Elizabeth W. Markson

The mirror has two faces

Have changing demographics, increased life expectancy and findings about gender similarities and differences, altered portrayals of older people in American feature films during the past 65 years? We identified 3,038 films made between 1929 and 1995 in which actors and actresses, nominated at least once during their lifetimes for an Oscar award, appeared when aged 60 years or older. Academy Award nominees were selected because they offered a sample of ‘notable’ performers and an accessible database. We selected an eight per cent random sample for a content analysis of their roles. Throughout this period, men were more likely to be depicted as vigorous, employed and involved in same-gender friendships and adventure (whether as hero or villain). Women remained either peripheral to the action or were portrayed as rich dowagers, wives/mothers, or lonely spinsters. Despite changing gender roles in later life since the 1930s and despite social and economic changes for older Americans (earlier retirement age and better health are but two examples), their film roles have remained remarkably static in age and gender stereotyping. In feature films, the mask of ageing differs by gender. Male masks veil inactivity and physical changes, while female masks reveal ageist and sexist stereotypes.

An Analysis of Types and Costs of Health Care Services Provided to an Elderly Inner-City Population

The challenge facing national policymakers is to provide health care that is comprehensive and cost-effective to our nations growing population of elderly people. A solution worthy of consideration is the use of health maintenance organizations (HMOs) in this capacity. An analysis of the services provided by a multidisciplinary health care system to 150 inner-city elderly, many of whom were “homebound,” reveals 1) this population is not homogeneous with respect to severity of disease and service utilization, and 2) a total mean cost per individual per year of

To be or Not to Be: Assisted Suicide Revisited:

2,021.34 covers: physician, nursing, and social service home visits; visiting nurse, homemaker, home health aide, occupational therapy and physical therapy services; outpatient, laboratory and medication costs. These findings suggest that while costs for those over 65 are many times the per capita costs of younger enrollees, these costs may be significantly less than the costs of institutional care. Further investigation of the costs of maintaining low-income inner-city old, as well as other elderly populations, at home is vital to planning for future long-term care.

TEACHING GERONTOLOGY TO THE BUSINESS COMMUNITY: PROJECT OLDER CONSUMER

Publicity accorded American physician-pathologist Jack Kevorkian and “physician-assisted suicide” bring a new, technological, twist to euthanasia. How and when we die and its meaning and how we live reflect cultural values within a historical context. High costs of medical care for the terminally ill when the cost of health care is the most rapidly rising portion of the consumer price index, Medicare expenses are the highest in the last year of life, and an estimated thirty-seven million people remain uninsured make euthanasia increasingly salient. Faced with great pain and the emotional and financial burden that often accompanies prolongation of life during terminal illness, the decision to die is not necessarily irrational, psychotic, or delusional but pragmatic. Yet inherent risks have often been overlooked in discussions of “the right to die.” This article reviews cultural values associated with beliefs about assisted suicide, the experience of other nations including the Nether; lands with assisted suicide, and the “slippery slopes” inherent in legitimization of physician-assisted suicide.

Gender roles and memory loss in old age: an exploration of linkages.

The design and evaluation of a continuing education program in gerontology for executives and professionals who provide products and services to the elderly but who are generally unaware of the needs and concerns of elders are described. Four workshops were designed and offered to decision‐makers in advertising/retail, finance, housing, and profit/nonprofit interfaces. Curricula developed, evaluation of workshops, and problems and barriers encountered in training business executives about aging are discussed.

A Touch of Class? A Case Study of Geriatric Screening Process

A framework relating gender roles, role loss, and memory is presented. For the now-old woman, her identity has usually been defined by her roles within the family; other personal touchstones have been less legitimate. In old age, when key family roles dwindle, many women who have relied on their families as sources of identity are placed in an anomic situation, especially women with limited resources. When few meaningful social roles exist in the present, memory becomes increasingly important as a link to develop and maintain the self. It is proposed that, without meaningful present roles to frame ones past experience, memory is likely to be characterized by a high frequency of nonintegrated, relatively meaningless relationships, in turn leading to a narrowing of horizons and inability to take the role of the other. Episodic memories may decay since present events have no interest and generic memory becomes impaired. A case study approach is used to examine the relationship between self-preoccupation, group affiliation, object relations, and memory loss among three older working-class women. Their speech patterns, specifically pronoun use, were analyzed and support the postulate that a high frequency of self-references indicates memory loss and paucity of present experience.

Disengagement Theory Revisited

That the poor, elderly and other “socially undesirable” people are at excessive risk of being sent to mental hospitals has been documented by a variety of studies. Once labelled, the person is likely to be almost automatically admitted. When specific screening criteria for admission are introduced to reduce inappropriate admissions, however, admission itself can no longer be automatic, for not everyone can be admitted. The present study suggests that, on one geriatric service, the relative repute of the potential mental patient is a decisive factor in his admission. Specifically, at an institution where the program is highly regarded by professional staff, patients with characteristics similar to the examiner are admitted, those dissimilar are rejected. The implications of this for control of persons needing mental health care are discussed.

Development of health risk appraisal functions in the presence of multiple indicators: The Framingham Study nursing home institutionalization model

Cumming and Henry erected the basic frame for a socio-cultural theory of normal aging in their 1961 book, Growing Old. The basic postulates of this theory are reviewed, and the overall structure of the theory briefly examined. Critical data necessary either to accept or reject disengagement theory are not yet available, although useful information has been gathered since the theory first appeared. Part of the difficulty in amassing “proof or” disproof is inherent in the intricate and complex nature of the aging process itself. This orienting paper introduces a set of contributions by other commentators on disengagement theory.