To make this goal a reality would develop and bring to the Americang melting pot millions of potentially brilliant black minds that could serve as the impetus to put America back on top.

It is the responsibility of every American to take immediate, specific, active steps to improve the plight of the black male. If we begin now to implement a powerful program and rescue troubled black males and to eliminate racism and other factors

that make it difficult for them to become good fathers, perhaps the definition of black family may still differ from that of mainstream society, but will nevertheless be futuristically and positively oriented as opposed to the destructive path now being traveled. Then, black youngsters will not need to look to athletes as role models. They can look within their own families. They can be their own heroes in a society that now seems to fear and despise them. •

Coping with the Methuselah Syndrome

Mary Ann Barnhart And all of the days of Methuselah were 969 years and he died.

—Genesis 5:27

When "Mother" Mary Jones celebrated her 100th birthday on May Day 1930, there was no Willard Scott or public television to announce it. But

assisted by her caretakers on the lawn of her home, she made a vigorous speech for the talking-picture cameras. Six months later she died of old age. Her funeral was not somber. The theme was taken from her own words: "Pray for the dead, but work like hell for the living." She had begun her career as a labor organizer at the age of fifty. She had no role models and no one of her own age to pal around with. She had a task to fulfill and a purpose to motivate her.

In the early 1950s when the study of social gerontology began, the reports sounded as if a hidden species had been found. Here in our own society we had people who were sixty, seventy, and even eighty years of age and they appeared to bear some similarity to younger members of the population. Ruth Cavan, a sociologist, contended that these people had the same needs as people of twenty, thirty, and forty, namely, to love and be loved, to make a contribution to those around them, and to engage in new and interesting activities. Those who agreed to be interviewed talked about personal failures and successes. A research project in a nursing home concluded that individuals who had been isolated in their rooms became more alert and responsive when moved into groups at various times of the day.

An article published in 1949 asked the question "Are the

Mary Ann Barnhart, a licensed professional counselor and a licensed marriage and family therapist, is the coauthor of one book and author of professional papers on family life and gerontological problems. Her practice is in North Texas.

Aging Ex-Family?"' There was nothing in family life-cycle research at that time to account for a family stage past the time of launching the children out into the world on their own. It had been very typical to die before old age.

Twenty-five years later, in the 1970s, family theorists focused on the "empty nest syndrome" and encouraged women to undertake pursuits to fill the void left by departed children. Today the so-called empty nest may fill up with grandmother or grandfather as well as a son or daughter going through a divorce or career change.

Of all the people in the history of the world who have passed their sixtieth birthday, an estimated two-thirds are alive today. There are more people over sixty-five in the United States than constitute the entire population of Canada. It is expected that within the lifetime of people now living, our present elderly population will double. We will see an America in which one out of four citizens will be older than sixty. The median age now is close to thirty-one years. By the year 2040 it will be over forty years. The fastest growing segment of the population is eighty-five and up. The ninetysomething generation numbers one million, with only one-third in nursing homes.

Speculation about human longevity and rejuvenation have flourished since antiquity in many different societies. There were sages who prophesied that human beings would find a way to become immortal. For hundreds of years, alchemists attempted without success to prepare rejuvenating elixirs. Currently there is a proliferation of books and articles on ways to defeat the aging process (cosmetically and otherwise).

Walter M. Bortz of the Palo Alto Medical Foundation in California has published a bestseller entitled We Live Too Short and Die Too Long: How to Achieve and Enjoy Your Natural 100-Year-Plus Life Span.2 The book builds a case for a possible maximum life span of 120 years. Drawing from thermodynamics, as well as from anthropological, geronto-logical, and biological research and his own clinical experience, Bortz teaches individuals to concentrate on health rather than

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disease and advocates a transition from the curative model to a preventive model in medicine.

Many would say, however, that although science and technology have extended our years of living, they have increased our years of chronic illness and misery. Medicine has taken us to the point of sophisticated dehumanization.

"The fastest growing segment of the popu-lation is eighty-five and up. The ninetysome-thing generation numbers one million, with only one-third in nursing homes."

Individuals seem to have been left without scripts or maps to handle the extra years they have been provided, just as they were left with no outlines for marriage and family life past the empty-nest stage. Today the challenge lies in making plans for late retirement, post retirement, or, perhaps, serial retirement.

n counseling persons age sixty-five and up on a daily basis, I hear many expressions of bewilderment about what to

do with this unexpected time. In the words of one woman, "It would be such a relief just to go to sleep and not wake up in the morning. My whole life was centered on my husband for fifty-six years. Since he died four years ago nothing has interested me."

Another woman said it this way: "I am bored shitless. At seventy-six there is no way I can get a real job. Everybody is crying for me to do volunteer work, but I'm sick of that."

A man in his eighties asked, "Why am I here when all of my friends and loved ones have died?"

