Introduction

When society is struggling as an older adult who has made a commitment to caring for my community, like as a physician or as a public servant, I might actually be acting with integrity to work and doing this. While it may actually put me at risk of harm with the Coronavirus, it actually might protect me from despair. So you see, taking a little time to understand what might be driving older adults to continue to work, even though they're encouraged to remain socially distant may make it a little bit easier to accept even if you don't agree with it.

I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging. Questions about mental health and wellness changes in the brain like with dementia, relationships and sex caregiving, and even end of life. Like I say in my therapy groups, no topic is off topic. We just have to have a healthy way of talking about it. So if you're an older adult or caring for one, you're in the right place. Let's get started.

Do you know any older adults who are refusing to maintain their social distance? Okay, let me give you an example. So have you seen the article of the Italian doctors who returned to work after retirement to assist the Italian healthcare system only to become seriously ill or die themselves as a result of the Coronavirus? A listener actually recently emailed me to say that she's really worried about her own parent who recently returned from retirement to assist with their medical clinic. And this clinic doesn't even treat coronavirus. So I wanted to spend some time on this podcast talking a little bit about the psychological underpinnings of why older adults might refuse to maintain social distance and work instead.

Sebastian Junger's book, Tribe, shares a relevant phenomenon

So let's try to understand this a little bit. Let's take the example of physicians returning to the healthcare system, even after retirement, during the Coronavirus. So you might be familiar with the phenomenon of soldiers wanting to go back to combat as soon as possible after returning home from deployment. Um, maybe you remember a book written by Sebastian Junger, that's spelled J. U. N. G. E. R. His book is called tribe. So there's actually something that happens in people who are on the front lines during traumatic, you know, they're, they're standing shoulder to shoulder in the face of trauma. And this creates a really intense bond between them and also a sense of duty to one another and to their mission. So the idea is that we're in this through thick and thin and this bond creates a sort of tribe and this tribe creates a very strong force that binds people together during uncertain and traumatic times. And it actually goes really, really deep. So in Sebastian Junger's book, he describes the sense of loyalty, belonging, and human quest for meaning that binds people together. Okay, now let's apply this to physicians. If we think about it, physicians are a tribe of their own. They experience unique life events that the rest of us don't. They're faced with unimaginable challenges and injuries and resilience on a daily basis. Like... Here are some examples. They help put people back together. They actually slice them open, fix something and then patch them up again. They bear witness to human suffering on an incredibly deep level, but that's not all. They also bring life into this world (ike with obstetricians), they help people to stay alive (like with chemotherapy when we're talking about cancer) and they help people to leave this world free of pain (like palliative care doctors) and then everything in between.

So it makes sense that physicians during a time of medical crisis would wake from the repose of retirement and return to their tribe and band together to offer and help where they can.

Erik Erikson's Psycho-Social Development Model

Now I'm going to use another psychological model to help us understand why older adults might be working instead of maintaining their social distance during the Coronavirus, you may have heard of the psychologist Erik Erikson. He created a psychosocial development model which describes the need for all of us as humans to achieve competence at each stage of life, literally starting from birth all the way to death. So I'm going to reflect on the final two stages in Erikson's model. So the final two stages that I'm going to look at are the stages between ages 40 'til the end of life. So at approximately 40 something to 65 years old, there is this stage called Generativity versus Stagnation.

Generativity vs Stagnation

So when people reach their forties they enter the time known as middle age of course, and this extends all the way until our mid sixties. The task and Erikson's model is Generativity versus Stagnation. So what's generativity? So generativity includes finding your life's work and contributing to the development of others. During this stage, middle-aged adults begin contributing to the next generation. So the older school of thought was that this had to do with childbirth and caring for others. But this can actually be done in all sorts of ways. Like for example, in my own life, when I was 11 years old, I had a big sister and the big brother, big sister program, my big sister Paulette, never had children, but she made a lifelong commitment to me. This is an example of generativity, but this can also be done in other ways more globally, like creating a business that focuses on helping others or many successful business owners actually create and promote charities.

I'm thinking of Sara Blakely. She actually might be the fairy godmother of Generativity. So you know Sara Blakely, she's the owner of Spanx, but she also has four kids. She has a charity called this the Sara Blakely Foundation, which supports underserved women and girls and creates wellness programs for her employees and even gives her employees money every year to donate to charity. So those are several examples of generativity. Okay. But not all of us can be Sara Blakely, but Generativity can include like volunteering, mentoring, engaging in meaningful and productive work, all with the mindset that it's contributing to the wellbeing of others and society. Erikson saw generativity as a task that needed to be mastered at this stage of life. And if we don't master this task, we're actually at risk of Stagnation, which is the opposite of Generativity. So stagnation could lead us to having very little connection with others and being unproductive and lacking in self-growth and actually not leaving our mark on the world in a meaningful way.

So stay with me. I'm sharing this all with you for a reason. So remember, the point of this is to help us understand why some older adults might choose to work or connect rather than to be socially distant.

Integrity vs Despair

So now I want to go to the next stage, which is the final stage in Erikson's model called Integrity versus Despair. So in this stage, essentially older adults around 65 to the end of life reflect on their lives and feel either a sense of satisfaction or a sense of failure. According to Erikson, people who feel proud of their accomplishments feel a sense of Integrity and they can look back on their lives with few regrets. But people who aren't successful at this stage may feel as if their life has been wasted and they maybe focus on what would have or should have or could have been. They're actually at a greater risk of facing the end of their life with feelings of bitterness, depression, and despair. Now, how does all of this relate to COVID-19 and older adults refusing to stay socially distant by going to work?

Okay, so in the case of the doctors and even older adults who choose to volunteer and work during COVID-19 Erikson's ideas of Generativity and Integrity may be playing a huge role. Let's review generativity. Remember, it's finding your life's work and contributing to others. We see this happening all over with pop-up nonprofits for COVID-19 relief dropping to 0% interest rates and people continuing to work. I actually called the national friendship line, put on by the Institute on aging, and older adults are answering the phone to give support to other older adults. Now for integrity. So when society is struggling as an older adult who has made a commitment to caring for my community, like as a physician or as a public servant, I might actually be acting with integrity to work and doing this, while it may actually put me at risk of harm with the coronavirus, it actually might protect me from despair. So you see, taking a little time to understand what might be driving older adults to continue to work, even though they're encouraged to remain socially distant, may make it a little bit easier to accept even if you don't agree with it.

Wrapping Up

So I hope that these psychological theories helped you to understand a little bit about why older adults might choose to work instead of maintain their social distance. I want to give a shout out to all of the health providers who are choosing to work instead of maintaining their social distance. I have a lot of love, respect and admiration for you, so thank you for all that you're doing!

That's all for today. If you liked this episode, be sure to subscribe so you'll be the first to know when new episodes are released and then leave a review. Subscriptions and reviews help people to find this show and wrapping up. I need to share that the ideas expressed here are mine and mine alone, and that the information shared does not take the place of licensed medical or mental health care. I'll see you next week for a love story. Lots of love to you and your family. Bye for now.