When people age, internal struggles or conflicts (perhaps best defined as forces of opposing meanings) emerge that heretofore have not existed. These struggles are stimulated by the aging itself and all the related implications, such as physical challenges, mental impairment, out-of-home residential placement, and the ultimate approach of death. And the struggles arise in the aged themselves, their loved ones, their caretakers, their therapists and anyone else with whom they cross paths. Much of the struggle is culturally stimulated, as we internalize value systems that put old-age, physical and mental impairments, and nursing home placement at odds with American life as we have come to know it. More and more, American living, until something like illness or death visits nearby, has become more commonly colored by materialistic achievement and Hollywood images.
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Susan L. Flinders (2003) studied this question.