4 - Social changes

Question 1

Marital satisfaction remains high until…

Answer 1

• Health problems begin to interfere with the relationship
  → increases shortly after retirement, but then decreases with health problems (when one of the partners gets a chronic condition or disease that may be very difficult to manage, p.ex dementia) and advancing age

Question 2

Marriage satisfaction is directly related to level of ___ ___; it is less related to the amount of ___ ___ or ___, but to the degree of ___ ___

Answer 2

Perceived support; sexual interest or activity; social engagement

Question 3

True or false: Marriage helps people deal with chronic illness, functional problems, and disabilities

Answer 3

True

Question 4

Older couples have reduced potential for marital ___ and greater potential for ___. Elaborate on this

Answer 4

Conflict; pleasure
→ there is a positivity affect with older adults, also because they’ve been together for a long period of time and have learned to adapt to changing situations and problem solve together - develop coping strategies and adaptive ways to avoid conflict and to grow more alike

Question 5

True or false: Marital satisfaction remains the same in relationships with a chronically ill person as when both people in the relationship are healthy.

Answer 5

False: Marital satisfaction is much lower in relationships with a chronically ill person
→ p.ex: one person needs care while the other remains healthy
→ chronically ill meaning someone who needs to be cared for by the other person
→ but there can always be small rewards that come with it, but these aren’t very frequent

Question 6

Explain what occurs in a marriage when one person needs to care for their partner.

Answer 6

• Caring for a partner can be difficult because the caregiver assumes new roles after decades of shared responsibilities
• Depending on the condition, it can completely change the relationship you had
  → the person can have a shift in temperament very quickly
• The caring partner sees a loss of companionship, intimacy, and emotional support

Question 7

What occurs during widowhood?

Answer 7

• Because our spouse tends to be biggest form of social support, losing them will increase social isolation
• Spousal death increases risk for morality in the other spouse for up to 10 years
• Women are more likely to be widowed than men
  → can be very lonely, this is why friendships are especially important
• Widows (females): have more financial difficulties (may then cohabitate or re-marry)
  → often because they have lower pension amounts and rely on their husband’s pension
• Widowers (males): recover more slowly unless they have strong social supports
  → report decreases in self-esteem, but if their partners have passed away and can carry on with their responsibilities, it can boost their self-esteem

Question 8

How does social isolation play into older adulthood?

Answer 8

• Lack of social interactions and meaningful relations that can lead to feelings of loneliness and diminished quality of life
  → 19.3% of adults aged 65 and older report feelings of loneliness
• Many older adults report being social isolated and experience loneliness
• Social isolation negatively affects quality of life, physical health, and mental well-being
• Can be exacerbated or diminished by certain factors or events
  → p.ex: losing finances, kids ends up taking your money, grandchildren don’t wanna speak with you
  → these can lead to depression and cognitive decline down the way

Question 9

What happens in older adulthood with kids vs. without kids?

Answer 9

• Those without children may experience a feeling of incompleteness, lack of care, and lack of informal support
  → Many older adults report being social isolated and experience loneliness
  → those without kids create their own network of friends and report high life satisfaction and happiness and have the same satisfaction as married people with kids, however there is little research done of people without children
  → They form strong bonds with siblings, cousins, nieces, and nephews as well as siblings, neighbors, and close friends
• Social isolation negatively affects quality of life, physical health, and mental well-being
• Can be exacerbated or diminished by certain factors or events

Question 10

What is the primary source of social support for older parents?

Answer 10

Their adult children

Question 11

Friendships are most important for…

Answer 11

High life satisfaction and well-being in youth and older age

Question 12

Do older adults get more enjoyment visiting friends or family? Why is this?

Answer 12

• Friends
  → you get to pick your friends but not your family, your friends are more relatable because you grew up in the same era
  → visiting with family is like a sense of obligation, they might not be doing so out of choice, however when seeing a friend it’s more voluntary
  → they tend to have more in common with friends like shared interests
  → Friendships result in a more positive happy feeling and increase our positive outlook vs. family
  → great for discussing health concerns, to turn to when lonely or sad, but many still are hesitant to talk about health issues or sharing financial insecurity with friends

Question 13

Having at least __ friend reduces social isolation.

