Older Women: Current and Future Challenges of Professionals with an Aging Population

This chapter explores the increasing phenomenon of grandparent caregiving and the impact on caregiver health and well-being. This chapter presents demographic data on grandparent caregivers as well as a profile of the unique challenges that they face with the hope of informing readers about how to best serve this particular group of older women. The population of grandparent caregivers is predominately female and, although the majority of grandmothers are not necessarily within the traditional ‘aging’ population, a significant portion of this population is over age 60. This chapter focuses on the ways in which these grandmothers differ from their non-caregiving grandparent peers as well as the unique challenges that they face, including risks to their physical, psychological and social well-being, balanced against the benefits that they describe associated with their caregiving roles. The authors include practice and policy implications for interventions with grandmother caregivers to assist social workers in their work with this population and present case examples with follow up questions to place the issue in context.

As women age, the likelihood that they will become caregivers increases. Older women perform caregiving roles in their homes and informally in long term care facilities for chronically ill and disabled family members. Married older women often provide eldercare to their spouses and caregiving roles are increasing as women age and men live longer. Providing eldercare has become a normative life transition for older women and a significant concern when their own health status is waning. Although older men also provide eldercare to parents and wives, their numbers are not as large. While less research has focused on the health implications of older women who are caregivers—the majority has focused on middle-aged adult daughters. Many older women provide care for family members and spouses in their home; however, when family members are too vulnerable and require higher levels of care (e.g. nursing homes or assisted living facilities), they spend considerable time visiting and helping care for them once they are in the long term care system. The purpose of this chapter is to examine the influence of demographic factors on the propensity of older caregivers to provide care to chronically ill and disabled family members and to examine the trends, policy and practice implications for social workers.

This chapter examines the economic wellbeing of older women. As the baby boom generation of women is moving into early “old age” they join earlier cohorts of older women, many of whom are in economically precarious situations, their wellbeing compromised by their economic instability. This chapter focuses on the various “pathways” and contexts that lead to economic distress among segments of older women, including a focus on factors that increase the likelihood of homelessness. Finally, it discusses various policies and programs that could both ameliorate this situation for older women in economic distress and also prevent future cohorts of women falling into economic difficulties.

Healthcare disparities in the United States have increasing become a concern in relation to healthcare outcomes, as well as to social justice issues. These disparities are reflected in statistical differences in healthcare outcomes for different population groups. In addition more recognition is being given to the role of factors influencing health in general. Older women are a subset of those experiencing disparities in access and differential care and many of the disparities are outcomes of the socio-cultural aspects of health. Two areas of inquiry regarding older women and their healthcare (1) are the differences between men and women, generally and more specifically older men and older women and (2) differences in healthcare between younger and older women. This discussion has implications for the practice of medicine, especially in the field of gerontology, as well as for social workers who advocate for individual clients as well as for programmatic and policy changes. This chapter will discuss some of these issues.

The older adult population in the US age 65 and older expected to grow from 12.9% of the population in 2009 to 20% by 2030 (Administration on Aging, 2011) [1]. The increasing proportion of Baby Boomer older adults are expected to live longer and attain a higher quality of life, dependent on improved management of health issues. However, there is a paucity of research in the area of sexual health in older adulthood, especially concerning older women. The reluctance to consider the conversations around sexuality may have direct consequence on health and well-being, Negative societal stereotypes, including a prevalent view of diminishing physical attractiveness, perpetuate false assumptions about aging and sexuality. Women in particular seem vulnerable to expectations of society people that a disengagement from sexual interest and acceptance of asexuality is normative. This myth that older adults are not sexually active individuals may impact the level of medical attention that they receive for issues related to sexual health. Many healthcare professionals are reticent to broach the subject of sexuality with their older adult patients. In this paper we discuss how societal and personal attitudes toward sexual behavior and aging perpetuate myths and taboos about sexual health and overlook the significance of sexuality identity and need for physical and emotional intimacy among older women.

As the baby boomer generation ages, the problem of substance abuse continues to grow among older adults in America. Older women remain one of the most vulnerable among those affected by substance misuse, abuse, and addiction, yet this population remains misunderstood, stigmatized, and overlooked. Unique life changes experienced by older women contribute to the difficulty in identification of substance misuse and abuse within this population. Such experiences include loss of loved ones, loneliness, physiological changes, financial stress, pain management, and other co-occurring mental and physical health conditions. Alcohol remains one of the most prevalent and relevant substances older women use to cope with these changes. This chapter explores the major issues surrounding alcohol abuse among older women by defining the problem, identifying key risk factors, signs, and symptoms, outlining useful screening and treatment tools, and providing implications for future research on this critical yet overlooked issue.

