Late Adulthood Human Behavior in the Social Environment: A Multidimensional Perspective Unit 9 LATE...

Late AdulthoodLate Adulthood

Human Behavior in the Human Behavior in the Social Environment: A Social Environment: A

Multidimensional PerspectiveMultidimensional PerspectiveUnit 9Unit 9

LATE ADULTHOODLATE ADULTHOOD

Chapter 12Chapter 12

No quiz this week.No quiz this week.

Let’s take a quick look at the Let’s take a quick look at the directions for your final project.directions for your final project.

Final ProjectFinal Project Due at the end of Unit 9.Due at the end of Unit 9.

Project Objective: Illustrate your knowledge Project Objective: Illustrate your knowledge of the course material.of the course material.

Summarize and evaluate the influences of Summarize and evaluate the influences of the environment on Luis’s behavior.the environment on Luis’s behavior.

Please review the rubric.Please review the rubric.

Late AdulthoodLate Adulthood

Late AdulthoodLate Adulthood

Developmental ThemesDevelopmental Themes

Late Adulthood (65-death)Late Adulthood (65-death) Erikson’s theory: Erikson’s theory: INTEGRITY versus DESPAIRINTEGRITY versus DESPAIR

Integrity is defined as the ability to integrate or Integrity is defined as the ability to integrate or satisfactorily blend one’s history and experience with the satisfactorily blend one’s history and experience with the task of evaluating & accepting one’s life.task of evaluating & accepting one’s life.

The oldest old (85+) & minority elders are the fastest The oldest old (85+) & minority elders are the fastest growing agesgrowing ages

Leaving a legacy is an important goal for many in later lifeLeaving a legacy is an important goal for many in later life

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Developmental ThemesDevelopmental Themes

General Characteristics of older adults by subperiodGeneral Characteristics of older adults by subperiod Young-old (65-74) - Young-old (65-74) - The young-old typically remain active in the The young-old typically remain active in the

community & maintain strong ties with families & friends community & maintain strong ties with families & friends

Middle-old (75-84) - Middle-old (75-84) - More in this age group experience chronic More in this age group experience chronic disease (arthritis, cardiovascular, respiratory, circulatory) disease (arthritis, cardiovascular, respiratory, circulatory)

Old-old (85+) Old-old (85+) - A predominant number of this group is dependent, - A predominant number of this group is dependent, frail & experiencing more disabilities & chronic illnessesfrail & experiencing more disabilities & chronic illnesses

Source: Based on Hartford (1985).

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Theories of AgingTheories of Aging

Source: Based on Hartford (1985).

Continuity theory:Continuity theory: emphasizes that people change less with aging than emphasizes that people change less with aging than they stay the same. Adaptation to changes that occur with age is done they stay the same. Adaptation to changes that occur with age is done using familiar strategies from the person’s pastusing familiar strategies from the person’s past

Activity theory: Activity theory: applies social role theory to late life. Older people applies social role theory to late life. Older people experience greater subjective well-being when they continue to be active in experience greater subjective well-being when they continue to be active in many roles. many roles.

Disengagement theory: Disengagement theory: disengagement occurs in late adulthood through disengagement occurs in late adulthood through the process of mutual withdrawal of the person and of society. the process of mutual withdrawal of the person and of society.

Socioemotional selectivitySocioemotional selectivity: as people age, familiar and reliable : as people age, familiar and reliable relationships become more important. People regulate emotions and relationships become more important. People regulate emotions and conserve energy by selecting with whom to invest their emotional energies. conserve energy by selecting with whom to invest their emotional energies.

Which of the theories relates to Carmen Perez?Which of the theories relates to Carmen Perez?

Late AdulthoodLate Adulthood

Biological DimensionBiological Dimension

Biophysical growth and developmentBiophysical growth and development Health care and medications Health care and medications Sexuality Sexuality Implications for practice: sexuality in late adulthoodImplications for practice: sexuality in late adulthood

Biophysical strengths and hazardsBiophysical strengths and hazards Chronic health problemsChronic health problems Death and dyingDeath and dying Advance directives for health careAdvance directives for health care Implications for practice: End-of-life careImplications for practice: End-of-life care

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Psychological DimensionPsychological Dimension

Cognitive Development & Information Cognitive Development & Information ProcessingProcessing

Selective Optimism & CompensationSelective Optimism & Compensation- - Focuses on ways the older self is able to cope & Focuses on ways the older self is able to cope & maintain integrity despite declines in reserve maintain integrity despite declines in reserve capacitiescapacities

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Cognitive Development & Cognitive Development & Information Processing Information Processing

Fluid Intelligence Fluid Intelligence -Abstract reasoning ability or -Abstract reasoning ability or “native intelligence”“native intelligence”• Does this increase or decreases with age?Does this increase or decreases with age?

