HDFS Final Stuff Thru Exam 4

wisdom

-hard to define, this is another component of intelligence *expert knowledge that people acquire in the fundamental pragmatics of life *ability to make sense of contradictions, use reason and info to effectively solve problems, learn from experience, make good judgements, etc-older ppl may be more likely to be wise-can help one adapt to aging *3 contributing factors to wisdom: 1) general personal characteristics, including cognitive ability 2) certain conditions of expertise 3) life experiences that enable acquisition of wisdom, such as education or leadership experience -"these experiences do require the passage of time but growing old itself is not necessarily correlated with the acquisition of wisdom" -but, not all old people are wise! -conception of this from Erikson = a kind of "informed and detached concern with life in the face of death itself"

false

-the majority of old people (past 65 yrs) have Alzheimers disease -as people grow older, their intelligence declines significantly -its very difficult for older adults to learn new things -personality changes with age -clinical depression occurs more frequently in older than younger people -alcoholism and alcohol abuse are significantly greater problems in the adult population over age 65 than that under age 65 -older adults have the highest suicide rate of any age group -high blood pressure increases with age -all women develop osteoporosis as they age -most old people lost interest in and capacity for sexual relations -kidney function is not affected by age -increased problems with constipation represent a normal change as people get older -retirement is often detrimental to health -ppl 65 yrs of age and older currently make up 20% of the US population -most older ppl are living in nursing homes -the modern family no longer takes care of its elderly -the life expectancy of men at age 65 is about the same as that of women -living below or near the poverty level is no longer a significant problem for most older Americans -older workers cannot work as effectively as younger workers -most old ppl are set in their ways and unable to change -the majority of old people are bored -in general, most old people are pretty much alike -older adults (65+) have higher rates of criminal victimization than adults under 65 do -older adults (65+) are more fearful of crime than are persons under 65 -older ppl do not adapt as well as younger age groups when they relocate to a new environment -participation in volunteering thru organizations tends to decline among older adults -older ppl are much happier if they're allowed to disengage from society -all medical schools now require students to take courses in geriatrics and gerontology -abuse of older adults is not a significant problem in the US -grandparents today take less responsibility for rearing grandkids than ever before

-both provide physical and emotional support *dif = EOL doulas do not provide medical nursing related care -- cannot perform certain medical tasks! *allows EOL doulas to focus more on emotional support (companion rather than treat) -different professional boundaries: can opt to help with various things families need -more likely to have 1 client at a time: more time for being present with client and family *hospice care is paid for mostly by medicare - since congressional act in 1982 -they thought it would save money but it really hasn't -- even tho the thought of dying at home instead of a hospital may be preferable from an individual's perspective, the savings are minimal bc costs are simply shifted from 1 part of the medicare budget (hospital care) to another (physician and home care services) ~real issue concerning hospice care is whether containing costs should be the main objective of public policy or whether other goals are more important ~should this matter = NO - you want your loved ones to be able to die comfortably, money shouldn't be a thought or a concern

-whats the difference b/w hospice nurses and EOL doulas? -how is hospice care paid for? -is it the cost savings that it was initially expected to be? should this matter?

disengagement theory

1st formal theory of aging, proposed in 1961 by 2 prominent University of Chicago researchers, Cumming and Henry -criticizing what they called the implicit theory, that ppl can be well adjusted, satisfied, and happy in old age only If they remain active and involved, they argued that normal aging involves a natural and inevitable mutual withdrawal or disengagement, "resulting in decreasing interaction between an aging person and others in the social system he belongs to" -bc of the inevitability of death, the society and the individual mutually sever their ties in advance so that the death of the individual will not be disruptive to the social system -either the society or the individual may initiate the disengagement, but once the process is initiated it becomes circular -- lessening social interaction leads to a weakening of the norms of behavior regarding interaction -the individual wants to disengage and does so by reducing the number of roles he or she plays and weakening the intensity of those that remain *most controversial = idea that disengagement was universal, meaning it happens everywhere and in all historical eras -that it was inevitable, meaning it must happen sometime to everyone -that it was intrinsic, caused by biological factors rather than social factors -theory didn't take into account widowhood, delayed retirement or illness and disability in old age (events which can greatly alter the way inds. relate to society as they age

activity theory

Havighurst formalized this, which Cumming and Henry called the implicit theory of aging -he argued that the psych and social needs of the elderly were no different from those of the middle aged and that it was neither normal nor natural for older people to become isolated and withdrawn -when they do, its often due to events beyond their control, such as poor health or the loss of close relatives -the person who aged optimally managed to stay active and resist the shrinkage of his/her social world = maintaining the activities of middle age for as long as possible and then finding substitutes for those that had to be relinquished - substitutes for work, for friends, and for loved ones who died (successful aging was active aging) -many studies of volunteering confirm the basic premise of activity theory ~more on par with what we believe now in terms of successful aging but still rejected bc not for everyone

elder abuse

acts of commission and omission that cause unnecessary suffering: includes neglect, financial exploitation, and physical, emotional, and sexual abuse -b/w 1-11% of the population over age 65 has been victims of some type of elder abuse or neglect

life expectancy

average number of years people in a given population can expect to live, or more precisely, the mean age at death -this concept is a measure of the combined outcome of many births and deaths -it's calculated by taking the sum of the ages at death of all individuals in a given population and dividing it by the number of people in that population -higher for females than for males

age effect

change that occurs as a result of advancing age -ex: declining health

*long term memory = permanent storage for past experiences (driving), involves our ability to recall distant ppl/events, such as those from our childhood, as well as various skills we've learned such as reading and driving-these help us remember places, individuals and events from our past; we also need this to do day-to-day activities *this doesn't change much; relatively stable -may take longer to retrieve, may make more mistakes *working/short-term memory = ability to temporarily Store and manipulate info; this declines with age & the greatest effects of age happen in this domain -(these declines have important implications for navigating everyday tasks such as memorizing lists of words, reasoning, producing complex written and spoken language & word-by-word processing of complex sentences) -linked to decline in other factors: such as slowing processing speed (jeopardy-- having to get to the buzzer; depends on reaction speed); decline in selective attention abilities ~normal memory changes related to age: tip-of-the-tongue phenomenon - reflects a problem in retrieving info from memory -as ppl get older, such annoying minor lapses in memory become more frequent = normal age-related changes in cognitive functioning -in most ppl these memory lapses are not symptoms of Alzheimers or any other disease ~forgetfulness can be frightening but most ppl find ways to compensate - making lists of things, keeping keys and glasses in the same place when they're not using them, and try to memorize *dementias = mental disorders caused by severe organic deterioration of the brain - they affect memory, cognitive functioning, and personality to a degree sufficient to interfere with normal activities and social functioning ~symptoms = impairment of memory, intellect, judgement, and orientation and excessive or shallow emotions -- may also be accompanied with depression, anxiety, delusions or aggressive behavior ~2 most common forms of dementia = Alzheimer's disease and vascular dementia - ALZHEIMERS MOST COMMON *many causes of dementia but early life adversity increases the risk of getting dementia in old age - infants who are deprived of adequate nutrition have smaller brains than infants who are well-nourished -- the aging process aggravates poor early brain development and leads to dementia ~early life adversity combined w poor nutrition and poverty can also reduce the chance for higher education and the mental stimulation that results from challenging tasks and the interesting jobs given to those w a college degree -cog impairment Is also hereditary -poverty is also a factor - greater risk of getting conditions that cause cognitive impairment -traumatic head injuries ~alzheimers disease: risk gradually increases with age, no known cure, not reversible, onset is slow and involves subtle changes -1 of the early signs (that also is found in those without the disorder) = loss of STM - but those w Alzheimers forget PERMANENTLY (those with normal memory loss only forget temporarily) -also repetition and confusion, may do things that are dangerous and have delusions -memory loss slowly progresses until the person can no longer perform daily activities like dressing and bathing -dramatic personality changes -exact cause is unknown: 2 theories = 1) genetic predisposition and 2) environmental influences (nutrition, disease, or stress) -meds can control sleeplessness, agitation, wandering, anxiety and depression *exercise regularly, walking, swimming, cycling, dancing = less risk of memory decline or developing Alzheimers ~vascular dementia: typically starts b/w the ages of 60-75 -- affects men more than women -caused by atherosclerosis of blood vessels in the brain - disruption of blood flow leads to mini strokes -- aphasia can be the consequence of a stroke -- symptoms = confusion, problems with STM, wandering, getting lost in familiar places, losing bladder or bowel control - no treatment, damage to the brain can't be reversed *major risk factor = high BP, diabetes, smoking, obesity

compare and contrast long-term and working/short-term memory -what types of changes are we likely to see in each type of memory? -which is more likely to decline with age (as part of normal aging?) -differentiate between normal memory changes related to age and the 2 most common forms of dementias -which is most common? -describe the common symptoms of dementias and the most commonly recognized factors that are believed to increase the risk of developing dementia in late life? what is the greatest risk factor?

-ideal housing policy = we want to live at home and age in place - want it to be easy for an elderly person to live there independently -- safe, stable, healthy home to live in -US is very far from having it ideally, most ppl want to stay in own homes for as long as possible - if you cant do that, then from there you can move to somewhere where u can stay for rest of ur life (CCRC) - maybe have someone come in to life with you ~older americans act (notion that there would be supporting to everyone to live on their own) - were far from that - money follows the person is designed to help us get there - develop houses as if no ones gonna grow old - disability rights moving helping to change that by saying you have to design these homes with entryways for a potential wheelchair

consider the ideal housing policy and how far we in the US are from this -identify some things we might do to move closer to this ideal and to describe the concerns that have been raised about expanding home and community-based services -are the concerns warranted/appropriate? why/why not?

