HDFS 3710 Exam 4

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

Competencies and Aspects

What do DNR and AND stand for?

DNR- do not resessitate AND- allow natural death

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

PT, OT, Speech Therapy, Rehabilitation

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

alleviate physical pain and discomfort

The situation in families when parents and their adult children no longer want to be with each other and, in fact, no longer value the relationship is known as a(n):

developmental scheme

Couples who divorce seem to adapt best if, in the process, they protect each other's sense of identity, in what's referred to as:

saving face

A meta-analysis of studies on satisfaction among couples before and after birth of the first child showed that, compared to non-parents, the parents:

slight decline of satisfaction

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

Aids

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

Intermediate care facility

Who covers costs associated with hospice?

Medicare, Medicaid

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

contingency theory

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

grandparenting improves overall mental health of grandparent

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

older generations value relationships with adult children more than kids do with parents

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

the ones who remarry

A marriage therapist working from the social exchange theory of interpersonal relationships would attempt to assess whether the partners in a distressed couple feel that:

the rewards of the relationships outwight the costs

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

- Denmark: equality, job passions, tolerance, and recreation - Singapore: order, racial equality, homeowners, and benevolence - Costa Rica: humor , low time urgency, strong faith, low materialism

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

- Denmark: equality, job passions, tolerance, and recreation - Singapore: order, racial equality, homeowners, and benevolence - Costa Rica: humor , low time urgency, strong faith, low materialism

what are the comonents of an ecosystem framework?

- Individual - Microsystem: immediate contacts - Mesosystem: ensure clear communication through all parties - Exosystem: no connection but effects individual (media) - Macrsystem: attitudes and ideologies have of intimacy that shape elders opinions

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

- Individual homes within a small community of 6-10 residents and skilled nursing staff - Designed to feel like a home - Seems to result in improved adaptation in residents and their families

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

- Infection control (most common) (exam question) - Unnecessary drugs - Pharmacy consultation

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

- Registered nurse - Home health aide - Licensed practical nurses - Social work services

List and describe the levels of hospice care provided:

- Routine Home Care: a physician, registered nurse, hospice aid, social worker, chaplain, volunteer and bereavement specialist, who come for scheduled visits depending on the needs of the patient and family. - Permanent Care: Shifts of continuous care at the bedside keep the patient comfortably at home for up to 24 hours a day - Inpatient Care: When symptoms cannot be managed at home, hospices must have beds in a hospital or other facility, sometimes in a wing or floor called an inpatient hospice unit, where patients are cared for around the clock for a temporary time, typically 3-5 days, until they can return to routine home care. - Respite Care: When a family caregiver needs a break, the hospice patient can be cared for in an inpatient bed for from 1 to 5 days, no matter what level of care they need.

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

- denial: avoidance and confusion - anger: anxiety and fustration - bargaining: struggling to find meaning - Depression: overwhelmed, helpless, hostility - Acceptance: moving on, exploring options

What are the 9 common traits of locations with the happiest and healthiest people?

1. Move naturally (exercise) 2. Know your purpose 3. Down shift 4. 80% rule 5. Plant Slant 6. Wine @5 7. Family 8. Belong 9. Right Tribe

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

14%

A woman would like to have her mother cared for in one of the best nursing homes in her town, but is unable to afford the cost which, for a private pay facility would be about $____ thousand per year.

60

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

Biopsychosocial model

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

Cognitive impairment: mood and anxiety disorder

A couple who had initially seemed destined to remain together for years, if not decades, surprised their families when they announced their impending divorce. Neither of them could cite a particular problem; it's just they felt they grew apart. This pattern of long-term relationship is known as:

Disillusionment Pathway

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

Donations, 10 years

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

For profit

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

Gradual disappointment with each other and the relationship.

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

Health and rehabilitative services as well as food, but do not have intense nursing care services.

Which type of care for older adults provides such services as Meals on Wheels, friendly visiting, assistance with household tasks, and rehabilitation, outside of an institutional setting?

Home health services

Who fore fronted the hospice movement in US?

Kubler Ross

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

Refer to Google Doc

A new administrator in a nursing home in a large city is concerned because the staff are not providing what she feels is adequate training in bladder continence. She feels this should be a priority because she knows that incontinence is associated with which problem in nursing home residents?

Social isolation

According to the perspective known as ________________ Theory, activating a person's thoughts about death may trigger a set of positive changes, including closer relationships, greater creativity, and more connection to others.

Terror Management

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

The Denial of Death

Pizzi discovered three sub-categories in the analysis of the interviews on the topic of promoting health and well-being at the end of life, what were these three categories?

adaption, client goals, choices

The relatives in a young woman's family see each other only for major holidays and family events on average about two or three times a year, even though they live within 30 minutes from each other. Based on this information, you would rate this family as on the negative end of which dimension of the Intergenerational Solidarity Model?

associational

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

attachment

Discussed in the guest lecture was a key sign or trigger that is often associated with the beginning phases of the dying process - what was this sign/trigger?

begin to have no appetite

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

behave according to traditional roles

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

behavioral

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

believe that the world is dangerous and threatening place

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

believe they are contributing similarily to the relationship

In Ancient Egypt, the ______________ was considered to be the guidebook to ensure that an individual would be guided through the underworld and into the afterlife.

