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Running head: DISENGAGEMENT IN NURSING HOMES

Term Paper Sociology 110 Alexander Schriber Storm Lake Senior High School, ICCC

Abstract The disengagement theory of aging is demonstrated within nursing homes. I interviewed several residents of a local nursing home. My intent was to ask simple questions to get the residents to feel comfortable. The questions and answers were not my goal for the interview. I simply used the interviews to make observations and apply them to Cumming and Henrys nine postulates of the disengagement theory. By asking about everyday matters, like food and friends, I was able to make the observations I needed. I found that most of the residents had completely disengaged from society; and the longer the residents had lived there, the less willing they were to share. Nursing home factors likely influenced this.

While being an effective way to manage the physical health of the growing number of the elderly, nursing homes do not provide enough psychosocial support for their residents. This leads into how the disengagement theory of aging is affected by the institution of a nursing home. Nursing homes are also known as long-term care facilities or rest homes. Nursing homes are now a normal part of our society. After much reform in the twentieth century, nursing homes developed into what they are today. They can be found near most communities. Many older individuals who are no longer able to care for themselves and require 24-hour care and maintenance end up in nursing homes. Long-term care facilities provide constant nursing care for physical and mental disabilities. Many residents in rest homes suffer from some form of mental impairment. Nursing homes do not give their residents much freedom. They are a total institution; a place where the individuals who reside are subject to every aspect of their lives being in control of the institution. When society thinks of total institutions it often thinks of prisons and the military; however, it rarely considers nursing homes for this. Nursing homes are in fact total institutions. Their residents are often set to schedule with little regard for the individual. They do not choose where or when they eat, where they are going, where they sleep, and often times even who they socialize with. This being said, resident socialization is severely crippled by these restrictions. In order to serve and benefit the residents, this control is necessary: almost every resident suffers from some form of physical or mental disability that requires constant supervision. Nursing homes often do try to help their residents socialize, but with the sheer number of individuals to manage and sustain this is very difficult. In the nursing home I visited small birthday parties and holiday parties were held almost every day. Even with these opportunities to

assimilate and socialize residents usually kept avoided unnecessary social interaction. This is likely because most of the residents I interviewed were long past their life expectancy, and knew they had numbered days. They hedged relationships and friendships, likely because they didnt want to become attached to someone who may not live to see tomorrow. The elderly population in America is booming. According to the 2010 Census, almost 20 percent of the total population in the United States are sixty years of age or older. This means that America must manage and compensate for this large number of aging individuals. Even though most seniors are capable of living independent, some require assisted services. An alarming 7 percent of individuals age seventy and older live in nursing homes (Egendorf, 2002). The elderly population is expected to increase substantially by 2050. With most of the projected rise residing in persons age seventy-five and older, there will be a need for nursing homes to accommodate more people.

Unfortunately there is not enough healthy socialization within nursing homes, so the residents are not stimulated enough socially. The disengagement theory of aging is built on the concept that there is a mutual withdrawal between society and the elderly. This is especially true for the residents of rest homes. Cummings and Henry theorized that the elderly go through nine

postulates for the process of disengagement. Starting with the realization that old age brings death. This all too true in nursing homes; all residents face their own mortality every day. Twenty percent of all elderly Americans die in nursing homes (Zimmerman, Sloane, Eckert, Lawton, 2003). Two-thirds of all nursing home residents will remain in the nursing home until they die (Egendorf, 2002). They see the sick and crippled all around them, or they could feel that their own time is coming soon. The second postulate states that an individual has greater freedom from norms the fewer social interactions they have. This is shown in nursing homes as well. Rest homes have very little interaction and stimulus for their resident, thus the residents and the care-givers view of the acceptable norms become stretched thin. It is not normal in our society for a person to soil themselves or say disrespectful things to those around them, but for the residents this defiance of societies norms have developed into the norms. Over the course of my interviews with residents of a local nursing home, I have found that most of the common boundaries that we impose on ourselves to restrain social scrutiny do not apply to the residents. Majority of the nursing home population is female. According to the CDC, this is most likely because women live an estimated five to ten years longer than men do. This has a major impact on the socialization of the residents of nursing homes. In the rest home I conducted my interviews and observations within; there was hardly any socialization between men and women residents. This could be because older men are less likely to socialize with the older women because they most likely aged with a different inset culture. In fact, according to Cumming and Henrys third postulate, aging women are centralized around a social-emotional role. Aging men are to serve an instrumental role, but within a nursing home with mental and physical burdens this becomes a difficult and almost impossible motive. That being said, men and women

