Question

Lydia and John were a couple in their nineties who lived in their own home and had been married over sixty years. Both were confused and forgetful. They had two sons who were in their seventies and lived in nearby towns. One son was estranged from them. The other was somewhat involved in their lives, but he had a mentally ill wife and health problems of his own to deal with. The couple first came to the attention of a protective service worker when John was hospitalized after a fall. When left on her own, Lydia’s confusion became more pronounced. A referral was made for home care services, but, when a worker went out to assess the couple, their son was present and refused services. Based on concerns of benign neglect, a protective services report was issued. A case worker investigated and substantiated the report, citing the son’s interference with services and the couple’s own inability to provide adequate care for each other. The protective services worker found both John and Lydia to be very forgetful and somewhat confused, though Lydia was the more impaired. Due to their increased physical frailty, they had been using only the first floor of their home. Since the bedrooms and bathroom were upstairs, the living arrangement presented several problems for the couple. Lydia had a regular bed, but John was sleeping on a cot. The low height of the cot caused him to lose his balance easily, resulting in several falls. Since there was no toilet downstairs, they were using a bucket in the kitchen and emptying it outside. They were unable to maintain their home and conditions became unsanitary. The son tried to help, but he had his own limitations. The elderly couple was well able to afford assistance, but they did not want to spend the money. Furthermore, even though the son who helped with paying the bills was not taking advantage of his parents financially, he was obviously concerned with “preserving his inheritance.” Meanwhile, John and Lydia were extremely conservative in terms of how they chose to spend their money; they insisted they could not afford help.

Consider Lydia’s and John’s cognitive and physical limitations as well as their social support. If presenting this case to a team of other human services providers, what developmental theories, concepts, and principles help explain this case?

Answer 1

Accordig to the National Institute on Aging (2007), in 2017, the number of individuals aged 65 years or above have been predicted to exceed the number of individuals less than 5 years old. Simply speaking, aging is an irrevocable process of becoming older, which sets in deterioration in physical and mental health of an individual and calls for dealing with several 'old-age challenges'. Old age is the final stage of human life span, which is known to commence after 65 years of age.

Delving deeply into aging led to development of theories, concepts and principles to help one understand the processes, changes and challenges involved in aging. The above mentioned case can be explained in terms a developmental theory called the Personality Theory of Age and Aging. According to this theory, unforeseen events (in this case the 'falls') or age-normative events may result in repercussions (in this case, confusion and forgetfulness). For any kind of adaptation, personality plays a significant role. According to the trait model, personality traits tend to be consistent with age. Lydia and John may have been 'extremely conservative' and continued to be so even after attaining old age.

A person not only has to adapt to physical and social changes, but also develop lifestyles, which can result in greatest ego involvement and life satisfaction. In this case, Lydia and John had developed cognitive and physical limitations and needed lifestyle changes and social support, but their personality trait of being 'extremely conservative' prevented them from utilizing 'home care services'.

Reduced Processing Resources is a theory which explains that there is reduction in cognitive performance or quantity of one or more processing resources, for example, reduction in attention, working memory or speed of processing. In this case, it can be said that Lydia and John became 'confused and forgetful', which highlights reduced processing resources to perform cognitive functions. Lydia and John failed to analyze the importance of home care services. therefore, they refused  to spend their money on home care services.