Women in their later years’ experience abuse from their intimate partner. This abuse can be ‘domestic violence grown old’ or ‘abuse in later life’. Two service systems in the public sector respond to these women-adult protective services and domestic violence programs. This chapter compares how elder abuse investigators and domestic violence workers identify intimate partner violence among older abused women by an intimate partner served at their respective agencies in a major urban city. The research study collected qualitative data from interviews of seven elder abuse investigators and nine domestic violence workers describes how they define and contrast elder abuse versus domestic violence. Both systems serving the older woman experiencing intimate partner violence (IPV) define domestic violence similarly. Entry into the systems can be based on mandate of the system rather than the needs of the client. Older women experiencing IPV require the expertise of each system. With strong leadership from both professions, the establishment of collaborative mechanisms, and cross training opportunities, the older woman facing harm from her partner will be served more effectively.

The self unfolds through a life long journey of becoming and making meaning. This chapter elucidates the role of spirituality in older women’s lives. First it sets the context for the role of religion, addressing demographics and research on gender and faith. The distinction between spirituality and religion is discussed. Spiritual struggle and suffering are identified as normative experiences. In a section on theory and models, feminism, gerotranscendence, and narrative are described as they relate to spirituality. Three modern writers and one research participant provide examples of the variation that may occur on a spiritual path. Discussion provides further elaboration and guidance to mental health professionals who want to address and support the spiritual lives of women. Aging invites women to come alive in new ways as they honor the journey home to their authentic self, a self that is always larger than what they can dream.

This chapter outlines the major challenges presented when conducting a survey with older women from a “total survey error” perspective. The total survey error perspective considers sampling error, coverage error, measurement error and nonresponse error in designing and executing a survey. Noting that multiple surveys are routinely conducted with mature populations for estimation, policy analyses, and program evaluation, the chapter discusses special circumstances that should be taken into account when mature women are in the sample or are the focal population. The chapter provides guidance in avoiding or mitigating error through design and adjustment.

Group connections are powerful tools to help older women to sustain a sense of well-being and health. The healing qualities of groups have the potential to mitigate issues of social isolation and loneliness. Women find support, camaraderie and hope through group membership. This chapter describes common challenges faced by older women and explains the healing quality of belonging to diverse types of groups.

Effectively exploring the well-being, health and mental health needs of the aging lesbian community can often be difficult and multi-leveled, while insuring a competent and comprehensive assessment of needs. A limited amount of research has specifically attended to the lives and unique experiences of aging lesbians, along with those of the larger LGBT community, therefore such matters remain poorly understood. Regardless, insuring any dialogue surrounding the needs of older lesbians must underscore their resilience - which for many has included becoming actively engaged as advocates for visibility and change - especially during the late 1960s and Stonewall Inn revolution, as well as the early 1980s and beginning of the HIV/AIDS epidemic - despite ongoing discrimination and prejudice. This chapter examines some of the background statistics on the older lesbian population, exploring lifespan and developmental topics including: coming out; relationships and marriage; parenting; and age cohort differences along with caregiving, death and dying, and risk/protective factors related to sex and sexuality. The chapter concludes with implications for social workers, counselors, and others health practitioners, focusing on affirming approaches and models of practice.

Background: There is evidence that the stigma regarding older adults can be modified with experiential opportunities early in medical students’ careers. The Buddy Program pairs first year medical students with persons with dementia to develop a mentoring relationship outside of the clinical setting. Methods: Using qualitative content analysis of journal entries kept over an academic year, this chapter examines the experience of a female medical student paired with a 74-year-old woman with Alzheimer’s disease. Results: Emergent themes included - 1) recognition of the evolving nature of the students’ thoughts about dementia over time, 2) the student’s awareness of the subjective response of the person with dementia, 3) the student’s own emotional reactions to the person with dementia, and 4) the student’s understanding of the family experience. Conclusion: As a result of taking part in the program, this student experienced a more holistic view of the person with dementia and her family and a changed perception of dementia and what it is like to live with it.