HDFS 3710: Exam 4

Couples in long-term relationships characterized by emergent distress show which pattern of conflict over time?

Poor conflict resolution

What is the first priority of the Balm of Gilead palliative care services?

physical suffering, alleviating the patients pain and distress

Siblings in later life who exchange more help, according to research on a Netherlands sample, are likely to have had parents who:

provided little support for them when young

The concept of defenses originated from ____________ tradition?

psychoanalytic

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.

$74,800

Describe in detail the 9 traits (i.e. what are key components of the common theme, diet? Or what are the elements of the common theme of socialization?)

***High diet grains, greens, nuts, and beans Healthy choice is the easy choice in these environments (walkable and bikeable environment) Fresh produce and food is easy to come by

List the top five deficiencies noted in the 1997 survey of U.S. nursing homes. Why do you think these problems exist?

-

List and describe the levels of hospice care provided:

1. routine( live at home not intense care) 2. respite (stay in hospice center to give primary care a break) 3. in- patient (living in a place and needs around the clock care) 4. Continuous (nurse is staying in the individuals home)

What is the approximate percentage of grandparents raising grandchildren who are 60 years and older?

22%

What is an ambivalent social relationship?

A relationship that has both positive and negative interactions

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?

Adaptation, client-goals, choices

The majority of employees of nursing homes fall into which category?

Aids rather than nurses

How was the building site for St. Mary's hospice center funded? How long did it take to complete the building process?

All donations and sponsorships and 10 yrs -- no funding from government

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?

Assisted Living Facility

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?

Associational

Where do the amount of activity and cognitive demands placed on the individual fit within the competence-press model?

Both are considered aspects of competence

What are key points and concepts to the hospice philosophy?

Caring and providing help to those who are near death, designed to restore dignity and provide a sense of personal fulfillment

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?

Client-centered care facilitates self-direction at the end of life, or provides clients with opportunities to say how they will live their lives until the end of life.

What is the difference between social network compensation and social network substitution?

Compensation: extent to which alternative sources of support boost emotional & physical health. Substitution: attain social support from others

In the Blue Zones and Longevity video three countries were focused on, Denmark, Singapore, and Costa Rica. Describe what the people in each country do to contribute to their high longevity rates; what makes these people happy and health?

Costa Rica: highest rating of positive day-to-day living Denmark: they have the most trust Singapore: everyone owns their own home, paid equal wages, racial equality

What do DNR and AND stand for?

DNR: Do not resuscitate and AND: Allow Natural Death

Summarize the five stages of dying in the theory of Kübler-Ross. Describe four criticisms of the theory.

Denial, Anger, bargaining, depression, acceptance. Criticisms: failed to mention that to reach acceptance of a fatal illness, the dying person must be able to communicate openly about their illness, stages started to be seen as steps.

What are the important personality traits or country beliefs in Denmark, Singapore, and Costa Rica? What 4 things do these countries have in common?

Denmark: equality, job passions, tolerance, recreation, social expectations, security, trust Singapore: Order, racial equality, homeowners, benevolence, sunshine, security, trust Costa Rica: Humor, low time urgency, strong faith, low materialism, sunshine, social, expectations 4 common things: generosity, tolerance, social, trusting

An advantage of the Green House model of institutional care for older adults is that it:

Designed to feel like a home, improved adaptation in residents and their families

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):

Developmental Scheme

The Theoretical Model of Strength and Vulnerability Integration is focused on what?

Distressing situations cause changes in arousal that challenge aging bodily system

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:

Divorce proneness

What are some of the vulnerabilities of older adults' social relationships (think about concerns such as unavoidable conflict)?

Early life experiences will influence the ability to have close, positive networks, some social network members are unavoidable, related to worse health across multiple domains

What framework did the authors work from? Why was this framework used?

Examine sexuality and end-of-life through an ecological (ecosystemic) framework. It provides a holistic framework for understanding multiple levels of influence on sexuality in end-of-life

Women who adapt more favorably to widowhood tend to be those women who:

Experienced "resilient grief"

True or False: Hospice care requires that family be defined and limited to only immediate blood relatives?

