HDFS exam 4
examine the relationship between adaptive defense mechanisms in midlife and physical health in late life
"Adaptive Midlife Defense Mechanisms and Late-Life Health" Malone Article -- What was the overall purpose of this article? What were they trying to test?
psychoanalytic
The concept of defenses originated from ____________ tradition? (Malone article)
finial obligation
The greatest degree of filial _________is likely to be experienced by Asian American families.
Denial of Death
The idea that Western culture is unwilling to accept the reality of mortality led Ernest Becker to write the critique of this attitude, called:
intermediate care
The least amount of nursing services is provided in what type of in-patient facility for older adults?
aids
The majority of employees of nursing homes fall into which category?
for profit
The majority of nursing homes in the U.S. fall into which category of ownership?
both bad and good
What is an ambivalent social relationship?
home
Where do most people say they want to be able to die?
individual
which ecological level includes the experience of intimacy that can be influenced by health status, hormonal chages, attidutes, and mental health?
need complementarity
A couple in their 30s is thinking of getting married. One partner is very outgoing and sociable, and the other is introverted and shy. According to the ____________ hypothesis on long-term relationships, they should be very happy together.
disillusionment
A couple who had initially seemed destined to remain together for years, if not decades, surprised their families when they announced their impending divorce. Neither of them could cite a particular problem; it's just they felt they grew apart. This pattern of long-term relationship is known as:
skilled nursing facility
A hospital social worker decides that one of her patients, an 82-year-old man who is recovering from a stroke, needs to be in a facility that provides him with rehab, round-the-clock nursing care, and help with planning his return to his own home. These kind of services are likely to be found in which type of long-term care facility?
rewards outweighs the cost
A marriage therapist working from the social exchange theory of interpersonal relationships would attempt to assess whether the partners in a distressed couple feel that:
slight decline in marital satisfaction
A meta-analysis of studies on satisfaction among couples before and after birth of the first child showed that, compared to non-parents, the parents showed:
consensual dimension
A middle-aged man was disappointed that his family reunion was spoiled when the older relatives clashed with the younger relatives about the most recent presidential election. No matter what he did, it was impossible for him to get each side to see the other's point. According to the Intergenerational Solidarity Model, the generations were separated by:
continence (quality of life)
A new administrator in a nursing home in a large city is concerned because the staff are not providing what she feels is adequate training in bladder continence. She feels this should be a priority because she knows that incontinence is associated with which problem in nursing home residents?
compensated for lack of parental support
A study in the Netherlands of parents and adult children testing the Intergenerational Solidarity Model showed that when parents had poor relationships with their children, the siblings:
identity is wrapped up in parent role, lack of control over children's lives, lack of support network, few or only one child, worried about Childs safety and well-being
A study of Canadian parents showed that the greatest difficulty in adapting to the empty nest was experienced by parents who
dual-processing coping
A woman grieving after the sudden and unexpected death of her husband is engaged in the "restoration" function of bereavement. This means that she:
74,800
A woman would like to have her mother cared for in one of the best nursing homes in her town, but is unable to afford the cost which, for a private pay facility would be about $____ thousand per year.
role reversal
A young woman feels that her parents treated her too much like an adult when she was growing up, giving her more responsibility than even she felt she could handle. This situation reflects a relationship characterized by:
marital strain
According to Umberson et al (2006) ______ accelerated typical decline in self-rated health that occurs over tilifeme?
attachment
According to the ________________ view of bereavement the bereaved can continue to benefit from maintaining emotional bonds to the deceased individual.
contingency
According to the _____________theory, parents tend to give more support to their adult children who need the most help
terror management
According to the perspective known as ________________ Theory, activating a person's thoughts about death may trigger a set of positive changes, including closer relationships, greater creativity, and more connection to others.
feels like home (better adaptation)
An advantage of the Green House model of institutional care for older adults is that it:
Long term relationships are preferred More maximum positive effects
Based on socioemotional selectivity theory, members of a couple in a long-term relationship should show which pattern of social interaction in relation to their friends and social network?
