HDFS 3710 Exam 4
press
***Where do the amount of activity and cognitive demands placed on the individual fit within the competence-press model?
$74,800
A woman would like to have her mother cared for in one of the best nursing homes in her town, but is unable to afford the cost which, for a private pay facility would be how much per year?
feel that they are getting the same out of the relationship as they are putting into it
In equity theory, partners are seen as having the highest marital satisfaction if they:
for profit
The majority of nursing homes in the US fall into which category of ownership?
improve health (mental, physical, quality of life)
The role of grandparenting to aging individuals is shown by researchers to:
holds both positive and negative characteristics
What is an ambivalent social relationship?
14%
What is the appropriate percentage of grandparents raising grandchildren who are 60 years and older?
Kübler-Ross
Who forefronted the hospice movement in the US?
social network substitution
obtaining support from others
social network compensation
the extent to which alternative sources boot emotional and physical well-being
interpreted as a series of steps that must be followed by each dying patient ignores other emotions that may be felt by the dying person failed to make the critical point that to reach acceptance of a fatal illness, the dying person must be allowed to talk openly about their illness people misinterpreted that if you didn't experience one of the 5 steps you weren't having 'the best' dying process
4 criticisms of Kübler-Ross' theory
denial anger bargaining depression acceptance
5 stages of dying in Kübler-Ross' theory
need complementary hypothesis
A couple in their 30s is thinking of getting married. One parter is very outgoing and sociable, and the other is introverted and shy. According to this hypothesis on long-term relationships, they should be very happy together.
disillusionment
A couple who had initially seemed destined to remain together for years, if not decades, surprised their families when they announced their impending divorce. Neither of them could cite a particular problem; it's just that they felt they grew apart. This pattern of long-term relationship is known as:
skilled nursing facility
A hospital social worker decides that one of her patients, an 82 y/o 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 kinds of services are likely to be found in which type of long-term facility?
the rewards outweigh the costs
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:
showed a slight decline in marital satisfaction
A meta-analysis of studies on satisfaction among couples before and after birth of the first child showed that, compared to non-parents, the parents:
disagreements and values
A middle-aged man was disappointed that his family reunion was spoiled when the older relatives clashed with the younger relatives about the most recent presidential election. No matter what he did, it was impossible for him to get each side to see the other's point. According to the Intergenerational Solidarity Model, the generations were separated by:
continence (quality of life)
A new administrator in a nursing home in a large city is concerned because the staff are not providing what she feels is adequate training in bladder continence. She feels this should be a priority because she knows that incontinence is associated with which problem in nursing home residents?
compensated for the lack of support from parents
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:
feel their identity is wrapped up in the parent role feel that they are losing control over their children's lives lack a support network have few or only children worried about children's safety and well being
A study of Canadian parents showed that the greatest difficulty in adapting to the empty nest was experienced by parents who:
has taken on new tasks or functions
A woman grieving after the sudden and unexpected death of her husband is engaged in the "restoration" function of bereavement. This means that she:
structural ambivalence
A young woman feels that her parents treated her too much like an adult when she was growing up, giving her more responsibility than even she felt she could handle. This situation reflects a relationship characterized by:
marital strain
According to Umberson et al (2006), this accelerated typical decline in self-related health that occurs over time?
terror management theory
According to this perspective, 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
According to this 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
contingency theory
According to this theory, parents tend to give more support to their adult children who need the most help.
attachment
According to this view of bereavement, the bereaved can continue to benefit from maintaining emotional bonds to the deceased individual
results in improved adaptation in residents and their families (feels like home; more staff)
An advantage of the Green House model of institutional care for older adults is that it:
people prefer long term relationships to maximize their positive affect; would rather spend time with partner than friends
Based on socioemotional selectivity theory, members of a couple in a long-term based relationship should show which pattern of social interaction in relation to their friends and social network?
good death
Being able to die in a way that protects the individual's sense of autonomy and control over end-of-life decisions is consistent with the idea of:
more likely to use negative problem solving skills
Couples in long-term relationships characterized by emergent distress show which pattern of conflict over time?