Cystallized Intelligence Cystallized Intelligence -- Accumulated Accumulated information & verbal skillsinformation & verbal skills• Does this increase, decrease or remain stable with Does this increase, decrease or remain stable with

age?age?

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Common Myths Associated with Common Myths Associated with Mental ImpairmentMental Impairment

NORMALNORMAL Temporarily forgetting a Temporarily forgetting a

colleague’s namecolleague’s name

Having a word on the tip of the Having a word on the tip of the tonguetongue

Misplacing objects in moments of Misplacing objects in moments of distractiondistraction

Forgetting for a moment where Forgetting for a moment where you’re goingyou’re going

Having trouble balancing the Having trouble balancing the checkbook accuratelycheckbook accurately

Temporarily forgetting the day of Temporarily forgetting the day of the weekthe week

Possibly Alzheimer’s or DementiaPossibly Alzheimer’s or Dementia Not being able to recall the name laterNot being able to recall the name later

Substituting strange words for forgotten Substituting strange words for forgotten wordswords

Misplacing things in unusual places & Misplacing things in unusual places & having no memory of putting them therehaving no memory of putting them there

Getting lost on your own streetGetting lost on your own street

Forgetting how to add or subtract Forgetting how to add or subtract numbersnumbers

Not knowing what season or year it is, Not knowing what season or year it is, even after thinking about themeven after thinking about them

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Attitudes & Emotions: Attitudes & Emotions: Loss, Grief & MourningLoss, Grief & Mourning

Factors that may affect experience, behavior Factors that may affect experience, behavior & adaptation in loss& adaptation in loss

ENVIRONMENTAL OR EXTRINSIC FACTORS• Personal losses or gain• Social forces• Socioeconomic adversities• Unwanted retirement• Cultural devaluation of older persons

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Attitudes & Emotions: Attitudes & Emotions: Loss, Grief & MourningLoss, Grief & Mourning

Factors that may affect experience, behavior Factors that may affect experience, behavior & adaptation in loss& adaptation in loss

INTRINSIC FACTORS• Nature of personality• Physical diseases• Age-specific changes• Experience of bodily dissolution and approaching death

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Loss, Grief & MourningLoss, Grief & Mourning Four Tasks Essential to Mourning A Loss:Four Tasks Essential to Mourning A Loss:

1. ACCEPT THE LOSSACCEPT THE LOSS: Initially people deny the reality of death, so the first task is to accept that the loved one is gone & will not return

• Often people display searching behaviors (seeing the loved one in a crowd or hearing their voice)

2. FEEL THE PAINFEEL THE PAIN: Many ask after the death of loved one “When does the pain go away?” But pain cannot be avoided & if not dealt with at the time of death, it may resurface later

• Bereaved individuals need to externalize the pain by talking about the death & the loved one

• Group therapy can be helpful to facilitate this

Source: Worden, (2002).Source: Worden, (2002).

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Loss, Grief & MourningLoss, Grief & Mourning 3.3. ADJUST TO THE NEW ENVIRONMENT:ADJUST TO THE NEW ENVIRONMENT:

External adjustments include dealing with practical realities External adjustments include dealing with practical realities & loss of social roles& loss of social roles

Internal adjustments may relate to the person’s identity as Internal adjustments may relate to the person’s identity as a child or a partner of the person who is deceaseda child or a partner of the person who is deceased

Spiritual adjustments, coming to some understanding of Spiritual adjustments, coming to some understanding of the meaning of the person’s life & the loss, need to be the meaning of the person’s life & the loss, need to be made.made.

4.4. FIND A WAY TO MAINTAIN CONNECTION WITH THE FIND A WAY TO MAINTAIN CONNECTION WITH THE DECEASEDDECEASED

Source: Worden, (2002).Source: Worden, (2002).