When asked by a peer why she said she wanted to die, a woman snapped back, "If you had lost your parents, your husband, and the use of your legs, you would want to kick the bucket too." Another man said, "Living in that retirement center is like looking down a gun barrel. You know it's the last stop."

Well-known author Kurt Vonnegut says he does not understand why more people don't commit suicide because of so much despair in their lives. It is good, however, to hear some optimism to counter the despair. A man who had taken care of his wife with Lou Gehrig's disease until her death said, "Well, I never expected to make it to eighty, but now that I'm here there must be a reason."

Zorba the Greek describes vigor and joy in a long life: "I've done heaps and heaps of things in my life, but I still did not do enough. Men like me ought to live a thousand years."

When persons of varying ages are asked, "Do you want to live to be 100?" responses almost always include a big "if"—"If I keep my wits"; "If my money doesn't run out"; "If I don't have some dreadful illness"; or "If I don't become dependent on anyone."

Some may spend years in ambivalence, holding somewhere between life and death. Mr. Dickson at the age of ninety-one made three attempts to commit suicide. When he talked

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about it he said he wanted to be with his wife who died eight years ago. His son said he made the attempts to get attention and always had someone close by who got to him in time. The last attempt was a slash across his groin with a dull razor.

Many engage in circuitous self-destructive behaviors. Mrs. Martin has told her children a number of times that she will probably die by choking. A few months ago she had a choking incident that resulted in hospitalization and eventually the insertion of a feeding tube. She has recovered somewhat. At least the tube has been removed and she eats small amounts of food on her own when carefully monitored. She is being treated for depression.

When Mrs. Massey was told by her psychiatrist that she needed to go to a nursing home, she got up from her chair, walked across the hall and began banging her head on a door.

Refusing to eat, refusing to take medication, continuing to smoke in spite of a diagnosis of pulmonary disease, substance abuse—all are forms of circuitous self-destructive behaviors. The current wish seems to be not that we achieve immortality but that we live out our fated life span with fewer infirmities and minimal loss of autonomy.

In a recent issue of Generations, the journal of the American Society on Aging, George Maddox states, "If personal goals however limited are achieved in a personally satisfying and socially acceptable way, aging well is theoretically within reach of most older adults."3 The "older persons" category has been broken down into subcategories. Those between the ages of fifty and sixty-four are referred to as "mature adults." According to marketing research, they spend as much money on sports and exercise equipment as those in lower age brackets. They are also the ones taking care of everyone else.

Those between the ages of sixty-five and seventy-four are referred to as the "young old." Many have good incomes. Their homes have been paid for, and they spend more on entertainment (including travel) than any other group. Some financial planners say this group should spend less time on fun and more time in community service in order to make up for the extended time that they will be unproductive as aging persons.

The bracket seventy-five to eighty-four finds many people continuing their lifestyles much as always, but there is an increase in spending for medical services and other kinds of assistance. Those eighty-five and up are referred to as the "extremely old."4 About 22 percent have disabilities requiring institutional care.

Occasionally you still hear the lament: "Why don't families take care of their older members the way they used to?" Actually, at an earlier time in our history the number of families that lived happily in three generational households like the Waltons was very small. At present, 80 percent of the caregiving for elderly persons in various levels of dependency is provided by family members. The fifty to sixty-four group, or the "sandwich generation" as it is often called, may be helping mom and dad with everything from transportation to finding a new living arrangement. At the same time, the sandwich generation helps children either in college or in the process of launching careers. It must be pointed out that the

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sandwich may have one or two additional layers. Many grandchildren are involved in caregiving.

Some families manage to be very agreeable in handling difficult situations. On the other hand, in case after case, one sibling becomes bitter because the others fail to share the burden. Disagreements arise about finances, about the amount of assistance the parent needs, about making the time to talk about institutional alternatives, and so on. Families are getting smaller, more women have full-time jobs, and family members are scattered throughout the country. This means that there are fewer caregivers to go around.

Marjorie had traveled daily back and forth across town for three years to monitor her mother, a victim of early dementia. She made sure her mother maintained good hygiene, ate nutritious foods, and had opportunities to be with friends. Jim, Marjorie's brother, agreed that Marjorie had been overworked. He moved their mother out of her home and into his in another state. In three weeks he called Marjorie to tell her that their mother was not adjusting to the new environment and he thought she should return. Unwilling to resume the daily struggles she had with her mother, Marjorie asked Jim to search for a personal care apartment in a retirement center for their mother. The mother moved in and everything was fine for six months. Then the administrator notified the son that his mother was becoming more confused and would require more care, which would cost more money. Ultimately, Marjorie moved her mother into her house and employed someone to stay with her during the day while she was at work.

