PSY 318 Psychology of Aging Final (Bartlett)

authority-oriented grandparents

(13%): grandparent seen as more of an authority figure or disciplinarian but otherwise they are not really involved discipline but no other role

What will Medicare cover?

1. Acute care in Skilled Nursing Facility 2. some hospice services in Assisted living Facilities but no room/board 3. home health care for homebound medical patients

Vaillant's Theory of How to Grow Old With Grace

1. Care for others and remain open to new ideas 2. Show cheerful tolerance of the indignities of old age 3. Maintain hope 4. Maintain a sense of humor and a capacity for play 5. Take sustenance from past accomplishments 6. Remain curious and continue to learn from the next generation 7. Maintain contact and intimacy with old friends

Residential Care Facilities

24 hour supportive care services and support to individuals who don't need skilled nursing or health related care -Most frequent diagnosis is blood pressure followed by AD -Patients aren't as sick, its less like a medical environment more like an apartment -Patients still may need help with adls

How age influences research on aging

Age can measure change within an individual is not a true independent variable: studies on aging are never true experiments because age can't be manipulated

Developmental schism

Gap between parents and children in how much they value the relationship and seek independence

Board and care homes

Group living arrangement designed to meet needs of people who cannot live alone and also need ADL assistance caregivers live there 24/7 to help patients with their needs PROS: Can be a lot more of a home-like environment; smaller so easier to supervise everybody CONS: the staff aren't required to be medical personnel/nurses, so there a chance they might not give medication the right way; due to small size they might not have the best activities or recreation program

How cohort influences research on aging

Measure influences relative to history at time of birth A cohort effect is the social, historical, and cultural influences that affect that cohort during a particular point in time

Intergenerational stake

Older generations value relationship with adult children more that children value relationships with parents - parents feel more positively about their children than do their children about them

Filial anxiety

Worry about being forced to take on care of aging or infirmed parents

Palliative Care

a form of care focusing on pain and symptom management as opposed to curing disease

Marcia's model: Identity achievement

by this stage you have had this exploration of roles and values followed by commitment Commitment like in foreclosure but after a period of exploration Typically people in this stage are very balanced in their thinking

Characteristics of caregivers

caregivers are very likely to suffer adverse effects from the constant demands placed on them caregiver burden is used to describe the stress that caregivers experience in the daily management of their afflicted relative

Sandwich generation:

caregivers taking care of kids and parents

What forms of long term care will Medicare/Medicaid NOT cover? (aka 'private pay')

custodial care in skilled nursing facilities assisted living facilities board and care homes in-patient hospice memory care units Continuous care retirement communities/ life span communities Professional caregiving "in home caregivers": (though sometimes covered by medicaid) Adult day programs Adult day health programs (sometimes covered by medicaid)

Qualitative Studies

explores complex relationships in situations that don't lend themselves to restrictions and assumptions of quantitative methods Ex: Interviewing an older adult about their life experiences for your 1st paper Advantage: Can look at a broad spectrum of influences and complexity in relationships Disadvantage: not systematic or scientific; cannot accumulate hard data

Filial piety

feeling of commitment that the child should take care of the patient - describes the cultural values that adult children are expected to care for their parents, including having them live in their homes.

Marcia's model: Identity diffusion

first stage; you don't have any exploration or commitment to your roles or values ; easily swayed, don't necessarily feel strongly about any one position Ex. Political orientation in adolescence

Case Reports

in-depth analysis on particular individuals Ex: the Nun Study Advantage: provides thorough insights into the lives of the subjects Disadvantage: can be subjective so a high level of knowledge is needed to analyze the findings

Levinson theory

life structure of work and family. During middle adulthood people try to give more attention to whichever they neglected before

Skilled Nursing Facility (SNF)

medical institution that provides room, meals, skilled care, medical services, and protective supervision - can be acute or custodial

Focus Groups

meeting of respondents asked to provide feedback about a certain topic of interest Ex: When SLO County received Mental Health Services Act money, focus groups were held to determine how the money should best be spent. Advantage: can be used as a pilot study to see if further research would be beneficial w/o using too many resources Disadvantage: Not systematic and the data cannot be analyzed statistically

problem-focused coping

people attempt to reduce their stress by changing something about the situation

life review

process of evaluating and making sense of one's life - one way to achieve ego integrity Includes reinterpretation of past experiences and unresolved conflicts

Observational method

researchers draw conclusions about behavior through careful and systemic examination in particular settings Ex: observing agitation and other behavior in an adult day care center

Cross-sectional design

study of cohort differences at one time of measurement researchers compare groups of people with different ages at one point in time. Used much more often in research on aging.

