Stress And Coping In Later-Life Families

Mary A. Stephens, Janis H. Crowther, Stevan E. Hobfoll, Daniel L. Tennenbaum

• Publisher: Taylor & Francis
• Year: 2018
• eBook ISBN: 9781317770442
• Topic: Psychologie
• Subtopic: Psychotherapie

A product of the Kent Psychology Forum 1989, the book focuses on how older adults and their families cope with the vicissitudes of later life.

1

SOCIAL RELATIONSHIPS AS COPING RESOURCES IN LATER-LIFE FAMILIES

Mary Ann Parris Stephens

Kent State University

One of the most important societal changes occurring in the 20th century has been the aging of the human population. The number of older adults is increasing not only in absolute numbers but also in proportion to the total population. In the United States in 1900, adults over the age of 65 years numbered about 3 million (representing approximately 4% of the total population), and in 1985 they numbered over 28 million (representing 12% of the total population). Demographic projections indicate that by 2030 these older adults could number more than 64 million and represent as great as 21% of the total population. The most rapidly growing segment of the older adult population comprises those individuals whose ages are 85 years and older (American Association of Retired Persons [AARP], 1986; Gilford, 1988). These figures indicate that the older adult population is not only growing larger, but it is also growing older. Evidence also suggests that these older persons frequently remain closely tied to their families. In fact 82% of older men and 55% of older women reside in a family setting (Gilford, 1988). These settings include residing with a spouse as well as with other family members, especially children.

These demographic estimations not only raise concerns about the quality of life that older adults themselves are likely to face, but they also raise concerns about the lives of their families as well. Most older adults are embedded in some form of complex family structure and in valued interpersonal relationships with their family members; therefore, whatever problems they experience are not theirs alone but are shared by their families. Thus, in a very real sense, the problems of aging are not simply problems that are experienced at the individual level by older people. They are also social problems that are felt at both the primary group level and by society. Chapters in this volume address various facets of this complex and pressing social issue, in particular, how older adults and their families cope with the stressors of later life.

This chapter provides an overview of existing theory and research that bears on stress and coping in these families. I review psychosocial theory and research concerning the following questions. What are the problems and stressors that older adults typically encounter? How can these problems be understood in the context of family systems? How do older adults cope with these problems, and how do their families function as sources of assistance in times of need? What is the impact on family members of providing sustained assistance to an older relative? In the final section of the chapter, I attempt to integrate knowledge related to these questions in order to provide a context for the chapters that follow.

STRESSORS IN LATER LIFE

It often has been observed that life is never free from stress, but rather is characterized by a continuing process of adaptation to struggles and challenges, or stressors, that tax coping resources to a greater or lesser degree. Thus, stressful encounters in later life are not new experiences for older adults, because they have weathered a lifetime of coping challenges. The very fact that old age has been reached implies a certain level of successful adaptation. The particular kinds of stressors that any individual is likely to face vary to some extent, however, as a function of the point he or she has reached in the life span. As such, older adults, by virtue of their age and its concomitant physiological, psychological, and social changes, are more likely to encounter certain stressful events that are younger people. In this section I describe some of these events and their implications for family relationships.

In contrast to stereotypic beliefs about older adults, most are fully independent in their activities of daily living and are cognitively intact (Rowe, 1985). Many of the problems experienced by older adults are health-related. Approximately 86% of older adults experience at least one chronic illness (Office of Technology Assessment, 1985). Nearly one-fifth require at least some assistance with activities such as bathing and grooming or in transportation or preparing meals (Gilford, 1988). These functional limitations also are reflected in self-reports of health. Nearly one-third of older adults rate their health status as fair or poor as compared to younger adults, of whom less than one-tenth rate their health as fair or poor (AARP, 1986).

