This article provides an overview of Japanese women in the role of caregivers of older family members. Cultural influence on women's identity, significance of the caregiver 's role, and the struggles and rewards of being caregivers are discussed. Finally, ideas are provided for the use of arts in counseling and implications of their use are discussed. ********** Challenges that Japanese women experience in being caregivers to older individuals (age 65 and over) are ever present in today's Japanese society. The number of older adults in Japan is increasing rapidly and is becoming one of the primary concerns for this society (Yamamoto-Mitani, Tamura, Deguchi, Ito, & Sugishita, 2000). According to the Ministry of Health, Labor, and Welfare, cited in the Statistical Handbook of Japan (Ministry of International Affairs and Communications, 2004), the Japanese population 65 years of age or older continues to show a significant increase. In 1970, 7.1% of the total population consisted of older adults, and this number had more than doubled (to 14.5%) in 1995. In 2003, the number reached 19% of the total population, and it is predicted to exceed 30% in 2040. A review of the literature suggests that the majority of participants in existing studies of caregivers were female adults who were in their 50s (Abe, Kashiwagi, & Tsuneto, 2003; Arai, Zarit, Sugiura, & Washio, 2002; Hosaka & Sugiyama, 2003; Yamamoto-Mitani et al., 2003; Yamamoto-Mitani et al., 2000). This phenomenon may not be exclusive to Japanese society because the role of caregiver seems to be assigned to women across cultures. In addition, women are more emotionally invested in family relationships and, thus, tend to be more susceptible to stressors related to changes in the family life cycle (McGoldrick, 2005). Meeting the obligations for aging parents is a commonly shared value in many Asian cultures, including the Japanese culture (Baruth & Manning, 2003). The concept of filial piety describes how the caregiver roles are ascribed to family members of a younger generation, and such a role is considered a cultural norm (McLaughlin & Braun, 1998). Although family structures have changed over the years (e.g., increase of dual-career couples, late marriage, fewer children), many Japanese women still assume the responsibility as caregivers for their older family members. The traditional cultural view on women's roles continues to have tremendous influence on Japanese women's identity development, including self-worth and perspective on life as a woman, throughout the life span. There are numerous studies (Abe et al., 2003; Arai et al., 2002; Hosaka & Sugiyama, 2003; Yamamoto-Mitani et al., 2003; Yamamoto-Mitani et al., 2000) related to older citizens in Japan, and these studies have raised concerns about family caregivers (e.g., their health and psychological well-being). However, little research has been conducted that examined the attitudes of caregivers toward older adults (Yamamoto-Mitani et al., 2000) or relationships between caregivers' coping strategies and their mental health (Abe et al., 2003). In addition, there is a void in these studies regarding incorporating counseling as a means of support to caregivers. The purpose of this article is to understand the significance of the responsibility of taking care of older family members that is passed on to women in Japan and the impact of caregiver roles on women's well-being. Using a case study, we attempt to explain traditional Japanese family values, women's roles within a family, and the concept of caring for older adults, as well as review the literature addressing these issues. In addition, we discuss culturally appropriate counseling approaches in working with female caregivers. CONCEPTS OF CAREGIVING FROM JAPANESE CULTURAL PERSPECTIVES With the implementation of home-care insurance in existing Japanese health care systems, more families are encouraged to provide home-based care to their older members instead of seeking longer term hospital care (Hosaka & Sugiyama, 2003). …

As the profession of counseling continues to expand and diversify, each division of the American Counseling Association (ACA) offering a professional, scholarly journal must be knowledgeable and open about that journal's expansion and diversification. The Association for Adult Development and Aging (AADA), under the leadership of wise and experienced boards of directors throughout the years, has continued to expand member services that include the publishing of the Adultspan Journal. The major goal of our journal is that it enhance the developmental point of view concerning adulthood, life span, and transition relative to the varied aspects of the counseling profession, from the perspective of scholarship and research. As we proceed as an organization and as a profession, many challenges appear and will continue to appear at every turn. Counselors and mental health professionals, as well as those working with adults in many other capacities, are confronted daily with events and fears that most of us would never have