Jung theory

suggests midlife transition is about reclaiming parts of the self that were repressed in the search for conformity in the first half of life

Mourning

the external expression of grief; social process including the cultural traditions and rituals that guide behavior after a death

Grief

the normal internal reactions/emotions of an individual experiencing a loss

Hospice Care

when person has 6 months or less to live; is holistic way of treating people at the end of life, done pretty much anywhere you live or wherever your home is, not the hospital Cannot receive hospice and acute care at the same time

How time of measurement influences research on aging

year or period in which a person is tested and measures the current influences on individuals being tested

influential grandparenting style

(17%): grandparent is involved in all aspects of caregiving, including discipline - highly involved, face-to-face contact, participation in shared activities, intimacy, discipline Could be taking on surrogate parent role, or parents are there but grandparents are just really involved Ex. "grandfamilies" and "skip generation families"

passive grandparents

(19%): grandparent is moderately involved but not in instrumental activities moderately involved but do not provide instrumental assistance or discipline

supportive grandparents

(23%): grandparent is involved in everything except discipline- still involved in day to day activities highly involved in everything except discipline

detached grandparents

(28%): grandparents are the least involved and score the lowest on all these dimensions - like the ones across the country etc

ways to achieve generativity in older adulthood

1. Successful parenting - having successful children both contributes to generativity and is caused by generativity 2. Grandparenting- mentoring, spending time with grandchildren, strengthening family bonds 3. Work, altruism, concern for broader community - Volunteering or doing something for the environment, mentoring, creativity (i.e. Art, music, poetry, writing; physically leaving something behind)

Montgomery & Kosloski Caregiver Identity theory stages

1. When the dependency situation begins 2. Self-definition of a caregiver begins 3. Performance of Personal Care Tasks - at this stage family members begin to evaluate whether to continue as caretakers or seek alternatives 4. Outside assistance is sought and formal service use considered 5. Consideration of nursing home placement 6. Nursing home placement 7. Termination of caretaker role

% of older adults that experience a midlife crisis

26% of US adults experience a midlife crisis

skilled nursing facility payment breakdown

63% medicaid, 22% private pay, 14% medicare Average cost is around $215 a day/$77,000 a year

Marriage rates among 65+

72% of men and 45% of women are married and living with spouses -Why? Women live longer and are more likely to be widows. Men more likely to remarry/ women widows may choose not to remarry due to appreciation of freedom

Death with Dignity law

A state statute that allows competent, terminally ill adult patients to obtain a physician's prescription for drugs to end their life.

Ego Integrity v. Despair

Achieving feelings of success, fulfillment, and wisdom vs. feelings of regret, lack of closure, questioning the meaning of one's life, etc. - associated with 65+ -Older individuals who establish a strong sense of ego integrity can look back at their experiences with acceptance, even the negative or painful attributes of one's life and self This sense of acceptance of the past and present self allows the individual also to view mortality with the acceptance that life inevitably must end

Psychological response to bereavement

Bereaved individuals can experience a range of negative emotions, impaired attention and memory

Erikson's Psychosocial theory characteristics

Biological, psychological, and social influences lead to "conflicts" that require resolution Erikson's theory is an ego theory- ego plays a central role in actively directing behavior Epigenetic principle proposes that stages unfold in a predetermined order

what population is least likely to be married

Black women 85+ are least likely group to be living with a spouse

Vaillant's Theory of Defense mechanisms: immature defense mechanisms

Denial - you refuse to acknowledge a bad situation Projection - you blame others Acting out - you release your feelings impulsively Passive aggression - you try to get back at others by finding a way to harm them without being obvious about it.

Filial maturity:

Developmental changes in children - Occurs when children reach the age of relating to their parents as equals

Role reversal

Discredited view that parent and children switch roles roles of parents and children flip, especially in times of parent illness

Vaillant's Theory of Defense mechanisms: intermediate (neurotic) defense mechanisms

Displacement - you transfer perhaps your angry feelings from their true target to someone who is less threatening Repression - you forget an unpleasant experience Reaction formation - you act in a way opposite to your true feelings.

