Aging: Promoting Awareness and Advocacy Dean D. VonDras, Ph.D. Human Development and Psychology Departments University o

1. Aging: Promoting Awareness and Advocacy Dean D. VonDras, Ph.D. Human Development and Psychology Departments University of Wisconsin-Green Bay vondrasd@uwgb.edu

2. Overview: • Recognizing physical/psychological/social interactions • Recognizing functional changes due to age and disability • Promoting awareness and advocacy

3. Psychological Physical Social

4. Observable Physical Changes with Age: Skin and face – wrinkles, sagging, leathering Hair – thinning and graying Height – decreases Weight – increases during middle adulthood, i.e., the ‘middle-age spread’, and often decreases in old age, especially in ‘physically fragile older adults’

5. Declines in Sensory-Perceptual Processes with Age: • Vision and Hearing • Taste and Smell • Somethesis: Skin, Temperature, Pain • Proprioception – sensations generated by the body that let you know the location of limbs in space • Kinesthesia – one’s sense of location while moving through space

6. Changes in Hearing: Presbycusis – age related hearing impairment • Caused by deterioration of mechanisms in the inner ear, long-term exposure to loud noises, certain drugs, an improper diet, or genetic factors.

7. Decline in sensitivity to tones and pitches – different frequencies decline at different rates with advancing age.

8. From Ordy et al. (1979), “Age differences in the functional and structural organization of the hearing system in man,” in, Ordy and Brizzee (Eds.), Sensory Systems and Communication in the Elderly.

9. Speech perception – becomes more difficult due to the decline in tone and pitch sensitivity.

10. Ways to make your speech heard: • Talk in a lower pitch but distinct voice • Articulate every syllable -- speak clearly • Talk face to face -- “read my lips”

13. Causes of Disability: Congenital – occurring at birth Accident/injury Because of illness/disease Age-related

14. Keep in mind… A disability may not be obvious to others. A disability is more likely to occur in old age.

15. Most Prevalent ChronicConditions in Later-life • Arthritis • Hypertensive Disease • Heart Disease • Hearing Impairments • Musculoskeletal impairments • Chronic Sinusitis • Diabetes • Visual Impairments

16. Most Feared Conditions in Later-life • Alzheimer’s Disease - Dementia • Stroke/Cancer • Physical disability that prevents independence and autonomy of “normal” life (e.g., Parkinson’s Disease) • Heart Disease/Chronic Pulmonary Disorder • Deafness/Blindness  

17. Old age and disability impact upon… • Activities of daily life (ADLs) • Instrumental activities of daily life (IADLs) • Sense of self

18. Ideal Self Real Self

19. Stereotype – a social belief about a group of people.

20. Stereotypes linked with traits of older adults: Negative Stereotypes -> Traits • Severely impaired -> Slow-thinking, feeble, senile • Despondent -> Sad, hopeless, afraid, lonely • Shrew/curmudgeon -> Ill-tempered, stubborn, bitter • Recluse -> Quiet, timid, naive

21. Positive Stereotypes -> Traits • Golden-ager -> Active, independent, happy • Perfect grandparent -> Loving, supportive, wise, kind • J. Wayne Type -> Patriotic, proud, religious

22. Loss ContinuumModel (Pastalan, 1982) Views aging as a progressive series of losses that reduces one’s social participation.

23. Shrinking Environment with Loss Greatest physical limitations--home bound/residential care Later life--with increasing physical decline Later life--healthy Young adulthood--Healthy

24. Person-Environment Interaction and Optimal Aging Kurt Lewin’s (1936) conceptualization: B = f (P, E) • Behavior is the function of both the person and environment

25. Competence and Environmental Press Model (Lawton and Nahemow, 1973) • Behavior is a result of a person of a particular competence in an environment of a specific press level. • Behavior exists on a positive-negative continuum and is observable at the behavior and affect levels.

26. Competence – the theoretical upper limit of a person’s capacity to function. Environmental press – the demands placed upon the person. Adaptation level –where press is in balance for particular level of competence.

27. Five Domains of Competence by Lawton and Nahemow: • Biological health • Sensory-perceptual functioning • Motor skills • Cognitive skills • Ego strength

28. Positive affect and adaptive behavior Negative affect and maladaptive behavior Marginal Competence-Environment Press Model (from Lawton and Nahemow, 1973) Marginal Adaptation level Maximum performance potential LowCompetenceHigh Negative affect and maladaptive behavior B A WeakEnvironmental PressStrong

29. The less the competence level of the person, the greater the impact of environmental factors

30. The competence-environmental press model is a useful lens of analysis for interventions in that it describes a scaffolding process, where modification of environment can increase adaptation. E.g., arranging living environment designs to increase social interaction

31. Ways to enhance a sense of competency: • Speak to a person, practice Buber’s “I and Thou”. • Be respectful—recognize independence and autonomy. • Recognize abilities and skills—wisdom. • See development occurring despite disability and infirmity. • Respect cultural differences in reaction to changes in life, e.g., death.

