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Aging: Promoting Awareness and Advocacy Dean D. VonDras, Ph.D. Human Development and Psychology Departments University of Wisconsin-Green Bay vondrasd@uwgb.edu. Overview: Recognizing physical/psychological/social interactions Recognizing functional changes due to age and disability

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slide1
Aging: Promoting Awareness and Advocacy

Dean D. VonDras, Ph.D.

Human Development and Psychology Departments

University of Wisconsin-Green Bay

vondrasd@uwgb.edu

slide2
Overview:
  • Recognizing physical/psychological/social interactions
  • Recognizing functional changes due to age and disability
  • Promoting awareness and advocacy
slide3

Psychological

Physical

Social

slide4

Observable Physical Changes with Age:

Skin and face – wrinkles, sagging, leathering

Hair – thinning and graying

Height – decreases

Weight – increases during middle adulthood, i.e., the ‘middle-age spread’, and often decreases in old age, especially in ‘physically fragile older adults’

slide5
Declines in Sensory-Perceptual Processes with Age:
  • Vision and Hearing
  • Taste and Smell
  • Somethesis: Skin, Temperature, Pain
  • Proprioception – sensations generated by the body that let you know the location of limbs in space
  • Kinesthesia – one’s sense of location while moving through space
slide6
Changes in Hearing:

Presbycusis – age related hearing impairment

  • Caused by deterioration of mechanisms in the inner ear, long-term exposure to loud noises, certain drugs, an improper diet, or genetic factors.
slide7
Decline in sensitivity to tones and pitches – different frequencies decline at different rates with advancing age.
slide8

From Ordy et al. (1979), “Age differences in the functional and structural organization of the hearing system in man,” in, Ordy and Brizzee (Eds.), Sensory Systems and Communication in the Elderly.

slide9
Speech perception – becomes more difficult due to the decline in tone and pitch sensitivity.
slide10
Ways to make your speech heard:
  • Talk in a lower pitch but distinct voice
  • Articulate every syllable -- speak clearly
  • Talk face to face -- “read my lips”
slide13
Causes of Disability:

Congenital – occurring at birth

Accident/injury

Because of illness/disease

Age-related

slide14
Keep in mind…

A disability may not be obvious to others.

A disability is more likely to occur in old age.

most prevalent chronic conditions in later life
Most Prevalent ChronicConditions in Later-life
  • Arthritis
  • Hypertensive Disease
  • Heart Disease
  • Hearing Impairments
  • Musculoskeletal impairments
  • Chronic Sinusitis
  • Diabetes
  • Visual Impairments
most feared conditions in later life
Most Feared Conditions in Later-life
  • Alzheimer’s Disease - Dementia
  • Stroke/Cancer
  • Physical disability that prevents independence and autonomy of “normal” life (e.g., Parkinson’s Disease)
  • Heart Disease/Chronic Pulmonary Disorder
  • Deafness/Blindness  
slide17
Old age and disability impact upon…
  • Activities of daily life (ADLs)
  • Instrumental activities of daily life (IADLs)
  • Sense of self
slide18

Ideal Self

Real Self

slide20
Stereotypes linked with traits of older adults:

Negative Stereotypes -> Traits

  • Severely impaired -> Slow-thinking, feeble, senile
  • Despondent -> Sad, hopeless, afraid, lonely
  • Shrew/curmudgeon -> Ill-tempered, stubborn, bitter
  • Recluse -> Quiet, timid, naive
slide21
Positive Stereotypes -> Traits
  • Golden-ager -> Active, independent, happy
  • Perfect grandparent -> Loving, supportive, wise, kind
  • J. Wayne Type -> Patriotic, proud, religious
slide22
Loss ContinuumModel (Pastalan, 1982)

Views aging as a progressive series of losses that reduces one’s social participation.

slide23

Shrinking Environment with Loss

Greatest physical limitations--home bound/residential care

Later life--with increasing physical decline

Later life--healthy

Young adulthood--Healthy

slide24
Person-Environment Interaction and Optimal Aging

Kurt Lewin’s (1936) conceptualization:

B = f (P, E)

  • Behavior is the function of both the person and environment
slide25
Competence and Environmental Press Model (Lawton and Nahemow, 1973)
  • Behavior is a result of a person of a particular competence in an environment of a specific press level.
  • Behavior exists on a positive-negative continuum and is observable at the behavior and affect levels.
slide26
Competence – the theoretical upper limit of a person’s capacity to function.