Answer 13

One

Question 14

True or false: The amount of support one gets from their social circle does not change across generations.

Answer 14

True

Question 15

Life satisfaction is strongly correlated with the ___ and ___ of friendships.

Answer 15

number; quality

Question 16

Why are older adult friendships particularly important?

Answer 16

→ friendships can help foster independence by providing transportation, checking in on neighbors, helping out with household tasks
→ most importantly, they provide a lot of support during the death of a loved one or during retirement as well

Question 17

Older ___ have more numerous and intimate friendships than older ___ (as is with younger men and women).

Answer 17

women; men

Question 18

How do siblings influence older adulthood?

Answer 18

• The supportive role of a sibling change throughout our lives, and most people report having positive and frequent contact with siblings
• Older women tend to have more active sibling ties (than men), and ties between sisters are stronger than others
• Tend to provide support after the loss of a partner (widowhood) and provide emotional support
• Siblings tend to engage in more mutual assistance than friendships (with practical tasks, managing health issues, coordinating medical care, providing physical support during illness and recovery, etc.)
• Their shared history and experiences can be comforting, especially as they face age related changes and losses

Question 19

What are the 2 dimensions that influence grandparents?

Answer 19

1) Social dimension: includes societal needs and expectations of what grandparents should do
→ some grandparents adhere to this and try to “meet their quota”
→ some grandparents just tend to do it naturally, i.e., they want to see their grandkids and have fun with them
2) Personal dimension: includes personal satisfaction and individual needs of the grandparents
→ so they may feel pride and satisfaction with helping their grandkids grow, improving their lives

Question 20

How does being a grandparent influence a person in their old age?

Answer 20

• Being a grandparent is meaningful for both the grandparent (generativity) and child
  → generativity: guiding the next generation contributing to society
  → grandkids get positive things out of this; more likely to see their grandparents as role models as they age, children see the positive and the negative because they see you helping them and take care of them, which can both be stressful and rewarding

Question 21

How do ethnic differences playing into grandparent-hood?

Answer 21

• There are ethnic differences
  → p.ex: in african-american and latino families, the grandparents play an important role in the grandchildren’s lives such as religion, story-telling, etc.
  → provide a great deal of care and continue on the cultural values and passing on traditional values (teaching them a language) – helps meet this generativity

Question 22

What are the 3 main sources of satisfaction and meaning in great-grandparents?

Answer 22

1) A sense of personal and family renewal
→ sense of integrity, renewing their sense of excitement for life and the continuity of their lineage
2) They provide new diversions in their lives
→ new people with whom they can share their experiences
3) Grandparenthood is a major milestone
→ mark of longevity that most people never achieve

Question 23

What are the 7 types of elder abuse?

Answer 23

1) Physical: physical force that inflicts harm
2) Sexual: unwanted or non consensual contact of any kind
3) Emotional: infliction of anguish, distress, pain
4) Financial: includes illegal or improper use of an older adults funds, property or assets
5) Abandonment: desertion of an older adult by someone who had physical custody or was caring for the older adult
6) Neglect: refusal or failure to fulfill any part of a person’s obligation or duties to an older adult
7) Self-neglect: behaviours of an older person threaten their health or safety, excluding those people who make a voluntary and conscious decision - excludes people with cognitive decline, don’t have executive decision making

Question 24

What type of elder abuse is most common?

Answer 24

• Neglect
  → this can happen at home (family member neglects you) or at a long-term care facility
  → it’s a single or repeated act or lack-there-of occurring within any relationship where there is an expectation of trust, which essentially causes harm or distress to an older person

Question 25

What is granny dumping?

Answer 25

• Right before some type of holiday or event, an elder would arrive in ER with a packed suitcase for a brief stay over the holiday season because they’ve been rendered “inconvenient” during this time of year – this could be their own decision
  → this could be considered abandonment, neglect or self-neglect (if they are unaware of where they should stay), could also be emotional or financial if they feel like a burden or are distressed about being alone for a holiday

Question 26

Define a stereotype.

