10 Older Adults 261
to recall of information than to recognition of previously known information
(Hooyman & Kiyak, 2008). Slowing the pace of the delivery of new informa-
tion, as well as connecting it to relevant and familiar material assists older
adult learning (Hooyman & Kiyak, 2008). Although the brains of older adults
tend to shrink, they remain able to learn with appropriate supports (Erickson
et al., 2013); old dogs can learn new tricks. Despite cognitive losses among
older adults, neurobiology and brain imaging techniques have demonstrated
that learning and brain development are aided through exposure to new expe-
riences and forming new relationships, including the therapeutic relationship
(Siegel, 2010a).
Psychological Development
The major developmental task of later adulthood is accepting one’s life to
achieve a sense of integrity or wholeness about oneself rather than face despair
(Erikson, 1980). This acceptance comes from introspection and life review (LR)
during which the older adult examines both positive accomplishments and
negative experiences to arrive at a sense of satisfaction about one’s life. Older
adults must be able to take pride in various achievements at the same time
they examine personal goals and expectations that have not been met. They
must be able to incorporate disappointments and areas of personal failure
without being overwhelmed by a sense of inadequacy.
This developmental task can also be described as one of maintaining self-
esteem in the face of the biopsychosocial challenges of aging. LR work is com-
monly used with elders (B. K. Haight & Haight, 2007) and has been shown to
enhance autobiographical memory (Williams et al., 2007). LR involves guided
discussions that allow the participant to describe varied events in life that may
be related chronologically, but often are guided by emotions (“what was a
happy memory in your past?”), events (“what do you remember about your
wedding day?”), or by relationships (“who was the person who you remember
as being most important to your success as a young adult?”). Recent experi-
mental studies using a short-term LR intervention (six sessions) with a focus on
positive life events have shown promise in decreasing depressive symptoms,
enhancing life satisfaction, and promoting the emotional health of older adults
(Latorre et al., 2015). Work with older adults is often aided by the use of gentle
humor (Lurie & Monahan, 2015) and openness to reflecting on memories.
Developing a Point of View About Death
One psychological development characteristic of older adulthood is the pro-
cess of developing a viewpoint about death. Older adults lose friends, spouses,
homes, and their own health and need to grieve these losses and try to make
some meaning about them to formulate their own viewpoint about death,
including a perspective about their own mortality.
Dying in Western society is primarily associated with old age and death
is a predictable function of age. Most deaths in old age occur as a result of
chronic disease, due to improved medical technology, early detection, and
diagnosis. People with chronic illnesses are maintained sometimes in very
debilitated states and many older adults are not “achieving a peaceful death”