Late AdulthoodLate Adulthood

Social DimensionSocial Dimension Families & GroupsFamilies & Groups

Parent-Child RelationshipsParent-Child Relationships

Communities & Support SystemsCommunities & Support Systems The Continuum of CareThe Continuum of Care

Social Strengths & HazardsSocial Strengths & Hazards Elder Abuse & NeglectElder Abuse & Neglect

Parent-Child Relationships

Increased health & longevity have complicated parent-child relationships, & there is considerable ambivalence about giving/receiving help & the changing roles

Caregiving is a broad term that may describe:• Hands-on assistance with activities of daily living• Helping to hire & manage professional caregivers• Making decisions about care for a parent who needs help • Overseeing the care a parent receives in a nursing home

Late AdulthoodLate Adulthood

Contributors to Resilience in Contributors to Resilience in Family CaregiversFamily Caregivers

Distancing from the care situation, physically & Distancing from the care situation, physically & emotionallyemotionally

Regular physical exerciseRegular physical exercise Keeping up personal hobbiesKeeping up personal hobbies Having at least one close confidant for emotional Having at least one close confidant for emotional

supportsupport Personal religious beliefsPersonal religious beliefs A philosophy of duty toward the parentA philosophy of duty toward the parent Sense of humorSense of humorSource: Adapted from Ross, Holliman & Dixon (2003).Source: Adapted from Ross, Holliman & Dixon (2003).

Late AdulthoodLate Adulthood

Communities & Support Systems: Communities & Support Systems: The Continuum of CareThe Continuum of Care

Long-term care- Long-term care- Medical & social interventions for Medical & social interventions for those who have chronic illnesses or impairments that are those who have chronic illnesses or impairments that are geared toward helping a patient live as satisfactorily as geared toward helping a patient live as satisfactorily as possible in an appropriate, least restrictive settingpossible in an appropriate, least restrictive setting

Senior living options:Senior living options: Independent living senior apartmentsIndependent living senior apartments Low-income-housing tax credit propertiesLow-income-housing tax credit properties Board & care homes or adult foster homesBoard & care homes or adult foster homes Freestanding assisted-living facilitiesFreestanding assisted-living facilities Continuing care retirement communitiesContinuing care retirement communities Nursing homesNursing homes

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Elder Abuse & NeglectElder Abuse & Neglect Elder abuse includes any mistreatment of older Elder abuse includes any mistreatment of older

adults, whether it is abuse or neglect, intentional or adults, whether it is abuse or neglect, intentional or unintentionalunintentional Physical Abuse, including Sexual AbusePhysical Abuse, including Sexual Abuse Emotional AbuseEmotional Abuse Financial ExploitationFinancial Exploitation

Self-Neglect occurs when an independent older Self-Neglect occurs when an independent older person is incapable of necessary self-care resulting person is incapable of necessary self-care resulting in being malnourished, dehydrated, dirty, ill or living in being malnourished, dehydrated, dirty, ill or living in a cluttered, unsafe environmentin a cluttered, unsafe environment Self-Neglect usually relates to dementia or psychiatric Self-Neglect usually relates to dementia or psychiatric

illness of an elder who lacksillness of an elder who lacks involved family nearbyinvolved family nearby

Late AdulthoodLate Adulthood

Risk Factors & Signs of Risk Factors & Signs of Elder Abuse & NeglectElder Abuse & Neglect

Presence of family member’s mental illness, or Presence of family member’s mental illness, or drug or alcohol abusedrug or alcohol abuse

Stressful life events for the family, such as Stressful life events for the family, such as financial loss, death, divorcefinancial loss, death, divorce

Cognitive impairment of the older person (more Cognitive impairment of the older person (more likely to be neglected)likely to be neglected)

Physical impairment/dependence on others for Physical impairment/dependence on others for physical needs (more likely to be abusedphysical needs (more likely to be abused

Late AdulthoodLate Adulthood

Risk Factors & Signs of Risk Factors & Signs of Elder Abuse & Neglect Elder Abuse & Neglect

Older person’s social isolationOlder person’s social isolation

Poor hygiene & nutritional status; obvious lack Poor hygiene & nutritional status; obvious lack of careof care

The older person appears hypervigilant or The older person appears hypervigilant or nervousnervous

The caregiver displays hostility & impatience The caregiver displays hostility & impatience toward the eldertoward the elder