*ageism = a set of beliefs about and attitudes toward the aged: ~involves 2 distinct activities: -prejudice = involves negative stereotypes about older people -discrimination = People are denied opportunities just because they are old *examples of how it operates at the different levels of the environment = ~individual: simplifying stories for older people, "oh look at that cute little old man", making fun of an older person as they attempt to use technology ~interpersonal: offering to help someone just because they're older - assuming they need help even if they didn't ask for it ~institutional = being denied a job bc you're an older person, neglect, medical professionals might not want to treat you ~cultural = assuming older people are slower at doing everything (especially driving), assuming aging = sickness, talking much louder to older people, assuming all older people = grumpy ~ageism exists because its a consequence of longevity -consider how ageism may affect males/females differently: ~males - aging may be considered a distinguishing look for them - a lot more positive for them - we view them as a lot more wise ~females - they may be looked at as just "old" - not socially acceptable for women to age or look old - they're supposed to stay youthful forever -how ageism operates in relation to work/employment = older individuals may be denied employment opportunities bc of their age ~common stereotypes = most retirees are lonely and depressed, most older people are poor, the aged are isolated from family members, most older people are disabled, people become more mellow as they grow old, nearly 1/3 of ppl 65 or older are in nursing homes, the aged are politically powerful, in the past, older parents commonly lived with their children and grandchildren, welfare is for the poor

define ageism -give examples of how ageism operates at the different levels of the environment (with a focus on old age) to affect the aging experience -why does ageism exist? -consider how ageism may affect males/females differently, and how it operates in relation to work/employment -distinguish fact from fiction in the facts of aging quiz and to articulate other common stereotypes about elders

*long-term care = refers to a range of services designed to help people with chronic conditions ~long-term care is needed most for the frail elderly, when one needs help with ADLs -3 markers of frailty = well elderly, somewhat impaired elderly, frail elderly (same as young old, middle old and oldest old) *continuum along which long-term care options exist = -family care (least formal) -home care -nursing care (most formal) *how well the US currently meets and is prepared to meet the health care needs of elders = with the increasing years a person is living, the money that theyre needing to take care of these chronic illnesses, the US isnt meeting these needs -"longevity is pretty much a crisis today" = the way the healthcare system develops creates a mismatch of funding of need ~living a long life is something that should be exciting/celebrated - we shouldn't have to worry about $$$ - also worried "who will take care of me? how will I afford it? will I need to rely on my kids?" ~we shouldn't be worried but we are bc of the way healthcare is set up in our country

define long-term care and explain when such care is typically needed, using the 3 markers of frailty as well as ADLs and IADLs -explain the continuum along which long-term care options exist and describe different points along this continuum -explain how well the US currently meets and is prepared to meet the health care needs of elders, using Dale Jaffe's claim that longevity is pretty much a crisis today

successful aging = origins of the concept - Rowe and Kahn - compared successful aging to usual aging ~helped shift the field of gerontology from 1 focus on loss to 1 focus on potential for growth -included attention to both individual/internal and external (structural/societal) factors and their interaction *concept based on recognition that there's great variability in aging -- focuses on the factors that contribute to successful aging ~text summary description = "peak physical and psychological functioning, participation in rewarding social & productive activities" *rowe and Kahn's definition = 3 main factors of successful agers: 1) no disability/disease 2) high cognitive and physical abilities 3) meaningful interactions with others (engaged relationships) -positives = focuses on individual variability - why do only some ppl age successfully?, also recognizes role of both intrinsic genetic factors and extrinsic lifestyle factors -helps us identify things individuals can do (and should not do) to age successfully -recognizes demographic variability: why are some groups more/less likely to age successfully (race, SES) *shifted the field from a negative to a positive focus, focused the field on factors that contribute to successful aging -issues/concerns = not everyone can age successfully, be free of disease/disability and have high physical and mental functioning -focus Is more on the individual than structural conditions, public policies, etc -narrowly defined, only available to the most privileged and lucky -focused mainly on the individual ~according to Rowe and Kahn, you cannot age successfully if you have a chronic disease or disability ~in reality, successful aging does NOT require peak physical and psychological functioning *current view = 2 factor model of successful aging: 2 independent dimensions to successful aging = objective success and subjective success ~4 groups = objective and subjective success, objective but not subjective, subjective but not objective, neither objective nor subjective *factors that promote successful aging = successful aging involves both the individual and society -some elders are better positioned to age successfully bc of factors at each of these levels: 1) individual level = biological make up and individual choices/behaviors 2) societal level = social location, race and ethnicity, trying to limit ageism and educate people about ageism 3) institutional level = changing SS so ppl who make the least get more SS when they're older so they aren't in poverty in old age, providing healthcare for all, quality of care in a nursing home 4) interpersonal = social support - relationships you might have ~things we wanna do to reduce the risk of getting Alzheimer's disease = avoid smoking, eat a balanced diet, stay social, continue to educate your mind, get good sleep, see a doctor regularly, etc

describe aging well, based upon the current research and measurement methods, and compare this to the original conceptualization of Successful Aging by Rowe and Kahn -explain the contributions Rowe and Kahn made with their original conceptualization and how it has been revised to address the challenges/problems with it -make the case for the factors at the individual, interpersonal, institutional, and societal levels most associated with fostering positive aging/aging well, including things we want to do regularly to reduce the risk of developing Alzheimer's Disease

~goal of the hospice movement = allow the terminally ill to die easily and at peace, without pain, in their own homes, special units of hospitals, or hospice facilities ~hospice movement in the US: originated in 1974 in Branford, CT -- as the idea of a more compassionate attitude toward dying spread, so did the hospice movement -roots = dr. dame Cicely saunders (st christophers hospice in London in 1967 = 1st hospice) -focus on QUALITY over QUANTITY of life -central component of hospice philosophy = pain management (similar to palliative care) -- terminal pain is considered an illness in itself *different from the medical model bc focuses on pain management rather than a cure! *role of hospice nurses= 1) care of patient: decrease suffering and increase comfort 2) care of the family - teach loved ones how to care for a dying person and what to expect in the dying process ~typically 1-2 hr home visits a few times a week - more as death nears *care of patient is focused on decreasing suffering and increasing comfort in 4 areas: -physical: assess and treat/manage pain -emotional -social: impact on relationships with others, reactions of others -spiritual: religious questions, questions about meaning of life/has life been worthwhile? *end of life doula = profession is aimed at meeting growing demand for end-of-life-support ~has grown in response to: baby boomers, people living longer, average dying process has become more gradual and anticipated -complements the care of others and helps to lower stress levels, aid in comfort, and promote personalized, even positive, dying passages for clients and their loved ones -they accept that dying and death are a normal part of life -they have a foundational knowledge of symptoms associated with terminal illnesses, physiology of death, and techniques for alleviating suffering -provide non-medical, nonjudgmental emotional/spiritual support and soothing physical comfort measures -create a calming, peaceful atmosphere -promote informed consent for each client -help gather relevant info and connect clients to beneficial resources -assist clients with living their days to the fullest -they hold a client's hand thru the purposeful work of resolutions, story sharing, life reflections, and legacy projects -trust in the inherent wisdom to decide and discover his/her own best path -companion rather than treat -empower and encourage client's friends and family members to operate within their comfort zones; fill in support gaps as they arise -feel comfortable sitting vigil and respectfully assisting in after death care as directed by a client's family -provide a continued presence, when requested, during the initial grief and bereavement period

describe hospice and its use -explain the hospice movement and the main roles hospice nurses play, and how this movement differs from the medical model -discuss how hospice nurses and end of life doulas differ

~common features of a nursing home = handling of many human needs by a bureaucratic organization -they're examples of a total institution bc it fits into an institution that is established to care for people who are both incapable and harmless -challenges of transitioning to a nursing home = 1. giving away life long possessions 2. severing ties with famliar places, people 3. comfortable daily routine 4. loss of independence ~daily life in a nursing home = sleep, wake up, fed breakfast, lunch and dinner, might have activities going on, however, some residents are left in bed too long by aides and get bedsores ~typical quality of care available in a nursing home = never that good bc low training, low wages, low benefits, care is needed on a 24 hr basis, manual labor is included and injuries are relevant, high staff turnover rates ~CATCH-22 = paid nursing assistants might want to put in more time to give the clients what they need but they have so many demands on their time that it doesn't let them spend that time w that person that would give them the absolute best care ~knowing the best care but also knowing ur boss is telling you everyone has to be fed by a certain time

describe nursing homes -make the case for how they are examples of a total institution -describe the challenges of transitioning to a nursing home, daily life in a nursing home, and the typical quality of care available in a nursing home -what are the main things that affect quality of care? -what's the Catch-22 (an irresolvable bind) that faces paid nursing assistants?

*this is a social insurance program: how the SS system operates = 1. all who contribute into the pot receive benefit 2. benefit levels are determined by a formula (length of time worked, amount of wages earned) 3. replacement rate: amount of $ that is made preretirement being replaced by the SS income (lower income workers will get a higher replacement rate, visa versa for high income workers) -some adjustments (those who've earned the most have a lower adjustment/replacement rate; -ex: those w/ higher earnings have a lower replacement rate)(those w/ higher earnings have a lower replacement rate) -women often have fewer wages of work-more elders are living longer- meaning more lives drawing from social security -a concern with the baby boom cohort-noted elders concerns about SS not lasting or changing in ways that will reduce payments that would cause more people to work into late adulthood ~how it works = -workers while working, pay SS -- this tax money goes into a trust fund-the trust fund is used to pay out benefits to those who worked before but are no longer working (and select other groups)-intergenerational transfer-your yearly contributions give you credit that you draw on when you're eligible for benefits According to American Academy of Actuaries, 2017, SS is not in danger of collapse -But some actions are warranted so we can continue to pay full benefits in the coming years *reason SS was created = Expected to try to help ppl not fall into poverty -was NEVER expected to cover ALL of elders' expenses (for some tho, it does serve as such, but not enough in those cases) *Social Security System Created Assuming and Privileging Two-Parent Heterosexual Families with Single (Male) Breadwinner -- which would assume that the wife stays home to care for the kids ~gender recognition: ~1 proposal based on this would eliminate the penalty mothers pay for taking time out of the labor force to care for their kids by removing periods of child care from the computation of SS benefit levels; ~another proposal would provide child care credit under a special minimum benefit *possible actions for benefit reductions = -gradually increase full retirement age (was 65, now 67 for those born in 1960 and up) -reduce cost-of-living-adjustments (COLA) -reduce benefits for future retirees -lower benefits for future high-income retirees *possible actions for revenue increases = -raise payroll tax rate -subject higher wages to social security payroll tax -subject benefits to higher taxes -apply payroll tax to health care premiums

describe the social security system - how it operates, where it stands currently, and what suggestions have been proposed to support it into the future? -explain how it tries to compensate for inequities in the labor market and explain how well it does in this regard -also explain gender related inequities that are associated with traditional roles for women around childcare -describe the different types of proposals for addressing SS so it'll remain solvent into the future, and argue for/select changes/adjustments to help keep the SS system solvent

*typical pattern of relationship satisfaction seen over the life course = U-SHAPED pattern over the life course ~high in early yrs ~declines seen during childrearing yrs ~beginning to rise after kids are launched, with highest level in retirement yrs *the initial decline in marital satisfaction is associated with the arrival of children -the 1st yrs of parenting are so demanding and difficult, so a couple has less time for other satisfying activities -middle years: childcare responsibilities and work pressures are maximized & can undermine marital quality ~later, after kids have left home, marital quality tends to improve -- among middle-aged parents, those whose children are successful are the happiest -bc of divorce, death, or late age at marriage, less than 3% of all marriages last 50 yrs - couples still married by 65 are the survivors; but not all long-term marriages are satisfying *general impact of marriage on health = -married adults tend to do better on a range of health outcomes than unmarried adults BC increased resources and increased attention by someone else to your bad health patterns ~caution: quality of marriage matters! -- those in poor quality marriages have been found to have more stress and poorer health than those divorced ~marital satisfaction for men and women: men- influenced by his own health women - most important is husband's view on the marriage, depends on husband's personality and health ~sexual activity: very much declines with age -although men report a less decline -however, activity may still be important to some people (determined by importance of sex to the person and the availbiltiy of a sexual partner)

describe the typical pattern of relationship satisfaction seen over the life course and the general impact of marriage on health -with regard to marriages between cisgender men and women, how, if at all, does gender relate to marital satisfaction? -how does sexual activity change with age and is sexual activity/satisfaction no longer important once people reach old age?

