Sociological Approaches in Social Work with Older Adults

Introduction

An approach refers to an act or means of approaching; a way of approaching an occurrence, which can also be termed as a theory that guides on ‘how it is done’ (Greene 2017). In this paper, an approach will be termed as the way in which a theory or theories are used in sociological interventions. In this regard, a theory is a specific manner in which sociological approaches are structures, which forms a pattern to be followed by social workers during intervention.

Plethora of literature identifies several approaches in social work with different groups. These approaches include psychosocial, behaviour modification, functional, problem solving, crisis intervention, psychoanalytical, family therapy, client-centred, transactional analysis, task-centred, existentialism, and reality therapy among others (Wang and Chonody 2013). This study primarily focuses on social work with older adults thus will consider how sociological theories can be used to understand older adults in the environment as well as the relevance of these theories in caring for older adults.

Disengagement Theory

Disengagement theory is a detailed theory that was created via research and documented in the “Growing Old” book in 1961 by William E. Henry and Elaine Cumming. Disengagement theory has emerged to be among the most popular theories in practice with older adults. This theory holds that older adults are the ones that initiate the disengagement process (Johnson and Mutchler 2013). The disengagement theory does not consider any society structures and processes that limit the opportunities in which older people can engage. Since its origin in 1961, the disengagement theory has been having an enormous effect on the ageing views. According to the disengagement approach, an adult who is older withdrawing from the community is part of the process of “natural ageing”, which is considered a lifestyle (Foster and Walker 2014). From this perspective, old age is seen as the period when an individual ready for death therefore they start foregoing the ties and relationships they had with others (Toepoel 2013). The disengagement theory also holds that ageing brings along a sense of loss of role, powerlessness, loneliness, increased dependency, and loss of sense of purpose (Lloyd et al. 2014). The theory also identifies older adults’ position as a costly and a burden which is non-productive on the community and the family, which is easily incorporated as a culture.

Hantman & Gimmon (2014) view the disengagement theory of ageing as a simultaneous withdrawal whereby adults who are aging withdraw from the community and as well the community withdrawing from the aging adults, which seeks to ensure maximum functioning of both the elderly and the society. The older adults wish to escape the pressure and the stress of their capacities which are diminishing and which compels them to withdrawing (Boudiny 2013). The time that disengagement begins varies across persons. The process involves loosening social ties which is influenced by reduced social interaction (Jewell 2014). On the other hand, Van Dyk (2014) state that aging older feel the period to death is foreshortened, life experience is narrowing, and they are losing their self-esteem, which are all factors associated with the start of the disengagement process. At the same time, the society is in need of people with newer skills and energy, which influences the society’s disengagement with the older adults. This implies that as people grow older, they gradually become disengaged to the society in that their energy is declining thus they lose their roles (Cosco et al. 2017). After the elder adults undergo the initial stages of disengagement, they accept their new status of being disengaged and regain a sense of self-worth and tranquillity.

The disengagement theory of ageing has received a great deal of criticism. According to Johnson and Mutchler (2013), the theory ignores the effects of social class on experiences of aging as well as how structures of the social class and the associated links hinder most of the aging adults from enjoying opportunities and advantages in the society. From the social class perspective, the authors hold that it could be argued that disengagement gives negative bias of ageing as part of the life to be feared, that on the other hand influences disengagement and a negative perception of older adults thus lowering the quality of the care they receive (Van Dyk 2014).

Zaidi and Howse (2017) criticise the disengagement theory purporting that the approach is ethnocentric since it reflects the serotyping of male-dominant industrial community. On the other hand, Greene (2017) states that the disengagement theory is disadvantageous in that it limits interventions through which the older adults receive care. Boudiny (2013) questions why some older adults choose not to engage while others do not embrace this idea holding that, therefore the community compels individuals into disengagement against their will and only the strong are not swayed by these forces. Therefore, the disengagement approach fail to explain why some aging adults disengage while others remain engaged to the society. On a different perspective, Bandura (2014) state that increased social and physical stress are what accompany ageing rather than age per se, which influences disengagement. Therefore, it is not ageing that causes an older adult to withdraw from the society but the physical and social stress associated with old age.

In light of the above limitations of the disengagement theory, Toepoel (2013) states that the approach emerged from a specific context of social thought thus cannot be generalised to the entire older adults’ population. The most suitable context is in which biology-as-destiny prevails and in which the role of various factors such as cultural, socioeconomic as well as gender factors are not considered (Toepoel 2013).

The disengagement theory has its relevance in social care with older adults. Topaz et al. (2014) write that the disengagement approach helps in getting rid of the negative and unrewarding activities and events, which significantly promotes the wellbeing of older persons. Additionally, the disengagement theory eliminates the unnecessary activities, which enables the older adult to focus on positive interactions that promote a healthy existence. To social work practitioners, the theory implies they should enable older adults identify the essential interactions that will promote their wellbeing and shun the negative and unrewarding ones. Thus, the social worker should be at the core of helping the older adults identify and work with the only rewarding activities. This way, the older adult will be able to optimise the value of his/her remaining days.

The activity theory is concerned with successful ageing and holds that people develop ideas about themselves and their identity from the things they do and the roles they fulfil in life (Rechel et al. 2013). The theory contends there are roles that people give up as they grow older and this significantly affects their identity. As such, the theory purports that new and meaningful activities have to be developed in order to replace those that have been lost. On the other hand, Topaz et al. (2014) state that activities in the later life phase are at the core of restoring an individual’s wellbeing and sense of value therefore the activities an older adult engages in in later life have personal meaning and value to different individuals. Thus, the activity theory serves to see that an older adult develops activities that deny limitation of old age to promote successful ageing (Jewell 2014).

