Although the ability to provide support to others may diminish with age, the desire to reciprocate persists. Using social exchange theory, this article examines deference as one form of exchange. Based on a sample of 31 residents age 85 and older in assisted living facilities, data were gathered via a semi-structured interview that was audiotaped and transcribed. This study analyzes their responses to open-ended questions using qualitative methods. Findings indicate that these “oldest old” respondents reciprocate for the support they receive from family and staff via deference. Four forms of deference are identified: participation, pleasantness, cooperation, and gratitude. In addition, the psychological costs and rewards of deference are examined from the elders' perspective.

This paper describes an educational innovation called the Longitudinal Elder Initiative (LEI), which was developed by a BSN program to improve students' knowledge about the health needs and nursing care of older adults. In the LEI, new nursing students are paired with older adults in the community and develop a relationship with them over the duration of the nursing program. Students complete a variety of assignments designed to facilitate learning gerontological nursing concepts. They also complete specific assessments designed to target common problems in aging. Students develop nursing care plans and interventions during the course of the project and monitor progress toward goals over time. Through the LEI, students develop relationships with older adults in the community and view their health changes longitudinally. In addition, students can observe how social, financial, and health-related factors affect health and well-being over time.

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