32. Promoting Awareness and Advocacy • Different instructional activities and levels of student engagement

33. Levels of student engagement: • Listening and reflecting – “Taking it in or tuning out” • Telling about personal observations or experiences – “This is what happened to me…” • Simulation experiences – finding out for yourself • Discussing different perspectives – exploring contrasts, finding similarities • Problem solving I – identifying problems • Problem solving II – generating and testing solutions

34. Self-Discovery Activity: What are the Most Valuable Things in Your Life? • List the 5 most valuable things in your life—and explain why they are important: • Now, choose one of the aspects you mentioned to give up. Which one would it be and why? • Now choose two other of the aspects you noted above to give up. Which would these be and why? • How might giving up these aspects of your life reflect the losses the elderly endure? • How do you think you will cope and adapt, as you encounter losses with age?

35. Film Review Essay: • Review a film where the main characters are elderly • Then compose an essay discussing how theories and research discussed in class coincide with characterizations or themes expressed in the film.

36. Interview an Older Adult: • Conduct a semi-structured interview of an older adult and provide a case study discussing how your understanding of the person coincides with theories and research discussed in class. • Our learning goal is to find practical application of theory and research to “real” lives and experiences, and further our understanding of various aspects of adult development and aging.

37. Sensory-Perceptual Deficit Simulation: Materials: • Two cotton balls and about 2 feet of plastic wrap Procedure: • Gently place cotton balls in each ear canal – this will simulate changes in hearing that might occur in old age. • Bunch up and then gently place the wrap across the bridge of your nose as if they were eye glasses – this will simulate changes in the peripheral visual mechanisms that might occur with cataracts.

38. Web-based learning activities: Common Causes of Age-Related Vision Loss: • Lighthouse International: Visual deficit simulation exampleshttp://www.lighthouse.org/patient/default.htm Noise-Induced Hearing Loss: • Health and Safety Executive: Auditory deficit simulation examples(This site allows a download to your computer)http://www.hse.gov.uk/noise/demonstration.htm

39. An online version of the Implicit Association Test (IAT, Greenwald et al., 1998): • The IAT is found at the Internet web project sponsored by the Southern Poverty Law Center http://www.tolerance.org/ Students’ Assignment: • Visit the web site, read about the IAT, complete two online tests. • Read tutorials on stereotypy and prejudice. • Write a brief reflection paper regarding this experience.

40. A sample of students’ narrative responses: • I learned that perhaps I had biases that I was not aware of … I felt that I had very positive attitudes toward older adults, but I was amazed to find out that I did indeed have biases! • I saw that even though you may not believe that you have bias towards others, unconsciously you probably do. Society has a huge influence over us. • I really did not learn very much from this activity. I feel this was more of a hand eye-coordination exercise than an attitudes test. If you really want to see how people have attitudes towards others then you need to ask them questions and do follow-up studies. • I learned that there are a lot of different ways to be biased against others.

42. Classroom advocacy assignment: • Identify an issue or problem, e.g., rising health costs, adapting to environmental press, etc. • Assign small groups a unique “case” to discuss and have them identify important concerns and possible solutions for the individual(s) represented in the case. • Cases may include the following individuals: - cognitively impaired elderly - institutionalized elderly - chronically ill elderly - economically disadvantaged elderly - mentally ill elderly - family caregivers of older adults - widowed elderly - new immigrant elderly - older adults from different ethnic backgrounds

43. Means, Standard Deviations, and Spearman Correlations of Survey Measures with Advocacy Perspective (N = 74) * p < .05, ** p < .01. a 0 = advocacy is for self or student perspective; 1 = advocacy is for unique group of older or disabled adults

44. Sampling of Student Narrative Responses Discussing What is Learned When Serving as an Advocate is a Required Aspect of Discussion

45. Overall… • The advocacy role takes the student beyond their usual realm of thinking and experience, enhancing depth-of-learning. • The activity stimulates a wide variety of learning behaviors, e.g., interactive inquiry, critical analysis, empathic understanding, etc.

46. Things an advocate can provide informally: • Moral support • Sense of belonging • Self-esteem • Recognition of competency and mastery • Practical aid • Safe environment

48. Acting with Empathy: Empathy – recognizing and understanding the state of mind, beliefs, desires and emotions of another person without interjecting your own. “Putting yourself in another’s shoes”

49. Sympathy – feeling sorry another person. Empathy ≠ Sympathy

50. Avoid patronizing speech – remarks that reflect stereotypes of incompetence and dependence. Avoid infantalization – e.g., using terms of endearment, using simple language, etc.