly activity? List five ways in which this contribution occurs.

Ans: Theory contributes to knowledge as a product of scholarly activity by (1) providing a set of propositions to model how the complex social or physical world operates and thereby opening up key issues for discussion; (2) advancing knowledge by helping to answer the “why” and “how” questions; (3) interpreting and explaining findings, observations, and meanings; (4) stimulating the development and accumulation of knowledge and the translation of that knowledge into the institutional fabric of society; and, (5) facilitating social and community interventions through the development, implementation, and evaluation of policies, services, and programs.

Page: 131-132 4. What are the foundational perspectives of social gerontology and what are they used for?

Ans: Foundational perspectives, sometimes labelled as schools of thought, provide a general orientation to developing research questions in social research. (1) Normative perspective: A sociological view of the world in which it is assumed that individuals learn, internalize, and accept social rules and roles without question. (2) Symbolic interactionism: A sociological view of the world in which individuals are active participants in defining both the social situation and the self according to how they interpret and define a situation. (3) Conflict perspective: A sociological view of the world in which society is seen as dynamic and changing, and conflict among groups is inevitable because of power and wealth distribution. Change occurs through this conflict and is necessary to ensure that all groups have an equal share of valued resources.

Page: 132-135 5. What are the differences between the structural functionalist and social constructionist perspectives?

Ans: Structural functionalism is rooted in the normative perspective and focuses on the relationships between social structures and social institutions, as well as on the resulting influence on the individual. This perspective argues that there is a commonly accepted social order (or structure) in a society; that it is essential to maintain the existing forms and functions of social institutions so that society can function efficiently; and that each element of the structure can be viewed analytically as having manifest (intended) or latent (unintended) functions. Social constructionists apply an interpretive lens to understand social life by examining the meaning of cognitive, symbolic, or behavioural acts. They are more concerned with challenging common assumptions and asking new questions than in perpetuating the social order (the normative approach). Understanding is reached when an individual defines the social situation in terms of what it means to him or her.

Page: 132-134 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

6. What is the social exchange perspective? Apply it to patterns of support across the life course.

Ans: A basic assumption of the social exchange perspective is that individuals search for social situations in which valued outcomes are possible and in which their social, emotional, and psychological needs can be met. Since this goal may involve acquiescence and compliance by an individual or a group a fair exchange may not be readily apparent, or possible, in every social relationship. Thus, social scientists seek knowledge about past experiences and current personal needs, values, and options before they determine the amount of equality or inequality in a specific social exchange relationship. This is especially the case when one attempts to explain the type and amount of exchange among individuals of different ages, particularly since roles, decision-making, and resources can shift with advancing age.

Page: 136-137 7. How might a postmodern feminist deconstruct the word “caregiving”?

Ans: A postmodern feminist who deconstructs the term “caregiving” might find that the activity involves intimacy and connection (care) and that the care is offered freely (is given rather than demanded or paid) to meet the needs of another person. The term might also be read to exclude the notion of care as hard work performed for remuneration (by a home nurse) or the idea that care begins because of a sense of duty or responsibility (by a daughter).

Page: 137 8. How is the concept of poverty central to the feminist perspective as it is applied to aging?

Ans: Feminists argue that the factors influencing the onset of poverty in later life differ between women and men. First, because of their irregular work histories, elderly women have few if any pension benefits. Second, some older women are not eligible for survivor’s benefits when their spouse dies. Third, women live longer than men and are more likely to exhaust their savings.

Fourth, when older women become ill, they seldom have a partner to care for them. Poverty, as seen from this perspective, is less an aging problem and more an issue for women who live a long life. Feminists conclude that older women are devalued and powerless in a male-dominated society that oppresses all women and that this situation is even worse for women who live a long life.

Page: 138-139 9. What is the life course perspective? How have its main assumptions changed over time?

Ans: The life-course perspective bridges individual and structural approaches to social phenomena. The approach requires a consideration of the interaction among historical events and social changes occurring at the structural (or macro) level, the individual (or micro) level, and the public policy (or meso) level. These capture the opportunities we have and the constraints we face in decision-making as we move through our life paths. While it was once assumed that the life course involved timely and sequential transitions along a clearly defined and common trajectory, the pathways today are deemed to be more variable and less “normative” than in early formulations of this theory.

Page: 139-142 10. What is masculinity theory? How does it relate to gender studies? Use examples to describe how masculinity theory has been used in research studies of older adults?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: Recently, gender theorists have drawn from feminist gerontology to develop and apply masculinity theory to older men. Masculinity theory attempts to explicate the unique dimensions of men’s identities and lives as they age. This theory has been used to understand older men’s experience of health and illness (see Chapter 7), of caregiving roles, of social relationships, and of widowhood. Some research has suggested that older men maintain traditional gendered identities even when crossing gendered boundaries in roles such as caregiving (McMullin and Curtis 2017). Others suggest that there is a blurring of gendered identities and roles in older age and, moreover, have been able to identify separate and unique experiences of the social processes of aging for men. For instance, van den Hoonaard (2010) found that older men experiencing widowhood do not conform to stereotypical images of being helpless and desolate, but rather, they redefine their masculinity through a process of developing new roles and identities. Masculinity theory, like feminism, gives voice to older men in an effort to show the significant diversity and complexity in their aging experiences. Finally, the boundaries between gender roles are becoming blurred as younger cohorts become exposed to greater diversity in gender relations and gender identities.

Page: 139 11. What is the relevance of structural lag in meeting the needs of an aging population? Provide examples to illustrate your point.

Ans: Structural lag is a period of social change in which social norms and institutions fail to keep pace with changes in individuals’ lives. For example, with rapid population aging, community services and institutional facilities lag behind the needs of the increasing number of older people who are no longer able to live independently in their homes. Imbalances created by structural lag, once recognized, become a stimulus for change to restore the balance between individual lives and social structures.

Page: 146-147 12. What are the premises of a political economy approach, according to Estes (1991)?

Ans: According to Estes (1991), a political economy approach to aging is based on the following premises: (1) The social structure shapes how older individuals are viewed and how they view themselves thereby affecting their sense of worth and power. (2) Labels such as “the elderly” or “seniors” shape not only the experience of old age but also society’s decisions concerning public policy. (3) Social policy and the politics of aging mirror both the inequalities in a social structure and the outcomes of power struggles that emerge because of structural factors, such as gender, class, and racial stratification. (4) Social policy embodies the dominant ideologies and beliefs that enforce, support, and extend the cumulative advantages or disadvantages in the larger economic, political, and social order.

Page: 147-148 13. How is critical gerontology useful in understanding aging processes?

Ans: Critical gerontology emerged when scholars began to question the assumptions of much of the social gerontology research of the 1970s and 1980s, especially the ideas based on essentialism. Much of the early thinking and research in gerontology emphasized the views of white, urban-dwelling, middle- and upper-class older people, primarily men. Critical gerontology Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

seeks to be inclusive and to emphasize the experiences of older people who are underrepresented or disadvantaged within a number of social institutions, including the labour force, leisure, housing, health care, and social services. This critical approach has generated knowledge of what it means to grow old within specific class, gender, racial, and ethnic boundaries, as well as how to empower older people to improve their lives.

Page: 148-149 14. How is intersectionality theory related to other theories of aging? How can it be useful in understanding aging processes?

Ans: Intersectionality theory contends that privilege and disadvantage needs to be examined at the intersections of major systems of inequality embedded in society along age, gender, sexuality, social class, race, and ethnicity lines (Calasanti and Kiecolt 2012). Intersectionality can be seen to have linkages to several prior theories, including the foundational interactionist and conflict theories, as well as life-course theory, postmodernism, political economy, feminist gerontology, and critical gerontology. Researchers employing this approach attempt to unravel multiple complex layers of inequality as experienced by individuals typically experiencing marginalization, subjugation, or other forms of discrimination in society (Ajrouch and Abdulrahim 2013; McMullin and Curtis 2017). For instance, researchers have examined how recent older female immigrants to Canada are excluded from many community social and health programs because of language and other cultural barriers and having fewer financial resources than the general population of older Canadians, which invariably leads to social exclusion. Others have examined discrimination among older persons of the LGBTQ community in long-term care (Furlotte et al.

2016). The synthesis of life-course and intersectionality theory connects the variant forms of inequality to cumulative advantage and disadvantage (O’Rand 2016).

Page: 149 15. How are theories and research linked?

Ans: Theories alone cannot guarantee that we will understand social reality. Rather, research is needed so that we can discover, describe, and interpret facts, behaviour, patterns, and relationships observed in the social world. Research is needed to both develop new theories and test present ones. While there is no agreement on which comes first—theory or research—there is agreement that both theory and research are essential components of scholarly inquiry and that they are linked in a creative dialectical process. Research refutes or supports hypotheses, theories, and perspectives; initiates the revision of existing theories or perspectives; or leads to the construction of new ones.

Page: 149-150 16. What is the qualitative approach to research? What are its evaluation criteria?

Ans: Qualitative research is based on observations, open-ended interviews, or analyses of textual material to interpret the meanings of what people say, do, or think. This approach is particularly useful for examining individuals and the context and meaning of social interactions. It is achieved through an analysis of letters, diaries, interviews, or reports, or observing what is said or done from the individual’s perspective. In qualitative research, interpretation and analysis are continual and subject to reinterpretation as new evidence is uncovered.

Page: 151-152, 160 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

17. What is the quantitative approach to research? What are its evaluation criteria?

Ans: Quantitative research is based on surveys or analyses of existing data to reach conclusions statistically. Generally, this type of research relies on random samples and large data sets. Thus, research reports based on quantitative studies contain statistics, graphs, tables, and figures.

Quantitative analysis shows us patterns in human behaviour but does not necessarily explain why the behaviour is the way it is.

Page: 151, 159 18. What is mixed-methods research? Why do you think it is becoming more common in research studies of older adults?

Ans: Mixed-methods research refers to the practice of combining several types of research approaches in one study to obtain a more complete picture. For instance, a researcher may determine that a specific method may be more suitable at one stage or level of research—for example, qualitative methods for understanding at the individual level and quantitative methods for understanding at the societal level—or there may be an advantage to employing both in a multi-method approach. Researchers employing a mixed-methods approach can combine various types of research methods, not only qualitative and quantitative approaches. Student responses will vary to the latter part of the question but should note that when qualitative and quantitative methods are deployed together, they alleviate the weaknesses of both by amplifying the strengths of both.

Page: 151 19. What is content analysis? Provide an example to illustrate your understanding.

Ans: Rozanova et al. (2006) analyzed how seniors are portrayed in The Globe and Mail through a content analysis of 30 articles published in 2004. An analysis of these articles revealed that there were six different contexts within which seniors were portrayed, including family, work/retirement, community networks, scientific studies of population aging, social and healthcare policy, and social attitudes toward aging. The authors found that ageism is portrayed in both positive and negative stereotypes. Older adults were characterized through intergenerational comparisons with younger age groups and through intra-generational comparisons. Older adults were also described as a burden to younger persons and society in many of the articles, supporting an apocalyptic perspective of population aging. Intra-generational ageism was evident from portrayals in which some seniors were depicted as aging successfully, whereas others were not. This contrast produces the notion that members of the latter group are to blame for not aging “successfully.”

Page: 152 20. What is meant by secondary analysis? Provide examples of what researchers can study using this approach.

Ans: In a secondary analysis, the researcher, to answer emerging research questions, re-analyzes data sets (surveys or a census) that were collected at an earlier time and often for some other purpose.

The goal may be to answer new research questions, to analyze data that were not used when the original study was completed, or to study changes by comparing earlier data with current data. A Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

serious weakness of secondary data analyses is that the data set may lack essential independent (or control) variables that could provide a more complete and valid explanation for any age differences or age changes that are discovered. Researchers can use large statistical data sets or other textual materials like diaries, letters, photographs, films, biographies, or newspaper articles Page: 151-152 21. What can narrative gerontology teach us about how people age? What are the limitations to this approach?

Ans: Narrative gerontology assumes that we are biographical beings with stories to tell and that in the process we become the stories. The stories told by individuals function as a lens through which continuities and discontinuities, transition points, crises, and the meaning of those events in our lives are revealed. Narrative gerontologists must tease out the truth in the stories they are told. One weakness of this method is that it may not work with people who are very reserved, not very articulate, not highly educated, not very fluent in English, or who have lost some of their memory.

Page: 153-154 22. Why is program evaluation important in gerontology? Why must we also be cautious about such evaluations?

Ans: Program evaluation is important in gerontology in that it is a form of applied research that provides feedback about the efficacy or effectiveness of a specific program, policy, or service.

This type of research is increasingly popular because policy-makers are under pressure to be more accountable and to use public funds fairly, efficiently, and effectively. With the aging of the population, it is essential to know which policies and programs work, for whom they work, and where they work best. However, sometimes such evaluations are funded by an agency that has an interest in either terminating or continuing a policy or program. Thus, we must be alert to possible hidden agendas when program or policy evaluations are commissioned.

Page: 155-156 23. What are the problems with cross-sectional designs? Provide an example to illustrate your position.

Ans: A cross-sectional design identifies differences between age groups but does not enable us to explain the reason for the differences; nor can it provide explanations about the process of aging experienced by a given cohort. For example, data might suggest that movie attendance declines with age but we cannot conclude that the differences between age groups are due to an aging effect. Those over age 65 may never have attended movies to any great extent at any time in their lives. This pattern may have evolved either because going to the movies was not popular in their early years or because they could not afford to go to movies when they were young. In either situation, this cohort, unlike later generations, may never have acquired the habit of going to movies. Consequently, in later life, they do not spend any of their fixed income on movies.

Page: 158-159 24. What are longitudinal research designs?

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Ans: Longitudinal designs involve collecting and analyzing data over time, including samples of different people (a trend design) or the same people at different points in time (a panel design).

A panel longitudinal design provides more accurate and complete explanations of the aging process because the same individuals or groups are studied over time, and the information can be used to identify and explain patterns and relationships associated with age and aging.

Specifically, we need longitudinal data to explain whether social, cognitive, or physical differences among individuals or cohorts at a particular age have always been present or whether these change with age.

Page: 159 25. What is meant by informed consent in research?

Ans: Informed consent refers to permission granted by a research participant to be interviewed or observed or to have their personal records examined. Regardless of the setting or the competence of potential research participants, participation in research must be voluntary and fully informed. Older adults who participate in research projects must understand what is expected of them, and why, and must give their consent freely and without coercion. The process of acquiring informed consent must allow participants time to consider whether they wish to be involved or not. If the potential participant has dementia, the concept of informed consent may not be understood, in which case a family member or a guardian with the legal power to make such a decision must give consent.

Page: 162

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Chapter 6

Social Structures, Social Inequality, and the Life Course Multiple Choice Questions 1. Which of the following are patterned relationships that differentially rank or distribute individuals according to socially evaluated characteristics related to privilege and power? a) Generations b) Values and beliefs c) Social structures d) Political parties Ans: c Page: 167 2. According to McDaniel (1997), which of the following is not a criterion for evaluating and understanding intergenerational transfers? a) The direction of the transfer b) The content of the transfer c) The sector d) The party that benefits most from the transfer Ans: d Page: 190 3. Which of the following is considered to be an achieved attribute in relation to social positions? a) Social class b) Race c) Gender d) Ethnicity Ans: a Page: 169 4. Which of the following is considered to be an ascribed attribute in relation to social positions? a) Social class b) Age c) Education d) Culture Ans: d Page: 169 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

5. What does biological sex refer to? a) The genetic and biological difference between males and females b) The socially constructed concept that defines what it means to be male or female in a given society c) Intimacy d) An emergent property of situated interaction rather than a role or attribute Ans: a Page: 172 6. Which of the following is not an aspect of women’s gendered reality? a) Less access to education and income b) Fewer difficulties in later life c) More responsibility for unpaid family caregiving d) A greater degree of poverty, in general Ans: b Page: 172 7. How has aging been described? a) As a man’s issue b) As a woman’s issue c) As an education issue d) As a family issue Ans: b Page 172 8. According to Ven et al., what is needed in order to fully understand the unique experiences of women and men, both separately and in relation to one another? a) Double jeopardy b) A gendered lens c) Feminism d) Intersectionality perspective Ans: b Page: 173 9. What is the feminization of later life? a) Dependence of men on their wives in later life b) Independence and wealth of older women c) Greater value of older women in society d) Vulnerability of women in later life because of lifelong gender differences Ans: d Page: 173 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

10. What type of environment encourages opportunities for education, work, and leisure at all ages? a) Alternative b) Age-segregated c) Age-integrated d) Adaptive Ans: c Page: 181 11. How have some scholars referred to the multi-dimensional impact of age and gender that can lead to social inequality? a) Double jeopardy b) Multiple jeopardy c) Age grading d) Ageism by gender Ans: a Page: 174 12. Who experiences the highest poverty rate in Canada? a) Senior men b) Senior women c) Single, unmarried, widowed, or divorced men d) Single, unmarried, widowed, or divorced women Ans: d Page: 176 13. What percentage of a man’s wage do women typically earn? a) 51 per cent b) 61 per cent c) 71 per cent d) 81 per cent Ans: c Page: 176 14. Which of the following is not one of the four major generations of the twentieth century? a) Adults who had just entered or were about to enter the labour force during the Great Depression of the 1930s b) The parents of the Depression generation c) The children of the Depression generation d) The baby-boom generation Ans: b Page: 179

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15. Which term refers to the subgroups of a generation who hold different world views or have a unique group consciousness? a) Cohorts b) Sub-generations c) Generational units d) Divergent cohorts Ans: c Page: 179 16. Which of the following refers to the comparison of specific cohorts—or groups of adjacent cohorts—on the basis of socio-historical experiences? a) Cohort analysis b) Generational analysis c) Lineage effect analysis d) Structural age analysis Ans: b Page: 180 17. Which of the following is not used to explain lineage gaps in the extended family? a) Differences in values and attitudes b) Generational effects c) Education d) Cohort effects Ans: c Page: 187-188 18. What is cohort-centrism? a) Members of a cohort seeing an older cohort as a threat to their pension b) Members of a cohort succeeding one another over time c) Members of a cohort believing that they are superior to another cohort d) Members of a cohort interpreting all social or historical events from their own point of view Ans: d Page: 184 19. What are most studies of generational succession and social change based on? a) Cross-sectional studies b) Longitudinal studies c) Interviews d) Focus groups Ans: a Page: 186 20. The Grandmothers to Grandmothers campaign is an example of which of the following?

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a) Ageism by older adults b) Social change by older adults c) Community healing d) Cohort effects Ans: b Page: 185-186 21. Which of the following should be considered when attempting to determine whether a generation gap exists at the societal level? a) Age or cohort differences b) Social class c) Ethnicity d) Religion Ans: a Page: 186-187 22. Why is it important to understand intergenerational strain? a) When intergenerational strain decreases, it could lead to cohort effects or social disintegration. b) When intergenerational strain arises, it could lead to generation gaps or inequities. c) When intergenerational strain arises, it could lead to societal harmony or equality. d) When intergenerational strain decreases, it could lead to generation gaps or inequities.

Ans: b Page: 186 23. Which of the following is not a debate surrounding societal gaps? a) To what extent a gap, if it exists, leads to generational conflict, social disharmony, or social change b) Whether there are societal or only lineage gaps c) Whether there are societal or only generational gaps d) Whether and to what extent generation gaps are widened due to the adoption of new technologies Ans: c Page: 188 24. Which of the following groups is least likely to integrate mobile and social technology? a) Gen Y b) Gen X c) Baby boomers d) Millennials Ans: c Page: 189 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

25. Which of the following continues to be debated in Canada as part of a discussion of changes in intergenerational relations and public policy that are needed to address population aging, both of which are complex issues? a) Generational ineptitude b) Generational norming c) Generational unity d) Generational equity Ans: d Page: 194

True or False Questions 1. Social structure is entirely responsible for an individual’s life course or outcome.

Ans: False Page: 168 2. Economic security and health in later life are influenced by gender, race, ethnicity, and class (especially the level of education) and to one’s marital and employment history across the life course.

Ans: True Page: 170 3. Age structures are social dimensions of age that influence individuals and society.

Ans: True Page: 167 4. Early and sustained poverty can predict higher rates of disability in later life.

Ans: True Page: 170 5. Education cannot facilitate upward mobility within the social structure.

Ans: False Page: 170 6. Transgendered older adults are an over-researched group.

Ans: False Page: 172

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7. Very few female Indigenous elders experience social isolation in rural and remote communities because of social structures.

Ans: False Page: 176 8. The terms “generation” and “cohort” are often used interchangeably in the media.

Ans: True Page: 179 9. Lineage effects are the same as cohort effects.

Ans: False Page: 180 10. Age strata are groups in a classification system in which individuals are classified according to chronological age.

Ans: True Page: 181 11. Private transfers are those that occur from the state to individuals or families.

Ans: False Page: 190-192 12. Age grading is the process through which age influences social positions, roles, and norms.

Ans: True Page: 181 13. Ascriptive age norms are based on rules and constraints related to specific ages, such as the legal voting age.

Ans: True Page: 181 14. Consensual age norms are when men and women agree to have sexual relations.

Ans: False Page: 181 15. Institutions for older adults should be age-segregated rather than age-integrated.

Ans: False Page: 181-182 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

16. There are likely more similarities in values, ideals, and behaviour in the family and extended kinship system than there are at the societal level.

Ans: True Page: 186 17. The definition of “old age” is generally the same for Indigenous people as it is for the rest of the population.

Ans: False Page: 183 18. Cohort flow is the process whereby individuals look older than their age.

Ans: False Page: 184 19. Teenagers feeling that their parents are out of touch with fashion is an example of a lineage gap.

Ans: True Page: 187 20. Role transitions across the life course tend to be shaped more by predisposition to disease than environmental factors.

Ans: False Page: 188-190 21. Because younger generations are so immersed in it, social media always intensifies generational separation and never facilitates bringing generations together.

Ans: False Page: 188-190 22. The concept of “linked lives” refers to the idea that different cohorts at the societal level and different individuals at the family level are connected over time.

Ans: True Page: 190 23. Private transfers across generations are a modern event.

Ans: False Page: 192 24. Generational equity issues are important in pension debates because they raise the problem of resource allocation across age groups.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: True Page: 193-194 25. Social inequity across age groups helps keep a society functioning smoothly.

Ans: False Page: 194-195

Short Answer Questions 1. What are age structures are and why are they important?

Ans: Age structures are socially-structured relations among individuals and age cohorts, and they create structural-level processes, such as cohort flow, intergenerational transfers of wealth and support within families and in society at large, age grading, and structural lag. “Old age,” per se, is socially constructed and defined in different ways at different historical times and in different religions and cultures. Consequently, across history and within some cultures, we have observed a shift from emphasizing filial piety to apocalyptic demography to intergenerational conflict as the status of older persons is constructed, deconstructed, and reconstructed. Age interacts with class, race, gender, and ethnicity to create and intensify power relations and life chances across the life course and across age cohorts.

Page: 167-168 2. Which theories guide our thinking about social structures and aging? Provide four or five examples.

Ans: The age stratification perspective focuses on inequality but minimizes the interaction of age with other systems of inequality. Similarly, the political economy and feminist perspectives focus on power relations in society but devote less attention to age per se and to the interaction of age with other dimensions of power. And while exchange theory may help us to understand intergenerational transfers in the family, it is not very effective in accounting for transfers at the societal level. The life-course perspective can bridge some of these elements, but it is difficult to test multi-dimensional theories. An intersectionality lens offers additional insight into the multiplicity of social structures and how privilege and power in old age can be understood as the result of combinations of roles, statuses, and their roots in social structures over the life course.

Page: 168 3. How is social inequality connected to one’s position in the social system? Use the example of a 65-year-old man to illustrate your answer.