Answer 26

• Stereotypes are an exaggerated and often prejudiced view of a type of person or group of people
  → p.ex: when you think of older adults like kids because you start having to watch over them a lot more often
• Stereotypes may have some basis in truth, but they are exaggerated and distort the truth, often leading to discrimination
• Stereotypes can be both positive and negative
  → typically when a person has a stereotype about a group and they meet one person that differs from it, they place that person as the exception, rather than adjusting the stereotype

Question 27

What is an age-based double standard?

Answer 27

• When we attribute an older person’s failure as more serious than if it was seen in a young adult (p.ex: memory loss)

Question 28

True or false: Younger adults have a much more positive view of aging compared to older adults

Answer 28

False: Older adults have a more positive view
→ Older adults will assess a memory failure in the same way as younger adults but in a more positive light

Question 29

What happens when an older adult believes a stereotype about themselves?

Answer 29

• They incorporate it into their belief structure about themselves it has negative consequences
  → affects cognitive performance, physical well-being, loss of brain volume associated to memory in the hippocampus (stereotype threat)

Question 30

What is elderspeak? Where does it stem from? Give examples of it.

Answer 30

• Elderspeak is when someone uses simplified speech to talk to an older adult
  → resembling baby-talk but towards an older adult
• Elderspeak stems from stereotyping older people as slow-witted or low mental ability
  → Using a singsong voice, changing pitch and tone, exaggerating words
  → Simplifying the length and complexity of sentences
  → Speaking more slowly and with a limited vocabulary
  → Repeating or paraphrasing what has just been said
  → Using terms like “honey” or “dear”
  → Using statements that sound like questions

Question 31

True or false: Elderspeak affects older adults evaluation of their abilities.

Answer 31

True; It can reinforce negative stereotypes about aging and erode older adults’ self-esteem
→ Elderspeak has a negative effect on the older persons, creating low self-esteem, reducing the person’s ability to communicate effectively, decreases the quality of the interaction, and reduces the older person’s sense of control

Question 32

How do most aspects of elderspeak decrease comprehension?

Answer 32

→ It is confusing when a word is exaggerated
→ It is hard to understand a statement that sounds like a question
→ Talking too slowly affects the listener’s ability to focus on the main point and retain information

Question 33

What is ageism? How does it affect older people? Where does it come from?

Answer 33

• Ageism refers to prejudice against someone based on their age
• Ageism has negative effects on an older persons’ self-image
• stereotypes and elderspeak can lead to ageism
• 6/10 older adult Canadians report being “treated unfairly or differently because of their age”
  → “Ignored or treated as though they are invisible”
  → Treated as if they had “nothing to contribute”
  → “Older adults are incompetent”
• Ageism stems from: 1) the young and middle-aged distaste for aging and 2) the lack of knowledge about aging

Question 34

The negative views of ageism come from many sources, such as…

Answer 34

→ Children’s literature
→ Books in general (show older adults in a negative light)
→ Television / media

Question 35

Ageism is often present in the workplace – with __% of older adults experiencing some type of workplace ageism.

Answer 35

80%

Question 36

__% of people agree that older people are less valued; __% agree that older adults are a burden to society.

Answer 36

70; 20

Question 37

What are ways we can reduce ageism?

Answer 37

1) Increasing the amount of knowledge people have of aging
2) Increasing contact between older adults and the rest of the population
→ these people have less stereotypes (stereotypes increase when we have little or no knowledge about or contact with the group)
- people with more knowledge about it have less anxiety about aging

Question 38

What are some changes in health issues seen in older adulthood?

Answer 38

• Changes in health in older age depend on habits (smoking, alcohol), income, environment (3rd-world), personal history (family issues p.ex), and social supports (access to medical services)
• Older adults report more chronic illnesses than younger adults and previous generations (90% of those 65+ have at least one chronic condition)
• Older adults with lower incomes suffer from higher rates of chronic illnesses
• Older adult women have higher rates of many chronic illnesses such as hypertension or arthritis
  → attributed to biology and genetics
  → females do tend to seek medical help more often than men though which could lead to a higher rate of diagnosis

Question 39

How do functional limitations influence old adulthood?

