The International Journal of Aging and Human Development

Nonverbal expressions of power and control in the daily lives of old people are examined from a life span perspective that combines social exchange theory, Goffman's classic work on deference and demeanor, and Henley's power theory of nonverbal communication and paralinguistics. Because of societal devaluation of the aged and the typical later life declines in power resources, old people are likely to experience a loss of status and social control during everyday nonverbal rituals of dominance and deference. Supporting evidence is drawn from studies of the social impact of the physical setting and interactions between institutionalized old people and staff members. Discussion emphasizes the generally subtle nature of nonverbal expressions of dominance and deference, the impact of normal sensory declines in typical later life role transitions, and the potential for ageist interpretations of nonverbal cues.

At the heart of the rapidly growing American hospice movement is a philosophy of care that emphasizes patient individuality and responsiveness to total needs of the dying and their families. To date, the response to this model of terminal care has been favorable. The hospice is viewed as a humanizing mode of health care with a capacity to enhance the quality of life experienced by persons defined as terminal. Data gleaned from participant observation in an American hospice program by one of the authors supports this view. The hospice has the potential to provide a social context for humane, personalized death in which maximum effort can be made to control pain in all its forms: physical, psychological, social, and spiritual. Sociological literature has been much harsher in its assessment of the quality of life in nursing homes. Such discussions frequently include references to nursing home environments as fostering loss of autonomy and social death. This paper suggests that the hospice approach to care of the dying includes several elements that can be utilized to improve the quality of life in nursing homes: a total needs emphasis, increased patient autonomy, open discussion of death, a community ideology, a team orientation that cuts across levels of staff hierarchy, a role blurring of caregivers, focus on patients and families as the unit of care, and mutually beneficial integration of hospice with the outside community. There are, however, crucial differences between a hospice and a nursing home which may hamper direct transference of humanizing hospice principles, e.g., hospice patients are defined as terminal; staff, thus, can be motivated to put forth their best because of perceived time limits. There are also important differences in the characteristics of patient populations, length of stay, economic constraints, ability to attract volunteers, and emphasis on task-orientation. The time has come to apply increased ingenuity to adapting humanizing hospice principles to the care of elderly in nursing homes.

This paper explores the nature of informal support given to older women, depending upon their marital status and the presence of living children. To control for differential availability of formal resources and for background characteristics, random samples of 371 noninstitutionalized female residents of two midwestern life care communities were interviewed. We found, unsurprisingly, that women who were presently, or who had been married, received more emotional, social, and instrumental support from their family members. But in further analysis it became clear, much to our surprise, that the presence of a husband only assured the married women of significantly more instrumental (task-oriented) support. It was the existence of living children-even just one child-that generated greater emotional, social, and instrumental support from her family. The greatest informal support deficits are among the never married, as expected, but are a result of the lack of children rather than the absence of a husband.

The life satisfaction and death anxiety of elderly women were investigated as a function of demographic, life history, and stress variables. Through multiple regression, life satisfaction was predicted by number of friends, good health, and, surprisingly, by having fewer offspring living in the same city. Health problems, change in living conditions, and relatively high educational level were predictors of death anxiety. It was concluded that life satisfaction and death anxiety are a function of past and present life experiences and conditions.

Sixty-eight recently admitted nursing home residents received a battery of psychological tests and were rated on a number of behavioral indices by a tester and by a nursing home staff member. A principle components analysis was performed on the tests and rating scales to determine their interrelationship. A varimax rotation was performed, and simple structure was approximated with four orthogonal factors, which accounted for a total of 71.4 per cent of the variance: Factor I, “Intrapsychic State”; Factor II, “Cognitive Competency”; Factor III, “Self-Image”; and Factor IV, “Environmental Competence.” These results revealed that: 1) the morale/anxiety dimension was independent of cognitive competency; 2) newly admitted nursing home residents who perceived themselves as internally controlled (felt that their behavior could affect change) were rated high by others in behavioral competency; 3) self-rating scales apparently measure something independent of the other tests and the ratings by others.

Intelligence can be defined as the ability to think logically, to conceptualize and abstract from reality. Wisdom can be defined as the ability to grasp human nature, which is paradoxical, contradictory, and subject to continual change. These two constructs hold potential for highlighting positive and adaptive features of development in the later years. Both are considered to increase with age, and both provide for life-long acquisition of knowledge. Despite these phenotypic similarities, this paper attempts to illustrate that the nature of wisdom and its function in the developmental process differs sufficiently from cognitive ability to warrant separate scrutiny. These two constructs are compared with respect to the domains of behavior they represent, the operational tasks used to assess them, and the relationship of logic and time in their development. The function of intelligence is characterized as focusing on questions of how to do and accomplish necessary life-supporting tasks; the function of wisdom is characterized as provoking the individual to consider the consequences of his actions both to self and their effects on others. Wisdom, therefore, evokes questions of should one pursue a particular course of action.