Ans: A 65-year-old man whose occupation is defined as labourer may have a moderately high status in the age structure of society because of his chronological age; a very high status in the family structure because he is the patriarch and primary wage earner; but a low status, responsibility, or power at his place of employment or in the community at large because of his low level of education and type of job.

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4. How are social positions assigned? What is the consequence in terms of opportunity?

Ans: Social positions, with variations in status and power, are assigned on the basis of either ascribed attributes (race, gender, ethnicity) or achieved attributes (class, age, and education), all of which represent social constructs. These stratification systems mean that some people have higher (or lower) status and more (or fewer) opportunities to acquire valued rewards, and they experience different lifestyles, challenges, and opportunities as they move through life. This leads to competition for, and sometimes conflict over, scarce resources among occupants of the various social strata. These status differences are reinforced, if not created, by government policies that allocate resources and define the eligibility for rewards on the basis of the status and needs of certain lower-status groups.

Page: 169 5. What variations can occur in the number of interlocking social classes or strata?

Ans: Most societies are structured into a number of interlocking social classes, or strata, that are socially constructed. The number of strata range from two (aristocrats and peasants) or three (professionals, white-collar workers, and blue-collar workers) to a more complex structure with many divisions, such as observed in Canada (upper class, upper middle class, middle class, lower middle class, upper lower class, and lower class).

Page: 170 6. In what ways is the social class structure strongly influenced by the level of formal education attained by individuals?

Ans: Education, as an investment, leads to skills, employability, a healthier and longer life, and higher standards of economic and social well-being. It can also facilitate upward mobility.

Educational status influences attitudes, values, behaviors, friendships, job opportunities, health, and income throughout life. Different age cohorts and specific members of each cohort have had differential access to education throughout history. For example, until the late twentieth century, few people—especially women—completed a university education. Today, however, a majority of the baby boom generation, especially women, have completed an undergraduate degree, and an increasing number have earned graduate degrees.

Page: 170 7. What is the difference between gender and sex? Why is it important to understand gender when studying aging?

Ans: Sex refers to the genetic and biological difference between males and females. Gender, however, is a socially constructed concept that defines what it means to be male or female in a given society and what types of behaviour and roles are expected of females and males at different stages in their lives. Gender is important to understand at any stage of the life-course because it shapes social life through agency and gender stratification; it is a central organizing principle of our social world, like class and race. Women’s experiences and situations are socially constructed in a male-dominated world where social norms and institutionalized structures are shaped by the division of power between men and women. That is, the lived experiences and perceived or real problems encountered by women are more structurally conditioned than they Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

are a product of individual behaviour and choices (Muhlbauer et al. 2015). Throughout the life course, and in all societies, males and females play different roles, receive different rewards, and experience different realities.

Page: 172 8. According to Ven et al. (2011), why are women disadvantaged in accessing adequate pensions?

Ans: Ven et al. (2011) contend that women are disadvantaged in accessing adequate pensions due to the following: life events, such as marriage and child care, which affect labour-force participation rates; working part-time or withdrawing from the work force, thereby reducing pension benefits; engaging in unpaid activities, such as caring for sick or older parents; receiving lower earnings and fewer advancements in the work force than men; living longer than men so that pensions must be spread over more years of life; experiencing widowhood, which significantly reduces income level and thereby increases the need for pensions.

Page: 174 9. Why is female poverty a catch-22 cycle?

Ans: Female poverty can be described as a catch-22 cycle because for older women, poverty is a symptom of social norms, and once it’s established, it becomes a cycle. Inequities during working life lead to higher rates of poverty and reliance on retirement income supports as women age. These inequalities need to be addressed.

Page: 176-177 10. What is generational analysis?

Ans: Generational analysis involves comparing specific cohorts or groups of adjacent cohorts that comprise a generation (the baby boom and the baby bust generations) on the basis of sociohistorical experiences. This approach, at the macro-level of society, seeks to understand how cohorts maintain continuity in the existing social order or how and why they initiate change in the social order. These outcomes are known as generational or cohort effects. This type of generational analysis examines the influence of emerging age cohorts on the stability of social structures and considers interaction patterns within and between members of age strata.

Generational analysis examines the impact on society of social consensus, conflict, change, or inequality among generations. It also examines the extent to which age stratification interacts with other dimensions of social differentiation and how this interaction affects individuals or society.

Page: 180 11. How do race, ethnicity, and age interact?

Ans: For many recent immigrants, the intersection of race, ethnicity, and age is quite evident.

For first-generation members of racial or ethnic groups in Canada and for some individuals in subsequent generations, poverty or lower-class status is synonymous with race and ethnicity, thereby fostering and perpetuating social inequality across the life course. Because of prevailing prejudices and stereotypes in mainstream society, members of these groups may experience discrimination in access to services and opportunities. With less education, lower incomes, and a Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

lower quality of housing throughout their lives, they are more likely to experience poor health and poverty in their later years.

Page: 175-178 12. What is age grading?

Ans: Age grading is the process by which chronological age influences elements of social life, such as social positions, roles, norms, and structured social relationships. This process results from a system of age stratification that is present not only in the society at large but also in social groups, organizations, and institutions. Age grades provide a cultural definition of the expected rights, behaviour, and responsibilities of an individual at a particular stage or age in the life course. These age-based cultural definitions become the basis for self-identification and for allocating positions in a society or institution.

Page: 181 13. What characterizes the debate surrounding age-segregated versus age-integrated social structures?

Ans: A long-standing debate in the aging literature has been the question of whether a society and its institutions should be age-segregated, as university residences and nursing homes are, or age-integrated like families and workplaces. This debate was stimulated by age stratification theory, which conceptualized society as age-segregated, and by the related question of whether an age-segregated structure stimulated or prevented age or generational conflict. In an agesegregated structure, different periods or stages in life were associated, in general, with specific activities or responsibilities: youth, with education; middle age, with work; and old age, with leisure. In contrast, the contemporary view is that age structures are integrated and should permit, as well as encourage, opportunities for education, work, and leisure at all ages.

Page: 181-182 14. Describe the concept of cohort flow.

Ans: Cohort flow is the process by which birth cohorts succeed one another over time. As cohorts pass through life, they become smaller and comprise a larger percentage of women.

Each cohort experiences the life course in different ways. While each cohort includes individuals with different social characteristics and experiences, all members of a cohort experience some similar events, thereby making them different from members of other cohorts—especially older or younger cohorts far removed from the trajectory of the cohort being studied.

Page: 184 15. What causes the structural lag in relation to policies and programs for older adults? How might this lag be reduced or eliminated?

Ans: Many policies and programs lag behind changing definitions and the changing needs of older adults. For example, because of healthier lifestyles, new programs and facilities for a healthy, active, and more heterogeneous older population are required. But they may not be available because of outdated ideas, policies, or programs. This lag might be eliminated if policymakers attend to the changing needs of aging cohorts and recognize the need for a dynamic network of programs and facilities.

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Page: 183 16. How can successive cohorts change the social stratification of society through agency?

Ans: A society and the social institutions in that society are characterized by social differentiation and social stratification. At the societal level, whether there is change, and if so how much, is influenced by whether successive cohorts accept, redefine, or reject the values and status quo that preceding cohorts have institutionalized. Newer cohorts initiate change when elements of the social stratification systems are no longer considered acceptable or just. For example, when older people perceive ageism, discrimination, segregation, or isolation, they seek to change the status quo by educating others, through political processes, or by rebelling and no longer conforming to social expectations.

Page: 185-186 17. What is intergenerational strain within immigrant families?

Ans: Conflict often occurs in immigrant families when the cultural values and experiences of different generations begin to clash. Second- or third-generation youth, socialized by parents or grandparents who were born and raised in another country, face the dilemma of having to choose between the traditional values held by older members of their family and the customs of their peers, mainstream society, and the media. In such a situation, intergenerational strain and conflict does arise in the family. However, these generational differences tend to narrow and disappear as subsequent generations become assimilated and adopt the cultural norms of mainstream Canadian society.

Page: 187 18. Is the technology generation gap widening?

Ans: The Highlight 6.4 box asks and responds to this questions by looking at current research findings. The short answer is that the gap may be narrowing and widening and that we cannot assume all aging adults are the same when it comes to technology use. What the textbook doesn’t address is the digital divide and how access to technology among aging adults (and all generations) is impacted by race, class, region, etc.

Page: 189 19. What is the generational equity debate?

Ans: The generational equity debate—about how to achieve equity, whether equity can be achieved, and whether there should be equity among generations—is really about fairness in the distribution of scarce public resources across a society and about how to finance transfers, such as income assistance, health care, and subsidies, to needy individuals. This debate is also about ensuring justice among age groups and generations.

Page: 193-194 20. What are intergenerational transfers?

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Ans: Social order and the stability and continuation of a society, an institution, or an organization are dependent on intergenerational transfers, which are “the essence of societal reproduction, continuity, interaction and exchange” (McDaniel 1997, 2). Transfer of money, property, formal services, or “in-kind” donations (child or parent care, housework) is a longstanding tradition in family units. Some transfers are directed to the oldest generation; others, to the youngest. Some are compulsory, others voluntary; some apply to everyone in an age cohort, others only to those who can demonstrate need; and some are taxed while others are tax-free.

Transfers occur along two dimensions: (1) upward or downward across three generations; and (2) transfers from the public (government or employer) or private (family) sectors.

Page: 190 21. How can intergenerational transfers create generational conflict?

Ans: In the family unit, transfers have the potential to maintain relative economic advantage from one generation to the next or to facilitate higher standards of living than those experienced by earlier generations. But there is also the potential for conflict if some or all members of a younger generation do not receive transfers, or equal transfers, and if they harbour feelings of resentment. This situation occurred in earlier times when the eldest son or the first-born child inherited the land while his or her siblings were left to fend for themselves.

Page: 190-192 22. What are four developments that suggest a loss of generational equity?

Ans: Four developments that suggest a loss of generational equity are as follows: (1) the rising cost of health and elder care, which will have to be borne by younger generations; (2) a decline in the economic status of many young people owing to high unemployment and underemployment; (3) the unequal distribution of wealth, which favours a small segment of the middle and oldest generations; and, (4) public policies that give more to members of one generation than to others—such as tax deductions for retirees and lower fares for older people on public transit.

Page: 193 23. How can debts due to population aging be eliminated?

Ans: Debts that have resulted from an increasing number of older adults can be eliminated if those now in the labour force pay higher taxes than previous workers (the retirees); higher tax rates are imposed on those over 65 for their accumulated wealth and for entitlement to pensions and income supplements they “earned” earlier in life; and, governments reduce services or make them more efficient. A combination of these approaches is applied.

Page: 193-194 24. There has been a growing feeling among younger generations that the benefits older people receive from publicly-funded programs are disproportionate to their current or past contributions or to their real need. What are four commonly-held opinions regarding this issue?

Ans: Four prevailing opinions of the younger generation regarding the benefits older people receive from publicly funded programs are as follows: (1) Eligibility for social benefits should be based on need, not on attaining a certain age. (2) Tax-sharing responsibilities are shifting too fast Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

from older to younger groups. (3) Other groups in society, such as single mothers and the homeless, have a greater need for public benefits or services than do older people. (4) Too many older Canadians are wealthy, greedy, and uncaring.

Page: 194 25. What is the difference between a generation and a cohort?

Ans: A cohort is composed of everyone who was born in a specified year (2008) or in a specific period of years (2005–10). A generation is more than a group of people (an age cohort) born during the same period. It represents a unique grouping of adjacent birth cohorts, many of whom have experienced a significant socio-historical event (a depression or war) in a similar manner or whose members tend to think and behave in a similar way because they interact frequently or adopt similar values (e.g., baby boomers).

Page: 178

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Chapter 7

Health Status and Health-Care Transitions in an Aging Context Multiple Choice Questions 1. Which of the following statements regarding drug use among older adults is false? a) The number and frequency of medications increase with age. b) Most drugs cure an underlying condition. c) Many older adults take more than one drug per day. d) In general, older women take more drugs than older men.

Ans: b Page: 231 2. Which of the following statements regarding the anti-aging movement is true? a) Anti-aging methods are a recent development in human history. b) The commercial market for anti-aging products is small and focused on younger age groups. c) Many anti-aging products and treatments are available in the offices of medical professionals. d) The anti-aging movement does not promote ageism.

Ans: c Page: 231 3. How long is the average hospital stay for those aged 65 and over? a) 1 day b) 7 days c) 17 days d) 27 days Ans: c Page: 227 4. What is the most common illness among older adults living in the community? a) Hypertension b) Diabetes c) Heart disease d) Arthritis Ans: a Page: 203

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

5. Approximately what percentage of persons aged 65 and over have mild, moderate, or severe dementia? a) 1 per cent b) 8 per cent c) 15 per cent d) 25 per cent Ans: b Page: 222 6. When does comorbidity occur? a) When two people suffer from the same illness b) When two people die from the same illness c) When one person is suffering from more than one condition at the same time in later life d) When a person develops the same illness as their spouse Ans: c Page: 199 7. Which of the following is not a cause of medical iatrogenesis? a) Patient behaviour b) Blood transfusions c) Over-prescribing drugs d) Unnecessary surgery Ans: a Page: 200 8. As people live longer, they are also free of disability for longer periods before death. Which of the following terms refers to this phenomenon? a) Compression of morbidity b) Compression of disability c) Health conundrum d) Health paradox Ans: b Page: 202 9. Prevalence of which disease has increased steadily over the past decade? a) Heart disease b) High blood pressure c) Arthritis d) Diabetes Ans: d Page: 204

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

10. Which of the following is true of baby boomers compared to people who were their age about 20 years ago? a) They have a significantly lower rate of smoking. b) They have a significantly lower rate of healthy exercise. c) They have a lower rate of obesity. d) They have a higher rate of heavy drinking.

Ans: a Page: 222 11. Which of the following is not a social determinant of health? a) Socio-economic status b) Living and working conditions c) Social support from family and friends d) Moral behaviour Ans: d Page: 211 12. Which of the following statements is false? a) Middle-aged immigrants who have arrived within the previous 10 years have better functional and self-rated health than their Canadian-born counterparts. b) Immigrants coming into Canada generally have poorer health than Canadians, but they become healthier over time. c) The healthy-immigrant effect is strongest among recent immigrants. d) The longer immigrants live in Canada, the more their self-reported health resembles that of the rest of the population.

Ans: b Page: 214 13. Which of the following is a necessary precursor to making a shift in behavior, according to Chou and Wister? a) Self-sufficiency b) Self-care c) Self-esteem d) Self-efficacy Ans: d Page: 211 14. Approximately what percentage of community-living older adults are estimated to have a mental health issue? a) 10 per cent b) 20 per cent c) 30 per cent d) 50 per cent Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: b Page: 220 15. Concerning dementia, which of the following statements is false? a) Dementia is characterized by severe losses in cognitive, emotional, or social abilities. b) The prevalence of dementia is greater among women than among men. c) The prevalence of dementia increases with age. d) Alzheimer’s disease is reversible with the appropriate treatment.

Ans: d Page: 222 16. Which age group has the highest suicide rate? a) Males 85 and older b) Females 85 and older c) Males 20 and younger d) Females 20 and younger Ans: a Page: 225 17. Which of the following is not a reason for the sharp rise in health-care spending in 2004–2011? a) Hospital costs b) Pharmaceutic costs c) Population aging d) Doctor payments Ans: c Page: 229 18. Approximately what percentage of all health-care expenditures in Canada are accounted for by home care costs? a) 5 per cent b) 10 per cent c) 25 per cent d) 50 per cent Ans: a Page: 227 19. What is the primary reason for the recent stabilization of total drug expenditures? a) Increases in the population of older people b) Increased dosages c) Generic drug policies d) Cheaper pharmaceutical ingredients Ans: c Page: 230 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

20. Which of the following is not included in integrated care delivery systems for older adults? a) Self-care b) Case management for home care c) Home support d) Community services to enhance independence and quality of life Ans: a Page: 235 21. Advanced and costly technologies contribute to which phenomenon, where higher-resolution images detect something unusual in a larger proportion of patients? a) Technological effect b) Integrative effect c) Cascade effect d) Cannabis effect Ans: c Page: 229 22. Which model of care emphasizes treating health problems with surgery, medications, bed rest, rehabilitation, or by moving elderly patients to a facility that offers 24-hour nursing care? a) The social model of care b) The medical model of care c) The integrative model of care d) The care model of health Ans: b Page: 199 23. Which model of care promotes healthy behaviours by targeting individuals or groups in a community or across a society? a) The medical model of care b) The integrative model of care c) The health promotion model d) The health maintenance model Ans: c Page: 200 24. Research shows that LGBTQ2 older adults require additional support systems and structural changes to the health-care system to meet a variety of unmet needs and vulnerabilities specific to their sexual orientation/identity and aging contexts. Which of the following is not an example of these unmet needs or vulnerabilities? a) Social isolation b) Access to health services c) Shifts in attitudes of health-care professionals d) Legislative changes Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: d Page: 213 25. What do the world’s “blue zones” often have in common? a) Citizens all have high rates of smoking. b) Citizens are socially engaged with their family, friends, and community. c) Citizens are not often physically active. d) Citizens eat plenty of locally-produced meat and eggs from organic farmers.

Ans: b Page: 207

True or False Questions 1. More than half of all older adults have at least one disability.

Ans: False Page: 198 2. The WHO defines health as the absence of symptoms of illness or signs of disease.

Ans: True Page: 198 3. Acute conditions occur more frequently than chronic conditions among older adults.

Ans: False Page: 203 4. The concept of health transitions captures the interplay between individual and societal factors that shape our health as we age.

Ans: True Page: 199 5. Morbidity compression is the tendency for the onset of disease to be compressed into a shorter period at the end of life.

Ans: True Page: 201 6. Recent trends imply that there is a compression of disability rather than a more general compression of morbidity.

Ans: True Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 202 7. Research suggests that contemporary older adults use fewer prescription drugs than previous generations.

Ans: False Page: 231 8. Longevity is due to genetics, social resources, and healthy lifestyles experienced throughout life.

Ans: True Page: 207 9. People tend to underestimate their subjective health status.

Ans: False Page: 210-211 10. The social determinants of health are factors that operate over the life course and include socioeconomic status, living conditions, and social support.

Ans: True Page: 211-212 11. Self-efficacy is the lack of confidence that people have in terms of keeping active.

Ans: False Page: 211 12. There no evidence that subjective measures are predictive of impending death.

Ans: False Page: 211 13. Physical activity levels of older adults have dropped significantly over the last two decades.

Ans: False Page: 218 14. The prevalence of dementia is lower among women than among men.

Ans: False Page: 222 15. Suicide is the leading cause of death for older males.

Ans: False Page: 226 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

16. Persons aged 65 and over account for over half of the patient days in acute-care hospitals.

Ans: True Page: 227 17. Health-care costs have risen mainly because of population aging.

Ans: False Page: 228-229 18. Pharmaceutical costs have been stable since the 1990s.

Ans: False Page: 230 19. Self- or prescribed medication use among older adults is decreasing.

Ans: False Page: 231 20. Older people are more sensitive than younger people to some drugs and may experience more side effects.

Ans: True Page: 232 21. Integrated models of care delivery use a coordinated assessment and management system.

Ans: True Page: 235 22. Integrated models of care cost more than other types of care models.

Ans: False Page: 235 23. To develop long-term funding of new models of care, Canadian health policy will require a restructuring of funding mechanisms and jurisdictional responsibilities.

Ans: True Page: 237 24. Health care for older adults is largely consistent in terms of amount of care, regularity of care, and continuity of care.

Ans: False Page: 233 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

25. Subjective feelings and experiences are important when reporting self-perceptions of health in social surveys and when reacting to and coping with an apparent change in one’s health.

Ans: True Page: 198

Short Answer Questions 1. What is good health?

Ans: The World Health Organization (WHO) broadly defines good health as the absence of symptoms of illness or signs of disease; the presence of well-being and a sense of being healthy (or not ill or sick); and the capacity to perform activities of daily living (ADLs) and to function with some degree of independence.

Page: 198 2. Describe the concept of health transitions. How do our own perceptions shape these transitions?

Ans: The concept of health transitions captures the dynamic interplay between individual and structural factors that shape our health as we age, sharing many of the same tenets of life-course theory. Our health perceptions also shape these transitions in that many older adults see their own health in a more positive light than others do.

Page: 199 3. What is the medical model of health and health care? What are some of the criticisms surrounding this model?

Ans: The medical model of health care dominated our thinking when life expectancy was shorter and disability rates among older adults were higher. This approach focuses on the incidence, causes, and treatment of disease, and the emphasis is on treating or curing health problems with surgery, drugs, bed rest, rehabilitation, or, for elderly patients, moving them to a facility offering 24-hour nursing care. This model perpetuates the idea that health status is caused by physiological and biological systems. It has also been criticized for “over-medicalizing” people— making them too dependent on formal health care when they should be taking greater control of their own health and illness and using community services as well as clinical health-care services.

Furthermore, the medical model has had a hand in perpetuating negative images of aging—that later life is a time of decay, inactivity, frailty, dependence, and incompetence.

Page: 199-200 4. What is the social model of health and health care? What is the major criticism surrounding this model?

Ans: The social model of health care builds on the medical model. It views health as having a social and psychological as well as a physiological, biological, and genetic basis. This model Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

stresses the role of agency in health decisions, self-care, and any changes in health behaviours and beliefs. Thus, it places more emphasis on prevention and less on drugs, surgery, and hospital stays. The model also includes a continuum of care in which health care and social services are provided in homes, in the community, and in residential facilities so that timely services can be delivered to older people as their needs change. The idea is to ensure that a safety net is in place to prevent older people from “falling through the cracks” as they might in a fragmented system of service delivery. The social model has been criticized—mainly by members of the health profession—as being an unnecessary and largely ineffective “add-on” to the medical model.

Page: 199-200 5. What is the health promotion model (HPM) of health care?

Ans: An offshoot of the social model is the health promotion model (HPM) of health care, which promotes healthy behaviours by targeting individuals or groups in a community or across a society. Developed within Health Canada, the HPM is aimed at achieving health for all Canadians by (1) addressing health challenges; (2) supporting the mechanisms of health promotion; and (3) implementing community strategies. This model seeks to empower people and communities and to foster equal access to health-care resources. The HPM also recognizes the impact of the physical environment, which tends to be outside the control of the individual.

Page: 200-201 6. What is the population health promotion model (PHPM) of health care?

Ans: An extension of the health promotion model (HPM) is the population health model (PHM), which was developed in the 1990s in response to a growing interest in identifying determinants of health. The HPM and PHM have been combined into the population health promotion model (PHPM). Hamilton and Bhatti (1996) developed this three-dimensional model based on health policy and health practice, which includes (1) the determinants of health, (2) health promotion strategies, and (3) the different service levels that are needed.

Page: 200-201 7. What is morbidity compression? Does it exist? Explain your answer.

Ans: Morbidity compression refers to the tendency for the onset of disease in later life to be compressed into a shorter period at the end of life. While this concept has been supported by a number of researchers, other studies have shown a worsening of health over time among older adults. This health paradox is probably due to the fact that health status is complex and is measured in a variety of ways, with different research designs and different sets of underlying causal factors, and that it is examined in different populations (some studies, for example, ignore those living in institutions) and in different health systems.

Page: 201-203 8. Will the baby boomers be healthier in old age than the previous generation? Explain your answer.

Ans: Baby boomers’ rates of smoking and unhealthy exercise are about 40 per cent lower than the rates for persons who were their age about 26 years earlier or a generation apart. As well, their rate of heavy drinking is lower by half. However, obesity rates among boomers have Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

doubled in just over two decades. In addition, baby boomers report a significantly higher rate of chronic illnesses compared to persons of the same age in 1978/79, a higher rate of hypertension, and more than twice the rate of diabetes, as well as an approximately 60 per cent increase in consulting a doctor three or more times a year. Research also shows that these individuals use prescription drugs significantly more than the previous generation at their age. These findings suggest that baby boomers are experiencing more complex health patterns and are more medicalized than the previous generation.