thought possible. The positions held by AADA/ACA members, whether as clinicians, counselor educators, mental/physical health advocates, or graduate students in the field, are vital to the society in which we live; the sharing of information and creativity must be invited for publication as a means to that sharing, which is one part that the Adultspan Journal plays within the counseling profession. Our unique developmental perspective stands out among the various and prestigious journals attached to many of ACA's divisions, and it is our uniqueness that will be the focus of this piece; thus, we hope to encourage and enlighten those professionals interested in publishing in the Adultspan Journal. Writing for publication is of utmost importance to academicians seeking promotion, tenure, recognition, and status within their field. Several editors of respected ACA journals have offered solid advice and counsel to prospective authors who choose to submit to scholarly counseling journals (Engels & Jackson, 1999; McGowan, 2002; Smaby & Crews, 1998). A prospective author might do well to consider the aforementioned journal articles, along with this one, and decide how to shape a manuscript and where to most effectively submit it. The sharing of workable techniques and creative conceptualizations in counseling adults of all stages is important to professionals in the field, in the classroom, and, most especially, to the clients with whom we work. Scholarly journals can be of great service to that end, and the Adultspan Journal is especially dedicated to those service objectives. Now that I have been editor of the journal for one full term, and, having recently been elected by the AADA Board of Directors in April to another 3-year term (2004-2007), it seems like an opportune time to share ways in which one might have a manuscript published in the Adultspan Journal, given the ever-broadening scope of developmental issues that we have an interest in sharing with counseling professionals. The following is a description of three initiatives that I am supporting as editor, to which manuscripts might be directed and from which, it is hoped, more participation will be gained. * I am currently soliciting manuscripts for a new section of the journal concerning practice issues, and I encourage clinicians and other individuals working with adults to share strategies in scholarly manuscript form. This section, it is hoped, will meet the needs of professionals in the field as well as those who are in training. These submissions should be shorter in length than a regular submission, between 5 and 10 pages. References and style must still follow guidelines in the fifth edition of the Publication Manual of the American Psychological Association (American Psychological Association [APA], 2001). * The topics of interest solicited for the journal in the past 2 years have been more and more diverse, which speaks to the diversity of position and individual interests within our profession. …

Existential therapy in groups for older adults can help to provide life meaning; to facilitate social support; and to improve coping with grief, loss, chronic illness, and ultimately death. A scenario is presented that provides a clinical illustration of the use of existentialism in groups with older adults.

Traditional views of women at are often inaccurate and may be deleterious to the emotional and physical well-being of women. The author reviews quantitative and qualitative research that may help guide counselors in their work with women. ********** Stories of the midlife man have saturated our culture and include images of balding men purchasing sexy red sports cars and abandoning their wives for youthful replacements. Female markers of include menopausal symptoms, targeted ads for reconstructive surgeries, and empty nests. There is a stark contrast between the very active and positive choices of men and the very reactive and negative markers of women. Although balding men may now seek treatment for this condition through chemical or surgical means, they are proving their enduring value by winning the young admirer, climbing the corporate ladder, and purchasing the new two-seater. Women, however, are seen as victims of the process. With the end of fertility often comes the departure of children from the home, and women are left to fight the natural shifting of their bodies in order to fight for their spouses. Because I view this as a very negative, sterile view of women at midlife, in this article I address the physical and psychological changes that herald transitions for women and provide recommendations for counselors who work with women who are moving through this passage. BACKGROUND Menopause, defined as the cessation of menses for a period of 12 consecutive months, generally occurs between the ages of 40 and 58, with an average age of about 51 (North American Menopause Society, 2001). Because information about menopause is often poorly communicated from doctor to patient or from one woman to another, perimenopause, the 4- to 10-year