they "slide" into marriage rather than making a mindful decision
Couples who cohabitant before getting engaged will have a higher divorce rate should they marry. The most likely contributing factor is that:
identity assimilation
Couples who divorce seem to adapt best if, in the process, they protect each other's sense of identity, in what's referred to as:
Move naturally Purpose- knowing your life path, having a goal, being ok with where you are at in life Down shift- have time for yourself to unwind 80% rule- eat few processed foods Plant Slant- eat greens, grains, beans, and nuts Wine at 5- occasional glass of wine Belong- face-to-face socialization Family- priority over work Right tribe- surround yourself with people that are similar to who you want to be
Describe in detail the 9 traits of locations with the happiest and healthiest people
Needs of individuals should not be met to the greatest extent possible (maximizing the fit between the person and then environment) Green House Model (6-10 residents and skilled nursing staff)
Discuss the implications of the competence-press model for the design of nursing home environments
assistance at their own home
Home health services typically include what types of support for older adults?
discussed how they adapt skills, routines, habits, or environments for people at the end of life; and how these adaptations can create a climate of trust, develop rapport, and establish well-being for people
How did participants in Pizzi's article discuss adaptation?
giving clients a choice is a source of empowerment; having choices is a free experiencing when the patient may feel that their life is in turmoil or disarray
How did the participants in the Pizzi article discuss choices?
ensuring to plan goals and meet needs that are more important from the perspective of the client and family; acknowledge the individuality of the patient, validating the client as a human with needs
How did the participants in the Pizzi article discuss client goals?
funded off donations only 10 years
How was the building site for St. Mary's hospice center funded? How long did it take to complete the building process?
Book of the Dead
In Ancient Egypt, this was considered to be the guidebook to ensure that an individual would be guided through the underworld and into the afterlife
were not supportive
In a test of the intergenerational solidarity model, researchers found that siblings were likely to exchange more help in later life when they had parents who:
Costa Rica- highest reports of positive affect Denmark- most trust Singapore- no ghettos, racial equality, equal pay, everyone has own house
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 healthy?
infection control accident environment food sanitation quality of care unnecessary drugs
List the top 5 deficiencies noted in the 1997 survey of US nursing homes. ***Why do you think these problems exist?
divorce proneness
Many adults that enter into remarriages are more likely to leave because they are open to the relationship's ending. They are said to be high on the factor known as:
improve the mental health of the grandparents (gives them a sense of identity)
Mental health workers who serve the older adult population are concerned about the skip generation family because they believe it has the potential to:
invisible
Moving dying patients from the home to hospitals in mid-20th century western culture has led to the ethos of this death
financial concerns
Older adults in the Living Apart Together relationship status do so primarily because of which consideration?
adaptation, client-goals, choices
Pizzi discovered three sub-categories in the analysis of the interviews on the topic of promoting health and well-being at the end of life, what were these three categories?
get along well in earlier years (enduring dynamics --> formed problem solving skills and established patterns early)
Research on satisfaction in close, long-term relationships shows that the couples who are most likely to get along well in their later years are those who:
married couples with children
Since 1970, there has been the greatest decrease in US households that fall into the category of:
less physical activity
Soon after becoming widows, research shows that women exhibit which behavior that relates to their health?
false
T/F: Hospice care requires that family be defined and limited to only immediate blood relatives.
emotional reactions that may occur on the date of certain anniversaries that may continue for 35 years or more after death of a spouse
The "anniversary reaction," as applied to widowhood, refers to the:
skilled nursing homes
The Balm of Gilead has recently received support from what type of facility for patient placement that will provide more 1:1 care?
major depressive disorder
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?
psychoanalytical
The concept of defenses originated from what tradition?
filial obligation
The greatest degree of this is likely to be experienced by Asian American families.
the Denial of Death
The idea that Western culture is unwilling to accept the reality of mortality led Ernest Becker to write the critique of this attitude, called:
parents are higher in effectual solidarity toward their children than their children are towards their parents
The intergenerational stake hypothesis about families with adult children proposes that:
intermediate care
The least amount of nursing services is provided in what type of in-patient facility for older adults?