Page: 205-206 9. According to recent global studies, what are the major factors that increase longevity?

Ans: Longevity is attributed to genetic predisposition and biomarkers, healthy lifestyles, social involvement and connectedness, and exposure to particular environments. The increase in survival into and beyond 100 years is due to a reduction in mortality among octogenarians and nonagenarians. Some researchers argue that centenarians possess no particular “secret.” Rather, they may be extreme cases in their cohort who aged later, developed chronic diseases later in life, and/or have milder forms of these diseases. However, in all likelihood, there are combinations of genetic, lifestyle, and environmental factors that enhance an individual’s ability to reach advanced ages.

Page: 206-207 10. Discuss the integrated models of care delivery in Canada. Are there any proposed changes on the horizon?

Ans: Integrated care delivery systems for older adults in Canada include case management for home care (i.e., short-term care at home typically after a hospital stay); home support (i.e., shortor long-term assistance with daily tasks at home for anyone meeting functional status assessments); community services to enhance independence and quality of life; residential care; and some aspects of acute care in hospitals. Recently, a number of integrated models of healthcare delivery for older adults with functional impairments have been proposed. These models would create a more seamless delivery system for elderly persons that would combine health, housing, and social services.

Page: 235-237 11. How can having a healthy lifestyle influence aging?

Ans: Healthy lifestyles entail clusters of health behaviours that influence the health risk of individuals as the result of life chances and choices and the social context in which they occur.

For example, health behaviours such as poor nutrition, obesity, low levels of physical activity, smoking, and heavy drinking significantly inflate the probability that an individual will suffer from disease or premature death. Approximately two-thirds of older adults report no efforts in the prior year to change or improve their health behaviours, and the same proportion feel that no change is necessary. Merely adopting one preventive health behaviour or practice does not necessarily mean that a person will adopt any others. But it is never too late to initiate health promotion programs and to initiate practices to prevent or reduce disease.

Page: 215-216

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12. What changes in appetite and food preferences may occur in the later years? How can negative eating habits be resolved?

Ans: Major dietary changes can result from poorly fitting dentures or other oral health problems, a diminished sense of taste or smell, depression and cognitive impairment, alcohol or drug dependency, difficulties in preparing and cooking food, the increasing cost of some foods, problems in chewing or digesting certain types of food, or the use of multiple medications that depress appetite or change the taste or smell of some foods. In addition, retirement, widowhood, inability to shop, or a low income can lead to poor eating habits, perhaps resulting in malnutrition. Community service agencies and families should monitor the older person’s nutritional status, especially if he or she lives alone. Interventions to change and improve nutritional habits include prescribed and over-the-counter nutritional supplements, as well as education on selecting and preparing foods. One of the most successful programs in ensuring adequate nutrition is Meals on Wheels.

Page: 216-217 13. Describe the prevalence of obesity among older adults. What is it caused by?

Ans: About 18 per cent of community-living elderly persons are obese and another 39 per cent are overweight. Obesity tends to result from lifelong overeating and physical inactivity. Studies have shown that among older adults an increase in body weight of more than 5 per cent raises the likelihood of lower-body functional impairment (joint pain or dysfunction, which affects walking, climbing, and stability functions). Being overweight is also associated with a number of chronic illnesses, including diabetes, heart disease, and arthritis. The rise in obesity is partly due to an increase in the average size of food portions and in the consumption of foods high in saturated and trans fats.

Page: 217 14. What are the benefits of regular physical activity for older people?

Ans: Physical activity provides a number of benefits for aging adults: increased life satisfaction, confidence, and sense of self-worth; reduced morbidity and mortality; reduced risk of cognitive impairment; improved physical health and functional ability, especially in flexibility, balance, strength, and endurance; less stress and depression; a higher self-reported quality of life.

Page: 217 15. Are physical activity levels high enough among older people today? Are there any perceived barriers to exercise?

Ans: An increasing number of middle-aged and older adults are physically active and are demanding activity opportunities. The proportion of Canadians aged 65+ engaging in leisuretime physical activity of an active or moderate level has increased slightly over the last decade.

Although this reflects improvement, more than half of all adults aged 65+ (and about half of those aged 35–64) are in the inactive category and therefore not enjoying or reaping the benefits of physical activity. This is even more pronounced when using the new Canadian physical activity guidelines, which recommend 10,000 steps per day of activity. Some of the common perceived barriers to exercise include physical ailments, fear of falling, lack of motivation or time Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

constraints, and a lack of understanding as to what can be achieved and how to engage in physical activity in later life.

Page: 218 16. Does the increase in physical activity occur in all demographics of older adults? Explain your answer.

Ans: Inactivity is more pronounced among women, the less educated, those with lower incomes, those who live in rural areas and small towns, and those employed in manual occupations. There is also an east–west provincial difference in physical activity levels, with those living in the western provinces being more active. Again, structural inequalities and regional cultures affect leisure norms, opportunities, and the desire to participate in regular physical activity.

Page: 218 17. What is the difference between mental health and mental illness?

Ans: Mental health is the capacity of each of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections, and personal dignity. Mental illnesses are characterized by alterations in thinking, mood or behaviour—or any combinations thereof—associated with some significant distress and impaired functioning. Mental illnesses take many forms, including mental disorders, schizophrenia, anxiety disorders, personality disorders, eating disorders, and addictions such as substance dependence and gambling. (Standing Senate Committee on Social Affairs, Science and Technology 2004) Page: 220 18. What are five ways in which older people or their caregivers can enhance mental health?

Ans: The ways in which older persons and their caregivers can foster good mental health in later life are as follows: engaging in social, physical, and intellectual activities to maintain competence; being connected to others in social networks or self-help groups/networks for social interaction and social support (social isolation is a risk factor for mental-health problems); maintaining independence and control over one’s life through empowerment and personal decision-making; attending educational programs to learn coping and adapting strategies for normal aging losses and changes; and, ensuring that older people live in a safe, secure, and familiar environment.

Page: 220-221 19. What is the difference between depression and delirium?

Ans: There are two types of depression. The first is major depression, characterized by a depressed mood or loss of interest or pleasure and typically accompanied by appetite loss, physical agitation, difficulty in concentrating or making decisions, and feelings of worthlessness or guilt. The second type is dysthymia, which includes depressive symptoms that may be less severe than major depression but typically endure for at least two years. Delirium, on the other hand, is a common but usually temporary cognitive disorder that involves fluctuation in consciousness, an inability to focus, hallucinations, periods of disorientation, and bizarre behaviour at random moments. Delirium is related to insomnia, the onset and progression of Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

chronic diseases, the onset of either sensory deprivation or sensory overload, bereavement, relocation to a new residence, or drug interactions.

Page: 221-222 20. What are the patterns of dementia in Canada? How might these patterns affect the lives of future cohorts of older people?

Ans: In Canada, dementia affects about 8 per cent of persons aged 65 and over and about one in three people aged 85 and over. The economic costs of care were estimated to rise from approximately $15 billion in 2008 to $153 billion in 2038. The prevalence is greater among women and increases with age. As well, persons with dementia are more likely to live in rural areas. While dementia appears to be on the increase, it is possible that it may not be increasing in prevalence, per se, but rather that more people are living beyond 80 and being diagnosed. It is also controversial whether dementia will “overwhelm the health-care system” as stated by the Alzheimer Society of Canada. While the number of dementia cases will increase as baby boomers age, there are potential advancements in health-care systems and treatments for older adults that may offset some of the expected increase in cases. In addition, improvements in some health behaviours and reductions of potential environmental risk factors may also lower dementia rates over time.

Page: 222-223 21. What barriers, if any, might older adults experience when accessing mental-health care?

Ans: Barriers to accessing mental-health care include the following: failure of partners or other family members to refer a person to a mental-health clinic; a lack of understanding of mental illnesses and treatments; inadequate funding for mental-health care versus physical care; a shortage of trained personnel for geriatric mental-health services; a shortage of mental-health clinics in a community, especially ones that encourage attendance by older people and that are staffed by psycho-geriatricians Page: 224-225 22. What are the five criteria that provincial and territorial health insurance plans must adhere to in order to be eligible for federal funding? List and describe each.

Ans: To be eligible for federal funding, provincial and territorial health insurance plans must adhere to five criteria in the Health Act. These principles state that health services must be as follows: (1) Publicly administered: This is on a non-profit basis. (2) Comprehensive: All “medically necessary” services provided by hospitals and physicians must be insured, including drugs, supplies, and diagnostic procedures within a hospital; some out-patient services are covered; and chronic care services are covered if accommodation costs are shared by the resident. (3) Universal: All eligible residents are insured equally. (4) Accessible: No additional fees can be charged for insured services, and there must be no discrimination on the basis of age, income, health status, gender, or ethnicity. (5) Portable: Residents are fully insured when they travel within Canada and to some extent when they travel abroad and are fully insured when they move to another province.

Page: 226 23. Why has the integrated model of care delivery not been more widely implemented?

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Ans: One reason why the integrated model of care delivery has not been more widely implemented is that health care and community care are funded from different provincial envelopes. In most cases, the ministries (health, social and community services, housing) do not communicate with each other to develop an integrated policy, nor are they willing to share resources or co-fund an integrated system that involves more than one ministry or level of government (municipal, regional, provincial). A second reason for a failure to implement an integrated model is that there are philosophical and policy debates pertaining to a commitment to expand the health-care system to cover a broader range of health issues, including those that address functional disability, chronic disease management, mental health, and prevention.

Page: 236-237 24. What is a blue zone? What commonalities do blue zones often share?

Ans: In the 1990s and early 2000s researchers identified and studied several isolated regions (“blue zones”) where people were living beyond age 100 at higher than normal rates compared to the general population. Originally, three different communities in very different parts of the world were identified as having high numbers of centenarians: Sardenia, Italy; Okinawa, Japan; and Loma Linda, California. According to early research carried out on these communities, several commonalities were identified that may be linked to longevity. None of the communities have high rates of smoking; they all highly value and are socially engaged with their family, friends, and community; they are physically active every day; and they eat plenty of fruits and vegetables. Although good genes play a role in long and healthy lives, much of the secret to longevity lies in adopting and maintaining healthy lifestyles.

Page: 207 25. What is the anti-aging movement and why is it problematic?

Ans: Throughout history, a variety of anti-aging methods have been proposed to achieve prolongevity—a significant extension of average life expectancy or the maximum lifespan.

Today, a commercial and clinical anti-aging movement offers a variety of products, treatments, and surgical procedures aimed at slowing or reversing physiological and psychological aging processes. These include efforts to reduce wrinkling of the skin, replace hair for men, increase muscle mass or strength, enhance memory, reduce obesity, lower the risk of major chronic illnesses (cardiovascular disease, cancer, arthritis, osteoporosis), and enhance sexual function.

Recent deaths during or following anti-aging surgery show that this way of fighting aging is not without serious risks. Also, Butler (2003) contends that the anti-aging movement promotes ageism, is class-based, and requires careful monitoring by government agencies to protect consumers from scams and the side effects of unproven medications and therapeutic modalities.

In his book The Longevity Revolution, Butler (2008) contends that there are many unanswered moral and ethical questions, such as, is prolongevity desirable, and what are the unintended consequences of this growing movement?

Page: 231

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Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Chapter 8

The Lived Environment: Community, Housing, and Place

Multiple Choice Questions 1. Which field of study examines the behavioural, social, and psychological implications of encounters between older adults and their environment? a) Physical gerontology b) Community gerontology c) Environmental gerontology d) Public gerontology Ans: c Page: 242 2. What is the goal of environmental gerontology? a) Maximizing independence b) Assessing need for long-term care c) Recommending medical interventions d) Prescribing alternative therapies Ans: a Page: 242 3. Who make up approximately one-third of accused individuals in violent crimes against seniors? a) Doctors and nurses b) Family members c) Repeat offenders d) Public officials Ans: b Page: 242 4. What percentage of older adults express fear that they may be victimized? a) 20 per cent b) 30 per cent c) 40 per cent d) 50 per cent Ans: d Page: 242

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

5. According to the WHO, what type of community has policies, services, and structures related to the physical and social environment that support and enable older people to live in security, to enjoy good health, and to continue to participate fully in society? a) Assimilated community b) Age-integrated community c) Age-friendly community d) Active-aging community Ans: c Page: 243 6. Which of the following is not an environment assessed in Lawton’s (1980) environmental press concept? a) Personal environment b) Work environment c) Supra-personal environment d) Social environment Ans: b Page: 249 7. According to the ecological model of aging, what will someone experience if they are prematurely confined to a nursing home with little contact? a) High competence and strong environmental press b) Low competence and strong environmental press c) High competence and weak environmental press d) Low competence and weak environmental press Ans: c Page: 250-251 8. Which of the following statements is false about falls? a) The definition of a fall can vary among older persons. b) Falls are the leading cause of injury and death among those aged 65 and older. c) The majority of injuries resulting in hospitalization are caused by falls. d) About three-quarters of older people have a fall each year.

Ans: d Page: 253 9. Activities of daily living (ADLs) include which of the following? a) Eating b) Preparing meals c) shopping d) Housekeeping Ans: a Page: 253 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

10. Instrumental activities of daily living (ADLs) include which of the following? a) Using the toilet b) Preparing meals c) Eating d) Bathing Ans: b Page: 253 11. Who is most likely to have access to private or public transportation in later life? a) Urban residents b) Individuals with low income c) Individuals in poor health d) Widows Ans: a Page: 255 12. Which of the following is true about older drivers? a) Older drivers account for fewer auto fatalities than other age groups. b) Older drivers rarely volunteer to stop driving when they experience problem. c) Older drivers have fewer accidents per kilometer than other age groups. d) Older drivers pose a significant risk to traffic safety compared to other age groups.

Ans: b Page: 256 13. Which of the following is true about older people and patterns of victimization? a) Older people are victimized more than younger people. b) Older people are more likely than younger people to report crimes. c) Older people are most commonly victimized by strangers. d) Older people are more likely to be victims of financial fraud.

Ans: d Page: 257-258 14. Which of the following is not a factor that influences whether or not older people are willing to adopt a new technology, according to Golant? a) Its perceived costs/risks b) Its perceived popularity c) Its perceived usability d) Its perceived efficaciousness Ans: b Page: 259

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

15. Which of the following refers to the type of housing for older adults that includes shelter and a variety of services that focus on the stimulation and activation of the residents by qualified staff? a) Independent housing b) Supportive housing c) Dependent housing d) Long-term care Ans: b Page: 265 16. Which term refers to the use of commonly held principles and ethical rules that guide what we “ought” to do when making decisions about or for others? a) Principlism b) Principle c) Ageism d) Sexism Ans: a Page: 273 17. Which of the following is not a key reason that an older adult would move away from their former residence? a) To better adapt to recent health limitations b) To be closer to family c) To live in a better neighbourhood d) To be alone Ans: d Page: 274 18. Which of the following is not a reason for a reappraisal of living arrangements and lifestyle? a) Retiring b) Becoming widowed c) Experiencing a significant change in health status d) Gentrification Ans: d Page: 274 19. Which direction reflects the most permanent interprovincial migration among the older population in Canada? a) Westward b) Eastward c) Northward d) Southward Ans: a Page: 275 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

20. Which of the following is not a motivation for international “assistance” migration? a) The onset of a moderate disability b) Aging itself c) Increasing poverty d) Civil unrest Ans: b Page: 275 21. Helen has lived in her downtown home for 40 years. Recently, she has been noticing that more and more of her older friends and neighbours are moving out of the neighborhood because they cannot afford increases in taxes or in the cost of heating and repairs. The last neighbor that moved out sold their house to a young professional couple who demolished the older home and put a larger, modern home in its place. Helen often worries about how much longer she can afford to live in her home and whether the neighborhood has changed for the better. What is Helen experiencing? a) Simplification b) Principlism c) Urbanism d) Gentrification Ans: d Page: 248 22. Which term has a number of meanings that we must be familiar with in order to create successful policies and programs for older people? a) City b) Community c) Activity d) Geography Ans: b Page: 244 23. André’s doctoral research examines the behavioural, social, and psychological implications of encounters between older adults and their environment. In addition to examining behavioural, sociological, and psychological theories, his thesis also recommends interventions that could create a better fit between older individuals and their environments, thereby maximizing independence and improving their quality of life as well as their physical and subjective health, including longevity. What field of study does André’s research fit in with? a) Interactive gerontology b) Ecological gerontology c) Applied gerontology d) Environmental gerontology Ans: d Page: 242 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

24. Which of the following is not an environmental challenge that older people face? a) Homelessness b) Fear of crime c) Increasing home equity d) Loss of private transportation Ans: c Page: 253 25. Which of the following is a key factor in maintaining one’s quality of life and is essential to maintaining independence in later life? a) Mobility b) Gentrification c) Mental health d) Supportive-care facilities Ans: a Page: 254

True or False Questions 1. Of people aged 65 and over, men are more likely than women to live alone.

Ans: False Page: 242 2. Environmental gerontology refers to the study of the ecological impact of seniors.

Ans: False Page: 242 3. The majority of older Canadians live in rural areas.

Ans: False Page: 246, 255 4. One goal of public policy should be to create “age-friendly” communities.

Ans: True Page: 243 5. In general, age-integrated communities are favoured by older people.

Ans: True Page: 244 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

6. Most research about older people has focused on residents of large urban communities.

Ans: True Page: 245 7. Older residents of rural communities lack access to inexpensive, locally grown food.

Ans: False Page: 245 8. Research shows that services like New Brunswick’s minibus service likely contribute to overall wellness for older adults.

Ans: True Page: 246 9. Some older people continue to live in the central core of cities because they cannot afford to rent or buy in newer areas.

Ans: True Page: 248 10. “Aging in place” is the preferred housing choice in later life.

Ans: True Page: 248 11. Environmental press includes the assessment of environments later in life.

Ans: True Page: 249-250 12. The less competent the individual, the more environment influences adaptation and quality of life.

Ans: True Page: 249-250 13. Falls occur about equally both inside and outside the home.

Ans: True Page: 253 14. Men are more likely to experience a fall than women.

Ans: False Page: 253 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

15. There are three types of risk factors related to injuries and falls among older people: personal, home, and community.

Ans: True Page: 254 16. For the average number of kilometres driven, older drivers have more accidents than any other age group.

Ans: True Page: 256 17. Only about half of the violent crimes committed against older adults are reported to the police.

Ans: True Page: 257 18. Violence against older adults is usually committed by a stranger.

Ans: False Page: 257 19. Older people are victimized less than younger people because they are not as exposed to risk.

Ans: True Page: 257 20. The number of older adults who use the Internet is increasing.

Ans: True Page: 260 21. The majority of older homeless people are women.

Ans: False Page: 261 22. More men aged 65 and over tend to be in partnered arrangements than women.

Ans: True Page: 262 23. Older women are more likely to remarry than older men.

Ans: False Page: 263 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

24. It is becoming more common to look to technological solutions and innovations to improve the quality of life of older adults.

Ans: True Page: 258 25. Residents in independent/supportive housing are viewed as “patients.”

Ans: False Page: 266

Short Answer Questions 1. What are three scenarios, as illustrated by Scheidt and Windley (2006), in which the local environment can create stress and change the lifestyles of older persons?

Ans: The textbook describes four scenarios (students must choose three) in which the local environment can create stress and change the lifestyles of older persons are as follows: (1) A 75year-old woman cancels a shopping trip after considering the problems posed by heavy traffic, poor sidewalks, and a user-unfriendly bus system. (2) An elderly married couple experience stress and unhappiness when forced to move from their lifelong home to an assisted living facility several miles away from their community. (3) Healthy rural elders, with strong attachments to their homes and small rural town, struggle to “age in place” as community supports dwindle and the town’s physical and service infrastructure deteriorates. (4) An elderly widowed woman who speaks and understands only her native language (Mandarin) is forced to leave the family home and move into a retirement residence where most or all staff do not communicate in her language.

Page: 242 2. What is meant by the “multiple meanings of community”?

Ans: On the simplest level, a community is a geographical space defined by political or natural geographical boundaries. A community may range in size from a few adjacent streets in a neighbourhood to a small city to a large metropolitan area. Some even refer to the world as a global community or a global village. A community can vary, as well, in location—rural, remote, urban, or suburban—with each location posing different challenges for aging individuals and for those responsible for public policies and social services.

Page: 244 3. Why is it difficult to agree on a definition of “rural”?

Ans: It is difficult to agree on a definition of “rural” because of the diversity in location, in socio-economic status, and in the composition of residents. Keating argued that any definition of rural life needs to consider several elements. First, occupations in rural communities have expanded and become more diverse, and we need to distinguish between “farm” and “nonfarm” occupations. Second, population density and distance from a metropolitan centre must be Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

considered. And in rural areas, population densities and living conditions are quite diverse. The third element of rural life is the presence of a rural ideology and culture—that is, the values and beliefs rural residents hold about their community, the interaction between people and nature and with other people in the community, and the links between the economic unit and the extended family.

Page: 244-245 4. What are some of the advantages and disadvantages to rural life for older adults?

Ans: Older residents of rural communities are disadvantaged in some ways compared to their urban counterparts. These disadvantages include lower incomes, little if any public transportation; inadequate housing options; and fewer leisure, social, and health services because of a lower tax base and the closure of small hospitals. Older people in rural areas who do not drive or who are no longer able to drive are isolated and dependent on others for transportation.

However, there are also advantages to living in a rural community, such as proximity to inexpensive, locally grown food and the support of long-time friends and neighbours. Those who have lived their entire lives in rural settings are part of a unique subculture characterized by a strong sense of community and feelings of independence, and a willingness to help others and to accept help from them.

Page: 244-245 5. What are some of the challenges of aging in urban communities?

Ans: There are an increasing number of adults aged 65+ who are living in the suburbs rather than in the central core of Canadian cities. Many of these older residents are “over-housed” in “empty nests,” and an increasing number are widows who live alone in houses that are now 30 to 50 years old. As in rural areas, those who live in the suburbs are likely to need a car for shopping, leisure, and medical appointments. However, some older people continue to live in the central core of cities because they cannot afford to rent or buy in newer areas. Some of these older residents are forced to move because of urban renewal projects or increases in taxes or in the cost of heating and repairs. In stable neighbourhoods, there is a high degree of homogeneity with respect to age, race or ethnicity, and class. This homogeneity fosters the development of a network of neighbours who provide mutual support and assistance in later life. But when a neighbourhood experiences a rapid turnover in homeowners, heterogeneity increases and a sense of community may be lost. Consequently, in the later years, an older person who ages in place may live in a non-supportive, gentrified environment.

Page: 246-248 6. What is meant by the proclivity to age in place?

Ans: The proclivity to age in place refers to older people, especially in urban areas, striving to live in the family home unless forced to move late in life. Over time, our home represents a defined, personal place that provides independence, security, a sense of belonging, and a repository of family history and memories. People establish ties to the place, the people, and the physical setting of the neighbourhood or community. Aging in place allows older people to form and maintain a sense of identity and autonomy that institutionalized living does not permit or often encourage. When older people are faced with declining personal abilities or a deteriorating Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

neighbourhood or home, they engage in psychological adaptation to convince themselves and others that they can remain in their current environment.

Page: 248-249 7. What is the interplay between objective and subjective environments within Lawton’s ecological model of aging?

Ans: Lawton’s “ecological model of adaptation and aging” includes the macro-environment (the community where older people live) and the micro-environment (the housing where they spend most of their time). This model is based on the premise that adaptation involves the interaction of individual competence and environmental press. Individual competence includes health, sensorimotor functioning, perception, and cognitive skills. Environmental press includes an assessment of five types of environments in later life that can create different demands, or “presses,” for older people. In addition to the objective environment, the subjective or perceived environment is also important for successful adaptation in later life. These subjective experiences influence behaviour in addition to, and independently of, the “objective” environment.