period that occurs before menopause, often takes women by surprise with the upset in a normally regular menstrual cycle, increased premenstrual syndrome symptoms, and hot flashes (Gregory, 1999). This passage, and prelude to menopause, is mythic in our culture and, typical of myths, fabrications and omissions are prevalent in the telling of the story. Women who are 40 years old or older accounted for about 45% of the total U.S. female population in the year 2000, and those from 40 to 59 years make up about 27% of the population (U.S. Bureau of the Census, 2001). These women are standing on the threshold of menopause or have already passed through this transi tion (Kunz & Finkel, 1987). With the mean age of U.S. women calculated to be 37.8 years (U.S. Bureau of the Census), it is apparent that menopause and hold immediacy for a substantial portion of the female population. However, Gergen (1990) noted that if the academic research and developmental theories were our only measure of reality, it might appear that only men survive past age 40. Perhaps the preponderance of theories built to explain men's developmental transitions reflects the absence of biological transition points that exist for women, including menarche, childbearing, and menopause. The belief that biology is destiny, which is generally attributed to Sigmund Freud, is a concept that is used to preserve the difference between genders and their respective opportunities. Science and industry seek to medicalize and pathologize the changes that women experience. Pregnancy tests, ovulation predictors, and now menopause tests (Flaws, Langenberg, Babus, Hirshfield, & Sharara, 2001) are available that allow women to divorce themselves from self-knowledge and rely on hard science to get in touch with their bodies. Plastic surgery has provided relief for wrinkles, crow's feet, and sagging breasts, and now a woman in may choose to firm up an aging pubis if she dislikes the descent of her pubic hair and labia (Alter, 2001). Another physician advertises on his Web site a procedure called vaginal rejuvenation (Matlock, 2001). …

Individuals ease life-span transitions for family members in each stage of life cycle. Parents educate their adolescent children about relationships and sexuality and act as role models. The author proposes that children can play a primary role in painful but potentially rewarding process of comforting and leave-taking of dying parents. ********** There comes a time when young adolescents become curious about sexuality. Parents struggle to find a way to broach subject of sex and relationships with their sons and daughters by having a talk that is historically known as the birds and bees. Parents help their children understand experiences of their bodies, biological mechanisms that allow their son or daughter to create a new life, and responsibilities and consequences of giving life. In a family where there is good communication, parents and children may talk about value of creating a home and emotional temptations and mistakes that young people can make managing intense emotions, attraction, and sexual urgency. There comes another time when these parents' children face a similarly weighty and yet often overlooked life-span hurdle. Parents know that their time is limited and that they are letting go, first of ambitions, then of possessions, and later of life itself. There are many kinds of loss that occur with aging, such as physical losses (gradual blurring of eyesight or loosening of teeth), loss of independence, loss of mental capacity, and as time goes on, inevitable loss of friends, peers, and colleagues. As they near end of their lives, parents want to know that their children are going to be well and content without them. They want to resolve unfinished emotional business and to die peacefully. At point of their parents' readiness, children need to talk with them about letting go. As de Hennezel (1998) observed, The dying person knows. All that is needed is some help in being able to articulate knowledge. Why should it be so hard to say? Isn't it because everyone else's distress makes it hard to talk, and so dying person has to protect them? (p. 26) Life is about and dying, growth and decline. Children who are in prime of their own lives face their parents' twilight with intense and mixed feelings. The limit on our time makes our being all more rich, and yet we resent it, resist it, and often close our eyes to it. That we die intensifies value of how we live while also making life painful. In his 73rd sonnet, Shakespeare pondered how we can love what we must leave: That time of year thou mayest in me behold When yellow leaves, or none, or few do hand Upon those boughs which shake against cold, Bare ruined choirs, where late sweet birds sang. In me thou see'st twilight of such a day As after sunset fadest in west, Which, by and by, black night doth take away, Death's second self, that seals up all in rest. In me thou see'st glowing of such fire That on ashes of his youth doth lie, As death bed whereon it must