Environmental press – the demands placed upon the person.

Adaptation level –where press is in balance for particular level of competence.

slide27
Five Domains of Competence by Lawton and Nahemow:
  • Biological health
  • Sensory-perceptual functioning
  • Motor skills
  • Cognitive skills
  • Ego strength
slide28

Positive affect and adaptive behavior

Negative affect and maladaptive behavior

Marginal

Competence-Environment Press Model (from Lawton and Nahemow, 1973)

Marginal

Adaptation level

Maximum performance potential

LowCompetenceHigh

Negative affect and maladaptive behavior

B

A

WeakEnvironmental PressStrong

slide30
The competence-environmental press model is a useful lens of analysis for interventions in that it describes a scaffolding process, where modification of environment can increase adaptation.

E.g., arranging living environment designs to increase social interaction

slide31
Ways to enhance a sense of competency:
  • Speak to a person, practice Buber’s “I and Thou”.
  • Be respectful—recognize independence and autonomy.
  • Recognize abilities and skills—wisdom.
  • See development occurring despite disability and infirmity.
  • Respect cultural differences in reaction to changes in life, e.g., death.
slide32
Promoting Awareness and Advocacy
  • Different instructional activities and levels of student engagement
slide33
Levels of student engagement:
  • Listening and reflecting – “Taking it in or tuning out”
  • Telling about personal observations or experiences – “This is what happened to me…”
  • Simulation experiences – finding out for yourself
  • Discussing different perspectives – exploring contrasts, finding similarities
  • Problem solving I – identifying problems
  • Problem solving II – generating and testing solutions
slide34
Self-Discovery Activity:

What are the Most Valuable Things in Your Life?

  • List the 5 most valuable things in your life—and explain why they are important:
  • Now, choose one of the aspects you mentioned to give up. Which one would it be and why?
  • Now choose two other of the aspects you noted above to give up. Which would these be and why?
  • How might giving up these aspects of your life reflect the losses the elderly endure?
  • How do you think you will cope and adapt, as you encounter losses with age?
slide35
Film Review Essay:
  • Review a film where the main characters are elderly
  • Then compose an essay discussing how theories and research discussed in class coincide with characterizations or themes expressed in the film.
slide36
Interview an Older Adult:
  • Conduct a semi-structured interview of an older adult and provide a case study discussing how your understanding of the person coincides with theories and research discussed in class.
  • Our learning goal is to find practical application of theory and research to “real” lives and experiences, and further our understanding of various aspects of adult development and aging.
slide37
Sensory-Perceptual Deficit Simulation:

Materials:

  • Two cotton balls and about 2 feet of plastic wrap

Procedure:

  • Gently place cotton balls in each ear canal – this will simulate changes in hearing that might occur in old age.
  • Bunch up and then gently place the wrap across the bridge of your nose as if they were eye glasses – this will simulate changes in the peripheral visual mechanisms that might occur with cataracts.
slide38
Web-based learning activities:

Common Causes of Age-Related Vision Loss:

  • Lighthouse International: Visual deficit simulation exampleshttp://www.lighthouse.org/patient/default.htm

Noise-Induced Hearing Loss:

  • Health and Safety Executive: Auditory deficit simulation examples(This site allows a download to your computer)http://www.hse.gov.uk/noise/demonstration.htm
slide39
An online version of the Implicit Association Test (IAT, Greenwald et al., 1998):
  • The IAT is found at the Internet web project sponsored by the Southern Poverty Law Center http://www.tolerance.org/