Page: 249-251 8. What are the weaknesses of the ecological model of aging?

Ans: A major criticism of the ecological model of aging is that it assumes that people are passive and do not try to meet their needs or preferences through the use of environmental resources, or agency. The model has been criticized, as well, for not taking into account a person’s familiarity with his or her current environment or a willingness to take behavioural risks in his or her environments.

Page: 251 9. What preventive measures can be taken to reduce the incidence and seriousness of falls?

Ans: Preventive measures can reduce the incidence and seriousness of falls. At the personal level, these measures include exercising to improve balance, gait, strength, and flexibility; using an assistive device, such as a cane or walker; moving slowly when changing position from lying or sitting to standing; reducing alcohol consumption; using safe, well-fitting footwear and clothing, perhaps with plastic hip protectors or foam pads; and avoiding medications that have such side effects as loss of balance or judgment. In the home, interventions and adaptations include installing grab bars and railings; using ramps instead of stairs; installing padded flooring; using brighter lights and movement-sensor lights for nighttime; installing alarm and monitoring systems; using portable cordless telephones so that the person does not have to rush to the phone; and keeping traffic areas clear of obstructions.

Page: 254 10. In what ways are transportation issues among the most important issue facing older adults?

Ans: Mobility is a key factor in maintaining one’s quality of life and is essential to maintaining independence in later life. Accessible and affordable transportation enables older people to remain independent, obtain the goods and services they need, do volunteer work, engage in social activity, and fulfill obligations in later life. Yet access to and personal availability of Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

transportation declines with age. Those who are most likely to have reduced access to private or public transportation in later life are widows, those in poor health, those over 80 years of age, rural residents, and those with low incomes. Those without access to a car or public transportation are less likely to go out of the home and those who relinquish their driver’s licence, especially men, have a higher risk of depression.

Page: 254-255 11. What are the challenges associated with ensuring that older drivers are competent, from a family and a public-policy perspective?

Ans: Ensuring that older drivers are competent is a difficult task for families, for physicians (who are now responsible to assess the health of older drivers prior to relicensing in some provinces), and for public-policy makers. Like other drivers, older people tend to engage in habitual driving behaviour until they experience a significant driving problem or crash. Older persons seldom volunteer to stop driving, but they often engage in some regulation of their driving behaviours, such as not driving at night or staying off busy highways. However, selfregulation does not necessarily reduce crash risk. Family members should be involved in these processes, and if there is concern, they should consult with the doctor or driving/licensing ministry. From a public-policy perspective, this issue is a classic case of whether policies should be based on age or on competence. General approaches are to identify problem drivers and delicense them, use a graduated or restricted licence system that would not allow them to drive at night or on certain highways, require older drivers to take retraining, require annual vision and motor performance testing, and increase the use of such aids as wider mirrors, pedal extensions, booster seats, and visual enhancement systems. There are many unresolved issues concerning any attempt to monitor or control older drivers: (1) How do we balance the rights of individuals to remain independent and to drive against the need to ensure public safety? (2) Who is responsible for de-licensing: the government, the family, the police, or the physician? (3) What tests and criteria are fair and accurate when older drivers are tested (medical and visual exams, motor skills and reaction- time tests, written tests, simulated tests, on-road tests)? In some jurisdictions, these issues have become highly political.

Page: 256 12. What kinds of fraud do older citizens often experience?

Ans: Older citizens are often victims of fraud, which may be conducted by mail, the Internet, telemarketing, or door-to-door salespeople. Fraud against older people involves credit cards, bank accounts, donations to fake charities, assuming a new mortgage on a mortgage-free home, contracting for unneeded home repairs, and even love affairs in which younger people gain the affections of vulnerable octogenarians and acquire money or property that might otherwise be left to adult children. The most common form of fraud is the awarding of fake prizes, typically through the Internet or mail. Being a victim of larceny, property loss, or a fraudulent crime is traumatic for older persons, partly because the loss often represents a larger percentage of their financial resources than it would for a younger person. Such crimes also generate fear and anxiety about the security of their environment.

Page: 258 13. Despite having lower rates of victimization, older adults tend to fear crime more than other groups. Why is this and what can be done to change it?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: One indirect result of greater publicity about crime against older people and the creation of special support systems to prevent or discourage crime is increased fear. Although older people are victimized less than other age groups, in some studies a large number of respondents (as many as 50 per cent) say that they fear being victimized and that a fear of crime is one of their most serious personal problems. Fear is generally reported more frequently by older women who are poor or live alone in high-crime neighbourhoods or in subsidized age-integrated or racially/ethnically integrated housing complexes. Fear is higher among those who have been victimized or know someone who has been victimized, who are physically disabled, or who use public transportation. The characteristics of the neighbourhood environment also influence the incidence and level of fear—if street lights are not very bright, if there are few pedestrians or little or no police or security surveillance, or if young people congregate there. These areas should be targeted to improve perceptions and the actual safety of older adults. Fear of crime is another example of how declining personal competence and an environment that is or appears to be dangerous can interact to influence the quality of life in the later years.

Page: 258 14. How can technology help older adults in their day-to-day lives? Provide examples.

Ans: Various assistive devices can maintain or increase functional capabilities among people with impaired vision or hearing or who have difficulty walking. Other devices provide assistance with personal care, homemaking, and leisure activities. The primary purpose of these devices is to enhance independence, safety, and function; increase the quality of life and active aging; and reduce health and social-support costs to the individual and to society. Technological devices include: mechanical and technological aids for the home include non-slip floors, walkers, chairs for bathtubs or showers, raised seats for furniture and toilets, L-shaped door handles, grab bars, personal emergency response systems, telephones and books with large print, kitchen utensils with larger handles, talking books and specialized computer software, hearing aids, motionactivated lights and security systems, and wheelchair-accessible vans, entrances, and doorways.

“Smart-home systems” assist and monitor older people with cognitive decline, difficulty in walking, and declining health.

Page: 258-259 15. Why do some older adults adopt and master new technology while others do not?

Ans: While older people are increasing their use of the Internet, not all older people are able or willing to use the new technology. Some are frightened or feel insecure about using technology, while others are ambivalent, especially toward information technology (IT). Golant (2017) has introduced a technology adoption model that suggests that older people are more likely adopt technology based on more positive appraisals of its (1) perceived efficaciousness, (2) perceived usability, and (3) perceived costs/risks. The rate of adoption and mastery of new technology also varies both across and within cultures and according to education, health status, and work experience with IT. This adoption lag within the older population needs to be reduced so that inequities in access to available services and opportunities are minimized for older adults. In this sense, there is an age-based (as well as a socio-economic) “digital divide” across the population: between those who have access to and use technology to help them adapt to their environment and those who do not.

Page: 259-260 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

16. In what ways homelessness an issue for older adults?

Ans: Although they are invisible to most members of a community, a growing number of older people live and sleep in public shelters or in streets, parks, subways, or abandoned buildings, especially in large cities. Homelessness among older people is often a continuation of a lifestyle begun in youth or adulthood. But for a smaller number, homelessness is a new living arrangement triggered by relatively recent financial, health, or personal trauma that caused the person to leave his or her permanent residence. Reasons for this new state in life include the onset of personal problems (financial losses, death of a close relative who had provided support and supervision); long-term poverty and marginalization; disputes with other tenants or neighbours that resulted in eviction; alcohol, drug or gambling addictions; or recent physical or cognitive impairments.

Page: 260-261 17. Why it is difficult for homeless elderly people to be reached by social services? What can be done to correct this problem?

Ans: Many homeless elderly people are transients who live from day to day or week to week in single-room-occupancy hotels (SROs) in poor, high-crime sections of a city. Here, they may develop an informal social-support system consisting of the hotel’s staff and fellow residents. To serve this unique subculture of older people, structural risk factors (poverty, lack of housing, poor access to mental health services, etc.) must be eliminated. Scholars suggest that the provision of a coordinated, seamless service network with accessible low-cost housing, income support, and community health and support services is needed. For some, learned helplessness has become a way of life, characterized by living in a dependent and marginalized condition over extended periods of time. But job training and help with finding a low-skill job can alter the behaviour of some older homeless people.

Page: 261 18. Why are values and preferences often linked to ethnicity important factors affecting the living arrangements of older adults in Canada?

Ans: In Canada, values and preferences that are linked to ethnicity are important factors affecting living arrangements. Elderly persons who hold familial cultural values (e.g., Italian, Chinese, South Asian, and East Asian) are more likely to live with kin than those embracing individualistic values emphasizing privacy and independence (e.g., British, German, Dutch).

Most three-generation households are headed by immigrants, most of whom are from Asia, where both a cultural tradition of extended family living and economic necessity still prevail.

Chinese Canadians between the ages of 55 and 59 are nearly twice as likely to live with adult children, and those aged 80 to 85 are nearly four times more likely to live with children than are non-Asian people of the same age.

Page: 262-263 19. What are the characteristics of the supportive housing option?

Ans: Supportive living is a form of housing that combines shelter, usually in the form of rented units, with a variety of services (congregate meals, security, housecleaning, and personal care) as Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

needed. This type of housing arrangement may include independent living communities, assisted living, congregate housing, and retirement homes. In supportive housing, meals, housekeeping, and social and recreational programs are provided by qualified staff or through a home-care program. Residents can furnish their suites with their own possessions and can lock their doors, but they also have access to common areas. Residents are not viewed as “patients,” as they are in nursing homes, and they are more involved in decisions about their “home” through a resident council and periodic consultations. This type of housing preserves the older person’s autonomy, freedom of choice, privacy, and dignity in a home-like environment. Most rooms are equipped with emergency call buttons.

Page: 265-267 20. What are five major issues concerning long-term care? Briefly describe each.

Ans: The textbook lists ten major issues concerning long-term care. Students are required to discuss five: (1) determining the best level of care and improving services for residents with highly complex care needs; (2) enhancing residents’ quality of life and survival rates; (3) meeting the needs of an ethnically and linguistically diverse older population; (4) meeting the needs of a socially diverse older population, such as a growing LGBTQ community; (5) designing institutions to facilitate autonomy, privacy, meaning, social interaction, and dignity in the later years of life; (6) defining “levels of care” with respect to the placement of individuals and the funding of institutions for the type of services they offer; (7) developing and maintaining minimum standards of care through voluntary or mandatory accreditation and/or licensing by the government; (8) deciding who pays for housing and services—the individual and/or the society—and in what proportions; (9) improving training and working conditions to retain employees and improve staff morale in retirement and nursing homes, where low wages are common in a very profitable industry; (10)conducting evaluation research to determine the efficacy and effectiveness of innovative programs, design features, and necessary staffing levels in LTC. Page: 267 21. How are decisions made about who should or must be admitted to publicly-funded long-term care?

Ans: Decisions about who should or must be admitted to publicly funded long-term-care institutions are difficult. To provide objective assessments of relative need before admission to a facility, to monitor the changes in personal needs, and to assess the quality of care in an institution, most provinces—since the mid-1990s—have adopted a series of what have been termed interRAI assessments (Hirdes et al. 1999b, 2001, 2011; Warren 2000). The interRAI assessment instruments employ standardized methodologies to assess complex populations across home-care, continuing-care, and long-term-care environments (Hirdes et al. 2011). A series of RAIs are used in Canada: the Resident Assessment Instrument (RAI 2.0) for use in long-term-care facilities; the RAI-Home Care Instrument (RAI-HC) for assessing home-care needs; the RAI-Mental Health Assessment; the interRAI Contact Assessment; the interRAI Community Health Assessment; and the interRAI Palliative Care. These instruments have been shown to be highly reliable, valid, and useful in assessing both the needs and the quality of continuing and long-term care (Hirdes et al. 2011; Kehyayan et al. 2015). In some provinces, RAIs are mandated by provincial legislation, whereas other provinces only recommend their use.

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The application of these standardized assessment tools provides vital information to address the long-term-care issues highlighted above.

Page: 268 22. What are some of the principles and regulations that the Ontario LTC system is attempting to put into practice through legislation?

Ans: Some of the principles and regulations that the Ontario LTC system is attempting to put into practice through legislation are as follows: ensuring a fair and equitable process for gaining access to LTC homes that preserves the client’s right to choice and maintains the requirement for consent on admission to any LTC home; promoting zero tolerance of abuse and neglect of LTC residents whereby any alleged, suspected, or observed occurrence of abuse or neglect must be reported; an enhanced Bill of Rights that entitles residents to privacy when meeting with a spouse or another person and to participation in the life of the LTC home; whistle-blowing protection for staff, residents, and volunteers who report abuse and neglect; requiring that a registered nurse be on duty in the LTC home 24 hours a day, seven days a week; requiring residents’ councils and encouraging family councils; establishing an Office of the LTC Homes Resident and Family Advisor to provide information and assist residents, their families, and others; restricting the use of restraints to limited circumstances where it is absolutely necessary and only with appropriate safeguards; and, defining licence terms for LTC homes of up to 25 years, with the right to revoke a licence for non-compliance.

Page: 269 23. What is one example of an ethical issue that may arise in a long-term care facility?

Ans: A number of ethical dilemmas confront family and care workers when caring for frail and vulnerable older adults. For example, a contentious issue in long-term-care facilities is whether restraints should be used to protect residents from self-harm. Often, it is argued, these devices are used to make life easier for staff. However, it is the dignity of the person and the competing values of autonomy versus safety that must be at the core of any debate or decision as to whether chemical (sedatives) or physical restraints should be used to prevent wandering, falls, or aggressive behaviour. Physical restraints, such as bed rails, straps, or confining chairs, are used to restrict movement. These restraints may cause physical pain, may violate the individual’s moral right to freedom of movement, and may cause humiliation and anger. If the person is mentally competent, informed consent is required for the use of restraints. As well, chemical restraints may add to a resident’s existing confusion, fears, and anxiety.

Page: 273 24. What is the importance of studying the migration patterns of older adults?

Ans: Migration involves a move across jurisdictional boundaries to another county, province, or country, either seasonally or permanently. The major pattern of migration for older Canadian “snowbirds” tends to be a seasonal path (November to March) to the southern United States or Mexico. Such movement raises a number of issues, including spending patterns outside of Canada, pension money flowing out of the country, and the cost of supporting snowbirds when they return home. In Canada, most permanent interprovincial migration among the older population is westward, although there is a small amount of return migration from Ontario to an Atlantic province. As a result of migration patterns, there is a concentration of the elderly Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

population in British Columbia, Alberta, and Ontario. The arrival or departure of large numbers of older people significantly changes the economic resources of and the infrastructure demands on the community. Some communities, for the sake of economic development, actively encourage older people to migrate there.

Page: 274-275 25. What additional challenges are faced by older individuals who are members of the LGBTQ community?

Ans: Members of a systemically disadvantaged community, such as the LGBTQ community, face additional challenges as they age. For instance, long-term care facilities need to do more to meet the needs of a growing LGBTQ community of residents. For instance, Furlotte et al.

(2016) found that lesbian and gay older adults have concerns about living in long-term care owing to issues of discrimination (e.g., not having their opinion or voice heard), having to hide their identity, and the quality of care and comfort level that they will experience because of their sexual identity and preference. Decisions pertaining to aging in place are also challenging among the LGBTQ community. One innovative approach to this particular community was conducted by a participatory action research project in which a partnership was formed among social workers, health-service providers, researchers, LGBTQ community members called Seniors Using Supports to Age in Neighborhoods (SUSTAIN) (Wright et al. 2017). The partnership developed a shared vision, identified service partners that met the needs of their community, and made decisions pertaining to building community capacity to meet their goals.

Page: 267, 269, 275

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Chapter 9

Family Ties, Relationships, and Transitions Multiple Choice Questions 1. The Vanier Institute of the Family defines which term as “any combination of two or more persons who are bound together over time by ties of mutual consent, birth and/or adoption or placement.” a) organization b) cohort c) family d) community Ans: c Page: 282 2. Which of the following are informal family-like relationships that emerge with neighbours or friends over time and often evolve to a level where a friend or neighbour is almost like a relative? a) Community networks b) Kinship circles c) Fictive kin d) Childless networks Ans: c Page: 284 3. What percentage of women aged 65 and over are grandparents? a) 80 per cent b) 70 per cent c) 60 per cent d) 50 per cent Ans: a Page: 282 4. What is the most common marital status for older adults? a) Married b) Common-law c) Widowed d) Divorced Ans: a Page: 282

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5. Margaret and her common-law partner Ahmed have one young daughter living at home and have shared custody of Margaret’s daughter from a previous marriage. For the past five years, Ahmed’s father has lived in their “in-law suite” independently but they provide meals for him and help with heavy cleaning tasks. Recently, Ahmed’s son from a previous marriage has moved back into the neigbourhood to be closer to family but is having trouble securing employment and is moving back into Margaret and Ahmed’s home with his husband and their son. Which term best describes this living situation? a) Familial chaos b) New age cohabitation c) An empty nest d) A cluttered nest Ans: d Page: 283 6. Which term is used to describe caregivers who provide care to both an elderly parent and children living at home? a) Doughnut generation b) Onion generation c) Milkshake generation d) Sandwich generation Ans: d Page: 283 7. What does “intimacy at a distance” in families refer to? a) Living in a separate part of the house b) Living far away from family members yet often talking to those family members on the phone c) Having separate social relationships but eating meals together d) Living independently yet being close enough to visit Ans: d Page: 284 8. Which of the following is true about the definition of family? a) Family is restricted to blood or marriage ties. b) Family is dynamic and changes across time and culture. c) Family is static across time and culture. d) Family is the same as kin.

Ans: b Page: 284 9. Which of the following statements regarding major changes in family and kinship structures is false? a) There has been a shift from an “age-condensed” structure to an “age-gapped” structure in some extended families.

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b) There has been an emergence of truncated families in which a specific family lineage eventually disappears when the youngest generation is childless by choice or by chance. c) The kinship system has become shorter, resulting in less complex family relationships. d) The number of reconstituted or blended families as a result of remarriage following divorce or widowhood has increased.

Ans: c Page: 286-287 10. Kinless older persons tend to be which of the following? a) Higher income b) Divorced c) Poorly educated d) In poor health Ans: d Page: 287 11. Which of the following refers to the role of facilitating kinship interaction taken on by one or two members of the extended family (usually women)? a) Kin curator b) Kin guardian c) Kin keeper d) Kin caretaker Ans: c Page: 288 12. Which of the following serves as the primary resource for assistance and support for people of ethnic minorities? a) Colleagues b) Social organizations c) Friends d) Extended family Ans: d Page: 288 13. Which of the following statements is true? a) Retirement leads to tension and conflict in marriages. b) Younger people are generally more satisfied with their marriages. c) High levels of marital satisfaction are generally reported more by elderly men than elderly women. d) Marital satisfaction is negatively associated with health and well-being.

Ans: c Page: 289 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

14. Which of the following is not a pattern that may be followed by siblings over the life course? a) No discernible relationship in later life b) Frequent interaction in the family home during childhood and adolescence, then little or no interaction after leaving home c) Frequent interaction in childhood continuing throughout the life course if siblings are “best friends” d) A slow drifting apart during adulthood after entering the labour force and getting married Ans: a Page: 291 15. Who represents the predominant monitoring system and source of physical, emotional, and financial support for elderly persons? a) Volunteer caregivers b) Adult children c) Siblings d) Social workers Ans: b Page: 294 16. Which of the following relationships is likely to have the strongest ties? a) Sisters b) Brothers c) A sister and a brother d) Siblings who hold different socio-economic statuses Ans: a Page: 291-292 17. Which of the following is true about divorced parents and their relationship with their adult children? a) Divorced fathers receive more assistance and support from their children than do divorced mothers. b) Divorced mothers receive more assistance and support from their children than do divorced fathers. c) Divorced parents generally provide more financial aid and support to their adult children. d) Divorced parents have more contact than married parents with their adult children.

Ans: b Page: 295 18. Which of the following statements concerning grandparent–grandchild relationships is true? a) Older people in the future will have more biological grandchildren than they do now. b) Face-to-face grandparent–grandchild interactions have increased. c) By 30 years of age, most people still have all four living biological grandparents. d) In skip-generation households, about half involve a single grandparent providing care for at least one grandchild.

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Ans: d Page: 296 19. Which of the following is true about common-law relationships? a) They tend to be less permanent than legal marriages. b) More women than men seek and enter common-law relationships. c) They are more common in older age cohorts. d) They are almost never converted to a legal marriage.

Ans: a Page: 299 20. Which of the following is true about never-married women? a) They have no access to a pension. b) They tend to suffer from financial insecurity. c) They feel stigmatized by being single. d) They are likely to be highly-educated.

Ans: d Page: 300-301 21. Which of the following statements is true? a) The “empty nest” stage is more common outside North America. b) For most parents, the transition to the “empty nest” stage is a negative experience. c) Sons tend to leave home later than daughters. d) A decreasing number of children continue to live in the family home well into their 30s.

Ans: c Page: 302 22. Which of the following is not a following for divorce among older adults? a) To increase the level of excitement in their lives b) To reduce stress c) To reduce boredom d) To improve their physical and mental health Ans: a Page: 304 23. Which term refers to adult children who return home after an assumed permanent departure? a) Bounce-back children b) Ricochet children c) Rebound children d) Boomerang children Ans: d Page: 302 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

24. In which of the following must a widowed woman engage in order to determine who she is as a single woman, following the death of her spouse? a) Identity work b) Lived reality c) Re-partnering d) Reclamation of self Ans: a Page: 305 25. Widowed women are more likely than widowed men to need help with which task? a) Handling financial matters b) Keeping in touch with family c) Cooking meals d) Cleaning the house Ans: a Page: 306

True or False Questions 1. Most older adults who remarry consider the marriage successful.

Ans: True Page: 308 2. Cohabitation is more common and accepted in the US than it is in Canada.

Ans: False Page: 308 3. Adult children usually return to live in the family home due to unemployment.

Ans: True Page: 303 4. Most older people prefer “intimacy at a distance.”

Ans: True Page: 284 5. In recent decades, there has been a shift from age-condensed kinship structures to age-gapped kinship structures.

Ans: True Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 286 6. Today, few people reach the later stages of life with no surviving kin.

Ans: True Page: 287 7. Widows usually have less contact with their children than older married or divorced women.

Ans: False Page: 288 8. Social class influences intergenerational relationships.

Ans: True Page: 288 9. Mother–daughter ties are stronger than son–father ties.

Ans: True Page: 288 10. An increasing number of older widows report that they enjoy the freedom and independence of being single.

Ans: True Page: 306 11. Having fewer children is associated with greater marital satisfaction later in life.

Ans: False Page: 289-290 12. More elderly men than elderly women report higher levels of marital satisfaction.

Ans: True Page: 289 13. Retirement usually leads to tension and conflict in a marriage.

Ans: False Page: 289-290 14. Sibling ties are stronger between brothers than between sisters.

Ans: False Page: 291 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

15. In the future, older people will have fewer biological grandchildren than they do now.

Ans: True Page: 296 16. Divorced parents generally provide less financial aid and support to their adult children.

Ans: True Page: 295 17. Becoming a grandparent after retirement is becoming less common.

Ans: False Page: 296-298 18. Most grandparenting is performed by a grandmother.

Ans: True Page: 296 19. Widowers tend to fare better than widows in terms of continuing or establishing new social relationships.

Ans: False Page: 304 20. The “empty nest” is more common outside of North America.

Ans: False Page: 302-303 21. The topic of family ties of older gay and lesbian adults is understudied.

Ans: True Page: 299 22. Gay and lesbian adults have similar levels of family support in later life to heterosexual adults.

Ans: False Page: 299 23. Older LGBTQ adults often face discrimination in terms of unequal access to services because of care-worker attitudes.

Ans: True Page: 300 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

24. In later life, most adults who never married report that they are lonely and socially isolated.

Ans: False Page: 300 25. Childless older adults report having low levels of well-being and inadequate support networks.

Ans: False Page: 301

Short Answer Questions 1. What is family?