disengage differently. The women of the nursing home I visited that did not possess and disabilities that interfered with social interaction or availably often did socialize with the other women that they were seated near. The fourth disengagement postulate is centered on the diminishing knowledge and skill and aging individual has left. All of the residents of a nursing home have been through this; the reason they are in a rest home is proof that they lack the proper skill and knowledge that society demands of them. This is one of the few factors of disengagement that is not affected by age in a nursing home. Highly influences by the social organization of individuals, total institutions, like nursing homes, provide ample reminder to the residents that they are not useful to society. When society and the individual are ready to disengage, the individual is cut off from society and interactions halt. Many individuals within a nursing home have reached this fifth postulate the moment they are checked into the care facility. They are often forgotten about, even by their own relatives. But when a person is disabled they are undesirable to society and are cast aside rather painlessly. Like in The Savages and Bubba Ho-Tep, family members can be quick to forget their relatives in nursing homes due to their lives continuance and the residents stagnant life. Even if the individual is not yet ready to disengage, if society is willing to part with them, then the elderly have very little power to maintain engagement. Work is mans center role; family and marriage are a womens role, according to Cumming and Henry. This sixth postulate of disengagement states that in the event that a man or woman is removed or abandons their respective roles, they will experience a distinct cut in their social life. They will most likely become depressed and feel that life is meaningless. This often happens when a man reaches full retirement, and when a woman has out lived their spouse. These roles are usually filled, to replace the void left by them. This is not so simple in nursing

homes: many times there is nothing available to the resident to fill the hole. That is why most of the residents I interviewed appeared to be depressed; this is especially true for the residents that have resided in a nursing home for more than five years. The seventh postulate is split: readiness to disengage, and societys eagerness for disengagement. Factors that affect a persons preparedness to disengage include: awareness of death and limited time left, their own perspective of how they have little to live for, and their lack of energy to fight the social change. Nursing homes residents are haunted everyday by these factors and often realize that society no long needs them in order to function. Society provides permission to individuals to disengage. Often society sees the elderly as a burden to functioning society. This makes it easier to justify disengagement. Society does not simply drop off their elderly at a nursing home and forget about them, but the end result often is the same: they die alone. Even though relatives occasionally visit or socialize with the residents of rest homes, it is not enough. Society cannot continue to juggle the lives of capable citizen while maintaining a connection to the elderly. The elderlys voice is rarely heard in society; this is only amplified within rest homes. The nature a nuclear family does not accommodate well with aging populations of nursing homes, so the nuclear families often move on without them. The death of an individuals center role, like the working man, will influence the remaining roles. Male residents can no longer provide for their family, visit their family, or have many of the freedoms they took for granted before reaching a physical or mental state that diminishes their function. When a role is destroyed the other roles are affected. Of the male residents that I interviewed the oldest was one hundred and four and the youngest was sixty seven, but both men felt isolated and longed to continue their previous roles. This regret shows a

direct relationship to Cumming and Henrys eighth postulate of disengagement. This postulate states that if one major role is disengaged, then the remaining roles change on a social level. The final postulate of disengagement in the elderly is culturally based. It says that culture binds the form that disengagement takes, but remains independent from culture. Culture influences almost every aspect of our daily lives. Residents in nursing homes had once lived in a culture motivated society, but they now reside in a rest home that is usually secluded from the rest of society. Residents then must develop their own culture: made of norms, and behaviors, but this is often difficult because of mental or physical disabilities. Nursing homes are total institutions that try to monitor and serve their residents in many aspects of life, but because of the large number of aging individuals in the homes it is not an easy task. Reform is needed, but not likely to happen. Social disengagement is almost completely unavoidable in nursing homes. Society deposits their weak elderly to die in rest homes; this isnt because they want to, but because sadly it is necessary in society to move ahead. Rest homes have been compared to prisons, and are essentially just that. Residents lose their individuality and ultimately their hope to live. Disengagement, to release from obligation, is inevitable within the confinement of nursing homes.

References Brown, V. Theories of Aging. Angelfire: Welcome to Angelfire. Retrieved December 1, 2011, from http://www.angelfire.com/ns/southeasternnurse/TheoriesofAgingC3.html This was the site I used to decide which theory of aging I would use for the basis of my thesis. I narrowed it down between activity theory and disengagement theory. Coscarelli, D. (Director). (2003). Bubba Ho-Tep [Motion picture]. United States: Silver Sphere Corp.. This film may have been a ridiculous comedy, but through all the pointless parody and humor there were some underlining truths about some nursing homes and disengagement. The nursing home residents often do not socialize well with the other residents. This might be caused by the physical difficulties that limit the frequency for social interactions. Cumming, E., & Henry, W. E. (1961). Growing old, the process of disengagement. New York: Basic Books. This book was very useful. Highlighting on the disengagement theory of aging, it provided the basis of the paper. The nine postulates of disengagement fit well into my paper. Egendorf, L. K. (2002). An aging population: opposing viewpoints. San Diego, Calif.: Greenhaven Press. Much of this book consisted of cause and reactions to the aging. This provided a lot of up-to-date statistics. The statistics from this texted were easier to apply to nursing

homes & the elderly population. It focused heavlly on the economic factors than social. FASTSTATS - Life Expectancy. Centers for Disease Control and Prevention. Retrieved December 3, 2011, from http://www.cdc.gov/nchs/fastats/lifexpec.htm This site supplied the CDC's stats and tables relavent to the elderly and death. I found a few stats about the aging in nursing homes as well. Wiersma, E. C. (2007). Making institutional bodies socialization into the nursing home. Waterloo, Ont.: University of Waterloo. Zimmerman, S., Sloane, P. D., Eckert, J. K., & Lawton, M. P. (2003). Assisted Living Needs, Practices, and Policies in Residential Care for the Elderly.. Baltimore: Johns Hopkins University Press. Relavent statistics are provided about nursing homes. Death also is addressed in this text. The text states that there is a need for a societal of cultural change within nursing homes.

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