-dramatic improvement -medical advances = less infant & child and maternal mortality -fewer people are smoking -new medications -1900 = low chance of surviving until old age -by 2010, infants had a much better chance of living to old age -greatest declines = in 1940s (medical advances = huge gains against infant/child mortality and maternal mortality) and 1970s -late 60's = death rate from heart disease started falling because of better prevention and treatment -progress against heart disease = most important reason for the reduction in the mortality rate in the past quarter century (greatest among older men) -cancer deaths have increased among the elderly -rates of cervical cancer have gone down bc some get pap smears -lung cancer = decreasing in men bc less smoking but increasing in women bc increase in smoking *HEART DISEASE = LEADING CAUSE OF DEATH FOR PPL OVER 65, THEN CANCER (for those 65-84) over 85 = 1) heart disease 2) stroke 3) cancer *CURRENT LOCATION = -currently in the 3rd stage: chronic illness - allows us to associate old age with ill health bc they're still getting older and staying alive but they are getting sicker and more chronic illnesses until they die -seeing most death happen with old age so we associate old age with death and sickness ~this can be connected to the demographic transition bc at the end of this process, a country's population is older and larger - which is true in our case we would be on stage 3 of the transition, which -stage 3 -- the population as a whole begins to age, and more deaths are caused by chronic ailments than by acute illness - when birth and death rates are both low, the demographic transition is complete - at that point a nation can be characterized as old ~current location??? ~compression of morbidity thesis: = when the years of chronic illness are compressed to the last years of life for someone and they are able to live a long healthy life 2 premises: 1. the maximum years a human has is fixed and finite 2. improvements in health care will compress the years that an individual will be disabled into the last few years of life!! IMPROVEMENTS IN HEALTHCARE - BETTER PREVENTION AND TREATMENT *EDUCATED ppl benefit the most from this thesis ~implications of this connection for how the larger, non-old age knowledgeable society thinks about/perceives old age???

describe the ways mortality rates have changed in the US over the past century -connect this to the demographic transition and also explain how our current location affects how we think about old age and its relationship to/association with ill health -what role does the compression of morbidity thesis play in this association and what are the implications of this connection for how the larger, non-old age knowledgeable society thinks about/perceives old age?

*processing speed: time it takes to do a task -declines start in our 30s; continue thruout life span (ex: famous athletes) *visuospatial ability: identify relationships among objects -tends to remain "intact" with normal aging

describe whether and how the abilities of processing speed and visuospatial ability decline with age (as part of normal aging)

~chronic illness = conditions for which there is usually no cure, doesn't necessarily mean being disabled ~functional disability = the degree to which a chronic health problem doesn't allow the person to perform necessary tasks for daily living; the help of another person is required ~signs used to determine if/when chronic illness requires intervention = can no longer perform ADLs independently, confusion, falling, losing weight bc can't remember to feed themselves, forgetting to take meds *the appearance of chronic conditions and the typical pace of decline into a functional disability differs between those from working vs middle class backgrounds -- the gap between the two widens at around age 50 -at this age, working class people start to experience declining health with advancing age

differentiate between chronic conditions and having a functional disability -identify the signs used to determine if/when a chronic illness requires intervention -explain how the appearance of chronic conditions and the typical pace of decline into a functional disability differs between those from working vs middle class backgrounds

~normal aging = wrinkles, sagging skin, gray hair, hair loss in men, excess hair growth (in all unwanted places), falls are very common, decrease in sleep, vision impairments, hearing loss ~pathological aging NOT NORMAL = skin cancer, Parkinson's disease, glaucoma, cataracts, osteoporosis, etc ~elders in general tend to experience various normal biological age-related changes - starts in their 60s prob -timing differs depending on prior experiences/demographic-identity groups -- earlier onset for lower SES/minorities

differentiate between normal aging and pathological aging and be prepared to describe normal age-related and common aging-dependent diseases -describe when elders, in general, tend to experience various normal biological age-related changes, and how the timing typically differs depending on prior experiences/demographic-identity groups

-more likely to experience mental and physical health problems -cognitive impairments -more likely to distrust other people -low self esteem -less likely to form secure attachments

discuss how caregiving of parents by adult children who were abused by their parents as children affects those children

politics play a critical role in determining policies and funding programs that might best support elders - may pit the young agains the old because the young may not want to pay for these programs/may not think they need to contribute or even start saving for their own old age

discuss the ways politics affects those in old age and how it at times pits different cohorts (and points across the life course) against each other

*passive euthanasia = withholding/withdrawing medical treatment from the hopelessly ill *active euthanasia = (AKA assisted suicide) - occurs when a physician, close friend, or relative helps an ill or disabled person teminate his or her life and it involves taking action to hasten death ~no legal distinction b/w active euthasia and assisted suicide, but the common understanding is that assisted suicide (active euthanasia) involves more planning and cooperation b/w the ill person and the individual who will assist (but the disctinction b/w active euthanisia and assisted suicide is vague) ~debate: court cases have revolved around 2 issues in defining the physician's right to withhold or terminate treatment: 1) the kind of medical care a terminally ill patient desires 2) the requests of patients who want to die to have treatment withdrawn *public opinion favors physician-assisted suicide for mentally competent patients who choose to die if they face terrible pain, an insensate existence, or a life so diminished that death would be preferable -those most likely to favor legalizing assisted suicide = white males who were less religious, had strained family relationships and were in failing health -the care dying patients will receive will vary depending on their physicians' religious characteristics, ethnicity, and experience ***proponents of active euthanasia contend that prolonging the suffering of the terminally ill who are in constant pain is inhumane - noting that euthanasia means a good death, they're arguing that in a caring society euthanasia should be offered to hopelessly sick persons as an act of life -for every argument in favor of it, there are counterarguments by those who consider it akin to murder and never morally justified *1997: Supreme Court ruled patients did not have the right to assisted suicide, but the ruling left open the possibility that states could legalize assisted suicide in certain states -legal in 5 states under certain conditions *VERMONT = assisted suicide is legal

distinguish between passive and active euthanasia -how is the latter similar to and different from assisted suicide? -explain the debate about active euthanasia/assisted suicide -where are we now in the US? In VT?

age integration theory

draws on a core premise of age stratification theory, the idea that society is stratified on the basis of age ~age stratification can create age-segregated institutions (age acts as a barrier to entrance, exit, or participation) ~society also has age-integrated institutions, which are characterized by an absence of age-related criteria (families are the most age-integrated institutions of all) -most people are involved in both ~concept of age integration applies not just to social institutions but also to periods in the life course -- ~age segregated life course = education is reserved for young people, work for ppl in the middle yrs, and leisure for the retired ~age-integrated life course = ppl of all ages have an opportunity to pursue education, work, and leisure

*social support system = the network of relatives, friends, and organizations that provides both emotional support, such as making the individual feel loved or comforted, and instrumental support, which refers to help in managing activities of daily living -support networks can be described by the characteristics of the people with whom an individual has ties: such as age, sex, number of years known, relationship, and geographical proximity *they make grids and track relationships - who ppl see and how frequently they see them ~support function = refers to what network members actually do *the convoy of social relations = a useful way to think about how social support systems operate over the life course; this consists of close social relationships that provide a protective layer surrounding an individual from birth to old age -they provide tangible assistance with everyday needs such as health care or finances, and they also provide emotional support and affirmation of an individual's hopes, goals, and values as they change over the years --over the life course, women are more likely than men to maintain social networks -- women have more people in their support networks than do men, more frequent contact with network members, and more complex relationships with these individuals ~fam life has become more complex than ever before IMPORTANT to study social support systems in old age bc we want to be able to view how support systems change/grow over the life course *social support systems and roles differ across different demographic groups and family contexts (gender, partnership situation, family structure, current LGBTQ elders): ~support from fam of origin may be limited ~current generation of elders more likely to have been rejected -current generation of elders less likely to have had children -set the stage for importance of friends as supports -however, increasing acceptance among today's generation - creating their own communities

explain how gerontologists define and study the social support system, who/what is included when assessing someone's support network -explain why it's important to study social support systems in old age -explain the similar and different kinds of supports typically provided by different parts of one's support network -describe how, if at all, social support systems and roles differ across different demographic groups and family contexts (gender, partnership situation, family structure, current LGBTQ elders)

~long-term care is typically funded in the US by medicare and medicaid -The only program that truly covers long term care is medicaid. Only the neediest are eligible for medicaid. -Middle class families don't have any money to cover long term care, yet medicare barely covers it? -when people get a lot older, in order to pay for the health costs they use spending down in order to qualify for medicaid. *spending down is when people literally spend their money until they have the bare minimum to qualify for medicaid

explain how long-term care is typically funded in the US and the challenges that arise from this -how does this relate to the phenomenon of "spending down"?

