will need to develop greater awareness, understanding and
appreciation of gerontology.
A global phenomenon
The world is experiencing a profound and irreversible
demographic shift in the developed and developing worlds that
is unprecedented in human history (UN, 2010). Thanks to lower
fertility rates and increases in longevity, the number of people
age 60 years and over is expected to triple worldwide, from 737
million people in 2009 to 2 billion by 2050 (UN, 2010).
Not only are people living longer, they are living healthier
lives less marked by disability among older Americans (Kinsella
& Wan, 2008).
The United States is ranked third in the world in terms of
the size of the population age 65-plus (Kinsella & Wan, 2008),
between therapist and client, chronological age by itself is less
relevant to the psychologist than understanding a person’s
social, cultural and technological experiences. As a result, it’s
important for psychologists to understand the gerontological
theories of aging, rather than age per se (Knight et al., 2009).
Longevity may be determined by genetics and heritability, but
we ignore at our peril the effects that lifestyle choices, chronic
illness and life events have on people’s physical and mental
health and ultimate longevity (Kirkwood, 2002).
Psychologists should also be aware that aging is a gender
issue. Women outnumber men at every age band (Kinsella
& Wan, 2008). Their longer lives mean they may face more
of aging’s challenges, such as chronic illness and loss of
spouses, than older men. Women are consequently more
likely to be living alone, with 70 percent of men age 75-plus
While depression rates may increase with age, rates of
depression and anxiety in later life are lower than rates
reported for working-age adults.
with the first of the baby boomers turning 65 this year ( Wan,
Segupta, Velkoff & DeBarros, 2005). Thus, psychotherapists are
increasingly likely to come into contact with older people and
geropsychology is likely to be a growth area for psychologists
(Koder & Helmes, 2008). Since the psychological and physical
health needs of a 65-year-old are markedly different from
those of a 95-year-old (Wan et al., 2005), we must consider the
potentially powerful implications of failing to train sufficient
health-care professionals to work with older people (Knight,
Karel, Hinrichsen, Qualls & Duffy, 2009).
Globally, the fastest growth in population is the “oldest old,”
people age 80 and over. Projections call for a near quadruple
increase, from 102 million in 2009 to 395 million in 2050 (UN,
2010). In 2009, there were 12 million older people age 80 and
older in the United States. However, by 2050, that number will
nearly triple to 32 million (UN, 2010). In the United States,
the numbers of centenarians is projected to rise by a factor of
close to eight, from 79,000 centenarians in 2010 to 601,000
by 2050 (US Census Bureau, 2008). Globally, the number of
centenarians is expected to increase nine-fold, from 455,000 in
2009 to 4. 1 million in 2050 (UN, 2010).
While we may make distinctions — and assumptions —
about adults who fall into young-old and old-old categories,
older adults are a heterogenous group and likely to become even
more so as longevity increases. Sadavoy (2009) notes that taking
account of complexity, chronicity, co-morbidity, continuity and
context may be useful in working with older people.
married, compared with only 20 percent of women age 75-
plus (Kinsella & Wan, 2008). This is likely to affect the sorts
of mutually supportive networks that the genders develop
(Ajrouch, Blandon, & Antonucci, 2005; Gray, 2009). As a
result, psychotherapists who work with older people need to
recognize that aging affects the sexes differently. Moreover, with
life expectancy increasing and with multigeneration families
becoming more multifaceted, we may need to consider a
stronger role for family systems work (Qualls, 1999).
Overcoming aging stereotypes
To meet the needs of aging clients, psychologists will need
to become knowledgeable about longevity statistics and
demographic change (Knight et al., 2009). One valuable
resource for practitioners is the practice guidelines developed
by the APA Working Group on the Older Adult in 1998. These
guidelines can help mental health professionals identify and
challenge many erroneous age-related negative cognitions — for
example, that growing older is depressing (Laidlaw et al., 2003).
Some people find that the transitions that come with aging,
such as retirement, are unwelcome and difficult since many
people do not recognize themselves as members of the “older”
population and may reject this definition. Levy (2003) suggests
that ageist societal attitudes are internalized from a very young
age and negative age-stereotypes are reinforced by attention
bias to negative information about aging. Aging stereotypes
operate outside of many people’s awareness, similar to how
latent maladaptive schemata operate in depression. In addition,