Types of intimacy:

Emotional intimacy Cognitive intimacy: - Connecting around ideas or specific types of conversation, share similar ideas, etc. Sexual intimacy: - Sexual acts or intercourse Physical intimacy: - Touching, holding, physical touch, closeness Spiritual intimacy: - Engaging in spiritual or religious endeavors together

Marcia's model: Moratorium

Exploration of roles and values without commitment Actively exploring and trying to figure out what your identity is

Big 5 personality trends on how people change with age:

Extroversion, Neuroticism, & Openness decline with age Agreeableness increases with age Conscientiousness and emotional stability peak in older adulthood Androgyny increases with age

Generativity v. Stagnation

Generativity - care and concern for guiding the next generation Stagnation - the things you accomplish benefit you in the present but not in the long run or being left behind Typically the stage attributed to middle adulthood

What is the Widowhood Effect?

Greater probability of death in those who have become widowed compared to those who are married, especially for men Shows higher risk of mortality for widows compared to married men and women Caused by factors such as depression, stress, financial hardship, loss of social support

Continuous care retirement communities/ life span communities

Housing community that offers different levels of care adjusted to the needs of the residents Residents buy in with a large down payment to care for life at varying levels depending on needs- could be an independent apartment. Assisted living, nursing home, hospice, etc. idea is it's a whole campus with different buildings for different living needs, transportation, etc You essentially buy in and they move you around as your care needs change, they essentially take care of you for the rest of your life

Assisted Living facilities

Housing complexes with independent apartments - larger kind of places, more apartment style (like garden creek) don't have to have medical staff on site, but they are larger and have more activities for patients Can be more expensive; $2,500-$10,000 range private pay PROS: more activities, more social interaction available, more privacy and personal space CONS: may be not ideal more patients with higher fall risk or dementia and prone to wandering bc there's more people

Erikson's Psychosocial theory "conflicts" most relevant to older adulthood

Identity Vs. Role Diffusion, Generativity v. Stagnation, Ego Integrity v. Despair

What are the stages in Marcia's model of identity formation?

Identity diffusion Foreclosure stage Moratorium Identity achievement

epigentic principle

In Erikson's Psychosocial theory that proposes the 'stages' unfold in a predetermined order

The difference between a Dependent and Independent variable

Independent variable - the factor the experimenter manipulates Dependent variable - the factor the experimenter observes

In-patient hospice

Medical and social based hospice services delivered in a residential care home setting PAYMENT: Private pay

What does Medicaid pay for

Needs based program Covers inpatient and community health care costs not covered by Medicare

Professional caregiving "in home caregivers"

No degree or certification required but trained caregivers would come to your home and help you with ADLs or IADLS Not covered by insurance - usually private pay. In home support services is a medicaid program that could qualify for low income households

what population is most likely to be married

Non-Hispanic White men age 65-74 are the most likely group to live with a spouse over 65+

big 5 personality factors

Openness - one's tendency to be curious, imaginative, adventurous Consciousnesses: one's tendency to be organized, reliable, responsible, have self-discipline Extroversion - one's tendency to be outgoing, friendly Agreeableness - one's tendency to be warm, caring, supportive, trusting, gentle, generous Neuroticism - one's tendency to be moody, anxious, self-conscious, and vulnerable

What does Medicare pay for

Pay-as-you-go, but beneficiaries also pay premiums Part A: hospital insurance, Part B: medical insurance, Part c: medicare advantage plans, Part d: prescription drug coverage

Biological response to bereavement

Physiologically, bereavement places stress on body

Adult day health care programs

Similar idea to adult day programs but there are medical staff there on duty/ medical services available paid for privately; typically not covered by insurance with the exception of medicaid (insurance for low-income) or veteran's admin

Home health care:

Skilled professionals come to the home to provide medical services to homebound individuals with medical needs. A short term service designed to help until the person is recovered enough or they transition into hospice You have a caregiver to care for you when these services leave

Memory care unit

Specialized care for those with dementia. May be locked and require special training and environmental accommodations it could be both a Board and Care home and Assisted Living Facility kind of style, but there are certain systems in place meant specifically for patients with dementia, like alarms in place to alert if a patients wanders, higher staff ratio, special door locks, etc