Ans: The family is one of the major social forces in our lives. Indeed, it influences us from birth to old age in profound and fundamental ways. While there is no singular definition of “the family” due to its diversity and ideological underpinnings, Mitchell (2012, 11) states that the term families can be “used in a fairly broad sense to refer to a group of people who have intimate or close social relationships and a shared history.” In an effort to reflect the diversity of family forms found in Canada, the Vanier Institute of the Family (2016, 1) defines “family” as: “Any combination of two or more persons who are bound together over time by ties of mutual consent, birth and/or adoption or placement and who, together, assume responsibilities for variant combinations of some of the following: physical maintenance and care of group members; addition of new members through procreation or adoption; socialization of children and throughout one’s life; social control of members; production, consumption, distribution of goods and services; and, affective nurturance—“love.”

Page: 282 2. Why is the “sandwich” generation part myth, part fact?

Ans: The sandwich generation is part myth, part fact—that is, relatively few middle-aged women are employed full-time, have a child at home, and have an aging parent who needs daily help, supervision, and care. However, those who provide caregiving to a parent and child simultaneously, without “working,” are a more common form of “sandwiched.” Analysis of the 2012 General Social Survey shows that about 4.5 million Canadians aged 45 and over provide care to a family member or friend with a long-term health condition, disability, or aging needs (Sinha 2013). This represents a 20 per cent increase over the five-year period between 2007 and 2012. Furthermore, about 28 per cent of these caregivers can be considered sandwiched because they provide both caregiving and childrearing to children under 18 living at home (Sinha 2013, 41). The average number of hours of care per day remained stable over the 2007 to 2012 period at approximately three hours per day. While a significant majority (95 per cent) of middle-aged and older caregivers (45+) state that they were coping with these responsibilities, and most (92 per cent) found it rewarding, about 28 per cent felt somewhat or very stressed with these duties, which increased with the number of caregiving hours. In addition, over half had felt tired over the last 12 months thanks to caregiving; about one-third felt irritable, overwhelmed, or Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

depressed or that they had lost sleep; and about 40 per cent of those who were employed experienced work disruptions (Sinha 2013; Turcotte 2013). Of course, the reported outcomes likely depended on both the intensity and the type of care that was provided. In Chapter 12, we discuss possible types of support for these sandwiched individuals. As for the future, Williams (2005) suggests that the associated stress and the number of sandwiched persons may grow when the boomer generation requires care because of their large numbers, increased life expectancy, longer work histories (later age at full retirement), lower fertility rates (fewer adult children to provide care), and delayed and later marriages because of their children, who will be more likely to have children of their own at home by that time. As well, there may be more sandwiched Canadians in their sixties caring for elderly parents who experience a “cluttered” nest when their adult children return home, sometimes with grandchildren (Mitchell 2017). This suggests that caregiving is a complex, multi-faceted, and fluid phenomenon that requires consideration along many social dimensions.

Page: 283 3. In what ways have discontinuities and irregularities in the traditional family life course resulted in a social reconstruction of the family?

Ans: Family structures and relationships are more fluid and diverse due to divorce, single parenting, permanent family conflict, remarriage, childlessness, never-marrying, engaging in serial or long-standing common-law or cohabiting partnerships (whether same-sex or oppositesex), and the return of adult children to live in the family home (because of educational pursuits, unemployment, divorce, illness, or preference). Thus, we use the term family in this broad sense whereas kinship refers to lineage through blood or marriage, although there is some overlap in the two concepts.

Page: 284 4. What is meant by a “grandfamily” household? How can this phenomenon affect older persons?

Ans: “Grandfamily” households are those in which a grandparent replaces biological parents.

Their number is increasing because of family crises, substance abuse problems, more divorces, and increased reporting of child abuse and neglect. This is especially common in Sub-Saharan Africa, where mortality due to the spread of AIDS has resulted in many skipped or grandfamily households. Within the North American context, grandparents raising children often view themselves more as a parent involved in education and discipline and as an authority figure than as a grandparent who can indulge and entertain the child. The entry of a grandchild into a grandparent’s household can create stress and uncertainty for older people. It changes their retirement plans and reduces their retirement savings; it interferes with their customary leisure and social activities; and it can harm the caregiver’s health and lower marital satisfaction.

Page: 298 5. What kind of information do we need in order to understand the family or kinship (lineage) structures and relationships across the life course?

Ans: To understand and describe family or kinship structures and relationships across the life course, we need the following: the number of generations and the fertility rates and timing of births in each generation; the relative age difference between and within each generation (ageAging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

condensed or age-gapped); the gender composition of each generation; the number of single, never-married individuals in each generation; and, marital patterns resulting from divorce, widowhood, remarriage, and cohabitation.

Page: 286-287 6. What are the myths and misconceptions about the structure of Canadian families over time—in particular, the view that multi-generational families were common in the past?

Ans: There are many myths and misconceptions about the structure of Canadian families over time. During the first half of the previous century, multi-generational families were not common because of lower life expectancies. Grandparents seldom survived to see their grandchildren marry or have children. However, as health improved and longevity increased, family structures became longer, and at least one member (usually a woman) in the oldest generation often lived into his or her eighties. Then, after the baby boom, fertility rates declined, and each generation became narrower. As well, more women entered the labour force, more men and women delayed marriage, and more divorces occurred. Consequently, average age at marriage and age when a first child was born shifted to the later twenties or thirties. As well, more women did not marry, and more couples did not have children. Some couples married, had children, and then divorced; often, one or both partners remarried, thereby creating another branch to an existing kinship system.

Page: 286 7. What are four major changes in family and kinship structures that have occurred in recent decades?

Ans: Students are asked to identify four major changes but the textbook lists six. (1) The kinship system has become longer, with more vertical ties and intergenerational relationships, resulting in more complex family relationships. (2) A shift from an “age-condensed” structure to an “agegapped” structure in some extended families. (3) The emergence of truncated families in which a specific family lineage eventually disappears when the youngest generation is childless by choice or by chance. (4) The increased number of reconstituted or blended families as a result of remarriage following divorce or widowhood. (5) The propensity for older adults to cohabit as partners. (6) The increase in same-sex partnerships in middle and later adulthood.

Page: 286–287 8. What are four factors that influence family relationships?

Ans: Four factors influencing family relationships are as follows: (1) the number of relatives available and the nature of their relationship to the older person; (2) the past and present patterns of contact and interaction (how many and how frequent) between older persons and available kin; (3) the quality of family relationships across the life course, ranging from a supportive and emotional caring relationship (parent to infant, or adult child to parent) to an abusive or neglectful relationship; and, (4) the types of communication, assistance, and support given and received among members of different generations and in what direction the exchange flows.

Page: 287

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9. What is the role of the kin keeper?

Ans: The kin keeper ensures that members of the family keep in touch with one another, reminds people about birthdays, coordinates the care of a sick or aging family member, and keeps in touch with various relatives by telephone, letter, email, or visits. Much of this responsibility within the extended family is assumed by a grandmother, an older daughter, or a daughter-in-law. The kin keeper often serves as a confidant or caregiver for aging parents or other family members, thereby providing care, emotional support, and advice within the extended family.

Page: 288 10. What is the importance of gender in later-life family relationships?

Ans: The importance of gender in later-life family relationships is partially related to the fact that women are more involved in expressive than in instrumental relationships at all stages of life.

Although sons act as caregivers in the absence of daughters, they tend to provide less personal care. Aging parents without a daughter may be at a disadvantage in the later years when they need assistance. For example, parents may receive financial aid from a son to hire a homemaker or nurse, or help with transportation or heavy work around the house, but they are less likely to receive personal care, care management, and medical treatment, which a daughter might provide.

With some men becoming more involved in family responsibilities throughout the life course, they likely will assume increased responsibilities for the monitoring and care of aging parents.

Page: 288 11. How does social class impact the frequency and nature of intergenerational relationships?

Ans: Social class has a marked effect on the frequency and nature of intergenerational relationships. Regular face-to-face visits are more common among those in the lower classes because of greater geographic proximity, in part as a result of less career mobility. Members of the higher social classes keep in contact more by phone and email and offer financial rather than instrumental assistance to their aging parents.

Page: 288 12. How can racial and ethnic background influence family relationships across the life course?

Ans: Racial and ethnic background can have a strong impact on family relationships across the life course. Most studies of ethnic or racial-minority families have found that there is greater obligation and dependence on kinship ties than in mainstream society for social relationships, housing, personal care, and financial support, especially in the later years. Perhaps because of minority-group status and unique cultural values, a closely knit extended family—rather than friends or social organizations—serves as the primary resource for assistance and support. But this dependence on family creates a stressful paradox for older members, especially those who are widowed. Elderly parents in immigrant families are well integrated into the kin network, often living in a child’s household. But they often report feeling lonely, isolated, and bored in this type of living arrangement. Many are dependent on kin for emotional, social, and financial support, and some report that they are just servants for their children and grandchildren. If they

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do not speak English or French and if they live in non-ethnic, suburban communities, with no contact with age peers from their cultural group, the family may be their only social contact.

Page: 288–289 13. How does marital satisfaction change over the life course and why?

Ans: While cycles of satisfaction and dissatisfaction are likely to occur in any marriage, two general but different patterns of satisfaction are reported across the life course. First, there may be a gradual decline in marital satisfaction through all stages of the marriage that may or may not lead to separation or divorce. The second, alternative pattern, with variations in the slope reflecting the time at which changes begin is curvilinear. These two patterns are supported by both anecdotal reports and research findings. There is continuing debate as to whether satisfaction is actually higher in the later years than it is during the early years before children are born.

Page: 289-290 14. Why are sibling relationships important for older adults?

Ans: Sibling relationships represent a long-lasting family bond, with a shared genetic and cultural heritage from early childhood to death, and usually last longer than any other family tie. In later life, these relationships are an important source of companionship and mutual emotional and instrumental support. Although only a minority of siblings report that they receive support from a brother or sister, many report that their siblings are an available source during a crisis, especially if they live nearby Page: 290–292 15. What patterns are possible for sibling relationships across the life course?

Ans: Sibling relationships can follow five possible patterns: (1) frequent interaction in the family home during childhood and adolescence, then little or no interaction after leaving home; (2) frequent interaction in childhood continuing throughout the life course if they are “best friends,” especially along a sister–sister or brother–brother link, and if spouses get along well; (3) a slow drifting apart during adulthood after entering the labour force and getting married; (4) renewal of contact and closeness in later life; and, (5) conflict in later life, sometimes due to issues related to inheritance or caregiving responsibilities.

Page: 291 16. What are four main issues concerning relationships between older parents and adult children that have been emphasized in recent years?

Ans: Four issues concerning relationships between older parents and adult children are as follows: (1) the amount of contact and the quality of interaction while an aging parent is independent, healthy, and mobile; (2) the type and amount of exchanges provided by aging parents to adult children who experience a crisis or traumatic event, such as a divorce, the death of a child, or a child with a serious illness, unemployment, or widowhood in early or middle adulthood; (3) the amount and quality of support provided to cognitively or physically frail parents who require increasing levels of physical, emotional, or financial assistance in the later Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

years; and, (4) the shocking finding that while it is not common, family members, rather than care workers, are the most frequent perpetrators of elder abuse, fraud, or neglect.

Page: 295 17. In what ways are gay and lesbian relationships disadvantaged in terms of family support?

Ans: The traditional kin network available to older gays and lesbians is generally small, and the composition depends very much on their personal history. Some have children from a failed heterosexual marriage, through adoption of a child as an individual or as a couple, or, for lesbian couples, through artificial insemination of one partner. Hence, children may be available for companionship and support throughout the middle and later years of life. Available research also suggests that gay and lesbian adults are often estranged from or rejected by family members and may have little or no family support in later life. In fact, many enter later life with a legacy of stigmatization, marginalization, and discrimination.

Page: 299-300 18. What are the differences between older never-married women and older never-married men?

Ans: Older never-married women are likely to be highly educated and to have earned a pension and achieved economic independence. They do not perceive being single as a stigma because their identity as a single person was defined and accepted much earlier in life. In contrast, many older single men have little education and are less financially secure than married men of the same age.

Page: 300-301 19. What are the reported advantages and disadvantages of being childless in later life?

Ans: Advantages: fewer worries and problems, more financial wealth, and greater freedom.

Disadvantages: lack of companionship, lack of support and care, and missed experiences and thus feeling incomplete (most likely to be reported by women).

Page: 301 20. What are the characteristics of the “empty nest” in North America in contrast to developing countries?

Ans: The empty nest is less common outside of North America. Because of a housing shortage in many countries, single children remain at home until they marry, and living on one’s own or with roommates is much less common. In many developing countries, in parts of Europe, and especially in Asia, where filial piety remains a revered family value, it is common for one child, even if married, to form a household with his or her parents. While there is a similar trend for parents in some ethnic groups in Canada, recent transformations in family structure are also altering the empty nest experience for ethnic families. As well, the empty nest experience is different across ethnic groups. Mid-life persons of Indo (South-Asian) descent, for example, report more negative feelings associated with this family transition than those of Chinese, Southern European, and British descent ethnic groups.

Page: 302

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21. How can divorce affect men and women differently in old age?

Ans: A divorce is especially traumatic for a man when it is initiated by his wife at or about the time he retires because he loses two sources of companionship and social support at the same time. Increasingly, because of the mandatory sharing of accumulated marital assets (including savings, property, and pensions) in divorce settlements, older women are less disadvantaged financially by a divorce than they were in the past. This is especially true if they have had a career and are entitled to their own pension plus a share of their former husband’s pension if their assets are lower.

Page: 304 22. How can widowhood affect men and women differently in old age?

Ans: Among those 80+, a majority of women compared to a minority of men are divorced.

Becoming and being widowed in later life is primarily a gendered experience. For many if not most older married women, it is an “expectable life transition” because of gender differences in life expectancy and the tendency of women to marry men older than they are. For many women, widowhood is often preceded by periods of caregiving and the institutionalization of a partner.

Most studies of widowhood have concentrated on how widows adjust to a change in their financial situation and on their social and psychological adaptation to living on their own.

Page: 304 23. What is meant by the phrase “intimacy at a distance” and why do older adults prefer it?

Ans: Rather than live in the same home as their adult children, most older people prefer “intimacy at a distance”—that is, living independently yet being close enough to visit. Even when health or financial losses force older people to leave their family home, they still prefer some form of independent living and view co-residence as a burden to their family. In contrast, older members of some ethnic groups (e.g., East or South Asians) prefer to live with their children where they are rooted in long-standing cultural traditions, or they do so because they have no choice owing to financial or health reasons. Highlight 9.1 on page 285 illustrates “intimacy at a distance” and why five older persons in Ottawa selected an independent life in a seniors’ residence rather than live with one of their children.

Page: 284 24. How might widows and widowers engage in identity work to adapt to being single again?

Ans: If a woman’s identity has been closely linked to her husband’s status and occupation, she may have difficulty changing from this identity to that of a single person. A woman must engage in identity work to determine “who she is now, given who she was” while attempting to rebuild her sense of self, her life, and her social world (van den Hoonaard 2001; Chambers 2005). In same- or opposite-sex common-law unions, surviving partners experience much the same grieving process, but rebuilding an identity, renegotiating relationships, and not having legal rights make the process somewhat different and often more difficult. The widowerhood experiences of older men have begun to receive attention in recognition of the unique experiences that are tied to their masculinity (van den Hoonaard 2010). While in the past widowers were often depicted in negative terms (i.e., as helpless and desolate), it is becoming Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

apparent that older widowers adapt to this new role in diverse and often positive ways, albeit not as well as women in many cases.

Page: 305) 25. How does the relationship between grandparents and grandchildren change after a milestone event?

Ans: The textbook looks at two major events that could impact grandparent-grandchild relationships: divorce or the grandparent entering a care facility. (1) The divorce of an adult child can change relationships with grandchildren. Usually, the daughter gains child custody (although shared custody is becoming more prevalent), and the maternal grandparents often become more involved through support and financial assistance. In contrast, paternal grandparents are more likely to have less contact, or perhaps none, with their grandchildren, especially if the custodial parent moves to another community or remarries and a new set of step-grandparents assume the grandparenting role. Grandparents may have to acquire legal visitation rights through the courts if they are not allowed to see their grandchildren after a divorce. (2) If one or both grandparents move to a residential-care facility, the relationship with their grandchildren often changes. In many cases, active grandparenting ceases when the older person enters a nursing home. Some child daycare centres have been located within or adjacent to retirement or nursing homes to create new opportunities for companionship for both preschool children and older people.

Through intergenerational programs, elderly volunteers teach or play with preschoolers, acting as surrogate teachers or grandparents or simply as older friends and confidants.

Page: 297-298

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Chapter 10

Later Life Work, Retirement, and Economic Security Multiple Choice Questions 1. Who is most likely to work beyond age 65? a) Women b) Poorly educated people c) Self-employed people d) Those employed in manufacturing and fabrication Ans: c Page: 317 2. What is the average age of retirement in Canada? a) 61.5 years b) 63 years c) 65 years d) 68.5 years Ans: b Page: 317 3. Which of the following statements is false? a) The Canadian labour force is becoming more highly educated b) The Canadian labour force is shrinking in size. c) There is a trend towards earlier retirement by older workers. d) Women are more likely than men to work beyond 65 years of age.

Ans: d Page: 317 4. Which of the following statements regarding women in the labour force is true? a) Women are less likely to leave the labour force if they are required to care for a frail parent. b) Married women are more likely to work, to work full time, and to work later in life. c) Women entering the labour force today face more discrimination than previous cohorts. d) Career paths for women are closely linked to family responsibilities.

Ans: d Page: 320-321

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5. After years without a promotion, Sandra took an early retirement package when her employer downsized her position and pressured her to take the package instead of re-training. After doing so, she decided to go back to school for a Master’s degree in her field because she wasn’t ready to stop working. After graduating at 58, she found there were fewer opportunities for older workers in her field and no one was willing to hire her. What is Sandra most likely experiencing? a) Feminization of poverty b) Inequality c) Age discrimination d) Market decline Ans: c Page: 321 6. Which of the following statements about older workers is true? a) The stereotypes surrounding older workers are often a function of the age of the evaluator. b) Productivity declines with age. c) Declines in physical or cognitive ability are rarely fully compensated for by experience in the labour force. d) Attitudes towards older workers are expected to get worse as the workforce continues to age.

Ans: a Page: 322 7. Which of the following is a limitation of the largely successful Targeted Initiative for Older Workers (TIOW) program? a) There was a too much formal, ongoing support following the end of participation in the program. b) There was a lack of formal, ongoing support following the end of participation in the program. c) Many of the program activities decreased job seekers’ self-efficacy beliefs. d) Many of the program activities strengthened job seekers’ self-efficacy beliefs.

Ans: b Page: 324 8. What is the contingent workforce? a) Working casually or seasonally through short-term contracts or consulting, leading to retirement b) Working for lower pay in order to avoid being laid off or forced into retirement c) Working in positions that rely on collective bargaining for pay, benefits, and retirement options d) Working for a salary provided by social security payments rather than by the employer Ans: a Page: 325 9. Which of the following is true for women preparing for retirement compared to men?

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a) Women retire with more financial resources. b) Women reach retirement with a less linear work history. c) Women and men have a similar work and family history. d) Women are more prepared for retirement.

Ans: b Page: 330 10. Which of the following is true for women preparing for retirement compared to men? a) Women retire with more financial resources. b) Women reach retirement with a less linear work history. c) Women and men have a similar work and family history. d) Women have more preparation for retirement.

Ans: b Page: 330 11. The Pension Act of 1918 provided financial assistance to whom? a) Men only b) Wealthy people only c) War veterans only d) Government employees only Ans: c Page: 331 12. What was the first truly universal pension plan in Canada? a) Old Age Security b) The Canada Pension Plan c) The Old Age Pension Act d) The Guaranteed Income Supplement Ans: a Page: 331 13. Most pension systems are designed to replace approximately what percentage of a person’s preretirement income? a) 30 per cent b) 50 per cent c) 70 per cent d) 90 per cent Ans: c Page: 332 14. Which of the following statements about pension income is true? a) An income security system helps eliminate income inequality later in life.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

b) The current economic and social security systems are likely to become bankrupt in the future. c) CPP/QPP beneficiaries can expect to receive approximately 50 per cent of their average preretirement wage. d) The income security system is more generous to those at or near the bottom of the socioeconomic scale.

Ans: d Page: 332 15. Which of the following is not an aspect of private retirement plans? a) Employer/employee contributions b) Individual savings c) Canada Pension Plan contributions d) Investments Ans: c Page: 332-339 16. What are the two types of employer pension plans? a) Registered retirement savings plans (RRSPs) and defined savings plans (DSPs) b) Defined retirement plans (DRPs) and retirement savings plans (RSPs) c) Defined benefit plans (DBs) and defined contribution plans (DCs) d) Registered retirement savings plans (RRSPs) and defined benefit plans (DBs) Ans: c Page: 334 17. At what age is an older citizen eligible for Old Age Security benefits? a) 60 b) 65 c) 67 d) 70 Ans: b Page: 336 18. Increased affluence and health among older adults has led to increased advertising and to the marketing of products for which market? a) The boom market b) The grey market c) The capitalist market d) The aging market Ans: b Page: 341 19. Which of the following is true with regards to women’s working lives compared to men’s?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

a) They earn more. b) They save more. c) They invest less. d) They own more property.

Ans: c Page: 342 20. Which of the following has caused an improvement in the economic situation of older women? a) Lower education levels b) Shorter periods in full-time jobs c) More wage discrimination d) Increased pension eligibility Ans: d Page: 342 21. Which term refers to the gender gap that makes women particularly at risk of living in poverty? a) Lady-poor b) Economic femininity c) Feminization of poverty d) Gender ghetto Ans: c Page: 342 22. Which of the following have been used as a measure of poverty? a) LICO and GDP b) LICO and LIM c) GNP and GDP d) LIM and GDP Ans: b Page: 344-346 23. Which measure of poverty is not an absolute measure of poverty but, rather, a relative measure of how individuals or subgroups of the population compare at a given time? a) The low-income cut-off b) The low-income measure c) The low-income after-tax measure d) The market basket measure Ans: a Page: 344 24. Which of the following factors increases the likelihood of poverty in later life? a) High levels of education b) Good health Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

c) Living as a couple d) Being female Ans: d Page: 347 25. Which approach merely pits one generation against another, and oversimplifies multi-faceted aging processes? a) Generational conflict approach b) Ecological approach c) Ageist approach d) Policy-centric approach Ans: a Page: 348

True or False Questions 1. Retirement emerged as a social institution with the establishment of social security payments in welfare states.

Ans: True Page: 325 2. Most research finds that more than 70 per cent of respondents have a great deal of trouble adjusting to retirement.

Ans: False Page: 329 3. Men are more likely than women to work beyond 65 years of age.

Ans: True Page: 317 4. Today, there is increased individualization of the work life.

Ans: True Page: 314 5. Many young people today are entering the labour force at a later age than their parents did.

Ans: True Page: 316

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

6. The participation rate of women in the labour force has decreased dramatically in the past few decades.

Ans: False Page: 319 7. The Canadian labour force is shrinking in size.

Ans: True Page: 317 8. People with less education are more likely to work past the age of 65.

Ans: False Page: 317 9. Productivity in the work force is inversely associated with age.

Ans: False Page: 322 10. There is no longer a biological or social basis for those in their 40s and 50s to be considered “older workers.”

Ans: True Page: 321 11. Declines in physical or cognitive ability in older workers are often compensated for by experience.

Ans: True Page: 322 12. Attitudes towards older workers are expected to get worse as the workforce continues to age.

Ans: False Page: 322 13. Discrimination against older workers is due largely to their personal abilities and chronological age.

Ans: False Page: 322 14. Studies show that productivity declines with age.