Adult children suffer shock, humiliation, grief, and anger in trying to cope with changes taking place in the life and behavior of their loved one. Beverly had watched her mother change from a capable business woman to an individual unable to complete a coherent sentence, select clothing, or distinguish edible from inedible substances. Because of progressive dementia, the mother could not be left unattended for even short periods. "The Lord is taking my mother home piece by piece—on the installment plan," Beverly said.

I have counseled many family members regarding their decisions to intervene in a parent's life. I also counsel the parents who are expressing anger or disappointment about decisions that their children have made on their behalf. Elizabeth received a call from the administrator of the Alzheimer's unit where she had placed her mother after five years of home care. "Your mother has become combative with other residents in the care center. She pushed a female resident out of her room, knocked her to the floor, and the woman's hip is broken. I need you to make other arrangements for your mother as soon as possible."

Family members try everything within their means to keep their incapacitated loved ones out of an institution as long as possible. Both generations also hold tenaciously to their money and property.

We may be looking toward a new rite of passage in which adult children accept appropriate responsibility for their

parents rather than succumbing to the temptation to grab the reins too vigorously or to reverse the roles.

Fall 1992

In order for older adults in in all age brackets to age well, it is necessary that more assistance be made available to caregivers so that they may both do their caregiving tasks more effectively and care for themselves as well. Caregiver "burnout" manifests itself in physical, emotional, and mental exhaustion. A recent issue of the AARP Bulletin cited a new phenomenon being reported in several large cities.4 It is called "Granny dumping." Frail, ill, confused elderly persons are left in hospital emergency rooms by family members who

"At an earlier time in our history the number of families that lived happily in three generational households like the Waltons was very small."

say they can no longer take the stress. An aged individual is slipped into the hospital and the "dumper" drives quickly away, leaving no identification. Studies have shown that, in the case of managing a patient with Alzheimer's disease or some other form of dementia, the caregivers have a higher level of stress than the persons for whom they are caring.

A bill proposed by New Jersey Senator Bill Bradley would provide a range of respite services for caregivers, including financial assistance for relief personnel in the home. Some major corporations are providing time off for elder care as well as child care. A new national organization of case managers assists adult children who wish to provide care for parents who live so far away that regular visits are virtually impossible.

People of advancing years can gain certain critical information about themselves by entering an assessment center like the one at the University of North Texas in Denton. Friends, relatives, and professionals sometimes observe in an aging person a change in gait, persistent confusion, weakness in performing ordinary tasks, hearing loss, or other significant behavioral changes that suggest impairment. The elderly can be encouraged to go to an assessment center to take tests that measure both covert and overt performances. Whereas some elderly persons demonstrating symptoms of dementia—confusion, memory loss, disorientation—may have suffered some insult to the brain that is irreversible, many others have reversible conditions that can be treated and normal functioning restored. The interaction of certain medications can cause confusion, slurring of speech, and various other problems. Depression has often been overlooked and untreated in the elderly because of the assumption that withdrawal, sadness, and slowness in response are the normal results of aging. At least 50 percent of stroke victims have depression that goes untreated. The more the population at large understands that some elderly persons suffer from psychiatric disorders that can be treated, the more rapidly will individuals find treatment and eventually recover, resuming their previous level of functioning for a full and rewarding life. Fortunately, Medicare provides coverage for in-patient psychiatric treatment and reimbursement to clinicians for out-patient counseling.

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"Adult children suffer shock, humiliation, grief, and anger in trying to cope with changes taking place in the life and behavior of their loved one."

Medicare has many gaps. It is still based on curative rather than preventive measures. It will pay $7,000 to $10,000 for a person with diabetes to have a leg amputated, but it will not pay for a prosthetic cast to aid in healing the ulcers on his/ her feet to prevent loss of the leg.

It is important that research on aging be expanded. The National Academy of Science Institute of Medicine has conceived a plan that calls for doubling government and private sector funding for aging research, placing it in the same funding range as cancer and AIDS.

There are businesses in the private sector providing special services to persons over sixty-five. Also, organizations may sponsor an alert system to detect problems in the elderly. The Puget Sound Water Company trains meter readers to be watchful of the needs of the older residents they serve. Some banks are watchful of elderly persons who make unusual

withdrawals or have frequent accounting problems. Financing is needed for affordable housing and expanded

home care. The rural elderly, minorities, and the poor are greatly underserved. Aging is, in a large sense, a female problem because women live longer, do more caregiving, and are more likely to be poor.

Like Mother Jones, we can find our own way, although we may have to accept a few props in transit. A philosopher of the Enlightenment, Immanuel Kant, gave voice to the supreme humanistic value: "Treat all people as ends in themselves and never as means only." One of the challenges that all of us have in relating to the elderly who function at a level lower than they have been accustomed to is, on the one hand, giving them concrete assistance and, on the other, respecting their dignity and autonomy as they interpret it and not merely as we do.

