Transcript Document

Aging: Promoting Awareness and Advocacy
Dean D. VonDras, Ph.D.
Human Development and Psychology Departments
University of Wisconsin-Green Bay
[email protected]
Overview:



Recognizing physical/psychological/social
interactions
Recognizing functional changes due to age and
disability
Promoting awareness and advocacy
Observable Physical Changes with Age:

Skin and face – wrinkles, sagging, leathering

Hair – thinning and graying
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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’
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Declines in Sensory-Perceptual
Processes with Age:

Vision and Hearing

Taste and Smell

Somethesis: Skin, Temperature, Pain
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
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
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.
Decline in sensitivity to tones and pitches –
different frequencies decline at different rates
with advancing age.
Decline in Hearing Sensitivity
Decibel
80
1 khz
2 khz
4 khz
8 khz
60
40
20
0
30
40 50
60 70 80
Age
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.
Speech perception – becomes more difficult due
to the decline in tone and pitch sensitivity.
Ways to make your speech heard:

Talk in a lower pitch but distinct voice
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Articulate every syllable -- speak clearly

Talk face to face -- “read my lips”
Percent of Decline in Physical and Cognitive Function:
Modified from Spirduso (1995) and Weg (1983)
100
Percent
80
Maximum Lung
Capacity
Heart Function
60
Nerve Conduction
Velocity
Speed of Cognitive
Processing
Arm Cranking Power
40
20
0
20
40
60
Age Group
80
Percent of Adults with Disabilities (National
Center for Health Statistics, 1999)
60
50
Percent
40
30
20
10
0
65-69
70-74
75-79
Age Group
80-84
85+
Causes of Disability:

Congenital – occurring at birth

Accident/injury

Because of illness/disease

Age-related
Keep in mind…
A
disability may not be obvious to others.
A
disability is more likely to occur in old age.
Most Prevalent Chronic
Conditions in Later-life
1.
2.
3.
4.
5.
6.
7.
8.
Arthritis
Hypertensive Disease
Heart Disease
Hearing Impairments
Musculoskeletal impairments
Chronic Sinusitis
Diabetes
Visual Impairments
Most Feared Conditions in Later-life
1. Alzheimer’s Disease - Dementia
2. Stroke/Cancer
3. Physical disability that prevents independence and
autonomy of “normal” life (e.g., Parkinson’s
Disease)
4. Heart Disease/Chronic Pulmonary Disorder
5. Deafness/Blindness
Old age and disability impact upon…

Activities of daily life (ADLs)

Instrumental activities of daily life
(IADLs)

Sense of self
Stereotype – a social belief about a group of
people.
Stereotypes linked with traits of older adults:
Negative Stereotypes -> Traits

Severely impaired -> Slow-thinking, feeble, senile
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Despondent -> Sad, hopeless, afraid, lonely
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Shrew/curmudgeon -> Ill-tempered, stubborn,
bitter
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Recluse -> Quiet, timid, naive
Positive Stereotypes -> Traits
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Golden-ager -> Active, independent, happy
Perfect grandparent -> Loving, supportive, wise,
kind
J. Wayne Type -> Patriotic, proud, religious
Loss Continuum Model (Pastalan, 1982)
Views aging as a progressive series of losses
that reduces one’s social participation.
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
Competence and Environmental Press Model
(Lawton and Nahemow, 1973)
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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.
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.
Five Domains of Competence by Lawton
and Nahemow:

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

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Biological health
Sensory-perceptual functioning
Motor skills
Cognitive skills
Ego strength
High
Competence
Negative affect and
maladaptive
behavior
Positive affect and
adaptive behavior
Low
Negative affect and
maladaptive behavior
B
Weak
A
Environmental Press
Competence-Environment Press Model (from Lawton and Nahemow, 1973)
Strong

The less the competence level of the person,
the greater the impact of environmental factors

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
Ways to enhance a sense of
competency:
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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.
Promoting Awareness and Advocacy

Different instructional activities and levels of
student engagement
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
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:
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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?
Film Review Essay:
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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.
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.
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.
Web-based learning activities:
Common Causes of Age-Related Vision Loss:

Lighthouse International: Visual deficit simulation examples
http://www.lighthouse.org/patient/default.htm
Noise-Induced Hearing Loss:
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Health and Safety Executive: Auditory deficit simulation examples
(This site allows a download to your computer)
http://www.hse.gov.uk/noise/demonstration.htm
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:
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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.
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.
Pretest-Posttest Self-Ratings of
Bias in Social Perceptions
Experience
Prejudice - Low
6
Experience
Prejudice - High
Self-Rating 5.5
of Bias in
5
Social
Perceptions 4.5
4
Pretest
Posttest
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:
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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
Means, Standard Deviations, and Spearman Correlations of Survey
Measures with Advocacy Perspective (N = 74)
Scale/Item
Mean (SD)
Advocacy Perspective
Discussion Activity:
Increased insight
7.32 (1.49)
.23*
Created new awareness
7.20 (1.55)
.25*
Enhanced understanding
7.49 (1.57)
.17
Gained knowledge
7.27 (1.57)
.16
Overall discussion score
49.90 (9.98)
.24*
Helped realize important concerns
6.97 (1.76)
.33**
Helped find insight into problems
6.91 (1.85)
.22*
Helped understanding issues
7.07 (1.95)
.26*
Position of Advocate:
Overall perspective-taking score
49.14 (10.42)
.30**
* p < .05, ** p < .01. a 0 = advocacy is for self or student perspective; 1 = advocacy is for
unique group of older or disabled adults
a
Sampling of Student Narrative Responses Discussing What is Learned
When Serving as an Advocate is a Required Aspect of Discussion

“From the new perspective, insight is gained, and different comprehension of the same questions.”
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“Thinking of how I want to be treated at 90+.”
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“Thinking outside the box.”
“I learn by hearing all the sides of the debate. It is never one sided there are many opinions and
voices to be heard.”

“Get to see different views from different positions. This just allows for a more open perspective in
daily life.”
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“We were able as young people to debate what we may want, even if it could potentially affect the
elderly.”
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“Many people have different ways of looking at the same topic. Small group discussion allowed us to
look at our topic through different vantage points. Also, giving us a unique group helps us think of
various people affected by the topic.”
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“Mentally ill elderly probably don't know a lot about what is happening so the more we can help them
and their families the less confused they will be.”
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“Have to consider the perspective, develop an argument, find credibility or resources to back it up
defend your view.”
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“You learn many more ways to look at a critical subject and not just the book’s view or the teacher’s.”

“It helped me understand the issues better.”
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.
Things an advocate can provide informally:

Moral support

Sense of belonging
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Self-esteem
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Recognition of competency and mastery
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Practical aid

Safe environment
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”
Sympathy – feeling sorry another person.
Empathy ≠ Sympathy
Avoid patronizing speech – remarks that
reflect stereotypes of incompetence and
dependence.
Avoid infantalization – e.g., using terms of
endearment, using simple language, etc.
Bernie’s Travels
1. Attended McBride HS -- all-conference and all-district as
a senior.
2. Attended UMSL – 3-year starter, 5th in career scoring,
senior co-captain and MVP in 1971-72.
3. Assistant coach at McCluer North HS 1972-1974.
4. Head coach at McCluer High 1974-1975 – Class 4A State
Champions.
5. Returns to UMSL as Asst. Coach, 1975-1977.
6. Head Coach Jefferson College, 1977-1985 – 182-69
record, eight 20-win seasons, Region 16 East finals 5
times.
7. Moves to Murray State (Ky.) 1985-1989 as recruiting
coordinator—1988 NCAA tournament, 1989 NIT.
8. Southwest Missouri State Assistant Coach, 1989-1992.
9. SMS Head Coach 1992-1995 – 48-37 record, NIT.
10. Assistant Coach New Mexico State -- 1996
11. Head Coach at Kirkwood High in St. Louis -- 1997
12. Head Coach at University of Missouri-St. Louis -- 1999
“We need to meet all kinds of people so that we
can find ourselves. Young people need older
people just as older people need young people in
order to become more themselves and more
human. That humanizing process will teach us
that there is a child behind the mask of each
older face, just as there is already an older
person behind the mask of each young face.”
– Leo. E. Missinne (1990)