Theories on aging
Written by Mary Perry, MSN, RN, PMHNP-BC:
The inevitability of aging and its developmental stages in association with human health have been studied and debated over the years. What follows is a summarization of the most common theories on older adulthood, from Sigmund Freud, Heinz Kohut, Bernice Neugarten, Daniel Levinson, and Erik Erikson. Healthcare workers see aspects of each of these while assessing and caring for the older adult’s mental health needs. Sigmund Freud was focused on the need to control the ego (part of the human psyche that operates in the real world) and id (part of the human psyche that strives to fulfill primal needs) with the superego (internalized values and morals that push the ego to act in a more virtuous way). Regression may induce rudimentary methods of coping to resurface in the older adult (Sadock et al., 2015). Heinz Kohut stated that the elderly are constantly faced with narcissistic injury as they cope and adapt to the biological, psychological, and social losses associated with the aging process. The central (psychological) task of aging is preservation of self-esteem (Sadock et al., 2015). Bernice Neugarten theorized the major conflict of old age to lie in the release of autonomy and authority; the focus is on accomplishments and previous victory. This time is for reconciliation with others and processing grief related to the death of others and the inevitability of death of self (Sadock et al., 2015). Daniel Levinson found that age 60 to 65 is a transition period. Older people, “late adults,” become consumed by the thought of their death and are often narcissistic and heavily engrossed in their body appearance. He found that creative mental activity is recommended and is a healthy substitute for decreased physical activity (Sadock et al., 2015). All the above theorists have aspects of interest for the healthcare worker to note; however, Erik Erickson’s eight psychosocial stages of development are especially worthwhile to consume prior to working with an older adult.