Working with older adults

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There are a wide range of factors to consider when working with older adults. This information sheet will focus specifically on issues relating to social support, vulnerability and consent, autonomy, and cultural and generational differences.

Ensuring older adults have effective support networks is important.

Factors such as loss of loved ones, health status and living arrangements can lead to loneliness in older adults.[1] This is important to note as social support is an important human need. For example, Self-determination Theory highlights that relatedness to others is a basic psychological need that is linked to our internal motivation (the ability to be motivated by internal rewards).[2] Social support is suggested to be important throughout life, but the source of social support changes. For example, parental social support is most important to children and adolescence, whereas spouses, family, and friends are relied on more by adults and older adults.[3] Social support is noted to be important to older adults, and specifically is related to their quality of life. The importance of social support for increasing positive experiences and improving ability to cope with stressful situations is also noted.[4] In addition, increased social support along with self-efficacy has been suggested to help increase physical activity in older adults.[5] This therefore highlights the importance of supporting the maintenance of social support with families, friends and neighbours².


Issues relating to vulnerability and consent must be kept in mind

 number of issues should be kept in mind when working with older adults that may impact their functioning and ability to consent such as: cognitive ability, sensory awareness (e.g. vision and hearing) [7]  and conditions such as Dementia[8]. As a result of this, it is highly important to understand key issues relating to safeguarding when working with older adults.


It is important to increase older adult’s sense of autonomy

The importance of promoting wellbeing and independence for older adults is noted[9]. This is highlighted in key theories such as Self-determination Theory where autonomy is highlighted as a basic psychological need, alongside relatedness and competency[10]. For example, it has been highlighted that “doing with” rather than “doing for” is important to support older adults to stay at their highest level of functioning[11]. The relevance of this for older adults was highlighted in seminal research conducted by Langer and Rodin (1976) who concluded that taking responsibility for themselves (and also for the care of a plant), and being able to make choices led to an increased level of active participation and general sense of wellbeing. [12] This highlights the importance of supporting autonomy in older adults.


Cultural and generational differences should be kept in mind

Cultural and generational differences are important factors to consider when working with older adults. Generational differences in relation to education and attitudes have been noted. In addition, changes in individuals as they age may occur through the natural process of aging (e.g. through biological, social, and psychological mechanisms) and through their responses to historical events and processes. [13] As a result, it will be important to be aware and considerate of these differences when interacting with older adults.


Article references

[1] American Psychological Association (2014). Guidelines for Psychological Practice with Older Adults. https://www.apa.org/practice/guidelines/older-adults
[2] Chen, Y., Hicks, A., & While, A. (2014). Loneliness and social support of older people in China: a systematic literature review. Health & Social Care in the Community, 22(2), 113–123. https://doi.org/10.1111/hsc.12051
[3] Deci, E., & Ryan, R. (2008). Self-Determination Theory: A Macrotheory of Human Motivation, Development, and Health. Canadian Psychology = Psychologie Canadienne, 49(3), 182–185. https://doi.org/10.1037/a0012801
[4] Gariépy, G., Honkaniemi, H., & Quesnel-Vallée, A. (2016). Social support and protection from depression: systematic review of current findings in Western countries. British Journal of Psychiatry, 209(4), 284–293. https://doi.org/10.1192/bjp.bp.115.169094
[5] Unsar, S., Erol, O., & Sut, N.(2016). Social Support and Quality of Life Among Older Adults. International Journal of Caring Sciences, 9(1), 249–257. [6] Becofsky, K., Baruth, M., & Wilcox, S. (2014). Psychosocial Mediators of Two Community-Based Physical Activity Programs. Annals of Behavioral Medicine, 48(1), 125–129. https://doi.org/10.1007/s12160-013-9578-3

[7] Griffiths, M. A., & Harmon, T. R., (2011). Aging Consumer Vulnerabilities Influencing Factors of Acquiescence to Informed Consent. The Journal of Consumer Affairs, 45(3), 445–466. https://doi.org/10.1111/j.1745-6606.2011.01212.x
[8] Evans, D., Price, K., & Meyer, J. (2016). Home Alone With Dementia. SAGE Open, 6(3), 215824401666495–. https://doi.org/10.1177/2158244016664954
[9] NICE Guidelines (17 December 2015). Older people: independence and mental wellbeing. https://www.nice.org.uk/guidance/ng32/chapter/Recommendations
[10] Deci, E., & Ryan, R. (2008). Self-Determination Theory: A Macrotheory of Human Motivation, Development, and Health. Canadian Psychology = Psychologie Canadienne, 49(3), 182–185. https://doi.org/10.1037/a0012801
[11] Metzelthin, S., Zijlstra, G., van Rossum, E., de Man-van Ginkel, J., Resnick, B., Lewin, G., Parsons, M., & Kempen, G. (2017). “Doing with …” rather than “doing for …” older adults: rationale and content of the “Stay Active at Home” programme. Clinical Rehabilitation31(11), 1419–1430. https://doi.org/10.1177/0269215517698733
[12] Langer, E. J., & Rodin, J. (1976). The effects of choice and enhanced personal responsibility for the aged: A field experiment in an institutional setting. Journal of Personality and Social Psychology, 34(2), 191–198. https://doi.org/10.1037/0022-3514.34.2.191
[13] Elder, G. H. Johnson, M. K., & Crosnoe, R. (2003). The Emergence and Development of Life Course Theory. In J. T. Mortimer & M. J. Shanahan (Eds.), Handbook of the Life Course. New York: Springer. doi:10.1007/978-0-306-48247-2_1

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