Advancements in the field of medicine

Advances in medicine have allowed Americans to live longer lives than in previous decades. According to current estimates, those over the age of 85 are the fastest rising group of the country’s population. At the moment, the elderly (those above the age of 65) account for about 10% of the American population. If current patterns hold, the figure will more than double in the next 30 years. Despite this, these advances pose major difficulties. Many unwelcome trials accompany old age, such as chronic ailments, mental difficulties, and isolation. Evidence suggests that the government has few structures in place to deal with the crisis. It is the argument of this paper that the government should allocate more funds to cater for the increasing proportion of the aging population.

Many rightly fear that the country is on the verge of healthcare crisis. Experts are of the opinion that the country and its healthcare systems are not prepared sufficiently to equip the elderly with the capabilities to contain these challenges. For instance, many doctors are preferring medical domains over family healthcare. Consequently, there exist few practitioners to care for the geriatric. Even though America has been able to contain highly infectious illnesses like tuberculosis and pneumonia, it is yet to device effective mechanism for managing complications that come with aging (Living Old, 00: 07: 30). According to Dr. Farber, a Geriatrician at Mt. Sinai Hospital, New York, no one is fully trained to care for the increasing number of the elderly (Living Old, 00: 09: 05). Moreover, American families that are becoming smaller and increasingly dispersed. These circumstances imply that the country is ill-prepared to cope with the difficulties that accompany longevity.

Competence-Environmental Press

The competence-environmental press theory models the process adaptation of aging population using two categories of variables: competencies and the environmental press. Competencies refer to variables that relate to an individual. They include affective and cognitive functioning, functional health and physical health, and quality of life (such as mastery or efficacy). Environmental press comprises all factors that make up a person’s environment. They include a person’s home and neighborhood, social factors, and other external variables that have a bearing on an individual’s life. According to the theory, the extent to which these variables fit to each other determines the functioning of an aging person (Lawton, 1985). The model has contributed greatly to the understanding of the aging process and provides a framework for caring for the elderly.

Figure 1: The ecological model of aging (competence press framework) (Lawton, 1985)

Figure 1 depicts the environment-competence model of aging. The interaction between the environment and competencies can produce either positive or negative effects on an aging person. When the environmental press is too weak and the competence level is too high, an individual develops maladaptive behavior. A similar condition occurs when the environment press is too strong and the capability to cope is too low. Adaptive behavior (optimal fit) takes place when the capabilities of an individual are consistent with environmental demands and opportunities.

In the case of an optimal fit, an individual is in the zone of either maximum comfort or performance potential and demonstrates positive affect and adaptive behavior (Figure 1). Estelle Strongin is one individual who appears be in such a state. At 94, she still engages in active business activities and appears to be in control of her life. Several factors could have contributed to her positive state. First, she keeps herself busy. In the video, she is seen performing different house chores, taking care of her physical looks, and making various business calls. She also maintains a positive outlook and sense of humor. For example, she refused to sign for the termination of life in case her situation appears hopeless because even doctors sometimes make mistakes (Living Old, 00: 01: 50-55; 00: 49: 47-50). Engaging in productive activities, keeping an optimistic attitude and confidence, and having a sense of hilarity have likely been instrumental in contributing to her well-being. Even though she experiences environmental pressures, she has high competence to manage the stresses.

If the environment demands more than a person’s abilities can sustain, then person-environment misfit occurs. Such a person experiences negative affect and maladaptive behavior. Laure Ange Gaeckle, 99, has been in a nursing home for seven years with a fractured hip. The physical pain she experiences and the psychological distress that comes with the realization that she is in such a condition inflicts too much environmental stress for her competence to bear. She feels hopeless and compares her situation to spilled milk over which one has no need to cry. She does not want to live any longer (Living Old, 00: 18: 50). In her case, there is a mismatch between the prevailing environmental press and competence.

Coping

Aging is a complex process that has associated losses and gains. For instance, as one approaches old age, the physical senses such as those of hearing or sight begin to diminish (loss) while the sense of well-being increases (gain). The theory of life-span developmental psychology that focuses on age-related (ontogenetic) transitions offers a useful basis for describing such gains and losses (Baltes, Reese, & Lipsitt, 1980). The need and mechanisms for coping vary with age. Even though people across all ages need to develop effective coping techniques, old age comes with a variety of complications and therefore requires than do other age brackets.