divorce proneness
Because many adults enter into remarriages more likely to leave because they are open to the relationship's ending, they are said to be high on the factor known as
good death
Being able to die in a way that protects the individual's sense of autonomy and control over end-of-life decisions is consistent with the idea of:
more likely to use negative problem solving skills- ends relationship
Couples in long-term relationships characterized by emergent distress show which pattern of conflict over time?
identity assimilation
Couples who divorce seem to adapt best if, in the process, they protect each other's sense of identity, in what's referred to as:
"slide" into marriage instead of making a mindful decision
Couples whom cohabitate before getting engaged will have a higher divorce rate should they marry. The most likely contributing factor is that
acceptance not included
Describe four criticisms of the Kugler-Ross theory
needs of individuals should be met to the greatest extent possible
Discuss the implications of the competence-press model for the design of nursing home environments.
individuals in hospice has no appitite
Discussed in the guest lecture was a key sign or trigger that is often associated with the beginning phases of the dying process - what was this sign/trigger?
intermediate care
Health-related, but not intense nursing services are provided in a(n) __________ facility.
assistance at their own residence
Home health services typically include what types of support for older adults?
adapt skills, routines, habits, or enivornemnts for people at the end-of-life. creates trust, rapport, and well-being
How did participants discuss adaptation? Pizzi Article
source of empowerment (self expression)
How did the participants discuss choices? Pizzi Article
meet needs that are important to the client and family. validating client as human with needs
How did the participants discuss client goals?Pizzi Article
Long term relationships are preferred more maximum positive effects
How does Socioemotional Selectivity Fit into the study of older adults' social networks?
lack of stress reducing activities (yoga centers, diets)
How is Loma Linda, Cali a blue zone? (happy place)
donations took 10 years
How was the building site for St. Mary's hospice center funded? How long did it take to complete the building process?
body
In Ancient Egypt, the ______________ was considered to be the guidebook to ensure that an individual would be guided through the underworld and into the afterlife.
social support
In Malone et al (2013) ______ was found to mediate the relationship between adaptive defenses and better physical health outcomes in late life.
a caring, dignified, and empowering environment for clients to direct the course of their care
In Pizzi (2015) The goal of the client-centered philosophy is to create:
were not supportive
In a test of the intergenerational solidarity model, researchers found that siblings were likely to exchange more help with each other when their parents:
Balance between contributions to a relationship
In equity theory, partners are seen as having the highest marital satisfaction if they:
routine (able to live at home with visits) respite (stay in hospice for 5 days to give caregiver break) general inpatient (lives in hospice round the clock care) continuous (nurse stays in invidividual home till can move to hospice care)
List and describe the levels of hospice care provided: ___ ___ ____ ____
infection control accident environment food sanitation quality of care unnecessary drugs
List the top five deficiencies noted in the 1997 survey of U.S. nursing homes. Why do you think these problems exist?
grains greens nuts beans
Long live people all across the globe exhibit the same 9 traits which may be linked to increased longevity. one of these 9 traits was a healthy diet, what are the 4 key ingredients to a healthy diet?
improve the mental health of the grandparents
Mental health workers who serve the older adult population are concerned about the skip generation family because they believe it has the potential to:
invisible
Moving dying patients from the home to hospitals in mid-20th Century Western culture has led to the ethos of the _________ death.
finances
Older adults in the Living Apart Together relationship status do so primarily because of which consideration?
adaptation, client goals, choices
Pizzi discovered three sub-categories in the analysis of the interviews on the topic of promoting health and well-being at the end of life, what were these three categories?
formed problem-solving skills and established patterns early (enduring dynamics)
Research on satisfaction in close, long-term relationships shows that the couples who are most likely to get along well in their later years were those who:
married with children
Since 1970, of the following, there has been the greatest decrease in U.S. households that fall into the category of
Less physical activity, depression, stress, economic hardship, loss of social support
Soon after becoming widows, research shows that women exhibit which of the following behaviors that relate to their health?
denial, anger, bargaining, depression, acceptance
Summarize the five stages of dying in the theory of Kübler-Ross.