expire, Consumed with that which it was nourished by. This thou perceivest, which makes thy love more strong. To love that well which thou must leave ere long. (quoted in Akhtar & Kramer, 1997, p. 131) Change is inherent in both adolescence and in final stage of life, both in reshaping years between loss of childhood and burgeoning sexuality and adulthood, and in passage from life itself. Loss is intrinsic to development, and with each progressive step growth requires us to relinquish aspects of what once was and what we once were. However, dying is not yet understood and treated as a part of living (Byock, 1996, A Developmental Model section, para. 1). We tend to assume that suffering is inevitable and without meaning. However, those who have provided palliative care typically find that after physical discomfort is reduced by controlling pain, addressing psychological suffering and loss becomes most important focus. …

The purpose of this study was to examine predictors of self-efficacy in older adults, with physical activity, age, and sex the predictor variables. Regression analyses revealed physical to be the only statistically significant predictor of self-efficacy. These findings may be of interest to counselors who work with older people. The population of the United States is rapidly aging. Life expectancies for men and women are increasing (U.S. Bureau of the Census, 1997), and the over-65 age group is projected to double in size by 2020 (Bokovoy & Blair, 1994). Within the population of older Americans, the number of individuals over 85 is expected to quadruple (Zedlewski, Barnes, Burt, McBride, & Meyer, 1990). From a social perspective, individuals in the 8th and 9th decades of life are expected to be involved in the health care system to an unprecedented degree if population growth continues projected (U.S. Bureau of the Census, 1992). National cross-sectional surveys of physical consistently report that physical declines with age and that older adults participate in less physical exercise than do younger adults (Stephens & Caspersen, 1994). Physical refers to any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above the basal level (U.S. Department of Health and Human Services, 1996a, p. 20). This definition includes all physical activities, well structured physical exercise. The relationships between health and and between sedentary living and disease are well documented (Cousins & Keating, 1995; Paffenbarger & Lee, 1996). The U.S. Department of Health and Human Services (1996b) reports that as many 250,000 deaths per year in the United States have been attributed to a lack of regular physical activity (p. 24). If the health care system is to be responsive to the needs of an increasingly older population, preventive measures to maximize independence will have to be explored and developed. Moving the older population from a sedentary to an active lifestyle is a challenge for health and mental health practitioners. Intuitively, we propose that the developmental tasks associated with independence and autonomy of the young-old, meaning those near 65 years of age, would differ from those of the old-old, meaning those 75 years and older. Yet, most research considers older adults to be a homogeneous group. This study looks at the relationship between physical and perceptions of self-efficacy in older adults, considering the group to be heterogeneous and not homogeneous. Bandura (1989) asserted that people who believe they are capable of controlling their lives are more likely to be able to do so. Self-efficacy expectations are not concerned with the skills individuals possess but what they think they can do with whatever skills they possess (Bandura, 1986). Individuals with a strong sense of self-efficacy are able to adapt emotionally to life's challenges and difficult situations without becoming overanxious (Maddux & Lewis, 1995) and depressed (Davis-Berman, 1988, 1990). Older individuals are faced with a variety of major life changes and losses. Perception of self-efficacy or confidence is an essential aspect of their coping efforts to deal with the negative life events that are associated with psychological distress and depression (Holahan & Holahan, 1987a, 1987b). In addition, highly efficacious older individuals are more independent (Abler & Fretz, 1988; Wahl, 1991) and have more enhanced feelings of control over their environment (Rodin, Bohm, & Wack, 1982) than do ol der individuals who are less efficacious. According to Myers (1990), efficacy expectations play a key role in successful aging. Aging is not an illness but a life condition that bears investigation with different parameters such physical and self-efficacy. Previous investigators have attempted to understand the factors that might promote psychological and physical well-being among different populations across the life span. …

The purpose of this article is to examine retirement while focusing on issues older adults face in adjusting to retirement and to suggest implications for counseling people who are making this transition.