False- family can be whoever the client defines as family

When children reach the age at which they enter adulthood, they and their parents experience a phenomenon known as:

Filial maturity

Older adults in the Living Apart Together relationship status does so primarily because of which consideration?

Financial Concerns

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:

Get along well during their early years together

How did the participants discuss choices?

Giving choices is a source of emportment

What are the traits that are commonly associated with mature defense mechanisms (hint: see page 2 of the article)?

Greater levels of success in work and relationships and lower levels of psychopathology

What type of care is provided in an intermediate care facility?

Health-related services for people who do not need hospitalization or skilled nursing care

Home health services typically include what types of support for older adults?

Help older adults within their own private residences

Discuss the implications of the competence-press model for the design of nursing home environments.

If press outweighs competence the individual does not have enough competencies to meet the pressure of the environment. If competence outweighs press the environment is not stimulating enough for the individual to be successful or adapt to the environment.

What are the components (i.e. individual, microsystem, etc.) of an ecosystemic framework? Briefly describe each.

Individual: the experience of intimacy is a very individual experience. Microsystem: those with immediate contact to the elders may serve as educators, supporters, or influences Mesosytem: ensure that communication is open and clear between all parts of the microsystem Exosystem: the environments that make not have a direct connection with the individual but still impact intimate expression at the end-of-life Macrosystem: the larger attitudes and ideologies that cultures/societies have of intimacy that shape opinions and thoughts of elders.

The number one deficiency in U.S. nursing homes in 2014, involving 43% of all institutions, was

Infection control

The least amount of nursing services is provided in what type of in-patient facility for older adults?

Intermediate Care Facility

Why focus on intimacy in late life?

Intimate relationshp, is often ignored but vital at end-of-life stages

Who fore fronted the hospice movement in US?

Kubler-Ross

Since 1970, of the following, there has been the greatest decrease in U.S. households that fall into the category of:

Married couples with children

The greatest degree of filial _____ is likely to be experienced by Asian American families.

Maturity

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?

Maximum positive effects

Who covers costs associated with hospice?

Medicare, private insureance, self-pay (room and board) and charity care - if your insurance only pays $x amount they will only charge you $x amount

The intergenerational stake hypothesis about families with adult children proposes that:

Older generations value relationship with adult children more than children value relationships

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?

Press

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?

Promoting a good death

What was the overall purpose of this article? What were they trying to test?

Purpose: look at how defense mechanisms in midlife affect the health in later life & see if social support helps to moderate defense mechanisms in midlife and health later in life.

What are the four major categories of community-based services and facilities?

Registered nurses, home health aides, licensed practical nurses, social work services

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?

Skilled Nursing Facility

What are some of the strengths of older adults' social relationships (think about the size and ability to negotiate conflict)?

Social network ties tend to shrink with age & handle negativity interactions more proficiently

What was the overall goal of this article?

To explore how intimacy in late life can be supported by practitioners

Soon after becoming widows, research shows that women exhibit which of the following behaviors that relate to their health?

Widowhood effect

According to the _________ of bereavement the bereaved can continue to benefit from maintaining emotional bonds to the deceased individual.

attachment view

The role of grand parenting to aging individuals is shown by researchers to:

be important for their mental health

The phenomenon in families known as "doing gender" describes what happens when parents:

behave according to traditional roles

The __________ to marital satisfaction predicts greater happiness when couples engage in positive behaviors such as expressing affection.

behavioral approach

A study of Canadian parents showed that the greatest difficulty in adapting to the empty nest was experienced by parents who

believe that the world is a dangerous and threatening place

Mental health workers who serve the older adult population are concerned about the skip generation family because they believe it has the potential to:

cause burden to grandparent

What is palliative care?

comfort care, a holistic approach to caring for the dying

According to the _____________, parents tend to give more support to their adult children who need the most help

contingency theory

What is one given reason for why age is relevant when considering the relationship between marital quality and health?

cumulative marital strain has more apparent health consequences for older adults

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:

disagreements and values

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: disillusionment

disillusionment

Those who study death and dying believe that the main outcome of the work of Kübler-Ross was her emphasis on:

emotional tasks?