Students’ Assignment:

  • Visit the web site, read about the IAT, complete two online tests.
  • Read tutorials on stereotypy and prejudice.
  • Write a brief reflection paper regarding this experience.
slide40
A sample of students’ narrative responses:
  • I learned that perhaps I had biases that I was not aware of … I felt that I had very positive attitudes toward older adults, but I was amazed to find out that I did indeed have biases!
  • I saw that even though you may not believe that you have bias towards others, unconsciously you probably do. Society has a huge influence over us.
  • I really did not learn very much from this activity. I feel this was more of a hand eye-coordination exercise than an attitudes test. If you really want to see how people have attitudes towards others then you need to ask them questions and do follow-up studies.
  • I learned that there are a lot of different ways to be biased against others.
slide42
Classroom advocacy assignment:
  • Identify an issue or problem, e.g., rising health costs, adapting to environmental press, etc.
  • Assign small groups a unique “case” to discuss and have them identify important concerns and possible solutions for the individual(s) represented in the case.
  • Cases may include the following individuals:

- cognitively impaired elderly

- institutionalized elderly

- chronically ill elderly

- economically disadvantaged elderly

- mentally ill elderly

- family caregivers of older adults

- widowed elderly

- new immigrant elderly

- older adults from different ethnic backgrounds

slide43

Means, Standard Deviations, and Spearman Correlations of Survey Measures with Advocacy Perspective (N = 74)

* p < .05, ** p < .01. a 0 = advocacy is for self or student perspective; 1 = advocacy is for unique group of older or disabled adults

slide44

Sampling of Student Narrative Responses Discussing What is Learned When Serving as an Advocate is a Required Aspect of Discussion

slide45
Overall…
  • The advocacy role takes the student beyond their usual realm of thinking and experience, enhancing depth-of-learning.
  • The activity stimulates a wide variety of learning behaviors, e.g., interactive inquiry, critical analysis, empathic understanding, etc.
slide46
Things an advocate can provide informally:
  • Moral support
  • Sense of belonging
  • Self-esteem
  • Recognition of competency and mastery
  • Practical aid
  • Safe environment
slide48
Acting with Empathy:

Empathy – recognizing and understanding the state of mind, beliefs, desires and emotions of another person without interjecting your own.

“Putting yourself in another’s shoes”

slide50
Avoid patronizing speech – remarks that reflect stereotypes of incompetence and dependence.

Avoid infantalization – e.g., using terms of endearment, using simple language, etc.

slide55
Bernie’s Travels

1.Attended McBride HS -- all-conference and all-district as a senior.

2. Attended UMSL – 3-year starter, 5th in career scoring, senior co-captain and MVP in 1971-72.

3. Assistant coach at McCluer North HS 1972-1974.

4. Head coach at McCluer High 1974-1975 – Class 4A State Champions.

5. Returns to UMSL as Asst. Coach, 1975-1977.

6. Head Coach Jefferson College, 1977-1985 – 182-69 record, eight 20-win seasons, Region 16 East finals 5 times.

7. Moves to Murray State (Ky.) 1985-1989 as recruiting coordinator—1988 NCAA tournament, 1989 NIT.

8. Southwest Missouri State Assistant Coach, 1989-1992.

9. SMS Head Coach 1992-1995 – 48-37 record, NIT.

10. Assistant Coach New Mexico State -- 1996

11. Head Coach at Kirkwood High in St. Louis -- 1997

12. Head Coach at University of Missouri-St. Louis -- 1999

slide56

“We need to meet all kinds of people so that we can find ourselves. Young people need older people just as older people need young people in order to become more themselves and more human. That humanizing process will teach us that there is a child behind the mask of each older face, just as there is already an older person behind the mask of each young face.”

– Leo. E. Missinne (1990)