Activity Theory

Activity theory has been considered dominant in that it continues to be used in social work in caring for the older persons. Victor (2013) states that social activity is necessary for all people despite their age thus not lost with ageing. As people grow older, they adjust to new activities, which keeps them physically, mentally, and, socially active. The early proponents of the activity theory contended that for people to age normally, they must retain the attitudes as well as activities of middle age as long as possible while replacing any activity the elderly have been forced to give up. According to Powell (2013), persons who have ability to remain socially active have a higher likelihood of achieving social integration, a self-image which is positive, life satisfaction, and as such might age successfully. The activity theory identifies social activities as the factor that significantly influences how an individual will age.

In most cases, the elderly have no real place in the society since they are left out of social activity (Martinson and Berridge 2014). From this perspective, older adults have a ‘roleless role’ thus should not be excluded from activities that are of social value. Instead, a new role for the elderly should be developed, which should consider obligations and responsibilities that could increase the lifestyle quality lived by older adults (Martinson and Berridge 2014).

The roleless role, which implies that the elderly have no social function, which is similar to Durkheim’s concept of the ageing where he holds that they are in a normless state. The elderly in the normless state do not agree with the rules that guide the behaviour of the society, and thus are discriminated from participating in community and social activities. Some elderly persons are able to maintain their sense of belonging and wellbeing as the social networks change, which indicates that not all elderly persons are in the normless state (Nyqvist and Forsman 2015). Those that are able to maintain their social networks are considered to have the ability to age successfully as they continually achieve satisfaction with their life (Gilleard and Higgs 2014).

Criticism against the activity theory finds it unnecessary for the elderly to maintain the same high degree of activity as they were in their middle age in order to age successfully (Victor 2013). Instead, recent researchers indicate that the elderly people have to develop other activities to replace what they are unable to complete in order to have high self-esteem and life satisfaction (Toepoel 2013). This implies that the notion normless state does not apply in that the elderly are continually finding new ways they can participate in the society. Additionally, at no point will the elderly have completely no role in the society since they had a planned behaviour, which subjects the roleless role to criticism). According to Walsh et al. (2017), when the elderly are not active in the society, they lose their self-esteem and therefore they have to look for opportunities they can fit in order to regain their self-esteem. Thus, the notion that the elderly play a roleless role in the society id misinformed. Still, Warburton et al. (2013) write that many of the elderly seek a more relaxed life and are quite happy when they achieve it, which means that the elderly do not always have to be active in the society in order to gain life satisfaction.

There is need for the active theory of ageing to be tempered with the reality because a significant part of the elderly have no ability to maintain a lifestyle which is active while lack the resources required to maintain an active role (Biggs and Kimberley 2013). The active theory of ageing cannot also be used in an increasingly judgemental society whereby a considerable amount of money is required to support the health and wellbeing of the elderly. In such societies, some older adults might be able to remain active and are seen to be responsible for their decline, which implies that the theory might blame the elderly for their decline in health and wellbeing. The active theory is also criticised for being so much idealistic thus forcing family-oriented activities and the moral of the middle class into the lives and actions older adults.

The active theory of ageing has implications for social work practitioners. From this sociological approach, successful ageing is realised when the elderly have a role to play in the society and are satisfied with their lives. This implies that social work practitioners should create new roles for the elderly in the society so they do not remain dormant. Such roles should not be very physical nor require a lot of movements given the limitations of the elderly. Such roles could include consultancy and advisory roles given the experience that comes with age. Alternatively, social work practitioners should identify the goals of the elderly in the society and support them to attain their targets in order to ensure the older adults acquire life satisfaction.

Continuity Theory

The continuity theoretical perspective holds that an individual’s preferences, patterns of behaviour and values remains consistent over his/her lifetime regardless the life dynamics the individual experiences (Minhat et al. 2013). From this perspective, the later lifestyle is just a continuation of the earlier lifestyle. This implies that how an individual is as a younger person is how he/she will be at older age. The patterns a person has developed over a lifetime have a considerable role in informing the beliefs, values, and behaviours in older age (Stephens et al. 2015). This individual change does not neglect the changes in the society over a lifetime since the social changes has a significant influence on the values of the people in that society.

Bluck and Liao (2013) identified four personality types in which older adults can be classified including integrated, armoured-defenced, passive-dependent, and unintegrated. The integrated personalities are those that have successfully adjusted to ageing and still broadly engaged in social activities. The armoured- defenced are inclined to continue the roles and activities they held during middle age. The passive-dependent persons are highly dependent on other in the society of show disinterest in the activities of the society. Lastly, the unintegrated personality types are those that fail to successfully cope with ageing thus completely withdraw from the society. From these four personality types, the continuity theory can be seen as a response to ageing, which differs across individuals.

Critics of continuity theory caution that the social context in which a person ages has a more important role than personality in determining how and what roles the individual plays in the society (Toepoel 2013). On the other hand, Van Dyk (2014) challenges the continuity theory in that as one ages, the ability to do some tasks in naturally lost thus the person at old age might not be able to complete the same tasks he/she completed at middle age. Further, one may not age in the same culture he/she was in during the middle age thus some activities might not be acceptable in the new culture: this implies the person might be forced to be inactive, which questions continuity in actions.

To promote continuity towards successful ageing, social work practitioners should seek to understand the social activities an older adult enjoyed and the role played during middle age and gives the necessary support for the person to complete them at older age. In cases where the roles played in the middle age cannot be played, social work practitioners should help person identify and develop new roles to ensure the person remains socially active. This will be essential in ensuring every older adult has a role to play in the society and values to pursue, which promotes life satisfaction.

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