*NDA = a special knowledge about and sometimes a control over the process of dying -in between place of being present/fully alive and being dead -challenge to loved ones/professionals = how to listen/attend to words and gestures that may easily be missed, especially if we don't know how to listen/attend -lots of metaphors in the book about traveling ~2 main categories of messages conveyed = 1) what the dying person is experiencing -places and people they see but others cant -awareness of when death will occur -traveling metaphors are common 2) things or people needed so death can be peaceful -what remains to be reconciled if possible, barriers to letting go/dying removed *all too common reactions ppl have when they learn someone who is dying = many/most are inexperienced and feel awkward, scared and overwhelmed ~to increase our comfort and competence, we can gain more knowledge on the subject as well as more experience - helps us to understand the physical process of dying *suggestions for those of us who want to be present with loved ones who are dying = decide what you can and can't do, convey you're open to listening and talking about dying if they want to -offer help but be specific about what you're offering -its okay to express your feelings -better to say something/express sadness than not as the latter - bc that may appear as not caring ~how to behave around those at the end of life 1) understand/be aware of your own feelings about death 2) try to imagine what the dying person might be feeling - use the stages to help guide you

explain nearing death awareness (NDA) and how knowing about this might change how those of us who are present with the dying respond to them -what are all too common reactions people have when they learn someone who is dying and what can we do to increase our comfort and competence? -what do Callanan and Kelley suggest for those of us who want to be present with loved ones who are dying?

~age-friendly communities = goal is to optimize opportunities to enhance QOL, and allow people to remain in their own homes for as long as people ~money follows the person movement = program that would take nursing home residents out of the nursing homes and place them into their own homes/homes of family

explain the age-friendly communities and money follows the person movement

~age, period and cohort effects can be hard to measure (Ex: older ppl are more likely to vote than younger ppl - is this disparity in voting patterns caused by an age effect, or is it caused by a cohort effect? *social gerontologists frequently use cross-sectional research to distinguish age, period and cohort effects, but longitudinal research is a better approach ~cross-sectional research: research comparing ppl of different age cohorts at a single point in time (most feasible for studying AGE - they're less costly than longitudinal studies and they let researchers draw conclusions about cohort effects that cannot be gained thru the study of a single age group, also takes less time to get results -(same info collected from ppl of several Dif age groups - study of 1000 elders at each age: 65, 75, 85, 95) ~longitudinal research: research that follows the same group of people over time -- can sort out some of the tricky methodological issues involved in distinctions between age effects, cohort effects, and period effects -better than cross sectional studies bc they follow 1 group of ppl over time, but longitudinal studies are very costly since they follow subjects for yrs or decades, and they have biases *critical in gerontology bc it helps us see changes within a person over time which is the goal of gerontological research ~sequential designs = combination of cross sectional and longitudinal designs -- gives us a solution (allows us to tease apart cohort, age and period effects) but not used often bc verryyy expensive

explain the challenges these effects present to gerontology researchers -what are the main research designs used in this field and their benefits and drawbacks, including how well they differentiate between age, period, and cohort effect

~financial or material exploitation = Illegal or improper use of funds or resources ~neglect or abandonment = Intentional or unintentional refusal or failure of designated caregiver to provide necessary care for older person's mental and physical health ~physical mistreatment = Infliction of pain or injury (e.g., slapping, hitting, kicking, force-feeding, restraining) ~psychological or emotional mistreatment = Infliction of mental anguish (e.g., verbal aggression, threats of institutionalization, social isolation, degrading statements) ~sexual mistreatment = Nonconsensual genital contact, unwanted sexual talk *physical abusers are typically drunk fam members & ppl who have experienced past childhood abuse by their fathers ~those most at risk of being abused = elderly women who are cognitively or physically impaired and who live with their abusers -personality trait - also a victim who reacts aggressively to daily frustrations is more likely to be VERBALLY abused by a caregiver ~additional risk factors = *Over 75 *More of the following risk factors: - Living with caregiver/abuser- Cognitive impairment with disruptive behaviors - Social isolation from family and friends - Caregiver mental illness [e.g., major depression], - Caregiver alcohol misuse - Caregiver dependency on the older person [e.g., financial]) *NOTE: These are also barriers to detecting abuse! 3 hypotheses = 1) learned violence hypothesis = the abuser might have been a victim of abuse in the past/learned or experienced violence at the hands of the parent and now has become the abuser-*Now it's one of their own strategies for dealing with stress- *Difficult relationship/mixed feelings may increase the stress of caregiving and/or also make violence feel more of a viable/appropriate option 2) dependency hypothesis = the abuse occurs when the victim is physically and mentally incapacitated and increasingly vulnerable and dependent on a caregiver and the caregiver takes advantage of this dependence and abuses the victim 3) stressed caregiver hypothesis = the abuser is most likely to be an overworked/underappreciated fam member who has major responsibility for the care of the older person -the pressure and stress of daily caregiving can cause that person to lose control (if little psychological reward for the caregiver)-adult children with limited resources themselves (for their own health care/support in general) -- MOST SUPPORTED bc seems like it would be the most common

explain the different types of elder mistreatment/abuse -explain what we know about the most typical perpetrators of and targets for this type of abuse -consider the 3 different hypotheses regarding why abuse and neglect by family members occurs and be prepared to make the case for which one is most supported/supportable

1) chronological age = commonly used marker of old age -pro = useful for making clear decisions about whom to include as subjects in a study, con = can be an arbitrary marker -con = can also be a poor indicator of old age, bc some ppl may be "old" at 50, whereas others may seem "young" at 80 -con = problematic bc It lumps together ppl of widely varying generations into a single category -con = may be an inappropriate indicator of old age for some types of research ~it matters how old age is defined because tremendous variability exists from individual to individual - the point is not that it's impossible to define old age but rather that the definition social gerontologists use depends on what they want to know *its about individuality - you don't want to have restrictions set on you just bc you fit into that age category ~bc of these problems, even when chronological age is used as a marker of old age, social gerontologists often divide older ppl into 3 subcategories: ~the young old = ppl 65-74 ~the middle old = ppl 75-84 ~the oldest old = ppl 85 and older ~it matters that we distinguish among these sub-groups because they all have different abilities, functions and interests and all older individuals should not be generalized as just "old" 2) social roles = sets of expectations or guidelines for ppl who occupy given positions, such as widow, grandfather, or retiree ~con = playing a role associated with a social position one typically assumes in old age doesn't mean an individual is old -- some ppl work jobs that allow them to retire after a certain number of years after employment 3) functional age = these definitions are based on how people look and what they can do -in functional terms, a person becomes old when he/she can no longer perform the major roles of adulthood -a woman may be old at 50 (bc of menopause), but a man may still be considered middle-aged at age 60 -this may also be measured by normal physical changes such as stiffness of joints, diminished short term memory, reduced skin elasticity, and diminished aerobic capacity *ppl age in Dif ways and at Dif speeds, but Dif parts of the same person may age at Dif rates as well -may also be determined by appearance - gray hair and wrinkles, but functional criteria can be misleading bc hair dye and face lifts can dramatically alter appearances so that the normal signs of physical aging can be largely obscured *3 categories to better classify ppl by their functional capacities: 1) well elderly = ppl who are healthy and active - involved in social and leisure activities and are often employed or busy with volunteer work - they Carry out family responsibilities and are fully engaged in the life of the community 2) somewhat impaired elderly = those in a transitional stage: they're beginning to experience chronic ailments and need some assistance from family or community service agencies - they can participate in many aspects of life but may need support in transportation, shopping, cleaning, or personal care 3) frail elderly = show some mental or physical deterioration and depend on others for carrying out their daily activities - they need more care from fam members and may be in institutions - yet even they can improve *ppl who are successful in compensating for functional limitations are able to maintain a subjective age identity of themselves as young -most important factors in subjective age identity = activity level and health, health being the most important! -older ppl who do define themselves as old can often pinpoint a particular incident that made them feel old -also influenced by social class - ppl of lower SES view the onset of old age as occurring at a younger age - more likely to classify themselves as old or elderly and more likely to feel older than their chronological age bc they have more pessimistic feelings ab their health -also influenced by gender - women hold more youthful age identities than men

explain the different ways that old age is defined and the pros and cons of each -why does it matter how old age is defined? -within old age itself, what are the 3 main sub-groups and why does it matter that we distinguish among these sub-groups? how do these sub-groups typically differ in terms of health and functional limitations?

~creativity: some believe that this peaks early but there are older people who still show this ~wisdom: older people have been shown to evaluate a stranger's personality and judge character more accurately than do younger individuals - wisdom helps people adapt to aging - wisdom doesn't alter the challenges facing the older individual but that one who has wisdom is likely to be more satisfied with life ~fluid intelligence: measured among verbal and performance intelligence - early psych research found age-related declines in verbal and performance intelligence among ppl older than 60 (more rapid decline around age 70) a finding so persistent they called it the classic aging pattern *4 main conclusions: 1) the classic aging pattern was generally confirmed but cognitive change in old age was more complex than a straightforward downward decline 2) noticeable changes in intelligence occurred around age 70 3) there's great variation among individuals in the rate of decline and lifestyle factors can slow the rate of decline 4) some individuals show no cognitive declines even in their 90s *his subjects declined on 1/5 mental abilities by age 60, none had declined on all 5, even by age 88 - significant intellectual decline occurs only late in life & theres great variation, many ppl maintain high levels of intellectual functioning on many measures in advanced old age *the idea that fluid intelligence does decline with age has been confirmed by other studies *lifestyle factors can play a big role In maintaining brain health: exercising regularly, eating a healthy diet and remaining socially engaged can reduce the losses in fluid intelligence that accompany advancing age *another factor is health: healthier ppl maintained higher levels of intellectual functioning than those who are ill *SES is also a factor: ppl of high SES are better able to maintain their intellectual abilities than those of low SES ~another factor = previous type of work and cognitive functioning

explain the effect aging has on each of these (types of intelligence) -describe the typical age-related pattern of decline in fluid intelligence - when we start to see decline - and whether this decline is evidenced in all domains -explain whether and how intelligence might be improved with age, and the 3 types of factors associated with maintaining (or not) fluid intelligence abilities

~CCRC = a living community that provides a continuum of housing arrangements and services from independent living to assisted living to skilled nursing care ~its the next best option to living in ones own home in terms of comfort -- aging in place ~SES - higher SES can afford these, lower SES cannot ~ppl who can't afford CCRCs = single occupancy hotels (not ideal), nursing homes *satisfaction = determined by autonomy and hominess

explain what a CCRC (continuing care retirement community) is -if and when "aging in place" in one's long term home is not available, explain how a move to a CCRC supports aging in place from that move forward? -how does SES factor into whether CCRCs are available to elders? -what kind of housing is available for people who cannot afford CCRCs? -what determines satisfaction in a CCRC, board and care setting, and an assisted living facility?

