The Internal Struggles of Aging

When people age, internal struggles or conflicts (perhaps best defined as forces of opposing meanings) emerge that heretofore have not existed. These struggles are stimulated by the aging itself and all the related implications, such as physical challenges, mental impairment, out-of-home residential placement, and the ultimate approach of death. And the struggles arise in the aged themselves, their loved ones, their caretakers, their therapists and anyone else with whom they cross paths. Much of the struggle is culturally stimulated, as we internalize value systems that put old-age, physical and mental impairments, and nursing home placement at odds with American life as we have come to know it. More and more, American living, until something like illness or death visits nearby, has become more commonly colored by materialistic achievement and Hollywood images.

Indeed, the smell of fresh cut lawns surrounding pristine rose gardens and the vision of playing children and dancing athletic adolescents typically align the vision of American values. We steer away from thoughts of silent hallways lined with wheelchairs containing the shrunken wrinkled shadows of children and adolescents from decades ago. Their sullen gazes send shivers to hearts while the faint smell of urine lingers beneath our noses, reminiscent of death and everyone's ultimate lack of control. Shapiro suggested that Freud himself focused on this view of death as an ultimate separation and withdrawal of love from loved ones, excluding a relational one centered on “the resolution of grief as the recreation of a new enduring relational bond” (547).

This is a particular challenge for those working with the elderly as it appears, from my experience, that they are often struggling between a view toward living and a view toward death. This can be central to the elderly in Nursing Homes and the behavior of those who interact with them. As Levin noted, “elderly individuals tend to become progressively ‘disengaged’