Ans: False Page: 322 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

15. Mandatory retirement can be described as an exit strategy to move older workers out of the workforce.

Ans: True Page: 319 16. Most Canadian provinces set a mandatory retirement age between ages 65 and 68.

Ans: False Page: 321 17. Negative attitudes about retirement are often based on a fear of financial difficulties in retirement.

Ans: True Page: 327 18. Economic security in later life is both a private and a public issue.

Ans: True Page: 330-324 19. The provision of economic security in later life was designed to shift responsibility from the state to the individual.

Ans: False Page: 331 20. Most pension systems are designed to replace 25 per cent of an individual’s pre-retirement income.

Ans: False Page: 332 21. Private retirement plans include individual savings.

Ans: True Page: 334 22. The economic status of Canadians has been declining over time.

Ans: False Page: 339 23. Many older people report that their basic need for goods and services decreases with age.

Ans: True Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 341 24. Women who were separated or divorced at age 45 or older were more likely to be poor later in life than either married women or men who divorced or separated in middle or later life.

Ans: True Page: 342 25. Canada has a high rate of seniors living below the low-income measure when compared to Australia, Germany, and Sweden.

Ans: False Page: 346

Short Answer Questions 1. What are the patterns resulting from recent transformations in the work force?

Ans: Recent transformations in the work force may result in the following patterns: More retirees have a great degree of economic security because of enhanced public retirement benefits.

There are more frequent and rapid shifts in the economy, leading to job losses, company mergers, downsizing, the outsourcing of work to other countries where labour is cheap, and fluctuations in retirement and pension plan investments. There is increased individualization of the work life: individuals, not just employers, make decisions concerning entry into and exit from the workforce based on personal interests, ambitions, and abilities to seek a “work–life balance.” There is increased education and labour-force participation among women. Gender relations are changing at home and at work: men are more involved in family responsibilities because of two-career couples; women are more involved in management and leadership positions at work.

Page: 314–315 2. Is the labour force greying? Explain.

Ans: The labour force is both aging and becoming more highly educated. In 2016, workers aged 55 or older made up 18.2 per cent of the total labour force, compared to 17.5 per cent in 2011, and 15.3 per cent in 2006. Furthermore, these rates were similar for women and men (Statistics Canada 2017a). The percentage of those 65 and over in the labour force also rose, from about 9 per cent in 2001 to 11.9 per cent in 2011 to 13.7 per cent in 2016 (Statistics Canada 2012; 2017b). This pattern is increasing as the baby boomers choose to work longer than previous cohorts (Carrière and Galarneau 2011; Bonikowska and Schellenberg 2013).

Page: 317 3. What are some of the demographic patterns related to delayed retirement?

Ans: Some of the demographic patterns related to delayed retirement are as follows: The employment rate for persons aged 55 and over reversed in the mid-1990s—declining from 1976 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

until the mid-1990s, and rising until 2010. While average age of retirement has remained relatively stable over the past two decades, and declined in the prior two decades, a more accurate method of estimation is to calculate average expected working life, similar to life expectancy calculations. This is because “average age” of retirement is a crude measure that is influenced by the large baby boomer cohorts transitioning from work to retirement and is more sensitive to early versus late retirements. Employed 50-year-old men can expect to work for approximately 16 more years, whereas women of that age can expect to work an additional 15 years. There is a significant increase in delayed retirement since the mid-1990s and an even longer expected work period than observed in the 1970s. Despite a small drop in the average work week for those aged 55 and over, there has still been a significant increase (87 per cent) in annual hours worked since 1997. Delayed retirement will increase economic sustainability in the face of population aging and will reduce population pressures on pension systems.

Page: 318 4. How can the projected shortfalls in labour supply over the next decades be offset?

Ans: The projected shortfalls in labour supply over the next few decades could be offset by recruiting and attracting highly skilled immigrants for specific occupations; by recruiting, training, or retraining younger and older workers for specific jobs; or by restructuring pension plans.

Page: 318–319 5. What interventions by employers have been proposed to retain or recruit older workers?

Ans: Proposed interventions by employers to retain or recruit older workers include, but are not limited to the following: improve the skills, motivation, and mobility of older workers; promote lifelong learning; adapt workplaces to workforce aging; facilitate access to more suitable and flexible forms of work for aging workers; remove age-discriminatory attitudes, policies, and practices; raise awareness of employers and human resource departments about the specific needs of older workers, including “at risk” older workers; and, implement job counselling and move employees to a new job that is better suited to their abilities.

Page: 319, 322 6. What are the features of the participation of women (and older women, in particular) in the labour force?

Ans: The participation rate of women in the labour force has also risen dramatically in the past few decades, with 61.3 per cent of women aged 15 and over in the labour force (compared to 70.3 per cent for men of that age) (Statistics Canada 2017b). In addition, the percentage of women working beyond age 65 has typically been very low but is increasing: the rate was 8.7 per cent in 2012, but had risen to 10.2 per cent by 2016; whereas for men aged 65 and over, the labour force rate was 16.9 per cent in 2012, rising to only 17.9 per cent in 2016 (Statistics Canada 2017b). Women tend to be clustered in occupations in the service-provision sector, while men tend to work in goods-producing sectors (Tannenbaum et al. 2016). Many women are employed in what are often considered traditional “female” occupations: clerical, sales or service, teaching, and nursing. However, with increased education and changes in gender roles, women have made inroads into most male-dominated occupations, with few exceptions. On average, however, women in these non-traditional occupations earn less than their male co-workers. In effect, Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

many occupations are becoming either more gender-neutral or gender-integrated, and some that were previously dominated by men are now dominated by women.

Page: 319 7. What factors contribute to the complexity of retirement transitions for women?

Ans: Cultural norms, structural inequities, historical events, and personal biographies (involving a partner, raising children, and caring for parents) influence the meaning of work and the career path for women more than for men. Thus, whereas studies of men’s involvement in work or careers focus almost exclusively on the work domain, to understand women’s involvement in work, we must look as well at their family situation across the life course. Although more childless and never-married women pursue continuous and successful lifelong careers, most women still acquire or assume family responsibilities or experience life transitions that significantly influence their work history—marriage, children, divorce, an empty nest, widowhood, and parent or grandchild care (McDaniel 2002; Moen 2012; Schein and Haruvi 2015). Many transitions into and out of the labour force are influenced by these family transition events. Consequently, some mid- and later-life work transitions for women represent a response to earlier unfulfilled life goals once a woman has fewer family responsibilities after her children leave home or if she becomes divorced or widowed.

Page: 320 8. How do governmental agencies often define “older workers?” What is potentially problematic about this definition?

Ans: “Older workers” are defined by most government agencies as those over 45 years of age.

Consequently, this category now includes the entire baby boom generation, most of whom are still in the workforce. Yet, with higher levels of education, improved health, and fewer strenuous jobs in most industries (because of automation and new technology), there is no longer a biological or social basis for those in their forties and fifties to be considered “older workers” or for age 65 to remain as the retirement age.

Page: 321 9. What characterizes age discrimination in the Canadian workforce?

Ans: While mandatory retirement has been virtually eliminated in Canada (the exception being New Brunswick), this has not eliminated age discrimination in the workforce. Age discrimination is manifested in stereotypical negative views of older workers held by employers and younger workers, in fewer opportunities for older workers to be trained or retrained, in fewer older workers being hired or promoted in open competitions, and in restructuring strategies that force older workers to accept an early retirement package. Once out of work, unemployed older workers take longer to find another job, receive a lower salary and fewer benefits than they did in their previous position, or find a new job that is only a contract position or temporary or seasonal work (NSC 2013). Some of these unemployed older workers eventually abandon the search for work and “slide” into retirement without ever returning to the labour force. Ageism in the workforce marginalizes older workers and increases their feelings of powerlessness.

Page: 321 10. Are older workers as useful as younger ones? Support your answer.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: Older workers are just as useful as younger workers, since most studies find that productivity does not decline with age, assuming average health and motivation. The amount and rate of any decline in physical or cognitive ability is highly variable. Where there is some decline, it is often compensated for by experience or adaptation. Adaptation varies among individuals at any age and is influenced by such factors as economic necessity, health, family demands, retraining opportunities and support, and the physical demands of the tasks. In short, there are individual differences in work-related skills and motivation among both younger and older workers.

Page: 321-322 11. What are four individual factors influencing retirement decisions and lifestyles?

Ans: There are many individual and societal-level factors that influence retirement decisions and lifestyles. Students are only required to list four but the textbook provides an extensive list in Highlight 10.4. Examples include but are not limited to (1) work history (regular versus irregular, full-time versus part-time); (2) partner’s work history and age; (3) economic status (earnings, savings, investments, entitlement to public and private pensions); and (4) health status (perceived, objective).

Page: 326 12. What factors help retired men and women adjust?

Ans: Individual adaptive strategies after retirement involve developing replacement roles and activities, adjusting to a perceived loss of identity and self-worth, adapting to new income and spending patterns, and re-establishing social relationships. If the retirement process involves an unstable exit via a series of “bridge” jobs or chronic unemployment after a stable career, there can be adverse effects on health.

Page: 329 13. What are the differences in retirement trends between men and women? How are women at a disadvantage when it comes to retirement?

Ans: Compared with men, women generally reach retirement “with fewer financial resources, less preparation for retirement, and a different work and family history” (McDonald and Wanner, 1990, 94). Many women enter and leave the workforce because of the gendered division of family responsibility for child-rearing or caring for parents or to follow a partner whose job required him to move to another city. Moreover, women are less likely to work fulltime, they are usually paid less than men, they are more likely to be employed in low-skill service positions, and they are less likely to have a pension.

Page: 330 14. Is there economic security for today’s older Canadians?

Ans: The economic status of older persons, in Canada and globally, ranges from extremely wealthy to very poor. In much of the world, especially developing countries, the economic status of older people is similar to that experienced earlier in life—namely, older people continue to live in poverty or near poverty. Brown (2011) contends that in comparison to the retirement Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

income in the countries of the Organisation for Economic Co-operation and Development (OECD: 34 European countries plus Canada and the US), retirement income among older adults in Canada has increased over time and is better than in most OECD countries.

Page: 330-331 15. What are the three levels of Canada’s retirement support system?

Ans: The three levels of Canada’s retirement support system are as follows: The first level includes three public-sector programs: Old Age Security (OAS), Guaranteed Income Supplement (GIS), and the Allowance (known as the Spousal Allowance [SPA] before commonlaw partners, including same-sex partners, were eligible for OAS and CPP benefits). The second level, also government-based, is the Canada Pension Plan or, for residents of Quebec, the Quebec Pension Plan. The third level includes private pensions and individual savings and investments. These elements require long-term planning and discipline if they are to ensure a secure financial future.

Page: 332-337 16. In regards to our retirement system, what challenges will Canada face in the next 20 to 30 years?

Ans: Important challenges we will face in the next 20 to 30 years include the following: an overall decrease in the size of the available labour force; a longer work life, as more years of work are needed to maintain sufficient income replacement in retirement; an ever-changing mix of philosophy, policy, practice (defined benefits versus defined contributions in private plans; the relative balance of private versus public pensions to provide adequate income), and legislation concerning the relative responsibility of the state and the individual to provide an adequate retirement income. (Should benefits be taxed or not? Should registered retirement savings plan [RRSP] annual contribution limits be increased?) These issues are classic examples of the debate as to whether private or public responsibility should be invoked and in what proportion.

Page: 331-332 17. What are the four options needed to maintain or enhance the economic viability of a public pension system?

Ans: The four options to maintain or enhance the economic viability of a public pension system are as follows: (1) Increase revenues by raising individual and employer C/QPP contributions, levying special taxes, or transferring more general government revenue to pension funds. (2) Decrease benefits by changing eligibility requirements, charging penalties or reducing the incentives for early retirement, eliminating partial indexing of pensions, raising the mandatory retirement age to delay payment and shorten the period for which benefits are paid and eliminating some benefits, such as the death benefit or the Allowance. (3) Shift the burden of financing pensions to individuals or to private pension plans by increasing the tax advantages of RRSPs. (4) Lower the dependency ratio by reducing unemployment rates through job creation and retraining; increase the labour force participation rate of older workers to delay or reduce the payment of pension benefits; provide a larger pension for those who remain longer in the labour force; eliminate discrimination in the hiring of and in the amount of wages paid to older workers; create incentives to increase fertility rates so that more workers are available in the Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

future; or raise immigration rates among young adults who will work in sectors where workers are needed.

Page: 338 18. What characterizes the economic status of older people in Canada?

Ans: The economic status of Canadians has been improving over time, whether we examine income replacement ratios, poverty rates, or actual income. One reference point is to compare income replacement against the average income level in a country, and to compare Canada against other countries. Canada’s figure is close to 90 per cent (meaning that retirement incomes are 90 per cent of the average income, or just below), which is at the high end of OECD countries. The financial well-being of retired people is also improving because of public and private pension reforms, greater incentives to save and invest, increased in-kind transfers and tax benefits for retirees, increased participation in private pension plans, especially by women, and greater financial planning earlier in life.

Page: 339–340 19. What is the “feminization of poverty”?

Ans: The gender gap in later life with regards to poverty levels—labelled as the “feminization of poverty”—can apply at earlier stages of life as well, especially for women who are single parents.

Most elderly women who are poor are not likely in this situation because they created their own poverty but because society creates gender-based inequalities that have economic consequences, creating a cumulative disadvantage over the life course. Women reach later life with fewer economic resources because, if married, they are economically tied to their husband’s wealth; because they lose economic capital if they are divorced; and because they have not been employed full-time throughout most of their working life.

Page: 342 20. In terms of pension reform, what are some of the proposed solutions to enhance benefits for women?

Ans: In terms of pension reform, some proposed solutions to enhance benefits for women include the following: provisions to allow women to accumulate pension credits when they are absent from the labour force to look after their children or parents; C/QPP pension eligibility for part-time workers; continuation of pension benefits to a surviving spouse, regardless of later marital or economic status; a requirement that private pension plans be offered by all employers, regardless of the size of the company; unisex tables for the calculation of retirement contributions and benefits; and, mandatory coverage in private plans for all permanent part-time employees on a prorated basis.

Page: 330–331 21. In Canada, what is the extent of poverty among older people?

Ans: Since the 1960s, the real income of seniors has risen substantially (and rates of poverty have dropped) in both absolute and relative terms compared to non-elderly persons. The poverty rate among seniors in Canada was the fifth lowest among the OECD countries. But despite economic gains in recent decades, income inequalities persist among older people.

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Page: 344 22. What is the most common and oldest measure of relative poverty in Canada?

Ans: The most common and oldest measure of relative poverty in Canada is Statistics Canada’s low income cut-offs (LICOs). This measure, which is adjusted annually according to the consumer price index, is based on patterns of family expenditures for food, clothing, and shelter for a given community size and family size. It is not an absolute measure of poverty but, rather, a relative measure of how individuals or subgroups of the population compare at a given time; it identifies those who are less well-off than the average for their family size and within their geographical region.

Page: 344 23. What is the low-income measure (LIM)?

Ans: Another common measure of poverty is the low-income measure (LIM) generated by Statistics Canada since the early 1990s. This is a much simpler measure that draws the lowincome line at 50 per cent of the median family or single income in Canada, after tax and transfers. This measure is adjusted for family size and is a common definition of “relative poverty” (Statistics Canada 2016a). This measure, which reflects an inability to pay for groceries, rent, and transit fares, is used to compare year-over-year changes in Canada and to compare poverty levels in Canada with those in other countries. Using the LIM after-tax low-income measure (also called the LIM-AT), the poverty rate among the elderly in Canada dropped significantly between the 1970s (approximately 35 per cent) and the mid-1990s (3 per cent) but has risen again to about 14.5 per cent in 2014 (16.7 per cent for older women and 12 per cent for older men) (Statistics Canada 2017e). More extreme gender differences exist across particular family types.

Page: 346 24. What is an example of an absolute measure of poverty? Briefly describe how this measure assesses poverty.

Ans: Human Resources Development Canada has developed an absolute measure of poverty that is a “market basket” measure of poverty – the poverty line is based on the income needed to purchase basic goods and services in the basket, is calculated for a typical family of four (family of two adults aged 25 to 49 and two children aged 9 and 13) based on a variety of geographical areas (Statistics Canada 2016a, 2017d). This absolute measure of poverty identifies families whose disposable income—total income minus taxes, payroll deductions, support payments, child care, and out-of-pocket medical expenses—does not enable them to purchase a basket of basic goods and services consisting of food, clothing and footwear, shelter, transportation, and other goods and services, including furniture, telephone service, and postage stamps. Being able to pay for this basket of goods represents the minimum standard for decent living in Canada. This measure generates a higher reported poverty rate in most communities than does the LICO measure.

Page: 346 25. What is the Targeted Initiative for Older Workers? How effective is this program?

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: The Targeted Initiative for Older Workers (TIOW) is a federal government program aimed at helping unemployed workers aged 55 to 64 living in small communities re-enter the labour force through training programs that are co-funded by the federal and provincial governments. A total of 287 projects (60 new ones and 227 renewed) were delivered across Canada. According to the evaluation report, overall the TIOW program was effectively designed and delivered to help older workers re-integrate into employment. Despite the overall positive program evaluation, several limitations were noted: (1) Many of the program activities strengthened job seekers’ selfefficacy beliefs; however, job goals were not consistently clarified nor set with participants.

When goals are clearly defined, a focused search strategy generally produces more positive employment outcomes. (2) The most successful programs for older workers provide some form of marketing of older workers to employers. Not all projects marketed participants to employers or established partnerships with potential employers. (3) A high level of ongoing, positive peer support motivates participants that is positively co-related with job-search intensity. There was a lack of formal, ongoing support following the end of participation in the program. (4) Labourmarket programs for older workers should include the careful identification, screening, and selection of its participants, since the processes and tools used for assessment vary from one jurisdiction to another, and some assessments are more robust than others.

Page: 324

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Chapter 11

Social Participation, Social Connectedness, and Leisure among Older Persons Multiple Choice Questions 1. According to Cutler and colleagues, which of the following encompasses volunteering on behalf of formal organizations, including schools, churches, hospitals, and non-profit organizations; political participation; as well as informal acts such as helping friends, neighbours, and relatives? a) Civic engagement b) Social participation c) Social organization d) Civic entanglement Ans: a Page: 353 2. Which of the following is not a possible outcome of social participation? a) A perceived higher quality of life b) Positive aging c) A decline in well-being d) A sense of belonging to a community Ans: c Page: 353 3. Which term did the World Health Organization adopt as an ideal lifestyle objective for middleaged and older adults, which involves optimizing opportunities for health, social participation, and security in order to enhance the quality of life as people age? a) Social aging b) Active aging c) Healthy living d) Optimal living Ans: b Page: 354 4. According to Hendricks and Hatch’s personal resource model, meso-level factors that influence activity in the older years include which of the following? a) Genetic heritage b) Social class c) Social policies d) Political economy Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: b Page: 355 5. Which of the following statements regarding most elderly adults is true? a) Most elderly adults engage in varying degrees of interaction with their social networks. b) Adults with lower social status tend to have larger, more widespread networks. c) Elderly men tend to be involved in kinship networks. d) Most elderly adults have little to no contact with their social networks.

Ans: a Page: 356-360 6. Which of the following is true of most older adults? a) They are isolated. b) They are interacting socially. c) They are disengaged. d) They are alienated.

Ans: b Page: 356-360 7. Which of the following statements regarding the social networks of Canadian seniors is false? a) The network is generally comprised of about 15 per cent immediate family. b) The network is generally comprised of about 45 per cent immediate family. c) The size and composition of these networks vary by ethnicity, gender, etc. d) The membership and composition of a network represents those who are potentially available for interaction or support.

Ans: a Page: 357 8. Which of the following groups has the smallest and least intimate networks and, in later life, fewer sources of informal support? a) Married women b) Unmarried women c) Married men d) Unmarried men Ans: d Page: 358 9. Which of the following statements about older adults is false? a) Most older adults are not abandoned. b) With age, older people tend to distance themselves from family and confidants. c) For older adults, the “convoy of support” does not guarantee that interaction will occur. d) Unmarried older men have fewer sources of social support than married older men.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: b Page: 358-359 10. Which of the following statements about social interaction for older adults is true? a) A majority of older people report living in social isolation. b) Loneliness is a common experience among older adults. c) Interaction with others in later life is highly correlated with reported well-being and happiness. d) Few people over 65 remain engaged in productive activities into later life Ans: c Page: 360-363 11. Which of the following groups of people is more likely to report feelings of loneliness? a) Women b) Men c) Those engaged with other family members d) Those in good physical or mental health Ans: a Page: 360 12. Which of the following constraints does not reduce social involvement or leisure pursuits? a) Declining health and energy b) Loss of interest in specific activities c) Being married d) A decline in financial resources Ans: c Page: 362 13. Which of the following is not a societal constraint imposed on older adults regarding participation in social activities? a) When information about leisure opportunities is widely disseminated b) When local or regional norms and cultural values discourage the involvement of older adults in specific activities c) When there are no programs or facilities, such as senior citizen centres, especially in rural and inner-city areas d) When public transportation is inaccessible or unavailable Ans: a Page: 362 14. Which of the following statements is true? a) With age, people read more books and newspapers. b) Religious beliefs are negatively associated with age. c) Civic participation does not count as active and productive aging.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

d) The average number of hours among senior volunteers is more than double that of volunteers aged 25–34.

Ans: d Page: 363 15. Which of the following statements regarding issues of concern to older volunteers is false? a) Clients are becoming more difficult to serve. b) Clients are becoming more demanding. c) Volunteers are increasingly concerned about their safety. d) Clients are becoming more independent.

Ans: d Page: 364 16. Which of the following is not a reason that people volunteer their time? a) To meet people, expand their network, and avoid social isolation and loneliness b) To demonstrate dependence c) To assist other generations d) To share their knowledge, experience, wisdom, and skills Ans: b Page: 364 17. Which of the following is true about voting behaviour among older people? a) Voting behaviour is strongly related to old-age policy issues. b) Voting behaviour is strongly related to age-based interests. c) Older people could swing an election if they voted in concert. d) Older people vote as a block.

Ans: c Page: 366 18. Which of the following statements about religious participation is false? a) Attendance at religious services often remains stable across the life course. b) Roughly half of Canadians aged 65 or older attend a religious service at least once a month. c) Quebec is the most religious province. d) Religion and spirituality are positively related to health, well-being, and social support in later life.

Ans: c Page: 368 19. What is the relationship between literacy and old age? a) Those with lower literacy levels are exposed to more information and understand it better. b) Those with lower literacy levels experience lower mortality rates and better cognitive functioning in old age. c) Those with higher literacy levels experience better health in old age.

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

d) Those with higher literacy levels watch more television in old age.

Ans: c Page: 369 20. Linda and her partner Gwen retired within five years of one another and have now decided to embrace travel and tourism. They want to spend at least three or four months of the year away from their home in Edmonton but think they will be bored if they remain in one place during their time away. In planning their trip to Australia, they make sure they will be constantly on the move, covering many kilometres, including travel to remote areas of the outback, regardless of the risks involved. What term best describes Linda and Gwen? a) Snowbirds b) Grey nomads c) Recreational experts d) Leisure travellers Ans: b Page: 372 21. Which of the following is true about gambling behaviour among older adults? a) They are likely to become addicted to gambling. b) They are likely to quit gambling. c) They are likely to require counselling or treatment. d) They are likely to experience moderate to severe health or financial problems.

Ans: b Page: 374 22. Most criminal offences committed by older men involve which of the following? a) Sexual assault b) Shoplifting c) Drunkenness d) Fraud Ans: c Page: 375 23. Most criminal offences committed by older women involve which of the following? a) Vandalism b) Impaired driving c) Shoplifting d) Fraud Ans: c Page: 375

Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

24. Which of the following is defined by the participants, at a specific stage or point in time, to meet their social, cognitive, and emotional needs; to help define themselves; and, perhaps, to provide intrinsic rewards? a) Civic engagement b) Volunteerism c) Work–life balance d) Leisure Ans: d Page: 376 25. Which of the following statements about leisure is false? a) Leisure is defined by participants, at a specific stage or point in time, to meet their social, cognitive, and emotional needs. b) Leisure is a human universal, meaning it is a concept found in all known societies and cultures. c) Leisure provides intrinsic rewards to participants. d) Leisure has the potential to provide an individual with a sense of worth, identity, prestige, and status.