1) studies employing such grids find that most older people are firmly embedded in an extensive social support network and that there tends to be a division of labor within the support network 2) typical roles of fam vs friends = FAM providing more INSTRUMENTAL SUPPORT and FRIENDS providing more EMOTIONAL SUPPORT ~benefits of a strong social support system in old age = more resources to draw upon, better health ~drawbacks of a strong social support system in old age = loss of autonomy or loss of privacy ~impact of divorce/remarriages = -parent-child relationships may be affected (increase the caregiver burden) -increase economic hardship -stressful event = leads to poor health ~3 types of grand parenting = 1) remote: infrequent, ritualistic, symblic 2) companionate: easy going, emotionally satisfying, friendly, do leisure activties togehter, doesn't interfer with parenting 3) involved: active role in child rearing 1) divorce affects grandparent-grandchild relationships: ~increase in the bond between parents, the adult child, and the grandchildren ~the divorced kids struck out alone and retained a separate, private life (intergenerational bond = intimacy at a distance) ~blurring of relatives by blood, marriage, divorce and remarriage--maternal grandparents would have greater access to a grandchild bc their daughter typically would have custody *IN GENERAL, RELATIONSHIPS W MATERNAL GRANDPARENTS FOLLOWING A DIVORCE BECOME CLOSER AND THOSE W PATERNAL GRANDPARENTS SUFFER

explain the impact of a strong social support system on old age -include attention to the impact of various types of supports/relationships (marriage/long-term partnerships, divorce/remarriage, friendships, adult children and grandchildren)

~baby boomers are almost 65 = older population increase (by 18%) and should more than double to 92 million in 2060 (ppl 65 and up should increase 21% by 2040; ppl 85 and up should triple by 2040) -baby boom = increase in fertility after WW2 (increase in 1946, peaking in 1958) ~nearly twice as many female baby boomers graduated college as women in the cohort before them - attending college meant delaying marriage (30% of them were still single in their mid 20s) -- delaying marriage meant delaying childbearing & decreases lifetime fertility, female labor force participation expanded rapidly in the 1960s ~baby boom women had fewer children than their parents' generation, but the number of babies born to their generation increased simple because there were so many boomers -2017: baby boomers were aged 53-71, and the echo boomers were aged 20-40 -- by 2050 most of the baby boomers will have died& the echo boomers must be growing old too *baby boom cohort = -largest cohort -will affect the overall/total dependency ratio - increase the burden on the younger population -increased demand on healthcare/housing -fewer workers to pay into the SS taxes ~fastest growing age group in the US = elders (those 85+) *the changing demographics of the US going to affect the way US citizens and the federal gov are likely to respond to the needs of elders = 1. policymakers are wondering whether they should encourage baby boomers should retire later 2. who will provide health care to all of these people

explain the impact of the Baby Boomer cohort on society -describe some of the key differences between this cohort and the cohort prior to it as well as future cohorts that are likely to affect how old age is experienced -identify the fastest growing age group in the US and other aspects of our current and future changing demographics in the US to likely affect the experience of aging and the way US citizens and the federal government are likely to respond to the needs of elders and other groups

~life course framework = early experiences, oppurtunties and decisions result in individual differences in adulthood and outcomes ~decisions made in our control that result in individual/group differences in adulthood = lifestyle factors (smoking vs not smoking, drinking a lot vs not drinking a lot, etc) ~decisions made OUT of our control that result in individual/group differences in adulthood = biology, economy, politics, change ~life course framework connects to the cumulative disadvantage theory bc both relate to how early on decisions and experiences affect you later on during your life course

explain the life course framework and be prepared to give examples of decisions made in our control and experiences out of our control in early life that result in individual and group differences in adulthood, that affect chances for successful aging -explain how this life course framework connects to the cumulative disadvantage theory

*designed to provide a bunch of different services that are critical to supporting elders/improving their quality of life and support their remaining independent ~services It provided: -meals on wheels is an example -senior centers -disease prevention and health promotion -support for enrolling in available benefits -basic transportation - can get a ride to the senior center and back -caregiver support -job training -abuse and neglect prevention -nursing home preventions

explain the main aim of the Older Americans Act of 1965 -explain what services were provided by it -explain how it's contributed to quality of life for all elders

higher SES= better health over life course/into old age - higher life expectancy lower SES= worse health starting from a younger age - lower life expectancy *cumulative disadvantage theory: 1. analyzes the stratification systems among the aged 2. inequality isn't an outcome but is a process that unfolds over the life course 3. people who begin life with greater resources have more opportunities to acquire more resources (impact of poverty/low SES = makes aging more difficult bc less resources - so more likely to acquire more illnesses and less likely to be able to retire in terms of having enough money saved up) *compression of morbidity thesis = when the years of chronic illness are compressed to the last years of life for someone and they are able to live a long healthy life 2 premises: 1. the maximum years a human has is fixed and finite 2. improvements in health care will compress the years that an individual will be disabled into the last few years of life *EDUCATED ppl benefit the most from this thesis

explain the major differences in life expectancy by SES background -how does SES affect health over the life course and in old age? -describe and explain the impact of poverty/low SES on the aging process and opportunities for/outcome in retirement, using the Cumulative Disadvantage Theory and the Compression of Morbidity Thesis -who has most benefited from the compression of morbidity to/in old age?

*major differences in life expectancy by race: -white adults with college education had greater life expectancies -14.2 more yrs for white men compared to black men -10.3 more yrs for white women vs black women (these gaps have widened over time in 1990-2008) ~race crossover = 1. among the very old, when the advantages of being white disappear 2. minority mortality rates are lower than whites after age 85 3. could be explained with the idea that African americans who have survived the stresses of their younger years may have a survival advantage that destines them to live a very long life -decrease in the black-white gap in mortality among men and women -black women = deaths have fallen; black men = deaths have also gone down

explain the major differences in life expectancy by race -why do the advantages associated with being white disappear in old-old age? -what has been posited as explaining this race crossover?

paradox of well-being = people stay relatively happy in old age ~things that contribute to high life satisfaction in old age = for men being satisfied with their life partners and feeling financially secure were most important -for women = stressed partner relationships but had a wider range of factors that affected their life satisfaction, including relationships w their children, sexuality, work situations, and their ability to contribute to the welfare of others ~activity theory: successful aging was active aging -- paradox of well-being means that older individuals have high life satisfaction if they remain active in terms of being satisfied w their life partners, feeling financially secure, positive work situations, being able to contribute to the welfare of others, etc *even tho aging is often associated w multiple losses, illness, financial instability and a decline in physical health, satisfaction w life among older people remains high, even in advanced old age ~things we could do to support more people to experience aging in a positive manner - youthful social relationships and networks, good resources, good sleep, diet, staying engaged in hobbies, mental stimulation

explain the paradox of well-being and how it relates to activity and/or disengagement theory -know the factors that contribute to reacting to aging in positive vs negative ways -offer and support suggestions for things we could do to support more people to experience aging in a positive manner

-Hippocratic oath still taken by physicians today = they shall do no harm -- physicians need not take extreme measures to prolong life -many physicians have traditionally let terminally ill expire peacefully without subjecting them to painful treatment -in recent yrs, more doctors have turned to modern technologies whose function is to keep the patient alive at all costs *racial differences in attitudes toward end of life care = whites were much more likely than African Americans to discuss treatment preferences before death, to complete a living will, and to give power of attorney over their affairs to a relative -among those who made treatment decisions, whites were more likely to want to limit care under certain conditions, and to refuse treatment before death if they were terminally ill -- blacks were more likely to request all possible life-prolonging care ~these racial differences can be explained by lingering distrust of the healthcare system among African americans -- in the past, black ppl haven't always been treated in an ethical manner by doctors and hospitals - Tuskegee syphillis study -another reason = religious and cultural differences in attitudes toward death and dying -older whites express greater concern for dying alone or in uncontrolled pain while older African Americans have more fears about punishment or reward in the afterlife ~when an individual's wishes aren't known: legally binding living wills in the form of an advanced directive from the patient or by the appointment of a proxy who has power of attorney -federal patient self determination act *the legal proxy has to make the decisions for them in that case

explain the right to die and the concerns raised about this right -consider such things as the appropriate role of a physician, racial differences in attitudes toward end of life care and where these come from, and what should be done when an individual's wishes are not known?

*parent-child relationship = unique bc permanent and involuntary -good relationships: positive impact on health and wellness - increase psychological and physical well-being -older parents who have close relationships W their adult kids are less likely than those who don't to be depressed or lonely -conflict is natural, but even with it there can be a supportive relationship ~6 major areas of conflict = communication, differences in lifestyles and personal habits, childrearing practices, religion, politics, work habits *theory of intergenerational solidarity = families adjust their living arrangements over time to reflect the changing needs and resources of different generations ~fams reconstitute themselves later in life, not necessarily in the same household, but thru close contact and frequent visits *intergenerational solidarity = measured by the amount of interaction between adults, children, and their parents; the amount of positive sentiment fam members feel toward each other; and the level of agreement about values and beliefs ~other measures = the degree to which kids and parents exchange services and how close they live to each other -~early in the life course, economic needs of adult kids determine their relative proximity to their parents --- later in the life course, the parents' economic and health needs influence how close their kids live to them ~3 phases in the parent-child life course in terms of proximity of living arrangements = -kids live w/near their parents before age 25, then there's a period of separation in which kids marry or move away for education/employment, healthy elders may also move away from their kids to a retirement destination -- later life = when aging parents become sick or disabled, they move nearer to their kids = fams reconstitute themselves later in life, not necessarily in intergenerational households but thru close contact and frequent visits! ***the exchange of services b/w generations varies over the life course, w a gradual shift from parents as givers to parents as receivers (not until their parents are 75 or older do adult children give more than they receive!!!) -when generations share a household, unemployment is one of the best predictors of conflict with parents

explain the unique elements of the parent-child relationship and the impact of these relationships on health and wellness in late adulthood -include attention to housing arrangements throughout the life course, using the theory of intergenerational solidarity, and to exchanges between parents and children over the life course -when, if at all, does the direction of help change in favor of adult children giving to late adult parents?