MDD
The DSM-5 considers extreme grief past a 2-week period following the loss of a close relative or friend to fit the criteria for which disorder?
distressing situations that cause changes in arousal on an aging body (harder to adapt with age)
The Theoretical Model of Strength and Vulnerability Integration is focused on what?
widowhood
The ___________ effect refers to the fact that widows are more likely to die after losing their spouse
intergenerational stake
The ____________ ________hypothesis about families with adult children proposes that: Parents are higher in affectual solidarity toward their children than children are toward their parents
maximum health expectancy
The __________________ is the length of time an individual can live without significant disease and disability.
behavioral
The ______________approach to marital satisfaction predicts greater happiness when couples engage in positive behaviors such as expressing affection.
skilled nursing homes
The balm of Gilead has recently received support from what type of facility for patient placement that will provide more 1-to-1 care?
infection control
The number one deficiency in U.S. nursing homes in 2014, involving 43% of all institutions, was:
doing gender
The phenomenon in families known as ____________ describes what happens when parents behave in stereotypically gendered ways
gender
The phenomenon known as doing _________ occurs after the transition to parenthood, when men and women adopt more stereotyped roles in the household.
associational dimension
The relatives in a young woman's family see each other only for major holidays and family events on average about two or three times a year, even though they live within 30 minutes from each other. Based on this information, you would rate this family as on the negative end of which dimension of the Intergenerational Solidarity Model?
improve health
The role of grand parenting to aging individuals is shown by researchers to:
only remaining members of their original family and have known each other longer than they have known anyone else
The sibling relationship in later adulthood is unique because siblings typically:
developmental schism
The situation in families when parents and their adult children no longer want to be with each other and, in fact, no longer value the relationship is known as a(n):
palliative
This form of care provides people with relief from symptoms such as nausea, pain, and dyspnea as well as some services such as physical and occupational therapy.
shifted thoughts on death (gave dying dignity)
Those who study death and dying believe that the main outcome of the work of Kübler-Ross was her emphasis on:
false
True or False: Hospice care requires that family be defined and limited to only immediate blood relatives?
women report lower MQ, stronger response to marital strain, and diff life experiences during life course
Were there any reported gender differences in the effects of marital quality on health
older participants
What age group were the effects of marital quality most pervasive for individual health (i.e. when poor marital quality was reported what age group had the worst health effects?)
sublimination, suppression, anticipation, alturism, humor
What are mature defense mechanisms considered to be according to the Malone article?
6 months to live, reside in service area
What are some of the eligibility requirements for entering hospice?
Easily conceptualize how carefivers and advocates can intervene at each ecoholigcal level to support client-centered and client-prefered intimacy at end of life. (bronfrenbrenners egological model)
What are the components (i.e. individual, microsystem, etc.) of an ecosystemic framework? Briefly describe each. (Morissey-Stahl Article)
aesthetics and safety convenience postive regard and mutual help fromm neighbors attractiveness and ease
What are the four major categories of community-based services and facilities?
generosity, tolerance, social, trusting
What are the important personality traits or country beliefs in Denmark, Singapore, and Costa Rica? What 4 things do these countries have in common?
success in work and relationships, low levels of psychopathy
What are the traits that are commonly associated with mature defense mechanisms (hint: see page 2 of the Malone article)?
Do not ressesitste allowed natural death
What do DNR and AND stand for?
ecosystemic framework
What framework did the authors work from? Why was this framework used? (morasses-stahl article)
ratio of caregiver to patient isn't 1:1 ( burnout occurs)
What is an issue of the Balm of Gilead utilizing boarding homes for patient placement?
marriages becomes more meaningful as we age Cumulative marital strain becomes more apparent in older age
What is one given reason for why age is relevant when considering the relationship between marital quality and health?
obtain support from others
What is social network substitution?