Ans: b Page: 376-377

True or False Questions 1. Approximately 15 per cent of people over the age of 65 have a gambling-related problem.

Ans: False Page: 371 2. Most retired adults want to be active, but many struggle with the meaning and form of activity.

Ans: True Page: 354 3. The size, density, and heterogeneity of our social networks can be represented by a curvilinear line across the lifespan.

Ans: True Page: 356 4. Social isolation represents a subjective evaluation of the situation people face when they perceive their network of relationships is small.

Ans: False Page: 360 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

5. Socially isolated persons are lonely, and lonely persons are socially isolated.

Ans: True Page: 360 6. The National Seniors Council Report identifies promising interventions to tackle social isolation and reconnect seniors to their communities.

Ans: True Page: 361 7. A convoy of support does not guarantee social interaction.

Ans: True Page: 358 8. Unmarried older men have fewer sources of social support than married older men.

Ans: True Page: 358 9. More older women than older men report being involved in volunteering.

Ans: True Page: 364 10. Higher literacy indirectly results in higher mortality rates and better cognitive functioning in later life.

Ans: False Page: 369 11. A person’s social network is partly influenced by his or her health.

Ans: True Page: 358 12. There is a cause–effect relationship between social isolation and loneliness.

Ans: False Page: 360 13. Loneliness is more likely to be reported by women.

Ans: True Page: 360 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

14. Very few older people live in isolation or report being lonely.

Ans: True Page: 353 15. Older people as a group are more conservative than other cohorts, which implies that they become more conservative with age.

Ans: False Page: 366 16. Membership in voluntary associations tends to be curvilinear across the life course.

Ans: True Page: 364 17. Older people generally have low voting participation rates.

Ans: False Page: 365 18. There is a curvilinear relationship between age and civic activity.

Ans: True Page: 366 19. Religious beliefs are negatively associated with age.

Ans: False Page: 368 20. Education is completed by late adolescence or early adulthood.

Ans: False Page: 369 21. Snowbirds in Australia are constantly on the move, covering many kilometres, including travel to remote areas of the outback, regardless of the risks involved in being alone as they pursue this lifestyle.

Ans: False Page: 372 22. Retirees represent big business for the travel industry and casinos.

Ans: True Page: 372-373 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

23. Leisure activities early in life often influence leisure involvement later in life.

Ans: True Page: 377 24. The stereotypical images of leisure pursuits in later life as sedentary and passive are largely true.

Ans: False Page: 378 25. The relationship between age and criminal behaviour is an over-studied sub-field in criminology.

Ans: False Page: 375

Short Answer Questions 1. How have older adults had to adapt to social changes in recent decades?

Ans: Older adults have had to adapt to social changes in recent decades by attaching less importance to work, with new meanings and greater importance being connected to leisure; shifting from a medical and disease treatment model of health to a health promotion and prevention model, which stresses the importance of “active living” or “active aging” as the ideal lifestyle; adjusting to technological forms of communication (e.g., cellphones, computers, social media); and, placing increased importance on participating in social networks to enhance health, well-being, and social integration into a community.

Page: 354 2. What is “active aging”?

Ans: The World Health Organization has adopted the term “active aging” as an ideal objective for middle-aged and older adults. This ideal lifestyle involves optimizing opportunities for health, social participation, and security in order to enhance the quality of life as people age.

Aging actively—and well—involves finding meaning and purpose in how time is spent, especially in the retirement years. One’s lifestyle reflects personal preferences and decisions (agency), modes of living, and social status whereby differences in personal, social, and structural circumstances yield different lifestyles.

Page: 354 3. How do social status and other demographics influence social networks as we age?

Ans: Adults with higher social status generally have larger, more widespread networks consisting of family, friends, and colleagues, whereas those from a lower-class background have smaller networks, mainly involving family and neighbours. Similarly, persons with specific racial, religious, ethnic, or cultural backgrounds, especially if they are recent immigrants, are linked to a homogeneous network primarily composed of their family and members of the same religious or Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

cultural group in the neighbourhood (Gaudet 2007; Jackson et al. 2011; NSC 2016). If most members of a racial or ethnic group have limited access to network resources, this could have a negative effect on their health outcomes over their life course.

Page: 358 4. Are loneliness and social isolation in later life myth or fact?

Ans: Loneliness represents a subjective evaluation characterized by the unpleasant feeling of lacking relationships or missing a certain level of quality communication in one’s contact with other people. Social isolation represents an objective evaluation of the situation people face when they perceive that their network of social relationships is small, or has decreased significantly, and that they lack relationships with other people. Loneliness is one possible outcome of perceived social isolation, but socially isolated persons are not necessarily lonely, and lonely persons are not necessarily socially isolated. Some people, even if they are embedded in a social network, may prefer to be alone and opt for privacy. Moreover, more supportive cultural and social norms about living alone and being independent in later life have changed the subjective perception of loneliness.

Page: 360–362 5. What are five constraints to social participation at the individual level?

Ans: Students are asked to describe five constraints but the textbook lists six constraints to social participation at the individual level. These include declining health and energy; loss of interest in specific activities; lack of a partner owing to illness, death, or divorce; a decline in financial resources and a loss of discretionary income; changes in the leisure interests or health of a spouse; and, an inability to drive or to use public transportation.

Page: 362 6. How do various forms of social participation contribute to life satisfaction in later years?

Ans: Interaction with others in later life is highly correlated with reported well-being, happiness, and life satisfaction. This does not mean that older people do not or should not engage in solitary activities, such as reading, watching television, or knitting. But it does imply that a mixture of group and solitary activities creates a balanced life that enhances well-being and both physical and mental health in the later years. Social activities provide an environment and a structure in which social networks can be maintained or created, thus enhancing a sense of selfworth.

Page: 362 7. What are four key findings from the National Seniors Council Report?

Ans: The National Seniors Council Report discusses four key findings: (1) Indigenous seniors, seniors who are caregivers, immigrant seniors, LGBT seniors, seniors living alone, seniors living in remote or rural areas, low-income seniors and those living in poverty, seniors with mentalhealth issues (including Alzheimer’s and other dementias), and seniors with health challenges or disabilities are all at risk of social isolation. (2) A two-pronged approach to addressing social isolation seems warranted, one that combines coordinated policy interventions that can facilitate social inclusion across the general population of seniors with targeted interventions. The concept Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

of age-friendly communities has the potential to underpin a range of interventions that fall within the scope of both approaches. (3) Research on social isolation would benefit from greater segmentation, increased reliance on mixed methods (qualitative and quantitative), conceptual clarity and consistency, and exploration of social isolation across the life course. (4) There is a need for more evaluation studies of different programs and approaches, and practitioners should be encouraged to build an outcome measurement component into all programs (though funding limitations can often make this difficult). In general, however, there is sufficient evidence to identify several common characteristics of successful interventions, as well as different types of interventions.

Page: 361 8. What are five constraints to social participation at the structural level?

Ans: Students are asked to describe five constraints but the textbook lists six constraints to social participation at the structural level. These include when information about leisure opportunities is not widely disseminated; when local or regional norms and cultural values discourage the involvement of older adults in specific activities, such as formal education, sports, or drama; when there are no programs or facilities, such as senior citizen centres, especially in rural and inner-city areas; when public transportation is inaccessible or unavailable; when government cutbacks limit age-friendly initiatives, such as green spaces; when expensive leisure pursuits are not subsidized; when a deteriorating and unsafe neighbourhood induces a fear of crime or a fear of falling so that older adults stay at home; when myths or negative stereotypes in the media promote the idea that older adults are not capable of or interested in studying and learning, becoming computer-literate, becoming physically fit, or dating.

Page: 362 9. What are the patterns of volunteerism among older adults?

Ans: Many people over 60 remain engaged in productive activities into later life through voluntary involvement in organizations and community groups or through informal contributions in the form of caregiving, social support, and donating money to family, friends, or neighbours. Other contributions provided by older adults include mentoring and counselling, providing leadership in community service organizations, volunteering in political parties and in religious organizations, and performing a variety of tasks or services related to one’s skill and experience (e.g., fundraising, home repairs, preparing tax returns, tutoring).

Page: 363 10. Why do people volunteer?

Ans: In general, people volunteer their time for the following reasons (among others): to meet people, expand their network, and avoid social isolation and loneliness; to be productive and contribute to society; to assist other generations; to share their knowledge, experience, wisdom, and skills; to advance a personal interest or cause; and, to acquire new skills.

Page: 364 11. What are the potential social benefits of volunteering?

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Ans: If not for volunteers, much of the unpaid help provided would have to be purchased by others in society or funded by the state. This is particularly true of caregiving. Moreover, from the perspective of a society or organization, volunteerism builds social responsibility; promotes social cohesion, integration, and assimilation (in the case of ethnic associations); builds social capital in a community or organization; creates a sense of community and belonging; provides social services (in the case of service and fraternal groups); and fosters social change (in the case of political activist groups or labour unions). Indeed, many voluntary groups are organized as advisory or advocacy groups to promote the specific interests and needs of older adults or retirees.

Page: 363 12. How have researchers attempted to quantify (by hours or dollars) the volunteering contribution of older people to Canadian society?

Ans: Various surveys have sought to quantify (by hours or dollars) the volunteering contribution of older people to Canadian society. The following patterns have been identified by Vézina and Crompton (2012), and Turcotte and Schellenberg (2007): Younger Canadians are more likely to volunteer than older Canadians. Over one-half of people aged 15 to 24 (58 per cent) and 35 to 44 (54 per cent) and close to one-half of those aged 25 to 34 (46 per cent) reported doing volunteer work in 2010. In comparison, pre-retirees aged 55 to 64 had a volunteer rate of 41 per cent in 2010 and seniors recorded a rate of 36 per cent. However, younger volunteers contribute fewer hours compared to older volunteers. The average number of hours among volunteers aged 15 to 24 was 130 hours; for those aged 25 to 34, it was 109 hours, but for senior volunteers it was 223 hours. This is likely due to younger people volunteering more for job experience (e.g., internship) and older people volunteering more for charitable organizations requiring more time.

Over three million retirees spend five billion hours each year on productive activities (paid and volunteer work), which represents a contribution to the Canadian economy of about $60 billion.

Page: 363 13. In what ways do older people commonly participate in politics?

Ans: As the older population has increased in size, and with each cohort that enters later life being better educated, more older adults report being involved as voters, as political candidates, as members of political organizations, and as political activists. While there is a general curvilinear relationship between age and civic activity, especially for voting behaviour, decreased involvement in later life is less pronounced today than it was 20 or 30 years ago. Much of the increased involvement among older people is accounted for by a significant increase in political interest and political activity among women.

Page: 365–366 14. What characterizes the activities and possible motivations of older adults who become political activists in later life, either individually or collectively?

Ans: Increasing numbers of older citizens who feel marginalized or isolated in the political domain are becoming political activists, either individually or collectively. That is, they engage in “self-advocacy” when governments ignore their interests or shift resources to other age groups, and when they perceive that they lack access to formal channels through which they could exert political pressure (Cutler et al. 2011). Moreover, under the guise of generational equity or the Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

influence of apocalyptic demography, politicians may not view older people as the “deserving poor” and begin to question the costs associated with population aging in terms of public pensions tied to inflation, long-term care, health care, social services, and housing (Walker 2006, 342). If older people feel ignored or discriminated against by politicians, they are more likely to engage in activist behaviour (demonstrations, lobbying, disrupting political speeches, withholding taxes). In other words, the aging of the baby boomers has created a large generation of older people, but this can both increase political power and compromise it due to intergenerational conflict and competition over scarce resources (Bramlett 2015). Age-based interest groups for older adults are created to generate visibility, to pool resources, and to lobby politicians on issues of concern, such as health care, housing, pensions, and transportation.

Beginning in 1958, the American Association of Retired Persons (AARP) is one of the world’s largest and most developed age-based interest groups, with over 40 million members (see www.aarp.org/). In Canada, a similar but much smaller organization (about 300,000 members) is called the Canadian Association of Retired Persons (CARP: see www.carp.ca). Most of these groups use researchers and marketing experts to develop factual and logical documents and to prepare effective advertisements or arguments on an issue. They also employ skilled lobbyists who generate media attention, mobilize seniors as necessary, and meet regularly with politicians and their staff to establish or keep an issue on the public agenda. Increasingly, these groups insist that they be consulted regularly, that they be given the right to contribute to royal commissions and other public inquiries, and that they be included on standing or ad hoc committees or as panelists at public meetings.

Page: 366-367 15. What can organized religion provide to older adults?

Ans: Organized religion provides some members of the older population with a sense of meaning and security, a readily available social and support group, and a sense of community that fosters social integration. It has been shown that religious attendance increases social integration and thereby decreases feelings of loneliness among older adults. Spirituality may assist, as well, in helping older people to cope with grief, changing personal situations, or death.

Page: 367 16. What is lifelong learning and why it is important to older adults?

Ans: In a knowledge-based economy, lifelong learning has become essential in the workforce because of rapid technological and social change. Lifelong learning also helps to prevent social isolation in the community and may help to increase a nation’s productivity if people engage in paid or volunteer work with upgraded skills and knowledge. It also increases life satisfaction and enhances subjective health. But learning has also become a major leisure activity during adulthood, especially as the level of formal education rises for each new cohort.

Page: 369 17. How do aging adults use media to receive educational programs?

Ans: The use of computers, television, or radio to deliver educational programs to older adults is increasing (Rogers and Fisk 2010). Cable television, pay-TV, and the Internet have the potential to provide learning experiences, intellectual stimulation, and social and commercial services for adults of all ages. Indeed, television and Internet shopping may serve the needs of housebound Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

older people in the future. As for “social media,” no studies as of 2018 have specifically examined the use of Facebook, Twitter, and so on, by older adults as a form of reducing social isolation.

Page: 369 18. What does gambling provide to older adults?

Ans: For many older adults, gambling is an enjoyable, non-serious leisure activity. It offers social interaction with others, an escape from boredom or loneliness, excitement and suspense, a safe way to “be bad,” and harmless entertainment in a socially acceptable setting. Currently, a visit to any casino in Canada, especially during the day or early evening, illustrates quite dramatically how many retirees are engaged in gambling, whether they are fully mobile or use a cane, a walker, or a wheelchair.

Page: 373–375 19. What characterizes gambling behaviour among older people? Is gambling addiction a problem among the older population?

Ans: Evidence is mounting that more older people are becoming addicted to gambling, although they are the least likely of all age groups to become addicted and to need counselling or treatment and are more likely to quit. As with all types of addictive behaviour, those afflicted are not aware that they have a problem, or if they are, they deny it or fail to seek help because they are embarrassed or do not wish to be labelled as a chronic or addicted gambler. In short, gambling addictions among the older population is a “hidden” issue, and the prevalence is probably highly under-reported. This type of addiction may start as a periodic social activity for fun that becomes a major activity, a habit, and a secret that can lead to loss of control and an addiction crisis.

Page: 373–375 20. What do we know about older criminals?

Ans: The number of criminal offences committed by older people is increasing, although the number of arrests and convictions is quite low. Only about 4.5 per cent of all incarcerated persons are 65 years of age or over (Public Safety Canada 2015). Of these cases, about 40 per cent are for violent offences, including sexual assault; 42 per cent, for property offences, such as thefts; and the remaining 18 per cent, for minor offences, such as disturbing the peace or driving while impaired. A conviction occurs in less than 60 per cent of the cases, since older criminals tend to be treated leniently by the courts: they are placed on probation or receive a fine or reduced sentence unless the crime involved violence or a firearm (Steffensmeier and Motivans 2000; Public Safety Canada 2015). In Canada’s federal prisons, approximately 24 per cent of the in-custody population is age 50 and over, and about 12 per cent of the population is over 60 years of age (Public Safety Canada 2011, 2015), but this includes a preponderance of prisoners who have aged in place, rather than entered prison as an older adult.

Page: 375 21. What are the benefits of leisure for older adults?

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Ans: Leisure, as an expressive rather than an instrumental domain of daily life, has profound meaning for those who do not find their identity in the world of work. Indeed, leisure has been associated with higher levels of self-esteem and well-being in older adults. Leisure, as well, is a domain of everyday life that illustrates the importance and potential of agency and autonomy and the reality and possibility of shifting priorities and interests over time.

Page: 376 22. How do longer lives and changing lifestyles influence leisure pursuits among older adults?

Ans: With longer lives and changing lifestyles, there is greater diversity in leisure pursuits, and new forms of leisure are emerging. As the baby boomers age, there will undoubtedly be even greater variety in the types of leisure activities that older persons engage in. There are both individual-level changes over time in agency, abilities, and interests as well as changes at the societal level in the structure and allocation of leisure opportunities, such as education, facilities, and programs. Thus, we are more likely today to see people from a lower-class background playing golf or enjoying fine art, women engaged in a wider array of leisure activities outside the home, and adults in their eighties who travel throughout the world and engage in physical activity.

Page: 376 23. Why has it been difficult to agree on a definition of leisure?

Ans: The inability to agree on a definition of leisure persists because it is a multi-dimensional concept, because activities have a variety of meanings or functions for an individual at different times in the life course, because individuals can engage in more than one leisure activity at a time, and because some activities fall into overlapping categories. Furthermore, people may consider leisure to be a non-essential, voluntary, not-for-profit activity, or others may view it as “big business,” for example, in the professional sport, travel, or entertainment industries.

Page: 377 24. How might leisure patterns change over time? What accounts for the patterns?

Ans: Changes occur in the relative balance between family, work, and leisure activities in our daily lives at different points in the life course. Hence, the way we use time for obligatory or discretionary activities varies. Individuals select leisure activities to fit their personal identity (how they define themselves) and their social identity (how they believe they are defined by others). We develop a “core” of leisure pursuits that persist throughout our lives, entailing solitary and/or group activities. These core pursuits may include such interests as the mass media, volunteering, cultural activities, tourism, and sports. Then, we pursue other activities that suit the needs or desires of our personal and social identity and our abilities and interests at specific stages in life. These latter activities change as roles, self-definitions, interests, occupations, competencies, relationships, and opportunities change (Gibson and Singleton 2012). Like many other aspects of social life, opportunities for leisure vary by income, gender, education, social class, ethnicity, health, employment, and marital status. Hence, as in other domains of our social and working lives, there is inequality in leisure. Structural constraints (gender, socio-economic status, place of residence) or lack of personal resources mean that some adults are not able to spend their leisure time as they might wish.

Page: 376 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

25. What stereotypes are common regarding seniors and leisure pursuits? How are today’s seniors challenging these stereotypes?

Ans: The stereotypical images of leisure pursuits in later life as sedentary and passive are being cast aside by “senior” role models, male and female, who volunteer, travel, attend university to earn degrees, and engage in such competitive sports as marathon races, hockey, windsurfing, skiing, and weightlifting. These new images fit with the known physical and cognitive capacity and potential of older adults and with the idea that leisure activities, especially outside the home, provide an opportunity for social relations. Students may also reference the story of David (featured in Highlight Box 11.7 Agency in Later Life: Toward a New Lifestyle on pages 379– 380). After taking early retirement at age 62, David sought to redefine his lifestyle by pursuing new interests and activities.

Page: 378.

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Chapter 12

End of the Life Course:

Social Support, Public Policy, and Dying Well Multiple Choice Questions 1. Who provides most of the care received by older adults? a) Family b) Publicly-funded care facilities c) Privately-funded caregivers d) Non-profit organizations Ans: a Page: 385 2. Which of the following is an example of a changing demographic or social trend that results in people being less able to look after their aging relatives directly? a) Shorter life expectancy b) Higher fertility rates c) More childless marriages d) Lower divorce rates Ans: c Page: 385 3. Which of the following is not a question surrounding the issue of social support? a) Who should provide care? b) What type of care and how much should be provided in the family home and by whom? c) Do men or women provide the best care? d) Who should pay for home care?

Ans: c Page: 385 4. What type of support is provided in the home or community by family, friends, neighbours, or volunteers? a) Flexible support b) Unintentional support c) Casual support d) Informal support Ans: d Page: 388

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5. Who tends to be the primary caregivers of elderly family members? a) Sons b) Daughters c) Grandchildren d) Siblings Ans: b Page: 389 6. Which of the following statements is false? a) More women than men aged 65 and older and living in the community, receive care. b) Family caregivers usually include daughters or daughter-in-laws. c) People who live in rural areas generally receive more help from community members. d) Indigenous peoples prefer government support services over family assistance.

Ams: d Page: 389 7. Which of the following represent the most burdensome cases of caregiving? a) Persons with an acute injury b) Persons with a chronic illness c) Persons with dementia d) Persons with mobility limitations Ans: c Page: 391-392 8. Which of the following is a subjective component of caregiver burden? a) A loss of sleep b) A change in employment status c) Financial difficulties d) Feelings of guilt Ans: d Page: 392 9. What type of support is provided to dependent and frail adults by public and private agencies in the home or in an institution by trained volunteers or professional health- and social-care workers? a) Organized support b) Funded support c) Structured support d) Formal support Ans: d Page: 394

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10. Which of the following does not contribute to the level of stress experienced by an adult child caring for aging parents? a) The caregiver’s speed of learning b) The type and degree of the older person’s impairment c) The availability of financial support d) The older person’s personality and demands Ans: a Page: 394 11. Which of the following is an example of employer-based support services for an aging population? a) Respite services b) Professional visits c) Information and referral services d) Flextime Ans: d Page: 395 12. Which group of older people are not main users of formal services? a) Frail couples living in their home b) Those who live alone c) Men d) Those over 75 years of age with poor self-reported health Ans: c Page: 396 13. Which of the following is not a common reason for avoiding community services? a) A desire to remain independent or dependent on a spouse, child, or friend b) Knowledge about the availability of formal services c) A denial that services are needed d) A fear of having strangers in the home Ans: b Page: 396 14. Which system was established in Canada in the early 1990s to relieve overburdened hospitals and long-term-care facilities, as well as overburdened or untrained informal caregivers? a) Intensive care b) Home care c) Palliative care d) Respite care Ans: b Page: 396 Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

15. Which of the following provides temporary supervision or care by professionals so that a primary caregiver can take a daily, weekend, or vacation break from the routine, responsibility, and burden of caregiving? a) Home care b) Respite care c) Intensive care d) Palliative care Ans: b Page: 396 16. Which of the following group is not typical of home-care clients? a) Men over the age of 65 b) Older adults with acute conditions c) Older adults with low levels of assessed complex needs d) Older adults who experience pain and/or depression Ans: d Page: 396 17. Most abuse and neglect of elders is committed by whom? a) A family member b) A stranger or acquaintance c) A doctor or nurse d) A social worker or counsellor Ans: a Page: 407 18. Which of the following authorizes an agent, usually a spouse or adult child, to act on behalf of an individual with regard to financial matters? a) Living will b) Durable power of attorney c) Guardianship d) Medical power of attorney Ans: b Page: 413 19. Nancy’s longtime neighbor and good friend Jill doesn’t trust herself to take care of her finances and make important decisions about her affairs anymore. Jill asks Nancy if she will sign some legal documents to state that Nancy can make decisions on her behalf if the need arises. For instance, depending on the agreement, Nancy would be able to financial, health care and/or medical decisions if Jill were incapable of doing so. What is Jill assigning to Nancy? a) Elder custodianship b) Guardianship c) Joint access d) Power of attorney Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Ans: d Page: 413 20. Which country has legalized euthanasia? a) United Kingdom b) Australia c) Germany d) Canada Ans: d Page: 413 21. In Canada, which of the following patients is eligible for medical assistance in dying? a) A 15-year-old boy with an inoperable brain tumour b) A 42-year-old woman with end-stage breast cancer c) A 67-year-old man in a persistent vegetative state d) A 80-year-old woman with advanced Alzheimer’s disease Ans: b Page: 415 22. Which of the following is not a difficult moral or ethical question raised by the practice of euthanasia? a) Should it be used only for physical and not for mental illnesses? b) Who should be involved in the decision to end a life: the individual, the family, a guardian, a physician, a religious figure? c) Should doctors receive specialized training in administering such drugs once the decision is reached? d) Should it be available only for a terminal illness and only when the quality of life deteriorates beyond a defined point?