The majority of nursing homes in the U.S. fall into which category of ownership?

for profit

The phenomenon known as doing _________ occurs after the transition to parenthood, when men and women adopt more stereotyped roles in the household.

gender

What is a key common theme to the places that have the happiest and healthiest people?

generosity, tolerance, social (6 hours of face to face interaction), and trusting with those they live with and their country

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:

good death

What are some of the eligibility requirements for entering hospice?

have to have a life limiting illness of 6 months or less, live in certain area, all ages, no interventions to cure disease

The________ is the length of time an individual can live without significant disease and disability.

healthy lifespan

Moving dying patients from the home to hospitals in mid-20th Century Western culture has led to the ethos of the _______ death.

institutionalized

Health-related, but not intense nursing services are provided in a(n)___________.

intermediate care facility

The healthy lifespan refers to the length of time that an individual can:

live without a significant disease and disability

The people who think life is ______ and ________ are 20% happier.

long & easy

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?

major depression disorder

The sibling relationship in later adulthood is unique because siblings typically:

may be the longest relationship in life

Which psychological disorders are most prevalent among residents of nursing homes?

mood and anxiety

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.

need complementary

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?

not hungry- no appetite (nips and bites) a trigger that the end is near

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?)

oldest populations

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)?

personal home (nursing, long time care, assisted living) NOT HOMELESS

How did the participants discuss client goals?

plan goals and meet people's needs, are important from the perspective of the client and family. Acknowledge the individuality of the patient, validating the client as a human with needs.

According to Umberson et al (2006) _______________ accelerated typical decline in self-rated health that occurs over time

poor marital quality leads to

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:

provide more support for each other

In a test of the intergenerational solidarity model, researchers found that siblings were likely to exchange more help with each other when their parents:

provided little support for them when young

The "anniversary reaction," as applied to widowhood, refers to the:

sadness that comes on their anniversaries after the death

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:

saving face

In equity theory, partners are having the highest marital satisfaction if they

seek balance between contributions to a relationship

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 about the same relationship satisfaction decline

The balm of Gilead has recently received support from what type of facility for patient placement that will provide more 1-to-1 care?

skilled nursing homes

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?

social isolation

What variable did the authors think would mediate the relationship between adaptive defense mechanisms and late life health?

social support

What best represents the definition of caregiver burnout?

state of physical, mental and emotional exhaustion

What is secondary trauma?

stress from helping or wanting to help a traumatized person - indirect experience of the traumatic event, mainly from hearing about an event or seeing an event

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:

structural ambivalence

What are mature defense mechanisms considered to be according to this article?

sublimation, suppression, anticipation, altruism, humor

A woman grieving after the sudden and unexpected death of her husband is engaged in the "restoration" function of bereavement. This means that she:

takes on new tasks

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.

terror management

The idea that Western culture is unwilling to accept the reality of mortality led Ernest Becker to write the critique of this attitude, called:

the Denial of Death

What model that has been discussed frequently in lectures best represents the goals of the Balm of Gilead?

the biopsychosocial model

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.

the book of the dead

What perspective or theory did Umberson and colleagues work from in their study on the effects of marital quality and health over a lifetime?

the life course perspective To understand age and gender differences in the link between MQ and health. How do positive and negative aspects of marital quality affect health? Do these effects vary with age or gender? Life course perspective

What is an issue of the Balm of Gilead utilizing boarding homes for patient placement?

the ratio isn't a 1 to 1 ratio, so they aren't always being looked after

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

the rewards of the relationship outweigh the costs

How did participants discuss adaptation?

they adapt skills routines, habits or environments for people at the end of life. This creates trust, rapport and well-being.

Couples who cohabitate before getting engaged will have a higher divorce rate should they marry. The most likely contributing factor is that

they slid into engagement/marriage instead of making a mindful decision

The _______ effect refers to the fact that widows are more likely to die after losing their spouse.

widowhood