Vaillant's Theory of Defense mechanisms: mature defense mechanisms

Sublimation - channeling your anxiety into constructive activity or projects Suppression - stifling negative emotions so as to prevent them from becoming destructive to your pursuit of your goals and values Ex. waiting to express your anger at your spouse until after the dinner party Anticipation - investing in preparation and planning as a way to reduce anxiety and stress Altruism - deriving satisfaction, perspective, and meaning from employing your resources and talents to help others Humor - the ability to see the funny, comical, or ironic aspects of a stressful or potentially upsetting situation

Adult day programs

The older adult lives at home but goes to a center during the day where they join other adults and have staff provide meals, activities, assistance in using bathroom Non-medical and are paid for privately

Marcia's model: Foreclosure stage

a commitment is made to roles and values without exploration Often times people in this stage are very close minded Ex. I am a democrat because my parents are democrats and im not open to

Intimacy

a sense of warmth or closeness that includes interdependence with another person, self-disclosure, and affection

Sociocultural response to bereavement:

altered position in family and community, financial burden. Change in support network

Surveys

gain information about a sample that can be generalized to a larger population typically through short-answer or multiple choice questions Ex: the census Advantage: able to gather info on data that is applicable to much larger sample sizes then you could get in the lab Disadvantage: Quality of the data may be limited; respondent bias when answering questions; test anxiety

Advanced health care directives

legally binding documents that give instructions about desired health care if, in the future, individuals cannot speak for themselves and appoint an agent to speak on the person's behalf if they are unable to communicate these wishes

Custodial Care - skilled nursing facility

long-term, general ADL assistance - you're there b/c you need help with (2+) ADLs; - not there exactly because medical reason, but bc you struggle with ADLS you can't live on your own no limit for how long you can stay in a nursing home Might not have skilled services; most of your care comes from professional nursing assistant

Daily diary

participants enter data on a daily basis such as personal ratings or activities Ex: asking caregivers to keep diaries of the problematic behaviors their loved ones with dementia are exhibiting Advantage: able to see small variations that can have an influence on the person Disadvantage: subject to misrecorded or absent info from the subjects

Laboratory Studies

participants tested in systemic fashion using standardized procedures, often involving some type of task Ex: measuring reaction time to word recall in a lab on campus Advantage: objective and systematic Disadvantage: cannot apply the stimuli presented to real-life experiences. Might not translate

emotion-focused coping

people attempt to reduce their stress by changing the ways they think about the situation

What does research show about how defense mechanisms change over time?

people who used more immature defense mechanisms in their earlier years tended to use the mature defense mechanisms in older adulthood The exception is denial; people continue to use denial throughout life

Correlational designs

relationships are observed among variables as they naturally exist. If one variable increases as another variable increases, it is a positive correlation If one variable decreases as another variable decreases, it is a positive correlation If one variable decreases as another variable increases, it is a negative correlation

Acute Care - skilled nursing facility

specific health related need, short-term, medical environment Ex. ​​If someone falls and breaks a hip, got surgery, and aren't quite safe to go home yet Patients receive Professional care/skilled services (such as nursing, physical therapy, occupational therapy, dietician, social services)

Meta-Analysis

statistical procedure to combine findings from independently conducted studies Ex: looking at several well known studies on cognitive therapy success in older adults and statistically comparing the results

Identity v. Role Diffusion

struggle to find one's true identity (values, belief system) that is separate and unique from one's family - associated with adolescence stage

Epidemiological studies

study frequency of a particular disease in the population Ex: What percentage of the population living at Leisure World has an STD? Advantage: can measure prevalence and incidence of diseases fairly easily using surveys/interviews

Longitudinal design

study of changes across ages in one cohort at a time people are followed repeatedly from one test occasion to another. By observing people as they age, researchers aim to determine whether participants have changed over time as the result of the aging process.

Loss

the severing of an attachment an individual has with a loved one, a loved object, or an aspect of oneself or identity

Bereavement

the state of having suffered a loss

Archival Research

using existing resources containing data relevant to a question about aging Ex: For her thesis project, looking at records of prior participants at ADC to determine what factors led to them participating in program the longest Advantage: readily accessible info Disadvantage: researcher doesn't have control over the data and it may not have been reliably collected