Aging, Isolation and Resocialization edited by Ruth Bennett. New York, Van Nostrand Reinhold Company, 1980. 207 pages plus index.
Aging, Isolation and Resocialization is a chilling call for awareness of and action against isolation of the elderly and its consequences. The purpose of the book is to present studies that analyze multifaceted aspects of isolation among an elderly population over the past 20 years, and to present ways of alleviating the consequences of such a lifestyle. As the title of the book suggests, it is oriented positively toward growth, renewal, and increased productivity among those elderly who have become isolated. It is shown that growth seldom is attained effectively in isolation. "Social skills, like other skills, are learned, and, as the results of previous research suggest, may be lost through disuse" (p. 54).
Bennett and others assume that isolation - lack of stimulation - is bad, and regard it as a problem to be solved. But not all isolation is of the same ilk. Bennett has identified four types among the isolates: those who are life-long loners, those involuntarily isolated due to circumstances, those isolated early in life but reintegrated into society in later life, and those who were integrated into society but became voluntary lifelong isolates. "These patterns were studied in relation to socialization. Findings show that all patterns of isolation had negative effects on socialization, in contrast to nonisolation" (p. 198).
However, isolation does not especially predispose one to poor adjustment in and of itself. An isolate may remain moderately adjusted in a society if life patterns are not disrupted, but the same isolate may suffer dire negative consequences if moved into an institution. This, of course, also is dependent upon the type of isolate the person is. There are very few rugged individualists clinging to that last shred of independence by isolating themselves. On the contrary, rugged individualists generally are more visible and integrated into the society.
In contrast with the rugged individualist is the institutionalized isolate who demonstrates a high level of persuadability, agreeing with the most contradictory of positions presented to him in one of Bennett's studies. The isolates were not the more tenacious or obstinate people but vacillated, readily confused about their own beliefs. "It would appear that social isolates are deprived of social support for their opinions. They are also deprived of the opportunity to sharpen their opinions by defending them when they conflict with the sentiments of others" (p. 89).
The book makes valuable contributions to the literature of gerontology. The material complements related theories in anthropology, sociology, psychology, nursing, medicine, and social work. It offers a "quantitative approach to the measurement of degree and type of isolation and its relationship to measurable aspects of adjustments," and "it demonstrates that much of the deleterious effects of isolation can be successfully remedied and even prevented" (p. viii). It suggests the possibility that geriatric clients worsen due to a marasmus-like condition that is similar to infantile marasmus in children which was seen in the adoption agencies of the 1930s and which was thought to be the result of lack of stimulation due to institutional overcrowding and inattention. Among geriatric clientele, this situation compounds itself by perpetuating poor release rates and low productivity and quality of life.
Studies of the 1970s demonstrated a noticeable improvement in interaction among the elderly and their family members and less of the influence of isolation when the elderly lived with their children in their homes, and the family sought respite when needed by enrolling the older individuals! in day-care centers nearby. Previously, these findings also were demonstrated by Bennett, but little attempt had been made in the meantime to apply these data and give greater attention to means of alleviating isolation and institutionalization among the elderly.
Bennett defines isolation based on the measurable constriction of roles. "Social isolation is defined as the absence of specific role relationships which are generally activated and sustained through direct personal face-to-face interaction" (p. 15). Isolation was measured by Bennett, et al., by using both a Monthly Index and an Adulthood Index tool, which were tested for validity and reliability. The Adulthood index assesses dimensions of role relationships: frequency and duration of activation of role relationships, looking at categories of organization, children, siblings, relatives, friends, mother, father, spouse, and job. The first five are the same categories as presented in the Past Month Isolation Index but the number of role contacts assessed is less. The authors concluded from application of these tools that "there are more life-long isolates in the institutions (45%) than in the community (32%), suggesting that those who have accumulated few social supports over a lifetime end up in institutions, whereas others. . .remain in the community"(p. 22).
Bennett first became interested in the problem of isolation among the elderly in 1956 when she began a research study of members of a Jewish home for the aged. In this study, she focused on the identification of ways to differentiate patients who deteriorate and must be placed in a mental hospital and those who remain integrated in the social life of the Jewish home. Since that time, she has given considerable attention to the issues raised by the 1956 study. In Aging, Isolation and Resocialization Bennett contributes four of the ten chapters, succinctly outlining and discussing concepts underlying social isolation as well as an encompassing literature review of such studies as those by Shanas (1968), Parson (1960), Townsend (1957), Kutner (1956), and Clausen (1954). The other six authors, Mulligan, Nahemow, Weiner, Arje, Barron, and Powell, brilliantly add to the composite picture for alleviating isolation among the elderly. They are realistic in their postulates and conclusions regarding causes and effects of isolation and revi tal iza tion of life. Moreover, they dispel myths and tell us who really is isolated, discuss the principles behind the isolation process, relate the effects of environment and socialization to isolation, describe the degree of isolation in institutionalized clientele, and present the results of two projects designed to remedy isolation. They suggest that isolation is not necessarily synonymous with disengagement theory postulated by Cumming and Henry in the 1960s, but they do suggest similarities that need to be tested. The concepts are not mutually exclusive. Disengagement implies voluntary isolation but the causes and consequences are not proven to be identical.
Aging, Isolation and Resocialization is a very timely book. It should prove very useful for care providers, academicians, researchers, and program administrators who focus either upon community or institutional problems of the elderly.