*a population ages bc of an increase in the proportion of older people in a society - can be assessed from census data *a population's age structure can change thru 3 fundamental demographic processes: fertility, mortality, and migration 1) fertility rate = measure of the incidence of births or the inflow of new lives into a population -- generally, declining birth rate is the main factor that results in population aging 2) mortality rate = 2nd process that influences age structure, it reflects the incidence of death in a population 3) migration = 3rd process, is the movement of ppl across borders - least influence on age structure ~US = old in terms of population - 20th century: US was aging = rate of change increased in the 21st century *population pyramid = bar chart that shows the distribution of a population by age and sex - when a population is young, it has a classic triangle shape (wide at bottom where fertility is high, and narrower at the top, where death takes its toll) -- when a population is middle-aged, fertility declines along with infant and child mortality (bottom of the triangle is squared off as fewer kids born and more survive) -old population when mortality is reduced at all ages, but especially among the elderly (rectangle shape) -in all developed nations, the 3 staged shift from high mortality and fertility rates to low mortality and fertility rates occurs thru a SES process called the demographic transition - as countries industrialize, accompanying changes in fertility and mortality produce changes in population structure - at the end of this process, a country's population is older and larger *stage 1) agricultural economy, women marry young and have a lot of kids, and infants often die from acute and infectious diseases - birth and death rates are both high so few ppl reach adulthood and even fewer survive into old age *stage 2) declining death rates and population growth - control of infectious and parasitic diseases produces modest declines in mortality among infants and young children - thru improved sanitary measures and health care, life expectancy increases, mortality among the old begins to drop, and the proportion of older people in the population grows *stage 3) the population as a whole begins to age, and more deaths are caused by chronic ailments than by acute illness - when birth and death rates are both low, the demographic transition is complete - at that point a nation can be characterized as old

explain the various ways that population aging may be assessed, and the 3 main contributors to population aging, in order of importance -how do these 3 contributors combined determine a population's age structure? -where is the US with regard to population? -draw/differentiate between populations of different ages presented to you using the demographic transition and the 3 main pyramid types

elder mistreatment

includes intentional or neglectful acts by a caregiver or trusted person that lead to, or may lead to, harm of a vulnerable elder

*theory = a broad explanation that provides a structure for organizing and interpreting a multitude of observable facts and their relationships to one another - explanation for WHY/HOW a phenomenon occurs -they help 1) define a research agenda, 2) provide a guide for scientific investigations, 3) predict what's not yet known or observed ~psychosocial = focused on the individual and how to age optimally - explaining personal adjustment to old age: disengagement theory (not normal/good - rejected bc not the same for everyone) ~micro = theories that stress the relationship between the individual and the social system: subculture theory (now largely rejected bc we have more identities rather than just age -- rejected overall bc lots of within group differences), exchange theory, and social constructionism (we all make meaning of the world - how we live our lives/interpret something) ~macro = focused on age and social status: modernization theory, age stratification theory (We base society on the notion of age), age integration theory ~macro focused on power/inequality = political economy theories, feminist theories, critical gerontology

explain what a theory is and the 3 main purposes they serve -describe/distinguish between the different levels/types of theories and the limitations of each that led to the other/next type -give examples of theories that fall within each level/type

~US: total dependency ratio = 71 for 2020 ~US: elder dependency ratio = 26 for 2020 ~US: child dependency ratio = 45 for 2020 *a rising dependency ratio is a cause for worry in countries that are facing population aging bc it becomes pretty hard for a relatively smaller proportion of working-age ppl to carry the burden of providing for a relatively larger proportion of dependents -in the 21st century, many more dependents will be old

explain where the US is in regard to the total, elder, and child dependency ratios -explain how dependency ratios relate to population aging

-1 of the most complex issues social gerontologists face is distinguishing age changes from age differences *it's often hard to tell whether an observed outcome is due to an age change in individuals or to an age difference between groups -- social gerontologists USE cohorts to help identify age differences

explain why cohorts are important to attend to in social gerontology

life span

greatest number of years any member of a species has been known to survive -human life span = 120 yrs

this is due to the convergence theory, which suggests that old age is a leveler and it reduces the inequality because everyone ends up sick and poor no matter how well off a person was during their life ~widens from birth-85 as we age bc cumulative disadvantage **Gap closes at age 85 bc most ppl are dead - those who are left represent the most advantaged since there's not that many people left

how and when does the gap between the different SES groups widen as we age and does it tend to close in old-old age (85+)? if so, why?

~personality - includes all facets of who we are and how we react to events in our environment ~measured by personality traits (enduring dispositions towards thoughts, feelings, and behavior, both inherited and learned) -- 5 major factors = openness, conscientiousness, extroversion, agreeableness, neuroticism *personality traits have an influence on how ppl adapt to some of the natural changes that accompany aging ~better coping = openness to experience ~worse coping = neuroticism, high anxiety levels, poor impulse control *3 adaptive skills necessary in more effective coping = 1) being able to marshal social support (bc social support system provides a buffer against stress) 2) person who's able to compensate for losses in social roles by substituting new roles will feel less lonely, remain more active and involved in relationships, and find greater meaning in life 3) being able to modify one's environment can reduce stress and enhance life satisfaction and emotional well-being

how does personality play a role in coping effectiveness? what personality traits are associated with better coping and what with less effective coping? -what are the 3 adaptive skills associated with more effective coping with stressful life experiences?

-support from fam of origin may be limited ~current generation of elders more likely to have been rejected -current generation of elders less likely to have had children -set the stage for importance of friends as supports -set stage also for greater loneliness in late adulthood *today = increasing acceptance, LGBT folks creating their own communities of friends and families -if they had a strained relationship w their parents as a result of their sexuality, they might be more hesitant to want to care for their aging parents

identify additional challenges LGBTQ and non-binary folks may face in caring for their parents and with regard to assumptions by siblings about their availability to care for their aging parents

ADLS (activities of daily living) = -Personal hygiene (e.g., bathing, grooming, oral care) -Continence management: Mental and physical ability to use the bathroom when necessary -Dressing oneself (appropriately) -Feeding oneself -Ambulating (getting around on own) (things you do TO your body) IADLS (instrumental activities of daily living) = -Cleaning and maintaining the house -Managing money -Moving within the community -Preparing meals -Shopping for groceries and necessities -Taking prescribed medications -Using the telephone or other form of communication (things you do WITH your body)

identify the elements of ADLs and IADLs and differentiate between these 2 types of activities

~this is a measure of the combined outcome of many births and is calculated by taking the sum of the ages at death of all individuals in a given population and dividing it by the number of people in that population *major differences in life expectancy by race and SES: -Lower SES = worse health with advancing age; higher SES = maintain relatively good health until late, late adulthood -this worldwide is higher for females than for males-- gender difference arises from a complex interaction among biological, social and behavioral factors (men are more likely to smoke/drink), but scientists can't fully explain it **life expectancy has gone down a little in the past couple yrs- could be bc not everyone has access to healthcare, increase in drug addiction and opioid epidemic and increasing suicide rates among the young

identify the typical factors included when assessing an individual's life expectancy -explain why life expectancy has fallen slightly in recent years after having increased between 1900 and 2010

~things to do = exercise for 40 mins every day, get good sleep, continue to exercise your mind and stay social ~things NOT to do = smoke, drink excessively, eat very unhealthy foods nonstop throughout all of your years (good in moderation), don't isolate yourself socially ~id tell them that they have a biological foundation already so some things are out of their control but that there are several factors that they CAN control

if you were asked to give advice to young people today regarding activities to engage in and not engage in, to best position themselves for better health in old age, what are at least 3 different but key things you'd advise them to do/not do? -how would you make sure that folks listening to you don't walk away thinking that their health is totally in their control? (consider micro/individual level and macro level factors that contribute to poor/good health)

period effect

impact of a historical event on the entire society -ex: Great Depression, 9/11 "attitude conversion"

child dependency ratio

indicates the number of persons under age 18 relative to those of working age

fluid intelligence

involves the ability to deal w novel situations & unforeseen problems (relates to creativity) = the capacity to process novel info; the ability to apply mental power to situations that require little/no prior knowledge -this is largely uninfluenced by prior learning-this is required to identify relationships and draw inferences on the basis of that understanding --ex: being able to figure out the rules governing a number series -this is measured along verbal (learned knowledge, including comprehension, arithmetic, and vocab) and performance intelligence (measures puzzle-solving ability involving blocks/pics) *this DECLINES with age

~these can all contribute to elder abuse: -understaffing -little training for staff -low pay ~can prevent this abuse by making sure staff is trained well, payed more, and sufficient amount of staff -family can also come to visit often to make sure nothing bad is going on

know the contributing factors to elder abuse and what kinds of things might help prevent this abuse -consider the role of family members as well as oversight policies and payment/training of caregivers

*varied reactions to death of partner: depends on nature of the relationship: -for some: loss of a unique, deeply loved person with whom they shared a multidimensional companionship -for some: change in status and loss of a social position and of a couples-oriented lifestyle -for most: associated with increased risk of illness and mortality, especially during bereavement period ~vary by gender: women vs men as widows (focus on heterosexual marriage contexts) -- -women = want more social support, reduced housework is positive -men = have to learn how to do things around the house, how to reach out and create their own social lives (might see these dif's in the current generations of elders) *depression, stress, loneliness are common for everyone in the beginning

know the impact of widowhood on a surviving partner's health, and how these vary by gender

~at no age will the majority of ppl will be in nursing homes - but it does increase as we get older -85 and above will be at nursing homes the most often!! *upper class neighborhood, white most likely to live there OR ppl who are rly poor and medicaid is paying for it (less likely to go there) ~cultural issue, as well as accessibility

know the percentages of elders typically in nursing homes and how this changes with age (consider young-old, middle-old, and old-old age groups) -explain why these percentages have gone down