Notes

I. Belle Boone Beard, Social Forces. 2. New York: Bantam, 1991. 3. Vol. xv, no. 1, p. 10. 4. Publication of the American Association of Retired Persons, vol.

32, no. 8, p. 1. •

(Family in Crisis, cont d. from p. 7) (Washington, D.C.: U.S. Government Printing 0ffice, 1988); Andrea Beller and John Graham, "Variation in the Economic Well-Being of Divorced Women and Their Children," in Horizontal Equality, Uncertainty and Economic Well-Being: Studies in Economic Wealth Series, vol. 50, edited by Martin David and Timothy Smeeding (Chicago: University of Chicago Press, 1985), pp. 475-506; Judith Selzer, "Legal Custody Arrangements and the Intergenerational Transmission of Economic Welfare," American Journal of Sociology (1991), in press.

4. Jay D. Teachman, "Contributions to Children By Divorced Fathers," Social Problems 38 (August 1991), pp. 358-371.

5. Trends in fertility and infant and material health—United States, 1980-1988. MMWR 40 (23) (1991), 381.

6. Ibid., Section I, Table 1-1, p. 1-5. 7. Ibid., Section 1, Table 1-8, p. 1-1 1. 8. David J. Kertzer, "Gender Ideology and Infant Abandonment in

Nineteenth Century Italy," Journal of Interdisciplinary History, 22:1 (Summer 1991), 1025, esp. p. 7.

9. See Robert D. Plotnick, "Welfare and 0ut of Wedlock Childbearing: Evidence from the 1980s," Institute for Research on Poverty, Discussion Paper No. 876-889, University of Wisconsin, Madison, February 1989.

10. Robert Hutchin, George Jakubson, Saul Schwartz, "AFDC and the Formation of Subfamilies," Institute for Research on Poverty, Discussion Paper No. 832-887, University of Wisconsin, Madison, April 1987.

11. Sara S. McLanahn, "Family Structure and Dependency: Early Transitions to Female Household Headships," Institute for Research on Poverty, Discussion Paper No. 807-886, University of Wisconsin, Madison, March 1986.

12. Philip K. Robins, "An Analysis of Trends in Child Support and AFDC 1978 to 1983," Institute for Research on Poverty, Discussion Papers No. 842-887, University of Wisconsin, Madison, 0ctober 1987. In fact, ability to work reduces female head of household status among blacks, although it might increase for whites. Sheldon Danziger, George Jakubson, Saul Schwartz, Eugene Smolensky, "Work and Welfare as Determinants of Female Poverty and Household Headship," Institute for Research on Poverty, Discussion Paper No. 559-580, University of Wisconsin, Madison, June 1980; Sandra K. Danziger, "The Impact of the Reagan Budget Cuts on Working Welfare Mothers in Wisconsin," Institute for Research on Poverty, Discussion Paper No. 761-784, University of Wisconsin, Madison, November 1984.

13. Anna Nichols-Casebolt and Marieka Klawitter, "Child Support Enforcement Reform," Institute for Research on Poverty, Discussion Paper No. 895-989, University of Wisconsin, Madison, September 1989. •

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(Family in Transition, cont d. from p. 11)

abiding concern found only in the long-term commitments that human beings need for well-being and a quality of life worthy of the species.

Notes

1. See Robert Nisbet, The Present Age: Progress and Anarchy in Modern America (New York: Perennial Library, Harper & Row, 1988), pp. xi-xx, 30-32.

2. Robert H. Lauer and Jeannette C. Lauer, Marriage and Family: The Quest for Intimacy (Dubuque, Ia.: William C. Brown, 1991), p. 3.

3. Judith S. Wallerstein, "Children After Divorce: Wounds That Don't Heal," Marriage and Family 91/92, Olie Poes, ed. (Guilford, Conn.: The Dushkin Publishing Group, Inc., 1991), p. 174f.

4. See Judith S. Wallerstein and Sandra Balkeslee, Second Chances: Men, Women, and Children a Decade After Divorce (New York: Ticknor and Fields, 1991). •

(New Testament, tont d. from p. 14)

Gender and the First Wave of American Fundamentalism (Minneapolis: Fortress Press, 1990), p. 47.

3. William Parker, "True Womanhood," Christian Workers Magazine, 16 (Nov. 1915), 185.

4. See Betty DeBerg, Ungodly Women, p. 141. The current appeal of fundamentalism for many will not be profoundly understood until it is seen as perhaps foremost a movement to conscript biblical sexist tests in the service of male domination. Over the decades, American men have literally been losing control of women. Ironically, the two major enemies of contemporary fundamentalism are not theological liberalism and science, but inflation and war, both of which upset the Victorian status quo and made it necessary for women to be absent from the house long enough to help earn money for the family.

5. The Criswell Study Bible, ed. W. A. Criswell (Nashville: Thomas Nelson Publishers, 1979), p. 1413. •

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