Not only do older adults experience problems of somatic health and functional disability, but also they often experience significant mental health problems. Approximately 15% to 25% of those over age 65 demonstrate symptoms of mental illness. Older people represent about one-fifth of all first admissions to psychiatric hospitals and occupy almost one-fourth of all psychiatric beds. Although many of these psychiatric problems appear to be organic, it is widely believed that many nonorganic problems, such as depression, are undiagnosed. Even so, the documented rates of depression range from 10% to 30% among older adults (Brody & Kleban, 1983; Kay & Bergmann, 1980). Many of these figures exceed the relative proportion of older adults in the population and suggest that mental health is often a key problem for older people.

In spite of these often considerable health problems, only about 5% of all older adults reside in institutional settings at any given time (AARP, 1986). National surveys indicate that there are twice as many ill elderly people living at home as there are in institutions. It appears that a key factor in the prevention of institutional placement is the availability of viable family relationships to provide assistance (Shanas, 1979).

In addition to the dependency and disability resulting from physical and mental health problems, older adults often experience a variety of other stressful life changes such as retirement, bereavement, and the lessening of authority and feelings of control (Bohm & Rodin, 1985). Although retirement from work is usually a planned event to which the retiree has looked forward, this change often creates large and sometimes unexpected negative alterations in the life style of the retiree and his or her family. Death of peers is another frequent experience for older adults. These losses may include long-term intimate relationships such as those with spouses, friends, and family members of the same generation. Almost all of the major life changes of older adulthood, including declining health and loss of important roles and interpersonal relationships, have implications for the family networks of these individuals. Because older adults’ needs for assistance from others often are increasing at a time when their involvement with and access to the social world are decreasing, a mismatch between needs and resources may result. In such times of need, it appears that older people turn first to their families for support and assistance. Family members often respond with many forms of assistance such as providing services and emotional support and making regular visits (Shanas, 1979; Weeks & Cuellar, 1981).

It is clear that the social and health-related stressors in later adulthood have far-reaching consequences that extend beyond the older person who experiences them directly. The family of this older person may be affected as well, sometimes in profound ways. Not only may family members be called upon to provide assistance and support to their older relative who experiences a stressful life situation, but also they often have to make adjustments to accommodate the stressful situation itself (McCubbin & Dahl, 1985). Thus families function as systems such that a change in any family member makes it necessary for other family members to adapt to this change. Several theoretical formulations have been proposed that describe family systems and their underlying dynamic relationships, and how these systems adapt to stressful life changes.

FAMILIES UNDER STRESS

The Oxford English Dictionary defines a family as a group of persons consisting of parents and their children, whether actually living together or not, or the unity formed by those who are connected by blood or affinity. A more psychosocial definition describes families as groups composed of individuals who have mutual obligations to provide a broad range of emotional and material support to one another (Dean, Lin, & Ensel, 1981).

Although a family unit in modern society is a highly complex entity that defies all but the most general definition, all families are considered to possess a number of important features, including structure, functions, assigned roles, modes of interacting, resources, a life cycle, and a set of individual members with unique histories (Turk & Kerns, 1985). Thus the family social system is an organization consisting of intricately related social positions that have complex sets of roles and norms. Families serve a wide variety of functions including reproduction, socialization, and emotionally intimate interaction. They also provide psychosocial protection for family members and accommodation to and transmission of a culture (Minuchin, 1974). In carrying out these functions, families appear to strive toward some sort of stability or predictability of preferred behavior among their members (Hess & Handel, 1985). Although different theories about family systems emphasize different aspects of family relationships, two dimensions related to family functioning, cohesion and adaptability, are prominent features of several theories. Because these dimensions may help shed light on the processes families use in coping with late life stressors, they are briefly discussed here.