Answer 39

• Chronic conditions/illnesses can lead to functional disability or a limitation in the performance of normal activities due to illness or injury
  → some disabilities impair some functions more than others
• Community services can help with these limitations (e.g., busses that lower to the ground) but not enough services exist
  → p.ex: more help with everyday house work
• Main causes of disability in older adults include foot problems, arthritis, cognitive impairment, heart problems, and vision

Question 40

What are the 3 main ways to decrease the effects of physiological change?

Answer 40

1) Changes in the environment
→ Ground level or one-floor homes; Home renovations to improve safety (p.ex: bathtub with bars, sliding door into bath..)
→ Special designs in facilities (colour coding certain areas)
→ Changing how we speak to an older adult with hearing loss
2) Improvements in technology
→ Can be simple or complex improvements
→ Can help with health issues, ADLs, IADLs, or sensory declines
→ Computer advancements help with access to medical information
→ Assistive devices can improve a wide range of functional limitations; p.ex: battery powered tub seat which lifts someone into the tub, pacemaker, etc.
3) Changes in Lifestyle
→ Smoking cessation; Exercise; Diet; Stress reduction

Question 41

Define frailty.

Answer 41

• Older adults who have physical disabilities, are very ill, have cognitive or psychological disorders, and need assistance with everyday tasks
  → could not maintain good physical and cognitive health
  → tend to have multiple health issues
  → although it’s a minority group, it does increase with age

Question 42

What are ADL’s?

Answer 42

Activities of Daily Living
- Basic self care tasks such as eating, bathing, toileting, walking, and dressing
→ if someone needs help with more than one ADL, they are considered frail

Question 43

What are IADLs?

Answer 43

Instrumental activities of daily living
- Actions that require some intellectual competence and planning
- Can differ across cultures; in western culture, it would be considered needing help with shopping, managing and attending appointments, etc.
→ in other cultures it may be caring for animals, tending to crops, making bread, etc.
→ this is why ADL’s are more common, because they tend to be stable across cultures

Question 44

What are PLIMs?

Answer 44

Physical limitations;
- Activities that reflect functional limitations such as walking (around the block) or sitting (around 2 hours)
→ insightful into determining underlying problems that someone might be having and limitations in these activities typically increase rapidly as someone nears death

Question 45

Diagnosis of frailty is based on 3+ of 5 key signs and symptoms; what are these?

Answer 45

1) Weakness
2) Slow walking speed
3) Low level of physical activity
4) Fatigue or exhaustion
5) Unintentional weight loss
→ physicians typically understand that frailty as a dysregulation across multiple systems , so it makes it much people for people who are frail to overcome further challenges or illness (p.ex: covid)

Question 46

What are factors influencing frailty?

Answer 46

• Smoking, heavy drinking, physical inactivity, depression, social isolation, and perceived poor health
  → limit your ability to partake in certain activities
• Lower SES (socio-economic status) is associated with increased rates of disability and lower health-related quality of life than those in higher SES groups
  → higher rates of cancer, cardiovascular disease, diabetes, obesity, all of which in the end result in higher rates of disability and later on, death
• Higher rates of disease and disability are higher in low-income countries and among women
  → but even in the US, they already have higher rates of chronic conditions and functional impairments when compared to places like England and Canada
  → comes down to a lack of access to health care

Question 47

_ in _ older adults fall each year

Answer 47

1 in 3

Question 48

Falls are strongly associated with…

Answer 48

• illness, poor balance, medications, and cognitive impairment
  → all of which can be categorized if you are frail, and the chances of developing each one

Question 49

Falls make up __% of older adult hospital admissions.

Answer 49

85%;
→ a lot of typical behaviours, such as climbing a ladder can now be very dangerous
→ can lead to pain, loss of independence

Question 50

How can older adults reduce fall risk?

Answer 50

• Similar to reduce frailty, which means avoiding alcohol, maintaining good health and diet, watching medication usage
• Fall prevention programs can also reduce fall risk
  → balance training, tai chi, can reduce the fall risk by 12 - 20%

Question 51

True or false: The more you fall, the more likely you are to be categorized as frail.

Answer 51

True