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"Those who love deeply never grow old; they may die of old age, but they die young."

—Arthur Pinero


By the end of this chapter, readers will be able to:

  1. Discuss the importance of social occupations in the lives of older adults.

  2. Describe typical social networks of older adults.

  3. Discuss the concept of reciprocity.

  4. Describe typical family occupations in later life.

  5. Identify cultural myths about sex and older adults.

  6. Describe how demographics, health status, and health care affect the sexual activity and sexual satisfaction of older adults.

  7. Describe strategies for responding to clients' concerns about sexual issues.

  8. Discuss the nature and processes of informal caregiving.

  9. Discuss strategies for establishing therapeutic interactions with elders and families.

Clinical Vignette

Manny Alvarez is a 72 year-old retired postal carrier. He lives in a well-tended bungalow in a suburb of a large Midwestern city, the same house in which he and his wife of 40 years (now deceased) raised their four sons. Mr. Alvarez spends a good bit of time sitting on his front porch chatting with his neighbors. The 93-year-old woman right next door has been the beneficiary of his handyman efforts, and he usually cuts her grass in the summer. Of his four sons, two live in the same city, and they stop by frequently with their children to visit. From time to time, Mr. Alvarez looks after the grandchildren while his sons and their wives take vacations or when the boys are out of school on a workday.

  1. What strengths do you see in Mr. Alvarez's social network? How do these strengths contribute to his quality of life?

  2. What concerns might you identify in thinking about Mr. Alvarez's current and future social needs?

Social interactions and occupations play a prominent role in the lives of elders. A huge body of literature discusses the importance of family and friends in promoting positive aging, quality of life, and well-being (Chappell & Funk, 2011). To be effective in providing services for older adults, it is essential to understand the diversity of social networks and families that include older adults, both in terms of structure and occupations. Factors associated with positive social interaction in later life include long-standing good relationships with family and friends (Choi, Yorgason, & Sohnson, 2016; J. K. Wolff, Lindenberger, Brose, & Schmiedek, 2016), ability to help others (Bulanda & Jendrek, 2016; Greenfield, 2009), sense of spirituality (Krause, 2003), and established intergenerational networks (Bulanda & Jendrek, 2016).

It is clear that elders with strong social networks age best, but it is also clear that they face various challenges in maintaining satisfying relationships and coping with the inevitable changes wrought by the aging process. Friends and family move away or die. Elders become more limited in the abilities required to sustain relationships, including community mobility that facilitates interaction and hearing required to communicate effectively. ...

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