book of the dead

what is palliiative care?

care to reliefe symptoms and stress of a serious illness

What are key points and concepts to the hospice philosophy?

caring that assists those nearing death in need of refuge

What was the overall outcome for Pizzi's () study on promoting health and well-being at the end of life (hint: what was the take away message?

client center cave is an important approach to end of life

A couple in their 30s is thinking of getting married. One partner is very outgoing and sociable, and the other is introverted and shy. According to the ____________ hypothesis on long-term relationships, they should be very happy together.

cohabitation

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

cohabitation effect

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

compensation represents extent to which alternative sources boost emotional well being

A middle-aged man was disappointed that his family reunion was spoiled when the older relatives clashed with the younger relatives about the most recent presidential election. No matter what he did, it was impossible for him to get each side to see the other's point. According to the Intergenerational Solidarity Model, the generations were separated by:

disagreement of values

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

distressing situation causes aging to body

Because many adults enter into remarriages more likely to leave because they are open to the relationship's ending, they are said to be high on the factor known as:

divorce proneness

How did the participants discuss client goals?

ensure to plan, it is importsnt, acknowledge indivuality

what was the overall purpose of this article?

examine relationship between adaptive defense mechanism in midlife and physical health in late life.

what was the overall goal for this article?

examine sexuality and end of life through an ecological framework

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

false

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

fear it will bring undeeded caregiving burden to the grandparents

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

filial maturity

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

financial and health concerns

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

financial concerns

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

gender

Being able to die in a way that protects the individual's sense of autonomy and control over end-of-life decisions is consistent with the idea of:

good death

Research on satisfaction in close, long-term relationships shows that the couples who are most likely to get along well in their later years were those who:

got along well with eachother in their early years

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

have known each other longer than anyone else in their lives.

How did the participants discuss choices?

having a choice is a source of empowerment

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

healthy lifespan

what framework did the authors work from? why was this framework used?

holistic framework for understanding multiple levels of influence on sexuality in the end of life care

How did participants discuss adaptation?

how they adapt to skills, routines, habits or environment for people at the end of life. - adaptions create a climate of trust, develop rapport and establish well being of people.

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

idea that ratio care giver is not 1 to 1. caregiver have 3-4 in one home. can experience burnout

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

infection control

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

intermediate care facility

why focus on intimacy in later life?

intimacy expression is vital at the end of life stages

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

invisible

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

length of time an individual can live without significant disease and disability

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

less physical activity

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

life course perspective

What are some of the eligibility requirements for entering hospice?

life limiting illness 6 months or less to live reside in service areas provide care to all ages cant be undergoing treatment (chemo)

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

long and easy

The DSM-5 considers extreme grief past a 2-week period following the loss of a close relative or friend to fit the criteria for which disorder?

major depression disorder

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

make the healthiest choices

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

marital strain

What age group were the effects of marital quality most pervasive for individual health (i.e. when poor marital quality was reported what age group had the worst health effects?)

marriages become more meaningful as we age marital strain becoomes more apparent

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

married couples with kids

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

obligation

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

older adults better than young, better emotional and physical health

Were there any reported gender differences in the effects of marital quality on health

older participants

Based on socioemotional selectivity theory, members of a couple in a long-term relationship should show which pattern of social interaction in relation to their friends and social network?

our social networks becoming smaller but more selective as we devote our limited emotional time to people

What were some of the acceptable places of residence for receiving hospice care? What was mentioned as an unacceptable place of residence (i.e. they were ineligible to receive hospice care)?

personal home, nursing home, assisted living, homeless not accepted

A study in the Netherlands of parents and adult children testing the Intergenerational Solidarity Model showed that when parents had poor relationships with their children, the siblings:

poorer relationships with parents = stronger relationship with sibling. Exchanged more help with each other.

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

poorer relationships with parents = stronger relationship with sibling. Exchanged more help with each other.

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

poorer relationships with parents = stronger relationship with sibling. Exchanged more help with each other.

Within the competence-press model of adaptation to the institutional environment, which dimension captures the extent to which the environment places demands on the individual resident?

press

What was the overarching theme that emerged from the qualitative data on the study of promoting health and well-being at the end of life?

promoting a good health

the concept of defenses originated from _______ tradition?

psycholanalytic

What is an ambivalent social relationship?

relationship that hist both positive nad negative interactions

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

renewed feelings of loss near the date of the spouse's death.

What is secondary trauma?

results when an individual hears about the firsthand trauma experiences of another.

A hospital social worker decides that one of her patients, an 82-year-old man who is recovering from a stroke, needs to be in a facility that provides him with rehab, round-the-clock nursing care, and help with planning his return to his own home. These kind of services are likely to be found in which type of long-term care facility?

skilled nursing home

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

skilled nursing homes

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

social support

What best represents the definition of caregiver burnout?

state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude

A young woman feels that her parents treated her too much like an adult when she was growing up, giving her more responsibility than even she felt she could handle. This situation reflects a relationship characterized by:

structural ambivalence

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

sublimation, suppression, anticipation, alturism, humor

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

takes on new tasks or functions

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

the way to reach acceotance us by openly talking with family and health care workers

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

widowhood