Elderly Care, Death and Dying Research Proposal

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The problem that exists in attempting to better understand elder care abuse from a clinical and social perspective, is that there are not enough studies relative to these contemporary times from which to gain insight in order to benefit a clinical approach to protecting elderly from the abuse, and to identity and intervene with a clinical approach at risk elderly people. Johnson, et al., describe elder abuse as interpersonal violence, that has beginning in the latter part of the twentieth century come to be identified as a violence against an age specific segment of the population (325). It is, Johnson, et al. say, a problem that has drawn focus on the same plane as human rights, gender, equality and population ageing (325). This is a timely focus and concern, because in the next decade there will be an unprecedented number of elderly world-wide, and especially in America, who are the product of the baby boom generations becoming the elderly population in America.

Johnson, et al., say that researchers in developed countries, presumably America too, have created a situational model of elder abuse, attributing it to overburdened care givers (325).

"a dependent elder (exchange theory), a mentally disturbed abuser (intra-individual dynamics), or as learned behavior (social learning theory) (Bennett, et al. 1997). Others have used the imbalance of power within relationships (feminist theory) and the marginalization of elders (political economic theory) to explore this issue (Whittaker 1997). Early on, elder-abuse researchers realized that a single theory could not accommodate such a complex, multi-faceted phenomenon. For child abuse and more recently domestic violence, a similar realization has led to the adoption of the ecological model as a means of explaining interactions across systems (Johnson et al. 325)."

The ecological model would be consistent with Cordry and Foster Stebbins identification of class distinctions related to family care and primary care givers in elder care settings across those class spectrums in America. The ecological is the most recent and prevailing theory that helps experts to explain the problem of elder abuse (Johnson et al. 325). Since it is a theory that is explains elder abuse in correlation to the findings of Cordry and Foster Stebbins, who actually because of the number of primary family care givers cited in the studies they relied upon, tend to overlook the potential for a family member as a primary caregiver to the elder family member as potential abusers.

The weaknesses of any of these theories, especially one that treats the care of elderly as irrelevant because a primary care giver is an immediate family member; is that there continues to be a lack of extensive and clinically useful data that can be used to prevent elder abuse. The dynamics of elder abuse are, therefore, best explained using the ecological theory, which encompasses all of the other socioeconomic factors, but perhaps overlooks the medical factors that come into play when an immediate family member is the primary giver. How the immediate family caregivers arrive at choices they make on behalf of their elderly parent or family member when that family member suffers from conditions like Alzheimers, dementia, or other debilitating diseases and conditions that are not readily explained by the theories offered, and even the ecological theory seems inadequate in explaining in cases that might involve assisted termination of the elderly life by the family member.

This is a complex problem wherein no individual theory is sufficient, and each case must be examined on specific and individual case criteria. Perhaps this is the biggest obstacle, because we cannot group under an individual theory the vast number of case dynamics across the class structures identified by Cordry and Foster Stebbins. Therefore, we must closely examine existing studies, and cases in the literature to weigh the problems at the source, and to attempt to better define the directions from which abuse is being leveled at elderly, and group those directions into a study. Existing literature would be an essential first step in approaching a directional approach to understanding the problem. Thus far, these theories fall short, probably because there is insufficient research to understand the problem on a larger scale.

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But we cannot stop at these theories alone, and must look across a broader spectrum, as broad as the class lines cited by Cordry and Foster Stebbins, to gain a larger understanding of the problem.

Age Discrimination Social Breakdown Labeling Theory

That the elder abuse problem is widespread, and increasing, is indicative of age discrimination, social breakdown and labeling theory. The problem must be discussed in part with this theory, because elder abuse at the end stages of life is the culmination of a pattern of discrimination that begins at around age 50. None of the theories so far discussed have adequately taken into consideration the pattern of discrimination that people begin to experience at around this time in their lives, tying that discrimination into the culmination of elder abuse.

Looking at these two aspects of social behavior, age discrimination and elder abuse, we are bringing to both concepts perhaps a new perspective by drawing a link between them. This requires an intensive review of existing literature on both subjects, and identifying the correlating social conditions, behaviors, and outcomes that support the correlation.

There is a vast amount of literature available on age discrimination. Raymond F. Gregory (2001), in his book, Age Discrimination in the American Workplace, introduces the older person (50 and up) as a worker in the work place, and then takes the reader through the worker's experience, first, as an aging person who experiences discrimination based on the age factor, then the legal processes and alternatives that the aging worker has in asserting their right to work (not the same as the right to work laws created to discourage and curtail Equal Employment Opportunity claims of age discrimination). As with any current discussion on ageing in America, Gregory introduces the subject of American baby boomers. Gregory introduces the baby boomer by saying:

"Employers commonly make decisions older workers that assume these workers are no longer capable of performing adequately. Older workers are thus subjected to adverse employment decisions, motivated by false and stereotypical notions relating to age, without regard to their physical or mental capabilities (5)."

As is evidenced in Greogry's opening remarks about the boomers, here is the beginning of the person who is embarking upon the first steps into their elderly years being socially devalued and relegated to role reflective of the end of their usefulness in contributing to society (consistent with Johnson, et al., observation of relegation concerning the elderly lifestyle). It would follow that the experience of being labeled as no longer useful in the workplace would impact the ageing person adversely, manifesting itself in other areas of the individual's life. Work and the sense of social contribution are tangential to maintaining the psychological and emotional wherewithal to experience a healthy ageing process. When age discrimination in the workplace occurs, it is a blow to the health of the person who experiences the discrimination, and who consequently suffers for that discrimination in the family and social settings. For this reason, Gregory's book, which is a thorough and detailed discussion of age discrimination, would be useful in furthering the statement of social causal relationship between age discrimination and elder abuse. "Age closes doors," Gregory writes (5), and those doors, remain closed as the individual ages through and beyond the workplace.

Your Time Will Come, a book by Lawrence Friedman, devotes part two of Friedman's discussion on age discrimination to retirement as the end of the road for the ageing (73). Friedman reviews the difficulty with which Age Discrimination Act laws were created, and their subsequent enforcement upon a society that had evolved to perceiving the ageing as irrelevant in the contributions they are capable of making to society (73). This supports the contention made in this essay that perceived as disposable, and beginning at a very early age in life, given that average life expectancy years have increased, society is relegating the ageing members of our society to roles of irrelevance. This having begun at age 50, as is supported by Friedman's book, institutes a pattern of acceptable attitude and treatment of the elderly by what has.....

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