Cohesion and Adaptability

Cohesion usually refers to the mutual attraction or attachment among members of a family unit. It has been defined as the degree of bonding or connection that family members have with one another (Olson, Sprenkle, & Russel, 1979). Cohesion from this perspective includes both the emotional bonding among members and the degree of individual autonomy each experiences. It has also been conceptualized within two constructs labeled affective responsiveness and affective involvement (Epstein, Bishop, & Levin, 1978). Affective responsiveness refers to the ability of the family to respond to a broad range of situations with appropriate feelings and emotional expression, whereas affective involvement refers to the degree to which family members value the activities and interests of one another. The focus is on how much and in what way family members can show an interest in and invest themselves in each other.

A second major dimension of family functioning, adaptability, refers to the family’s capacity to adjust to and accommodate change with little psychological or organizational discomfort (Burr, 1982). It has been defined as the potential that a family system has for changing its power structure, role relationships, and relationship rules in response to situational and developmental stress (Olson et al., 1979). Adaptive flexibility is a related concept and refers to a family’s ability to negotiate, function, and deal effectively with stressful situations (Beavers, 1977). Families that possess a high degree of adaptability are thought to have greater freedom to evolve and differentiate. Family problem-solving is closely related to adaptability and refers to a family’s ability to resolve problems at a level that maintains effective family functioning.

Common to the major theories of family systems is the assumption that families often are confronted with stressful situations that require change or accommodation. Other theories have been developed to explain relations between a family’s experience of crisis or disruption and its adaptation to this change.

Response to Crisis

Theories of family stress define family stressors as events that are perceived as disrupting or changing the family social system. These events represent something more than the normal changes that are expected as part of a family’s regular routine. Rather, they are sufficiently unusual in that the family system itself changes (Hansen & Hill, 1964). Family crises evolve and are resolved over a period of time; therefore, families are seldom dealing with a single stressor. Instead, they often experience an accumulation of stressful events, especially following a major stressful life change (McCubbin & Patterson, 1983).

During times of stress, the family initially attempts to make adjustments in its pattern of interaction, with minimal change or disruption of the family’s established patterns of behavior and structure. However, families in crisis often come to realize that in order to restore functional stability or family satisfaction, they need to restructure. Restructuring efforts may include modifications in established rules, goals, or patterns of interaction. To assist in this process, families call upon a variety of resources including psychological, social, interpersonal, and material contributions of individual family members. These resources may be old and established or they may be newly developed or strengthened in response to the demands emerging out of the stressful situation (McCubbin & Patterson, 1983).

Coping efforts such as restructuring and resource utilization are directed at restoring organization and unity within the family and promoting growth and development among its members. Adaptation, which encompasses the long-term effects of stressors on family functioning, represents the outcome of coping efforts. Such efforts highlight the paradox of family stress. Stressors present the family unit and its members with the opportunity for personal and family system changes and growth, while making the family increasingly vulnerable to emotional distress and family instability (McCubbin, Cauble, & Patterson, 1982).

From a family systems perspective, families that possess greater organizational adaptability or flexibility have the potential to respond to the demands for change with less psychosocial discomfort and disruption in normal functioning. Members of well-organized families have the ability to redefine or alter role functions with relative ease so as to accommodate changes imposed by stressors. In addition, the strong emotional bonds that exist among these individuals provide important interpersonal resources for coping efforts that include socially supportive interactions.

Although family systems theories posit that cohesion among family members is a key ingredient for optimal family functioning, its effects may not be wholly positive, either for the person who receives the support or for the family members who supply it. From the recipient’s perspective, families may represent unique reservoirs of tangible and interpersonal support, and as such, they often provide critical assistance during periods of stress. However, in the course of receiving this assistance, there is always the potential that feelings of dependency, inadequacy, and resentment will be engendered in the recipient. From the perspective of the support provider, being able to h...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Contributors
• Preface
• Acknowledgments
• 1 Social Relationships as Coping Resources in Later-Life Families
• I STRESS IN LATER-LIFE FAMILIES
• II SOCIAL RESOURCES FOR COPING WITH STRESS IN LATER-LIFE FAMILIES
• III THE IMPACT OF PROVIDING CARE IN LATER-LIFE FAMILIES
• Index