14%
What is the approximate percentage of grandparents raising grandchildren who are 60 years and older?
alleviate physical pain/discomfort
What is the first priority of the Balm of Gilead palliative care services?
biopsychosocial
What model that has been discussed frequently in lectures best represents the goals of the Balm of Gilead?
life course theory
What perspective or theory did Umberson and colleagues work from in their study on the effects of marital quality and health over a lifetime?
caregiver burnout
What term is used for the stress experienced from daily management of afflicted relative. emotional, physical and mental exhaustion
social support
What variable did the authors think would mediate the relationship between adaptive defense mechanisms and late life health? Malone article
how end-of-life sexuality and intimacy can be supported by practitioners in multiple nested contexts and provide suggestions for theoretically-driven interventions
What was the overall goal of this article? (Morissey-Stahl Article )
client-centered care is important approach to end-of-life
What was the overall outcome for Pizzi's study on promoting health and well-being at the end of life (hint: what was the take away message?
promoting a good death
What was the overarching theme that emerged from the qualitative data on the study of promoting health and well-being at the end of life?
homelessness is unacceptable
What were some of the acceptable places of residence for receiving hospice care? What was mentioned as an unacceptable place of residence (i.e. they were ineligible to receive hospice care)?
filial maturity
When children reach the age at which they enter adulthood, they and their parents experience a phenomenon
both are considered aspects of competence
Where do the amount of activity and cognitive demands placed on the individual fit within the competence-press model?
A
Which best matches the description of respite care (i.e. one of the levels of care provided by hospice)? A. A designated time a patient may come to stay at a hospice center to provide a caregiver a break and to avoid caregiver burnout B. A brief time where a hospice patient stays in the hospital for a thorough check-up C. A patient is at a level when they are mostly functional, but need nutritional assistance D. Described as a time when a patient is visibly near the end of life and needs intensive care
mood and anxiety
Which psychological disorders are most prevalent among residents of nursing homes?
home health services
Which type of care for older adults provides such services as Meals on Wheels, friendly visiting, assistance with household tasks, and rehabilitation, outside of an institutional setting?
medicate, medicaid, private insurance, self pay/ charity care
Who covers costs associated with hospice?
need for intimate relationship in late life is often ignored
Why focus on intimacy in late life?Morissey-Stahl Article
press
Within the competence-press model of adaptation to the institutional environment, which dimension captures the extent to which the environment places demands on the individual resident?
remarry
Women who adapt more favorably to widowhood tend to be those women who
move naturally (move every 20 min) purpose (accept place in life) down shift (time for selves) 80% RULE (diet, grains greens nuts beans) Plant slant (95% non processed produce) wine at 5 belong (community) loved ones first right tribe
common denominators in happiest places promoting longevity
anniversary reaction
emotional reaction that may occur on the date of certain anniversaries. may continue for 35 years or more after death of spouse
social support
mature defense mechanisms is connected to good health at ages 70-75- using what mediator?
microsystem
people in what ecological level are the gatekeepers to intimacy? they can encourage it or stop it?
long and easy
people that are 20% happier are those that though life was what?
80
social support does not have strong mediation effects for the relationship between defense mechanisms and health at age ___
client-centered care
this is the approach to service that incorporates respect for and partnership with clients as active participants in the therapy process. this approach emphazies the client's knowledge and experienece, strengths, capactity for choice, and overall autonomy
true
true or false: practitioners still do not discuss intimacy in later life
social network compensation
what is the extent to which alternative sources of support boost emotional and physical health
macrosystem
which ecological level includes the experience of intimacy as the larger attitudeds and ideologies that cultures/societies have of intimacy that shape opinions and thoughts on elders
mesosystem
which ecological level includes the experience of intimacy ensuing that communication is open and clear between all parts of the microsystem
exosystem
which ecological level includes the experience of intimacy in the enviornments that may not have direct connection with the individual, but still imact intimate expression at end-of-life (media, policies)
microsystem
which ecological level includes the experience of intimacy with those with immediate contact to the elders may serve as educators, supporters, or influencers (caregivers)
c
which of the following is a component of the ecosystemic framework? a. family b. practitioner c. macrosystem d. spirituality
Kubler Ross
who fore fronted the hospice movement in the US?