Late AdulthoodLate Adulthood

Causes of Elder Abuse & NeglectCauses of Elder Abuse & Neglect Caregiver StressCaregiver Stress- Refers to situations in which the caregiver becomes - Refers to situations in which the caregiver becomes

overwhelmed by the demands of the dependent elderoverwhelmed by the demands of the dependent elder Caregiver may perpetrate abuse in a moment of anger/stress or may Caregiver may perpetrate abuse in a moment of anger/stress or may

neglect the person’s needsneglect the person’s needs Caregiver stress only accounts for a very small amount of abuse casesCaregiver stress only accounts for a very small amount of abuse cases Wolf (2000) cites multiple risk factors that cause elder abuse, including Wolf (2000) cites multiple risk factors that cause elder abuse, including

the earlier relationship of the victim & abuser, the abuser’s mental state the earlier relationship of the victim & abuser, the abuser’s mental state & the lack of appropriate alternative services or caregivers& the lack of appropriate alternative services or caregivers

Caregiver ImpairmentCaregiver Impairment- Refers to a caregiver’s mental illness, personality - Refers to a caregiver’s mental illness, personality disorder, or substance abuse & may involve more serious acts that are disorder, or substance abuse & may involve more serious acts that are perpetrated repeatedlyperpetrated repeatedly

Ecological Model of Elder AbuseEcological Model of Elder Abuse Views elder abuse as multidimensional & linked to other social Views elder abuse as multidimensional & linked to other social

problemsproblems

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Developmental Considerations for Developmental Considerations for Assessment in Late AdulthoodAssessment in Late Adulthood

ROUTINE OBSERVATIONS• Examples: Chronic health conditions; Chronic health conditions;

functioning in activities of daily living; functioning in activities of daily living; medications used & their side effects; medications used & their side effects; Opportunities to exercise; Mental status: Opportunities to exercise; Mental status: memory, judgment ; social and community memory, judgment ; social and community opportunities ; family support or conflictsopportunities ; family support or conflicts

Late AdulthoodLate Adulthood

Developmental Considerations for Developmental Considerations for Assessment in Late Adulthood Assessment in Late Adulthood

STRENGTHS & LANDMARKS OF STRENGTHS & LANDMARKS OF DEVELOPMENTDEVELOPMENT

• Examples: Examples: Maintaining interests & activities to Maintaining interests & activities to capability; interest in remaining as independent as capability; interest in remaining as independent as possible; interest in sexual expression & possible; interest in sexual expression & companionship; desire to leave a legacy; desire to companionship; desire to leave a legacy; desire to maintain family & friendship connections; may take maintain family & friendship connections; may take comfort in religious beliefs or spirituality comfort in religious beliefs or spirituality

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Developmental Considerations for Developmental Considerations for Assessment in Late AdulthoodAssessment in Late Adulthood

EXAMPLES: Physical vulnerability due to senescence of EXAMPLES: Physical vulnerability due to senescence of bodily systems; cognitive processing speed decreases; bodily systems; cognitive processing speed decreases; short-term storage & recall memory decreases; short-term storage & recall memory decreases; strengthening of religious beliefs (sometimes); selective strengthening of religious beliefs (sometimes); selective about appropriate activities & interests; may need to give about appropriate activities & interests; may need to give up drive; may need supportive end of life careup drive; may need supportive end of life care

DEVELOPMENTAL ISSUES DEVELOPMENTAL ISSUES

(NOT PROBLEMS) (NOT PROBLEMS)

Late AdulthoodLate Adulthood

Developmental Considerations for Developmental Considerations for Assessment in Late AdulthoodAssessment in Late Adulthood

EXAMPLES: Little affect; lack of interest or EXAMPLES: Little affect; lack of interest or enjoyment; talks of being worthless or being a enjoyment; talks of being worthless or being a burden; social isolation; slurred speech or burden; social isolation; slurred speech or otherwise not alert; walking unsteadily but without otherwise not alert; walking unsteadily but without cane or walker; possible alcohol misuse; repeats cane or walker; possible alcohol misuse; repeats same questions, gets lost, obvious memory loss; same questions, gets lost, obvious memory loss; signs of physical neglect- dirty, unkempt, bedsores; signs of physical neglect- dirty, unkempt, bedsores; signs of nutritional deficiency- too thin, little food in signs of nutritional deficiency- too thin, little food in the house, etc.the house, etc.

DEVELOPMENTAL OBSERVATIONS REQUIRING ATTENTION

Your final project is due at the end of Unit 9.

For Unit 10, please read the article titled, From Tragedy to Triumph: Counselor as Companion on the Hero’s Journey (the article is in DocSharing). I encourage you to post to the discussion board in Unit 10.

Thank you for a great term!