Ans: c Page: 413-414 23. Which of the following is designed for those with a terminal illness who need relief from pain and other symptoms, such as loss of appetite, nausea, incontinence, and breathing difficulties? a) Home care b) Critical care c) Acute care d) Palliative care Ans: d Page: 416 24. Which of the following is true about the meaning of death in different cultural contexts? a) It is socially constructed. b) It is biologically determined.

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c) It is universal and unchanging. d) It is dictated by the state.

Ans: a Page: 419 25. Which of the following public agencies or departments is not responsible for the needs of older adults? a) Employment and Social Development Canada b) Health Canada c) Indigenous and Northern Affairs Canada d) Office of the Superintendent of Financial Institutions Ans: d Page: 421-422

True or False Questions 1. Most care received by older adults is provided by family sources.

Ans: True Page: 385 2. Serial, or one-way, exchanges of resources generally involve a downward flow of assistance from the older generation to a younger generation.

Ans: True Page: 387-388 3. Regulations and laws are increasing the risk of abuse and provide little protection for residents of institutional care facilities.

Ans: False Page: 404 4. For aging adults, the ideal support system involves different sources, formal and informal, providing a combination of emotional, psychological, and instrumental help when and where it is needed.

Ans: True Page: 387 5. The most important predictor of who would share a home with an elderly parent was the quality of the adult child’s relationship with his or her parent.

Ans: True Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 385 6. A recurring debate involves the extent to which elder care is a private trouble or a public issue.

Ans: True Page: 385-396 7. Family caregivers usually include daughters or daughters-in-law.

Ans: True Page: 389 8. Increasingly, more men are involved as the primary caregivers for elderly relatives.

Ans: True Page: 389 9. The cost of caregiving can be financial, emotional, and psychological.

Ans: True Page: 391 10. The financial costs of informal caregiving are easy to estimate.

Ans: False Page: 391 11. The use of formal services by older adults is quite high.

Ans: False False: 396 12. Hospice care provides temporary supervision or care by professionals so that a primary caregiver can take a daily, weekend, or vacation break from the routine, responsibility, and burden of caregiving.

Ans: False Page: 399 13. Respite care provides permanent supervision or care by professionals.

Ans: False Page: 399 14. Elder abuse was first exposed in the late 1980s.

Ans: True Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

Page: 402 15. Older adults may engage in self-neglect or self-abuse that threatens their own safety and health.

Ans: True Page: 405 16. Older adults tend to over-report their experiences with fraud.

Ans: False Page; 405 17. Traditional intervention strategies to prevent and/or stop elder abuse are less successful in multicultural settings, where cultural or ethnic differences in values, traditions, beliefs, and language make it difficult for an outside professional worker to intervene.

Ans: True Page: 410 18. Dying and death is a family experience.

Ans: True Page: 411 19. The person assigned by an older adult to make decisions on their behalf if the need arises has power of attorney.

Ans: True Page: 413 20. Euthanasia and assisted suicide are illegal in Canada.

Ans: False Page: 413 21. Most palliative care facilities are dedicated to those dying of cancer or AIDS. Ans: True Page: 416 22. Bereavement groups have been shown to be ineffective when dealing with loss.

Ans: False Page: 419-420 23. The cost of a funeral, an administration fee, and a casket or urn, plus a burial plot, is usually less than $2,000.

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Ans: False Page: 420 24. The issue of who is responsible for the welfare of older adults is uncomplicated because there is a clear structure of government in Canada.

Ans: False Page: 421 25. The apocalyptic view of public policy argues that population aging means we can no longer finance all the health, social, and economic benefits that older adults need.

Ans: True Page: 423 Short Answer Questions 1. What is the integrated continuum-of-care model? What does it include?

Ans: In an ideal world, a continuum of informal and formal care and support would enable older people to age in the family home for as long as possible; to live in their home after being discharged from a hospital; and to receive help with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) as their strength, mobility, cognitive functioning, or health declines. This continuum includes the following: (1) Informal assistance provided by family, friends, or neighbours with shopping, shoveling snow, daily monitoring, cooking, bathing, banking, or transportation. (2) Formal care by paid employees who visit or live in the family home to help with meals, bathing, therapy, and mobility. (3) Twenty-four-hour care in institutions (retirement homes, nursing homes, and long-term geriatric-care facilities) Page: 385, 398-402 2. What are the major factors influencing patterns of informal support?

Ans: Patterns of assistance are affected by the availability and ability of potential caregivers, and available support systems for the helper. For example, parents in their eighties may have adult children who are in their sixties and need assistance themselves. In this situation, other relatives or public or private agencies may have to assume responsibility for the oldest generation. It has been concluded that the continued focus on the family to meet the needs of older Canadians is not sustainable because of the growing number of older persons and the decreasing number of children available. Consequently, new public policies and respite care services for family caregivers must be developed.

Page: 386 3. Is there reciprocity in terms of social support over the life course? Support your answer.

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Ans: Social support and the exchange of gifts, assistance, and money usually flow in two directions between aging individuals and others in their social network. Within the family, physical, emotional, economic, and social resources are exchanged, depending on the needs and the stage in life. Serial, or one-way, exchanges of resources generally involve a downward flow of assistance from the older generation to a younger generation because of a sense of responsibility and affection. They typically flow in the other direction (upward) because of health-care needs.

Reciprocal exchange, or a two-way flow, is most common between the members of the middle and oldest generations. This process of exchange usually involves services (babysitting, giving advice, shopping, and household maintenance); gifts of money or goods; or companionship through visits, telephone calls, or while helping an older person with an ADL or IADL. Reciprocity continues in later life as children spend more time helping and monitoring their parents.

Page: 387–388 4. What is caregiver burden?

Ans: Many caregivers feel the burden of caregiving as the length of time in the role grows and as the demands of caregiving increase. Indeed, one in six people providing informal care to seniors experiences distress. The most burdensome cases involve caring for a person with dementia because of behavioural problems, such as wandering, sleep disturbances, agitation, verbal or physical attacks on the caregiver, incontinence, and paranoia, as well as memory, understanding, and decision-making problems. The burden is greatest if the caregiver lives with the older person 24 hours a day. Double-duty caregiving occurs when a person provides care duties in a work role, such as nursing, concurrent with caregiving for an older parent. This can result in compassion fatigue, suggesting the need for professional, workplace, and government practice and policy changes.

Page: 391-392 5. What are the visible components of caregiver burden?

Ans: Visible components of the caregiver burden include the following: demands that cause changes in lifestyle; a loss of sleep; a change in employment status; financial difficulties because of increased expenses and loss of income; physical or mental-health problems; a loss of friends and leisure time as a result of having no vacations or days off; and, a deteriorating personal relationship with the older person or with others in the immediate family.

Page: 392 6. What are the challenges of caregiving for a spouse?

Ans: Caregiving is especially stressful when an elderly person is caring for his or her cognitively impaired spouse. Distress is twice as likely among spousal caregivers as among other family members. The 24-hour-a-day duties represent a significant problem. These difficulties are compounded by the loss of a partner in an emotional sense, by physical difficulties in coping with some of the necessary tasks, by anxiety about financial matters, by deterioration in the caregiver’s own physical health, and by depression or loneliness. Often, spousal care is not adequate compared with what would be available in an institution. But sometimes the caregiving

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spouse decides against transferring a dependent spouse to an institution, even if he or she no longer wishes to be a burden to the spouse or family.

Page: 392–393 7. What is formal support? What are the recent trends in formal support?

Ans: Formal support includes a range of health care and social services provided by government agencies, not-for-profit voluntary organizations, or private businesses. The aim is to provide a safety net through such services as community-based and in-home programs, adult daycare centres, respite care, retirement homes, nursing homes, and long-term chronic care institutions.

Ideally, formal support should involve a coordinated system so that all needs are met and so that no one is neglected or overlooked. Historically, public funds have been allocated to long-term institutional housing. Since the 1970s, there has been a gradual social movement toward deinstitutionalizing all special groups—physically and mentally disabled people of all ages, elderly people, and criminals. Not surprisingly, the rising cost of caring for an expanding aging population has forced the state to shift more responsibility for the care of frail and dependent older adults to individuals and families or to the private sector. However, to help families assume more responsibility, governments and employers have introduced services for caregivers, as well as for elderly care recipients. These programs are designed to support and complement the services provided by informal family caregivers.

Page: 394 8. What are some of the reasons that older adults do not use formal services in the community?

Ans: There are several possible reasons for not using community services: a lack of knowledge about the availability of formal services or how to use them; a desire to remain independent or dependent on a spouse, child, or friend; a denial that services are needed; a fear of having strangers in the home; subtle discrimination against members of ethnic groups who speak and read only their own language; user fees, which may be too expensive; and, a lack of services in rural or remote communities.

Page: 396 9. How can we assist caregivers?

Ans: There are three general methods of helping both older people and their primary caregivers: First, to relieve the caregiver’s stress and improve the quality of care for the recipient, programs should provide educational, emotional, and social support for the caregiver. A second type of assistance consists of financial incentives or reimbursements for the caregiver through tax credits or a subsidy to offset lost income or to purchase needed services. A third source of assistance involves private or publicly supported care (with or without a subsidy/user fee) provided within or outside the home. Some of these programs include the provision of assistive devices or home maintenance services, such as mobility and health monitoring devices; transportation; congregate or communal housing; or personal in-home health care, such as bathing, nursing, and therapy.

Page: 398–399 10. What is respite care and why is it important?

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Ans: Respite care provides temporary supervision or care by professionals so that a primary caregiver can take a daily, weekend, or vacation break from the routine, responsibility, and burden of caregiving. The older person remains in his or her home, and a care worker moves in.

Or she or he is moved to a retirement or nursing home as a short-term visitor or stays at an adult daycare centre or a hospital as an outpatient for a short period. Ideally, respite care is used before any family crisis arises. Respite care is underused, however, perhaps because people may not know it exists or they worry about the quality of care provided. For caregivers, the temporary relief gives them an opportunity to look after other responsibilities, to interact with friends and others in similar situations (through support groups), and to have a complete physical and mental break from caregiving and the care recipient.

Page: 399 11. What is an “integrated continuum of care”? What are its advantages?

Ans: Since the 1970s, many provinces and some communities have created integrated care models or systems (also called an integrated continuum of care) to a varying extent. This system has a single entry point, which is initiated through an in-home or in-hospital assessment by a multidisciplinary team consisting of a social worker, a nurse, a home-care manager, and a doctor.

Then, after the assessment and a discussion with the older person and his or her family caregivers, recommendations are made about the best location and sources of care, including a broad range of services, such as home care and home support services, supportive housing, residential care, and geriatric assessment. Once an initial decision has been made about needs and care, the team performs regular assessments, ideally under the leadership of the same case manager. An integrated care system can prolong independent living and delay or prevent premature admission to or a long-term stay in an acute or chronic care hospital or nursing home.

Moreover, integrated care has been shown to be less expensive than more fragmented models of care.

Page: 399–402 12. What is meant by elder abuse and neglect? How is it measured?

Ans: There is no single definition of elder abuse and neglect, although there is agreement that the major types of elder abuse include physical, psychological, financial, and sexual abuse. What is considered abusive in one family may be considered normal in another because of past practices or because of cultural or religious beliefs and practices. In general, three types of instruments have been used to measure or identify abuse or neglect: interviews with older people by professional care workers to identify victims; classification schemes to indicate types of abuse; and survey instruments with lists of abusive behaviour to identify incidents of abuse or attitudes as to whether such behaviour is abusive and, if so, how prevalent. The Elder Abuse Survey Tool (EAST) lists 96 behaviours that constitute mistreatment in a situation where a person lives with or is supervised by a person in a position of trust and 15 that might take place when older people live in an institution.

Page: 404 13. What is meant by self-neglect or self-abuse among older adults?

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Ans: Older adults may engage in self-neglect or self-abuse that threatens their own safety and health, especially when they are not monitored or visited regularly by family, friends, or care workers. Self-neglect is the failure to provide oneself with the necessities to ensure physical and mental health and a safe environment—food, clean clothing, regular bathing, shelter, medication, or social interaction. Self-neglect may involve self-abuse, such as malnutrition or drug or alcohol abuse, which results in physical or mental injury. This type of abuse is “hidden” and is often undetected unless a care worker or emergency department personnel are called to the home. For some, self-abuse is a continuation of behaviour exhibited in early and middle adulthood, especially if the person is socially isolated. For others, this behaviour begins after they retire, are widowed, or are diagnosed with a chronic or terminal illness and become depressed or isolated.

Page: 405 14. According to the literature, what do we know about the prevalence of elder abuse?

Ans: Prevalence statistics are derived from cross-sectional studies that identify the proportion of incidents or cases of abuse that have been experienced by or observed in members of a particular age (in this case, 65 and over) or gender or among those who live at home or in a retirement or nursing home. These statistics identify the approximate extent of the problem by type and location (nationally, regionally, or locally) and by gender of the victim and perpetrator.

It is difficult to determine the number and type of elder abuse and neglect cases in a given community or setting. Studies are limited and often not comparable because they are based on small and non-representative samples (since the respondents are volunteers); they use different definitions and measures of abuse; and respondents may not be able to remember or be willing to report incidents, or reported cases cannot be confirmed. In most jurisdictions, the police do not include a victim’s age in crime reports, nor are specific crimes labelled as “elder abuse.”

Moreover, abuse and neglect in an institutional setting is often “covered up” and seldom reported by co-workers who may have observed or suspect a person is abusing a resident. Most population-based studies suggest that there is considerable variability in the prevalence of elder abuse, depending on the definition, country, and characteristics of the sample used (e.g., sample size, design, and income level of country or region). While the overall rate of violence is higher among older men than older women, senior women are more likely abused by a family member, whereas senior men tend to be victimized by a stranger or acquaintance.

Page: 405–407 15. How can we prevent abuse and neglect among older persons?

Ans: Different types of abuse and different situations require different interventions.

Intervention involves identifying high-risk elders and caregivers and providing social assistance, enacting legislation to protect the rights of elderly people, enforcing and prosecuting violations of criminal and civil law, and requiring professionals to report any suspected cases of abuse or neglect. Specific policies or programs include the following: educating seniors and their family about abuse, neglect, and fraud; providing social, financial, and health resources directly to an elderly person, who then purchases services from whomever he or she chooses; offering financial support to caregivers, who purchase services such as nursing care and transportation from trained professionals, thereby alleviating some of the burden; providing professional case managers with the right to make decisions about who should be the primary caregiver and how Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

total care should be managed; training police officers to deal exclusively with the problem of elder abuse, fraud, or neglect; and, establishing a seniors’ abuse telephone line.

Page: 409-410 16. What are advance directives and why are they important?

Ans: Advance directives written by lawyers are legal documents about preferences for medical and personal care if at any time in the future persons cannot speak for themselves. Thus, they enable incapacitated people to control their destiny. These documents can be amended or revoked at any time as long as the person remains mentally competent. Family doctors should have a copy in the patient’s file because adult children may not be present or able to make a decision if one is needed.

Page: 412 17. How have attitudes towards euthanasia changed over time?

Ans: Just a few years ago, euthanasia was illegal in Canada. Since 2016, the medically assisted form of assisted suicide or euthanasia has been legal in Canada, similar to legislation in Belgium, the Netherlands, Switzerland, and Oregon. Despite its legality, practical, moral, and ethical questions remain unresolved in the court of public opinion. For example, opponents argue that there is an important difference between refusing life-sustaining medical treatment and obtaining a lethal dose of medication. Other opponents argue that dying patients are not receiving the care they need, and if good palliative care were available, physician-assisted suicide would no longer be wanted.

Page: 413 18. What is Bill C-14 and what does it cover?

Ans: In 2015, the Supreme Court of Canada ruled in the Carter decision that sections of the Criminal Code that make it illegal for anyone, including a doctor, to cause the death of another person who consents to die or to assist a person to end their own life, are unconstitutional. Bill C-14 formalizes and amends legislation to legalize medically assisted suicide. The Bill addresses who would be eligible, protective measures, implementation, access, monitoring, palliative care, and existing end-of-life measures.

Page: 414-415 19. What is palliative care and what role does it play in aging?

Ans: Palliative care, sometimes called hospice care, is designed for those with a terminal illness who need relief from pain and other symptoms, such as loss of appetite, nausea, incontinence, and breathing difficulties. The goal is to improve the quality not the quantity of life through physical, social, emotional, and spiritual support for the dying person; as well as provide education, training, and support for their caregivers. Such care is available in a limited way in acute-care hospitals as well as in nursing homes, in the person’s home, or in hospices, which are separate buildings used only for this purpose. To date, most palliative care facilities are dedicated to those dying of cancer or AIDS, and little space is available for older people with dementia or

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chronic degenerative disease. Yet these diseases are on the increase, leading many to argue that palliative care units are underfunded.

Page: 416-419 20. How is death socially constructed?

Ans: The meaning of death is socially constructed in different cultural contexts, as is the coping by family and friends through bereavement and the rituals associated with burial and with honouring and remembering deceased relatives and friends. Social values, beliefs, and practices concerning death and dying are changing. There is more open discussion about and acceptance of death, more advance directives are written, more palliative care is provided, more decisions are being made not to delay or impede death, and there is more emphasis on managing a “good and dignified death.” As well, support is growing for the right to die through assisted suicide, for death ceremonies and rituals that are viewed as a celebration of life, and for cremation rather than burial in a casket and large plot (Taylor and Martin 2014). Just as there are individual differences in the way people live, so, too, are there differences in beliefs and practices concerning death. Death rituals change as new ways of thinking about death are introduced into a society, subculture, or religion. Often, religious and cultural beliefs and practices interact or coexist, as in the case of Catholicism and Hispanic culture. Such interactions have a direct influence on bereavement practices, on whether and how end-of-life decisions are made or not made (Braun et al. 2001; Leming and Dickinson 2011; Sharp et al. 2012), and on the type of ceremony to honour and bury a relative.

Page: 419 21. What is bereavement and how does it relate to grief and mourning?

Ans: Bereavement is the objective state of having lost a significant other and of coping with a death. Consequently, grief in the days following a death can be expressed through shock, numbness, vulnerability, and depression. A grief response involves expressing feelings for a deceased person, as well as recognizing the social loss and vacuum created by his or her death. A partner is left alone, and a child becomes an orphan when the last parent dies. The grief period raises thoughts and questions about the reality of death and the meaning of life, and it offers a period in which to reflect and to learn about oneself and others. The mourning period involves short-term decisions about religious and cultural rituals (a public or private service, a funeral or a memorial service, internment in a casket or cremation, flowers or charitable donations, a small reception or a wake) and about personal behaviour (what to wear to a service, the amount of social interaction and with whom). Mourning is both an individual and a cultural matter. This period is somewhat easier if the deceased openly discussed his or her wishes with partners and family and if pre-planned funeral arrangements were made, including payment for a plot and a casket or urn, the format of the service, and even the writing of an obituary.

Page: 419-420 22. Why is the issue of who is responsible for the welfare of older adults complicated?

Ans: The issue of who is responsible for the welfare of older adults is complicated by the multilevel structure of government in Canada (federal, provincial, regional, and local). The British North America Act (1867) gave the federal government jurisdiction over social matters and Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

economic security (public pensions) but left other, related responsibilities to the provinces.

However, the provinces could not afford to offer all necessary services and became dependent on the federal government for transfer payments to pay for health care, education, social welfare, and transportation. When the federal debt and deficits grow, transfer payments to the provinces are reduced. One outcome of reduced federal transfer payments is that the quality of and accessibility to health care, higher education, and community social services that are delivered by the provinces is reduced. And, in turn, the provinces reduce transfer payments to regional and municipal governments—a process known as “downloading” fiscal responsibility to a lower level of government and to the individual, who must now pay for a service that might previously have been provided by a government agency. This process represents a “retrenchment” of the welfare state.

Page: 421 23. How can the services and programs provided under a policy create social equality or produce positive outcomes?

Services and programs provided under a policy should not create or perpetuate social inequality or produce negative unanticipated consequences. Policies must accommodate gender, marital, ethnic, regional, class, urban-rural, and other personal differences among both the recipients and those who provide care and services. Given the sex ratio of the older population, social policies must not ignore the special needs of older women, especially those who live alone. Policies should address the needs of older people who are most at risk because of their personal circumstances. What is needed are “inclusive” policies that take into account risk factors that are often related (e.g., being a divorced woman and poverty), emerging situations (e.g., benefits for gay and lesbian partners), and diverse geographical settings where older people may live (e.g., rural as opposed to urban or an Indigenous community in a remote northern region). Although not typically performed, analyses of existing or proposed policies should assess the relative costs and benefits of implementing the policy and examine the intended and unintended consequences of the policy for an older population.

Page: 423 24. What are five criteria that policies and programs for older adults should meet to be effective?

Ans: Policies and programs for older adults are often most effective if they are created with the following criteria and related questions in mind (textbook lists 12, students are required to identify 5): (1) Not exclusively based on age as a criterion for access or eligibility; age as the sole criterion ignores the heterogeneity of the older population in terms of abilities, interests, and needs. (2) Developed by following need assessments and research reviews that facilitate evidence-based decision-making. (3) Inclusive benefits—ask who is included and excluded: Are the needs of the frail elderly and special groups (Indigenous people, recent immigrants, and the homeless) being met? (4) Based on sharing through user fees—costs can be covered through full or partial subsidies and by co-payments from the private and public sectors and the individual.

(5) Client-centred—direct or indirect payments can be paid to the client or the caregiver. (6) Coordinated and integrated—there are no gaps between the informal and formal support systems. Has jurisdictional responsibility been established or negotiated to prevent gaps in the system and to ensure the seamless delivery of services? (7) Based on collaboration and cooperation between ministries or agencies at all levels of government. (8) Protective of legal and Aging as a Social Process, Seventh Edition © Oxford University Press Canada, 2019

human rights—one asks whether an older person is living in the community or in an institution.

(9) Designed to ensure that a minimum standard of living is maintained throughout the later life of all older citizens—policies and programs must serve the needs of aging persons more than those of the state. (10) Evaluated and revised, as necessary—a schedule is established for evaluating and, if necessary, revising or rescinding the policy if it is not meeting its objectives.

(11) Flexible—allowing for access to benefits on a temporary or permanent basis and providing minimum or maximum amounts of support as needs change. (12) Sustainable—ensuring services will continue during economic downturns and following changes in governments.

Page: 425 25. What kinds of economic and social questions fuel the debate about whether the needs of older people should be viewed as a “private trouble” of the individual or a “public issue” facing society?

Ans: This debate is fuelled when the following questions about economic and social security are raised: Should the public provide universal and complete pensions, or should individuals, through the private sector, be responsible for building their own pension benefits? Should the family or the state be responsible for the care and welfare of older citizens? Do older adults have the right, because of their past contributions, to be cared for in the later years? Should expensive health-care services, such as heart transplants and hip replacements, MRI scans, pacemakers, and kidney dialyses, be rationed or restricted on the basis of age rather than need, or should there be co-payments? Should scarce resources be reallocated to the elderly in the interest of social justice? For example, should we reduce public financial support for schools in order to provide more universal programs and facilities for baby boom retirees?

Page: 424

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