aids (64%)
The majority of employees of nursing homes fall into which category?
infection control
The number one deficiency in US nursing homes in 2014, involving 43% of all institutions, was:
long and easy
The people who think life is ___ and ___ are 20% happier.
behave in stereotypically gendered ways
The phenomenon in families known as "doing gender" describes what happens when parents:
associational dimension
The relatives in a young woman's family see each other only for major holidays and family events on average about 2-3 times a year, even though they live within 30 minutes from each other. Based on this info, you would rate this family as on the negative end of which dimension of the Intergenerational Solidarity Model?
are the only remaining members of their original family and have known each other longer than they have known anyone else
The sibling relationship in later adulthood is unique because siblings typically:
behavioral approach
This approach to marital satisfaction predicts greater happiness when couples engage in positive behaviors such as expressing affection.
widowhood effect
This effect refers to the fact that widows are more likely to die after losing their spouse.
doing gender
This phenomenon occurs after the transition to parenthood, when men and women adapt more stereotypical roles in the household.
failure to make the point that to reach acceptance of a fatal illness, the dying person must be allowed to talk openly about their illness
Those who study death an dying believe that the main outcome of the work of Kübler-Ross was her emphasis on:
older participants
What age group were the effects of marital quality most pervasive for individual health (i.e. when poor marital quality was reported what age group had the worst health effects?)
embrace a holistic approach that includes physical, emotional, and spiritual concerns mutual care giving between patient, family, and hospice staff dignity, quality of life, family as defined by the patient, comfort, honor of traditions and religion
What are key points and concepts to the hospice philosophy?
sublimation, suppression, anticipation, altruism, humor
What are mature defense mechanisms considered to be according to this article?
must have life limiting illness giving them 6 months to live, can't be receiving interventions to cure the disease
What are some of the eligibility requirements for entering hospice?
older adults remain close with only their most rewarding social ties their relationships elicit more positive and fewer negative emotions than those of younger people
What are some of the strengths of older adults' social relationships (think about the size and ability to negotiate conflict)?
some older adults reach late life without a close net of relationships that can be preserved when older adults ARE unable to avoid situations of distress, they are more likely to experience arousal that will challenge their aging systems and will compromise their physical and emotional health
What are some of the vulnerabilities of older adults' social relationships (think about concerns such as unavoidable conflict)
move naturally know your purpose down shift 80% rule plant slant wine at 5:00 family belong right tribe
What are the 9 common traits of locations with the happiest and healthiest people?
aesthetics and safety of the local area convenience of access to shops and services positive regard and mutual help among neighbors attractiveness and ease of accommodation within the home
What are the four major categories of community-based services and facilities?
generosity, trust, tolerance, sociability
What are the important personality traits or country beliefs in Denmark, Singapore, and Costa Rica? What 4 things do these countries have in common?
successful at work and in relationships; exhibit lower levels of psychopathy
What are the traits that are commonly associated with mature defense mechanisms?
Ecological- it provides a holistic framework for understanding multiple levels of influence on sexuality in end-of-life care; can easily conceptualize how caregivers and advocates can intervene at each level to support client-centered and client-preferred intimacy at the end of life
What framework did Morissey-Stahl work from? Why was this framework used?
generosity, tolerance, social, trusting
What is a key common theme to the places that have the happiest and healthiest people?
there isn't 1:1 care because there are more patients than caregivers
What is an issue of the Balm of Gilead utilizing boarding homes for patient placement?
marriages become more meaningful as we age cumulative marital strain becomes more apparent in older age
What is one given reason for why age is relevant when considering the relationship between marital quality and health?
to alleviate physical pain and discomfort
What is the first priority of the Balm of Gilead palliative care services?
individuals in hospice care begin to have no appetite
What is the sign/trigger that is often associated with the beginning phases of the dying process?
biopsychosocial model
What model that has been discussed frequently in lectures best represents the goals of the Balm of Gilead?