~the minority aged are more likely to be impoverished than whites and older women more so than men - minorities have less access so they have worse health as a result -Hispanic and black elderly fared worse than whites - among all racial groups, women have higher poverty rates than men ~income disparities by ethnic/racial origin are due in part to differences in sources of income: SS makes up a larger share of the total income of minorities than it does whites, who are more likely to have other sources of income - the largest source of racial disparity is income from assets (stocks, bonds and rental property) *policies/practices that contribute = racism, living w micro-aggressions on a daily basis - impacts your health, also the way our healthcare system is set up *2 common explanations = 1) biological race differences (tied to our genetic makeup) and 2) societal (processes due to our social structure/social setting -- cumulative disadvantage = MOST SUPPORTED)

know the prevailing patterns regarding race and ethnicity and health status, and the various policies and practices that contribute to these patterns -know the 2 common explanations offered for why racial/ethnic disparities exist and explain how one is better supported

daughters typically provide the most long-term care to frail elders -sons help with less personal tasks such as paying the bills or doing the lawn -then spouses ~impact of family caregiving on the caregiver and the caregiver's family = can be emotionally draining but can also be very positive ~caregiver burden = difficulty in managing the specific tasks to be performed in caring the elderly ~caregiver stress = the strain that is actually felt by the cargiver

know what family members typically provide the most long-term care to frail elders and the kinds of things different family caregivers often do to support their loved ones -explain the impact of family caregiving on the caregiver and the caregiver's family -differentiate between caregiver burden and caregiver stress

active life expectancy

measure of the number of years a person can expect to live without a disability

cohort aging

the continuous advancement/movement of a cohort from one age category to another over its life span

subculture theory

shared several traits with activity theory and disengagement theory - a conviction that ppl lost status in old age, a focus on role changes in later life, and a belief that activity enhanced the lives of the elderly -it differed in that it built on a sociological theory of subcultural development -subcultures develop under 2 sets of circumstances: 1) when ppl share similar interests, problems, and concerns or have long-standing friendships, they may form a subculture 2) when groups of ppl are excluded from full participation in the wider society -social gerontologist argued that older ppl were subject to both conditions - they have a positive affinity for one another based partly on their physical limitations and their common interest in a physically easy and calm existence -they also share common role changes and common generational experiences in a rapidly changing society -drawn together bc they're excluded by younger ppl, who tend to evaluate others based on factors such as occupational status or ability in sports *bc the elderly are isolated from young ppl and share common experiences with other older ppl, they're likely to form a subculture - high status on those who have good physical and mental health ***true that older ppl experience common role changes, but the idea that the aged form a single subculture has now been discounted!!! - older ppl are much more likely to form affiliations on the basis of family ties, racial and ethnic identity, social class, or religious affiliation than on age

~theory of ego development = he wanted to trace the development of the conscious self over the life course -to successfully resolve the dilemma posed at a given stage and move on to the next developmental stage, a person needed to master certain developmental tasks ~if a person didn't master a task appropriate to a certain stage, development in subsequent stages would be impaired, as unresolved conflicts from early stages were perpetuated -at every stage the individual would incorporate earlier themes in the process of confronting the central developmental task *humans experience 8 stages of psychosocial development from infancy-old age: 1st 6 stages = yrs b/w birth-young adulthood ~in the 8th and final stage, which ends in a person's 70s and 80s, the opposing possibilities are integrity and despair: old age imposes its own challenges (the certainty of death gives experiences a new meaning) - the challenge of this stage is to draw on a life path that's nearly complete, to put oneself in perspective among generations still living, and to accept one's place in an infinite historical progression *a person who feels his/her life's been appropriate and meaningful achieves integrity, but someone who feels his/her life's been unfulfilling, that the time remaining is too short, and that death is to be feared falls into despair ~the way ppl experience these stages depend on their race, ethnicity, gender and social circumstances

review Erikson's Theory of Psychosocial Development and be sure you understand what the 2 main factors that facilitate a person's movement from 1 developmental stage to another are, as well as the opposing possibilities or dilemmas relevant to adulthood -focus especially on the last stage in this theory -explain the factors that contribute to the likelihood that this and earlier stages of development will be resolved positively

age stratification theory

shared w modernization theory a concern for the status of the aged - however, It originated from sociological research on status attainment, not from population aging - emerged when it appeared that the US was becoming "classless" -now researchers had to determine how important ascribed characteristics such as one's family of birth, gender, or race, were compared with achieved characteristics such as education *has its origin in status attainment research ~was devised to analyze the relationship b/w age and social structure *began w the underlying notion that all societies group people into social categories and these groupings provide people with social identities - such as by age, wealth, gender and race *age cohort = of central interest ~4 key research questions emerge from this theory: 1) how does an individual's location in the changing age structure influence his/her behavior and attitudes? 2) how do individuals relate to one another within and between age strata? is there an inevitable gap between generations? 3) how do individuals pass thru key transitions from infancy to childhood to adolescence to adulthood to old age? 4) what's the impact of the answer to those 3 questions on the society as a whole? ~limitations = focus on individual life course differences vs larger structural changes, also focuses our attention on age, ignores other bases of social stratification such as social class, gender, and race that create inequality within age cohorts, can create age-segregated institutions

cohort effect

social change that occurs as 1 cohort replaces another -ex: age of expected retirement -ex: increasingly liberal attitudes = more common in younger than older cohorts

epidemiological transition

stage 1: pestilence or famine -malnutrition -the plague -epidemics stage 2: infectious disease -TB -pneumonia -influenza stage 3: chronic illness -poor health becomes associated with old age -chronic diseases -mangeable but dont go away

euthanasia

the act of killing or permitting the death of hopelessly sick or injured individuals in a painless, merciful way - sometimes called mercy killing ~2 kinds = passive and active

cohort

the aggregate of individuals who experienced the same event within the same time interval-age cohort = all individuals born into a population during a specific time period; or children born the same year (ex = first year college freshmen regardless of age)

total dependency ratio

the combined ratio of children and older people to workers

cohort effects

the distinctive experiences that members of a birth cohort share and that shapes them throughout their lives -ex: ppl who grew up during the Great Depression of the 1930s may be more cautious about spending money than ppl who grew up during the 1990s

creativity

the most elusive mental process to define and measure -this is a component of intelligence *this is a measure of divergent thinking, meaning the production of alternative solutions to a problem or situation

elder dependency ratio

the ratio of old people to adults -calculated as the number of persons aged 65 and older per 100 persons of working age (18-64 yrs old) -provides a rough estimate of the proportion of workers to retirees

crystallized intelligence

this is based on the info, skills, and strategies that ppl have learned thru experience - it reflects accumulated past experience and socialization -defining a word draws on this -this refers to the acquisition of practical expertise in everyday life ~little to no decline in this in old age! - on most measures adults, stay stable or improve w advancing age although they do show a decline on a measure of intellectual interest

exchange theory

this is similar to the other psychosocial theories In its interest in explaining why some older ppl withdraw from social interaction -this theory suggests that personal relationships feel most satisfying when both participants are perceived as contributing equally to the relationship -central premise of this is that resources are often unequal and that actors will continue to engage in exchanges only as long as the benefits are greater than the costs ~1 problem w this is that it ignores the value of non rational resources (love and companionship), which often even out what seems to be an unequal exchange ~another problem = it overlooks that exchanges b/w generations take place over the life course -immediate exchange strategies = b/w friends and neighbors -deferred exchange strategies = strong ties built up over time, long term close relationships w fam and friends represent a lifetime credit stored up against the burdensome needs that accompany old age

stratification = key sociological concept that refers to the grouping of individuals within society~by SES (most common basis for stratification), age, gender, race and ethnicity, kinship ****basic sociological approach to stratification = views inequality as a product of social processes, NOT innate differences b/w individuals *central question that's the focus of the study of stratification = how social inequality is produced, maintained, and transmitted from 1 generation to another

understand the basic sociological approach to stratification and the central question that's the focus of the study of stratification

~elders are less likely to be clinically depressed than younger people ~its NOT depressing to grow old - its a normal part of life -women exhibit MORE depressive symptoms than men bc loss of a support network, declining health, and decreased income ~clinical depression = Must have depressed mood and loss of interest in pleasurable activities plus 3 other symptoms for at least a 2 week period -when we use broader definitions, many more old ppl can be considered depressed ~risk of depression for elders tied to: bereavement/loss of a loved one, and stress of caring for a loved one ***however, success rates of suicide In older people are higher than in younger people bc they do it in less violent ways, less warning ***suicide rates tend to go up in old age in most economically developed countries -less warning = more likely to be successful (same attempts, higher success rates) -increase in rates in elder white men in late life — only group more likely to commit suicide than die in an auto accident — completion rates higher among ppl 85 and older ~3 dif types of contributing factors: -social isolation, boredom, sense of uselessness, financial hardship, mult. Losses of loved ones, chronic illness and pain

using the traditional diagnostic way of measuring depression, are elders more likely to be depressed than younger people? in other words, is it depressing to grow old? -how do your answers relate to the findings regarding suicide in old age in most so-called developed countries?

3 major programs of the welfare state = 1) public assistance programs -provides minimal benefit to those already in need -only certain ppl are eligible: widows, sick, disabled, aged -*require a means test to prove they are worthy -funded through income taxes ex 1. Temporary Assistance for Needy Families (TANF) ex 2. Supplemental security income (SSI) 2). social insurance -provides economic security over the life course, to prevent ppl from falling into poverty -the people that benefit is anyone who contributes over their working life -any worker is eligible to contribute, but you must reach a certain age to receive the benefits -funded by payroll taxes (contributions) ex 1. Social security ex 2. medicare 3) fiscal welfare (tax expenditures) -indirect payments to individuals through the tax system (aka tax breaks) -people that benefit would be home owners, people with pensions, people with health insurance through their jobs-ppl that are eligible are funded by the tax system ex 1. food stamps ex 2. reducing income taxes for low income workers *social insurance + public assistance programs gets the most scrutiny *tax expenditures fly under the radar

what are the 3 major programs of the welfare state? -how do these differ in terms of who is eligible/who benefits from these and how they're funded? -provide 2 examples of each type of major program -which of the 3 types of welfare are usually thought about and critiqued and which tend to fly under the radar?

1) income 2) wealth 3) prestige 4) power

what are the 4 dimensions of social class?

*subcultures develop under 2 sets of circumstances: 1) when ppl share similar interests, problems, and concerns or have long-standing friendships 2) may also develop when groups of people are excluded from full participation in wider society ~Rose argued that older people were subject to both conditions - they have a positive affinity for one another based on their physical limitations and their common interest in a physically easy and calm existence -they also share common role changes & common generational experiences due to a rapidly changing society -older ppl are also drawn together bc they're excluded by younger ppl (who evaluate ppl based on factors such as occupational status or ability in sports) *bc the elderly are isolated from young ppl and share common experiences w other older ppl, they're likely to form a subculture - w high status on those w good physical/mental health as well as those who have leadership roles in organizations of the aged ***the idea that the aged form a single subculture has now been DISCOUNTED - older ppl are much more likely to form affiliations on the basis of family ties, racial and ethnic identity, social class or religious affiliation than on age (subculture concept is useful for understanding the lifestyles of ppl in age-segregated communities like retirement homes)

what are the conditions that encourage the development of sub-cultures? -do older people experience these conditions? -do they tend to form a sub-culture? why/why not? -what's a better way to think about elders and sub-cultures than one sub-culture?

