Promotion

is that older people have fewer resources to offer in the exchange. One of the main
criticisms of the approach is that it fails to take into account the quality and the meaning
of social contacts, focusing mainly on the number of social exchanges and the
prediction of exchange behaviours (Bengtson et al. 1997). Again, we need to recognize
that these perspectives have been developed in a Western culture with its particular sets
of values and norms. Although we can speculate that social exchange theory might
help explain the mental health impact of rapid social transition on older people no
studies have been published that might corroborate this.
Gender
It is well-known that women are recorded more frequently as suffering from mental
health problems compared to men. A study of 14 European countries reported a
clear excess of depression among older women in 13 of the 14 countries. In a survey
of psychiatric morbidity among adults in Great Britain older people generally showed
a lower prevalence of common mental disorder. However, older women were still
more likely than older men to be diagnosed with depression and anxiety (Evans et al.
2003). A survey of ethnic minority psychiatric illness rates found a considerable variation
in prevalence among women across ethnic groups (Sproston and Nazroo 2002).
The association between gender, mental health and ageing can easily be over simplified.
In many societies women have lower social status than men and consequently
less access to services, education, food and employment. Women’s traditional role in
the family can be a factor in women experiencing increased poverty and deprivation
in old age. Women also tend to live longer and are more likely than men to live alone in
later life. A consequence of this may be isolation linked to inadequate pension, lack of
affordable and accessible transport, loss of property and status and real or perceived
threats of violence in the external environment. However, in some cultures older men
are more likely to be rejected by their community once they have ceased to be ‘productive’
due to ageing or poor health (HelpAge International 2002). For an older person
the loss of what we perceive as traditional gender roles, whether male or female, with
associated loss of status, respect and independence is likely to impact on their mental
health.
Bereavement
OLDER PEOPLE: THE RETIREMENT YEARS 181
Bereavement is associated with a range of physical and mental health risk factors.
Although the causes are not fully understood, studies have suggested that there are
some important links between depression, loss, older age and perceived health, which
may be more salient for older men (Tijhuis et al. 1999; Alpass and Neville 2003). The
services required (such as therapeutic, spiritual) for older people needing help with
dealing with dying and death go beyond the scope of this book. For anyone who
is particularly interested in mental health in relation to dying and death in later life
there are several books available (see for example Dickenson et al. 2000; Hockey
et al. 2001; Owen 2005). However, it should be emphasized that although some older
people are not comfortable about talking about dying and death, many are and do
(Owen 2005).