Helping Relationships With Older Adults. Adelle M. Williams

organization decreased with age (tendency for individuals to impose greater organization of words, either no improvement or a decrease in sequential organization) but remained strongly related to the number of words during acquisition for all age groups. The two oldest groups demonstrated significant declines in words recalled on the 20-minute and 1-day delay trials. Thus, it was concluded that many aspects of free recall are impaired with age, and variance measurement of recall showed greater interindividual differences with increasing age. This increase in individual differences could reflect a single form of age-related memory impairment, or it could indicate that memory impairment in the elderly is due to multiple processes (Davis et al., 2003).

      Physically, the function of the prefrontal cortex is altered with aging. There is evidence of atrophy in gray and white matter within the prefrontal cortex, which results in slowed neurotransmissions, which causes slowed reactions, thinking, and signaling among other functions (Head et al., 2004). The brain of older adults works harder and uses both the right and left hemispheres (bilateral recruitment) for functions that young adults can perform unilaterally. These activities include the initiation of goal-related task strategies, and with age the brain will recruit additional prefrontal regions to help perform the task (Kensinger, 2009). The hippocampus (part of the brain involved in emotions, memory, learning, and the autonomic nervous system) is the other region of the brain that shows large decline with age and affects the encoding and retrieval phases of recollective and associate memory, which tend to be underused in aging adults. Recollective memory is recall in memory, which is the retrieval of events or information from the past, whereas associate memory is the ability to learn or remember the relationship between unrelated items (e.g., name of someone you just met or aroma of a particular perfume). The changes within the hippocampus correlate with reduced performance on memory tasks.

      As adults progress through their later years, many note the decline in their ability to recall bits of information and perform mental calculations. Though reflections about cognitive aging are expected to grow more pessimistic with the passage of chronological time, people’s life courses elapse in ways besides objective days, months, calendar, and years. Therefore, age identity may be a more telling indicator of dispositions toward cognitive aging than chronological age. Subjective evaluations of age are an important aspect of the self with implications for well-being (Westerhof & Barrett, 2005).

      Language

      Normal aging causes widespread changes in the brain, many of which could be expected to impact language functions. However, in the absence of disease (such as Alzheimer’s dementia) or stroke, which can have serious consequences for language, it is generally found that older adults perform much like younger adults on language comprehension tasks, and indeed, that vocabulary and other kinds of knowledge can increase throughout the life span (Cognition and Brain Lab, 2015). Vocabulary increases well into the 50s and 60s and shows no decline with age in those who continue to be engaged in complex language use. Similarly, syntactic skills, the ability to combine words in meaningful sequences, show no decline with pure aging. Subtle differences in performance on language tasks occur after middle age. Some of these changes such as poorer speech processing and less accuracy is related to the loss of auditory (hearing) acuity. Older people have more difficulty finding specific words and making inferences from complicated discourse. However, knowledge of words and the understanding of real-world expectations, as well as storytelling skills, appear to remain unimpaired (Clark-Cotton, Williams, Goral, & Obler, 2007).

      Declining language skills have been associated with diminishing cognition, overall health, factors of fatigue, and a variety of social variables (level of education, gender, culture, and socioeconomic status), behavioral factors (motivation and interest), and comfort of the assessment environment. Disease can compound any language usage. For example, a transient ischemic attack (TIA), also referred to as a mini stroke, will interfere with the ability to speak. Also, a childhood language disorder (stuttering) if left undiagnosed and untreated, will lead to problems with disordered language production in older adulthood (Clark-Cotton et al., 2007). However, most older adults communicate successfully throughout most of their lives.

      Intelligence

      Intelligence, as measured by the Wechsler Adult Intelligence Scale, declines with age, but the biggest, earliest losses were reported in flawed studies. Cohort differences undermined these cross-sectional studies, causing selection bias regarding education, gender, race, occupation, and income. However, measuring specific intellectual functions has become typical. Crystallized intelligence (learning and experience) remains stable or improves with age until the late 70s or beyond, especially in those who remain healthy and engaged in cognitively demanding activities. Fluid intelligence declines rapidly after adolescence. Perceptual motor skills (timed tasks) decline with age (Besdine & Wu, 2008).

      Individuals may experience a wide array of physical and cognitive shifts as they go through the aging process. Such changes can include issues with vision to problems with cardiovascular or integumentary systems to losses in episodic memory to attention deficiencies. The degrees to which these changes occur differ from person to person. Older adults’ health and well-being are dependent on the professionals who are available to help them through these new stages of life. In particular, counselors should acknowledge any diminished capacities that a client is experiencing and provide him or her support in those areas, while also reinforcing the person’s strengths and emphasizing his or her ability to lead a happy life.

      Keystones

       Natural physiological and psychological changes occur as one ages.

       Older adults are able to adapt to these physiological and psychological changes.

       Declines in functioning and strengths can and do coexist within elders.

       Professional counselors are encouraged to acknowledge diminished capacity while reinforcing the older client’s strengths.

      Additional Resources

      Print Based

      Aldwin, C. M., & Gilmer, D. F. (2004). Health, illness, and optimal aging. Thousand Oaks, CA: Sage.

      Cutler, N. E. (2000, November 20). Myths and realities of aging 2000. Paper presented at the Annual Meeting of the Gerontological Society of America, Washington, DC.

      Dalton, D. S., Cruickshanks, K. J., Klein, B. E. K., Wiley, T. L., & Wondahl, D. M. (2003). The impact of hearing loss on quality of life in older adults. The Gerontologist, 43, 661–668.

      Desai, M., Pratt, L. A., Lentzner, H., & Robinson, K. N. (2001). Trends in vision and hearing among older Americans. Aging Trends, 2, 1–8.

      Kemmet, D., & Brotherson, S. (2008). Making sense of sensory losses as we age—Childhood, adulthood, elderhood. Fargo: North Dakota State University.

      Masoro, E. J. (2001). Dietary restriction: An experimental approach of the biology of aging. In E. J. Masoro & S. N. Austad (Eds.), Handbook of the biology of aging (5th ed.). San Diego, CA: Academic Press.

      Olshansky, S. J., Hayflick, L., & Carnes, B. A. (2002). No truth to the fountain of youth. Scientific American, 286, 92–95.

      Rattan, S. J. S., & Clark, B. F. C. (2005). Understanding and modulating ageing. UBMB Life, 57, 297–304.

      U.S. National Library of Medicine and National Institutes of Health. (2009). Aging changes in the senses. Medline Plus. Retrieved from http://www.nlm.nih.gov/

      Vijg, J. (2007). Aging of the genome. Oxford, UK: Oxford University Press.

      Web Based

       www.aarp.org

       www.aghe.org