~stage theory of dying: 1) early period of denial 2) anger 3) bargaining 4) depression 5) acceptance *the idea that dying occurs in stages has gotten a lot of criticism -- major one is that these stages do NOT occur in a fixed sequence ~how an individual responds to death is similar to how he/she has responded to other stressors in life ~stages might still be useful bc it could make the individual realize that what they are going through is normal/ there's nothing wrong with them for feeling this way ~examples: 1) I am not dying. I don't know what you're talking about. 2) f this!!! 3) please God I promise to be a better person and go to church more if you give me more time even just one more year 4) im so upset that I'm dying I refuse to leave my bed and I can't eat 5) okay its happening, I'm dying but I'm okay with that. I lived a great life surrounded by my closest loved ones.

what are the kubler-ross stages of dying? -why has this model been critiques and yet why/how might the stages still be useful? -use the stages of death to explain how a dying person might react to news of their impending death -give an example of each

SIGNS AT THE INDIVIDUAL LEVEL: ~Malnutrition, dehydration (signs: weight loss, mental confusion) -Unexplained injuries or unlikely explanations for injuries -Untreated bedsores -Poor personal hygiene -Missing necessities such as eyeglasses, hearing aids, walkers -Being unclothed, or improperly clothed, for the weather -Depression; extreme withdrawal, extreme emotional distress; agitation -Sleeping problems -Ambivalent feelings toward caregivers or family members SETTING BASED SIGNS = -Lack of basic necessities (food, water, heat, light, etc.) -Unsafe housing situation (bug infestations, disrepair, filthy) -Empty, outdated or unmarked prescription bottles ~self-neglect = the individual doesn't do things like brush their teeth, take baths -- sometimes bc of depression, sometimes bc they genuinely can't get into the shower (they wanna live alone but don't wanna let anyone know they can't do it themselves) - not engaging in necessary care for one's own health- Sometimes because physically or cognitively can't ~neglect = acts of commission (dif. Kinds of abuse, failing to do something -- they might develop a rash or bedsore) ~hard to distinguish b/w the 2 - might assume its neglect but is actually self-neglect *what we should do if we suspect elder abuse or neglect: -Contact Adult Protective Services or one of the Elder's Medical Professionals (unless concerned about them) BUT: Some elders won't want you to report...- --Talk with Elder and Caregiver Separately PREVENTION: Support the caregiver - Respite (formal services) - Support groups - Share the care among family members as possible ~Greater resources for elders in need

what are the signs we should attend to when trying to determine if abuse might be occurring? -how might we best differentiate between self-neglect and neglect? -what should we do if we suspect abuse or neglect? -what about to prevent or avoid these settings in the first place?

-in the past retirement was viewed as a single event -nowadays, its more complex and longterm process -elders are working longer so they can have more $ in retirement (SS, pension) -this is effecting younger workers bc there are limited jobs opening ~dif ways ppl might transition to and actually retire = 1. bridge jobs -moving from their full time career to a bridge job of a completely different career - most likely part time, or self employed 2. phased retirement -an arrangement that older workers make to reduce their responsibilities and ease gradually into full retirement (fewer hours, share the job with another person) 3. contingent work -an arrangement in which workers are hired on a temporary basis to a do a specific task -gives lots of flexibilty to the worker *factors that contribute to the likelihood of enjoying retirement = -good health -good income -advanced planning -volunteerily retiring -people who are married (when they retire at the same time)

what does retirement typically look like today and how does this compare to how it looked in the past? -explain the contributing factors to the trend of elders working later and its impact on younger workers -describe the different ways people might transition to and actually retire, and the factors that contribute to the likelihood of enjoying retirement

education - its the foundation for employment opportunities and resulting income

what is the best way to measure SES in old age? why?

*social gerontology = subfield of geronology -workers in this field are concerned mainly with the social, as opposed to the physical or biological, aspects of aging -topics of interest = family relationships, health, economics, retirement, widowhood, and care of the frail elderly -interested in/aim = to understand how the biological processes of aging influence the social aspects of aging ~~our focus this semester = individual level factors: (ex: how does the choice to smoke or not, exercise or not in earlier life affect aging?), social structure/societal level factors (how do health policies, fam structure, economic policies, societal aging etc affect aging?), also various isms ~its a subfield of gerontology - concerned more with social instead of physical/biological aspects of aging - incorporates both sociology and HDFS -- social gerontologists Draw on research from all the social sciences -sociologists focus on social institutions, groups and cultures as a whole -HDFS: focus on individuals across the lifespan and how individuals are affected by/affect their contexts -- how do individuals and their contexts interact to affect each other?

what is the field we have just spent the semester studying? how does it fit within/why is it associated with both HDFS and sociology?

1. providers say that elderly patients were more difficult to care for 2. physicians find it frustrating 3. providers find it hard to communicate with elders 4. providers complained about the medicare burdens- that consumed too much time

what other challenges are all too often present for elders in regard to getting good quality medical care? -consider both micro and macro factors

modernization theory

~argued that nations could be placed on a continuum ranging from least developed to most developed, according to such indicators as level of industrialization or degree of urbanization -those exhibiting certain qualities of social structure were termed modern *basic premise = there was once a golden age of aging - the old were few in number but held great power and authority in the community and in the family -3 generations- grandparents, parents, and grandchildren, usually lived together in extended family households ruled by the aged - older ppl were valued bc they had skills and knowledge that were transmitted to younger generations - they were also leaders in the community (veneration) ~then, modernization occurred - shattered this traditional society - the number of people who were self-employed declined, the aged lost their economic independence and were forced into retirement, urbanization drew young ppl from rural areas to cities which destroyed the extended family household and isolated the elderly 1) advances in health technology 2) modern economic technology *critique = challenged the idea that a golden age of aging ever existed

~most end of life care typically occurs in the ICU (intensive care unit) ~implications of this in terms of the odds of a good death & implications of this in terms of expense of care = -in the ICU, the decision for the person to die is often laid onto a surrogate- who may not know whether to pull the plug or not -this may cause much unwanted time for the person to remain alive (more pain) and more $$$$ ~good death = dying peacefully, comfortably, etc -how common/rare is it in the US = RARE! our society is more concerned with fighting death - doctors and families all try to fight death and prolong life rather than let their loved ones pass on when they're ready to die ~end of life doulas - -provide emotional support, comfort, assist clients in living their days to the fullest, doesn't do anything medical ~hospice nurses - -physical treatment (make most comfortable), emotional, social, spiritual support ~aging life care specialists - specialized health and human service pros advocating and directing the care of older adults and others facing ongoing health challenges -working w fams, their expertise provides the answers at a time of uncertainty — their guidance leads fams to the actions and decisions that ensure quality care and an optimal life for those who they love, reducing worry and stress ~those with more money are more likely to be able to afford/hire these types of professionals

where does most end of life care typically occur and what are the implications of this in terms of the odds of a good death, expense of care, etc? -what is a good death and how common/rare is it in the US? -what roles do/might end of life doulas, hospice nurses, and aging life care specialists play in fostering a good death? -who is most likely to use/have access to/be able to afford to hire/use these types of professionals?

~ALCs = Specialized health and human service professionals advocating and directing the care of older adults and others facing ongoing health challenges -they might help us address the challenge of conflicting care - -meds can interact - multiple doctors - if they arent aware of that it could be problematic - ALCSs say we need 1 person who pays attention to all of the elder's care and their needs - if someone's paying attention then they'd be able to catch a mistake like that - ok, you have a dr appt here, tell them youre taking this, this and this *not easily accessed - only to those with a lot of money! - usually their children pay for them

where/how do aging life care specialists (ALCSs) fit in? -how might these professionals help us address the challenge of conflicting care? -are ALCSs easily accessed/available to all elders and their families?

~too expensive!!! Most ideal but not in terms of $$ -no its not reasonable for us to expect most elders to pay for long term care

where/how does private long-term care insurance fit in? -is this a reasonable way for us to expect most elders to pay for long term care? why/why not?

-language barriers -unfamiliar foods -culturally may be know for the children to take care of the parents -lack of access

why are elders from marginalized racial and ethnic backgrounds in the US less likely to receive home and community-based care and to enter a nursing home even though they are, on average, in poorer health than white elders? -consider cultural norms as well as structural considerations

~most older people live with their family but they prefer to live on their own or in their own house ~aging in place = better defined more broadly as referring to the ability to or actual staying in one's own home and community through old age -relates to the preferred living situation of most elders bc most older ppl prefer to stay in their own homes as they grow old ~benefits of aging in place = they would be able to grow old in their place of choice and feel comfortable, better quality of life, feeling more independent ~drawbacks of aging in place = many homes and communities may not be well suited to elders, social isolation, malnutrition, maintaining the house takes a lot out of an older person ~things we can do as individuals/communities = create support groups for neighborhoods -~SASH = support and services at home: -medicare eligible -able to live safely at home -SASH coordinator and SASH nurse ~healthy living plan = disease education ~access to medical info and providers (decreases emergency and hospital visits) -choices for care -- medicaid program that allows nursing home eligible ppl to receive their services in their home (this is in VT) *national programs for older vermonters: -home share = a person lives with you and pays little or no rent in exchange for help around like lawn maintenance, cooking, laundry, etc ~*the village model = a community non-profit organization which provides membership for older adults ~membership benefits include volunteer services such as transportation, home maintenance, friendly check-ins -- also emphasis on social engagement in the community

with whom do most older people live? -explain the concept of aging in place **use class definition -how does this concept relate to the preferred living situation of most elders? -what are the benefits and drawbacks/risks of aging in place? -what are things we can do as individuals/communities and in terms of policies that would help reduce the risks and better support healthy aging in place?

true

~memory loss is a normal part of aging -as adults grow older, reaction time increases -older adults are at risk for HIV/AIDS -older adults have more trouble sleeping than younger adults do -older people perspire less, so they're more likely to suffer from hyperthermia -a person's height tends to decline in old age -physical strength declines in old age -bladder capacity decreases with age, which leads to frequent urination -all 5 senses tend to decline with age -as people live longer, they face fewer acute conditions and more chronic health conditions -older adults are less anxious about death than are younger and middle-aged adults -remaining life expectancy of blacks at age 85 Is about the same as whites -social security benefits automatically increase with inflation -most older drivers are quite capable of safely operating a motor vehicle -older people tend to become more spiritual as they grow older -geriatrics is a specialty in American medicine -older persons take longer to recover from physical and psychological stress -most older adults consider their health to be good or excellent -older females exhibit better health care practices than older males