life course theory
What perspective or theory did Umberson and colleagues work from in their study on the effects of marital quality and health over a lifetime?
health-related services for people who do not need hospitalization or skilled nursing care
What type of care is provided in an intermediate care facility?
social support
What variable did the authors think would mediate the relationship between adaptive defense mechanisms and late life health?
to examine sexuality and end-of-life through an ecological/ecosystemic framework
What was the overall goal of the Morissey-Stahl article?
client-centered care facilities self-direction at the end of life, or at the very least, provides clients with opportunities to say how they will live their lives until the end of that life
What was the overall outcome for Pizzi's study on promoting heath and well-being at the end of life (hint: what was the take away message)?
to examine the relationship between adaptive defense mechanisms in midlife and physical health in late life
What was the overall purpose of this article? What were they trying to test?
promoting a good death
What was the overarching theme that emerged from the qualitative data on the study of promoting health and well-being at the end of life?
personal home (including nursing, assisted living facilities) being homeless
What were some of the acceptable places of residence for receiving hospice care? What was mentioned as an unacceptable place of residence?
filial maturity
When children reach the age at which they enter adulthood, they and their parents experience this phenomenon.
mood and anxiety disorders
Which psychological disorders are most prevalent among residents of nursing homes?
home health services
Which type of care for older adults provides such services as Meals on Wheels, friendly visiting, assistance with household tasks, and rehabilitation, outside of an institutional setting?
medicare managed medicare medicaid private insurance self-pay/charity care
Who covers costs associated with hospice?
the need for intimate relationships, especially during late life, is often ignored; older adults and those at the end of life are still interested in intimacy
Why did the Morissey-Stahl article focus on intimacy in late life?
press
Within the competence-press model of adaptation to the institutional environment, which dimension captures the extent to which the environment places demands on the individual resident?
remarry experience "resilient grief" experienced extensive caregiver burden at the end of their spouse's life
Women who adapt more favorably to widowhood tend to be those women who:
exosystem
component of the ecosystem framework (Morissey-Stahl article) in which the environments may not have a direct connection with the individual (media or policies), but still impact intimate expression at the end of life
individual
component of the ecosystem framework (Morissey-Stahl article) in which the experience of intimacy is a very individual experience that can be influenced by health status, hormonal changes, attitudes, and mental health
macrosystem
component of the ecosystem framework (Morissey-Stahl article) in which the larger attitudes and ideologies that cultures/societies have of intimacy that shape opinions and thoughts of elders
microsystem
component of the ecosystem framework (Morissey-Stahl article) in which those with immediate contact to the elders may serve as educators, supporters, or influencers
mesosystem
component of the ecosystem framework (Morissey-Stahl article) that ensures that communication is open and clear between all parts of the microsystem
continuous
form of hospice that provides around the clock nursing care for patients in crisis
intermediate care
health-related, but not intense nursing services are provided in this type of facility
secondary trauma
indirect exposure to traumatic event- often by word of mouth (often experienced by therapists, practitioners, etc.)
respite
level of hospice care in which someone comes to stay in hospital center for 5 days to die primary caregiver a break
routine
level of hospice care in which someone is able to live at home and receive infrequent visits from hospice care provider
general inpatient
level of hospice care someone is entered into to receive pain control or symptom management
caregiver burnout
physical, emotional, and mental exhaustion that also may be accompanied with a change in attitude about their caregiver duties
palliative care
provides patients with relief from symptoms (nausea, pain, dyspnea) as well as some services such as PT and OT; should neither hasten nor postpone the end of life
distressing situations that cause changes and arousal to bodily systems
the Theoretical Model of Strength and Vulnerability Integration is focused on what?
live without significant disease and disability (in good health)
the healthy lifespan refers to the length of time that an individual can:
developmental schism (scheme)
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:
maximum health expectancy
this is the length of time an individual can live without significant disease and disability
all healthy/happy places are communities where the healthy choice is the easy choice
what is the common theme of socialization in the Blue Zones Lecture