The ability of an individual to withstand adverse life circumstances is an important personality building block and an integral component of effective socio-emotional functionality as one approaches adulthood. Accordingly, defense and coping mechanisms are essential for positive development outcomes during old age. The strategy that a person uses to manage old age related stresses can influence the outcome of the process. Coping mechanisms are valuable in managing external settings that create problems for an individual. Psychologists have identified various mechanisms through which individuals cope with stress. They include problem-focused, emotion-focused, appraisal-focused, and occupation-focused approaches. While problem-focused approaches aim at reducing associated stresses, emotional-focused techniques attempt to relieve a person of the feelings of anxiety resulting from the situation rather than the exact problem. Appraisal-focused techniques involve modifying a person’s view of the problem. Finally, in the occupation-focused mechanism, a person engages in activities that generate positive outcomes. The outcome of each strategy depends on an individual and the prevailing conditions.

The elderlies in the video apply different coping strategies. For instance, Clara Singer is approaching her 100th year. When he was 95, her loneliness forced her to seek companionship in a nursing home. According to Singer, her major losses are a home and old friends. She makes up for the loss by applying a variety of coping mechanisms. For instance, she use the appraisal-focused by modifying her perception to the prevailing conditions. Even though the people in the home are not like the friends she left back home, she still views them as people and makes maximum utilization to her benefits. Instead of focusing on her loss, she does whatever is in her capacity to make herself happy. Additionally, Singer uses the occupation-focused approach. She keeps herself busy by looking through the magazines that she keeps (Living Old, 00: 21: 14-00: 22: 54). Such techniques help her to have a measure of control over her circumstances.

Another person who is trying to cope with his status is Chester Haak. He is in his 90s and has lost mobility. He attempts to manage the circumstance by employing the problem-focused technique. For example, he tries to learn to walk by using a walker. Although learning to move is hard for him, he appears not to be giving up. Even though his condition is getting worse day by day, especially after the death of her wife, he endeavors to make the most of every day he lives (Living Old, 00: 46: 07-47). The complications that come with aging has made life difficult for both Clara and Haak. Nevertheless, applying various coping strategies help them to endure. Still, the extent to which they cope with their situations vary from one person to another depending on the health status.

Conclusion

From the video, it is evident that the government should increase its funding for the elderly. The need to allocate more funds arises due to at least three reasons: to cater for the increasing costs of caring for the geriatric, to improve the nursing facilities, and to train more experts. Even though many old people do not like being in nursing homes, such facilities have played essential roles in taking care of most of American’s aging population. According to the video, the percentage of the American population above the 65 percent is increasing faster than any period of the country’s history. The situation implies that the country is likely to face a shortage of nursing homes. Therefore, there exists a need for the government to increase its investment on such amenities.

Even though there have been many improvements in the field of medicine, caring for the aging population is becoming increasingly expensive every year. Many of the interviewees expressed their anxieties of rising costs. Allocating funds would help reduce the expenditure. The number of doctors caring for the elderly has been outnumbered by the patients. Therefore, there is a need for the government to implement mechanisms that will aid in narrowing the widening gap. One approach would to be to train more doctors in this field. A factor that has contributed to the gap is the fact that many doctors are choosing medical fields over family health. In this regard, the government can create incentives such as increasing salaries to attract people to family health. In summary, increasing allocation will help reduce the cost of caring for the elderly, increase the number and improve the status of nursing facilities, and increase the number of experts of family health.

References

Baltes, P., Reese, H., & Lipsitt, L. (1980). Life-span developmental psychology. Annual review of psychology, 31(1), 65-110.

Lawton, M. P. (1985). The elderly in context perspectives from environmental psychology and gerontology. Environment and Behavior, 17, 501–519.

Navasky, M. [Username]. (November 21, 2006). Living old [Video File]. Retrieved from http://www.pbs.org/wgbh/frontline/film/livingold/