Helping Relationships With Older Adults. Adelle M. Williams

as part of the National Institutes of Health. The establishment of the Social Security Administration was particularly significant, as there were very few officially recognized federal agencies on aging before 1935. At this time, the age 65 was chosen as a reflection of the age used by retirement, or pension, systems that were in place for private industry and state systems.

      Several aging-related organizations developed between 1935 and 1950 and more were established after the Older Americans Act (OAA) of 1965 (Smith, 2014). The OAA established the Administration on Aging within the Department of Health, Education, and Welfare and called for the creation of State Units on Aging. State Units on Aging (SUAs) are agencies of state and territorial governments designated by governments and state legislatures to administer the Older Americans Act in their area. States coordinate and oversee the services through Area Agencies on Aging in their particular state (Day, 2014). Also in 1965, Title XVIII of the Social Security Act, a health insurance program for the elderly (also known as Medicare), was established as well as Title XIX, a health insurance program for low-income persons, known as Medicaid.

      Additional amendments to the OAA authorized funding for nutrition programs for the elderly; grants for multipurpose senior centers and employment programs; and transportation, congregate housing services, home care, legal services, and home renovation/repair services. The OAA established a long-term ombudsman program to cover nursing homes and emphasized supportive services to help older persons remain independent in the community while expanding ombudsman coverage to board and care homes. The Long-Term Care Ombudsmen are advocates for residents of nursing homes, board and care homes, assisted living facilities, and similar adult care facilities. They work to resolve problems of individual residents and to bring about changes at the local, state, and national levels that will improve residents’ care and quality of life (U.S. Department of Health and Human Services, 2015).

      Many other notable events related to aging and gerontology have occurred to date, including resource centers, research, consortiums, additional amendments to the OAA, White House Conferences on Aging, enactment of the Medicare Prescription Drug Act, NIA activities, and the development of the Administration for Community Living (ACL). The ACL brings together the Administration on Aging, the Office on Disability, and the Administration on Developmental Disabilities to focus on reducing fragmentation in community living services (Smith, 2014). The Age Discrimination and Employment Act of 1967, amended in 1978, ended mandatory retirement in the federal government and advanced it to age 70 in the private sector. Mandatory retirement at all ages was abolished in the United States in 1986 (with a few exceptions), and the European Commission has mandated that members of the European Union have laws making age discrimination illegal in place by 2006.

      Although the underlying dread, fear, and distaste for older persons remains for some individuals, several trends may reduce ageism in the future: (1) With the aging of baby boomers, old age is in the process of being redefined as a more robust and contributory stage of life. (2) Increasing interest in aging in the general public, mass media, government, and academia will support increasing knowledge and reducing misconceptions about older persons. (3) Increasing scientific research on aging has reduced and will continue to reduce ageism by providing a realistic picture of older persons. (4) Stereotypes are being challenged and disproven. For example, in 2009, for persons 65 and over, 77% had completed high school or more education, and 20%completed a bachelor’s degree or higher education (U.S. Census Bureau, American Community Survey, 2009), challenging the stereotype that older men and women were illiterate or poorly educated. (5) As people become more aware of racism and sexism, they tend to become more aware of discrimination in general and will be less likely to approve of or practice ageism (Palmore, 2004). Numerous developments, both positive and negative, have evolved over time. However, a re-evaluation of pre-existing negative patterns of behavior is necessary to encourage greater participation of older adults in all aspects of society.

      Aging of the Baby Boomer Generation

      As the boomer generation moves through the life course, the projected growth of the 65 and older population, as seen in Table 2.3, will have big implications over the coming decades. The baby boomers will be influenced by age effects, period effects, and cohort effects. Aging effects are brought about by the physiological process of aging, along with responses to those effects by others. Period effects are those affecting all age groups in society at the same time. Finally, cohort effects are associated with events affecting groups of people during the same years (Moody & Sasser, 2012).

      The baby boomers are an extremely large group because of higher fertility rates. They make up around a quarter of the entire U.S. population. There are a number of aspects that differentiate this segment of the population from the older and younger groups. First, more attention has been paid to this group as they crowded schools, became a target for marketers, and reached eligibility to vote. Second, boomers on average have higher levels of educational attainment than earlier generations. Third, in their childhood (1950s and 1960s), they experienced an extended period of post-war affluence and economic prosperity. Finally, the 1960s and 1970s were a time of dramatic upheaval, including the Vietnam War protests and campaigns for civil rights, feminism, and environmental advocacy. Some boomers protested, while others were more conservative, which is an example of the diversity within the cohort (Moody & Sasser, 2012). Baby boomers are a large and unique cohort who share common experiences and express their individual differences. They are expected to transform the way aging and older persons are viewed and treated in society.

      Table 2.2

      Source: U.S. Census Bureau (2014a).

      Table 2.3

      Source: U.S. Census Bureau, Population Division (December, 2014b).

      Differences in the Baby Boomer Generation

      A number of differences exist between the baby boomers and previous generations. Baby boomers are in better physical health than the generations preceding them (Zapolsky, 2003). They hold vastly different worldviews because they have been raised in a country at relative peace and have not faced a global war. Furthermore, unlike any prior generation, their worldviews have been expanded by mass media, technological advances, and world travel.

      Fewer tragedies and family sacrifices were the goals set by their parents for the baby boomers, which were believed possible because their parents were America’s Greatest Generation—strong, courageous, and self-reliant. The baby boomers grew up differently than their parents did. They are more affluent than their parents, perhaps because of their education, their courage, their ingenuity, or a combination of these (Vaillant, 2003). This group has not experienced the same struggles as their parents, such as the deprivations brought by the Great Depression. Although these differences make them unique, these same differences will affect the needs of those baby boomers who will reach their 60s in this decade and the future concerns of the baby boomers who are in their early 50s. Case Illustration 2.3 highlights some of the challenging aspects experienced by persons of the older generation.

      Case Illustration 2.3

      Mr. Jones grew up during the 1930s and experienced the Great Depression. Older persons today who grew up during this period are a distinct group and were shaped by the events and experiences in their youth. Mr. Jones was from a middle-class family and enjoyed the luxury of having nice clothes, a nice home, vacations, allowances, and several cars in their garage. They had family dinners, and he was able to attend a reasonable private school in his neighborhood. He recalled his life changing during the Great Depression because his family lost everything. They lost their jobs, their home, their cars, eliminated vacations, and Mr. Jones was enrolled in the public school within his neighborhood. His family did everything and sold everything to put food in his mouth, and while not nutritious by today’s standards, it kept him from going hungry.

      Mr. Jones’s daughter is concerned because he is stockpiling canned goods, dry goods, newspapers, and a host of other items. He is what she calls “stingy,” and while he has money from a pension and savings, he refuses to