chapter 5 Flashcards

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1
Q

Person–Environment Interactions

A

Behavior is a function of both the person and the environment

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2
Q

Developmental Trends in Psychometric Intelligence

A
Kurt Lewin (1936) 
B = f(P, E),
	where
	B = Behavior
	P = Person
	E = Environment
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3
Q

Competence

A

is the theoretical upper limit of a person’s capacity to function. into five domains: physical health, sensory-perceptual skills, motor skills, cognitive skills and ego strength

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4
Q

Environmental press

A

refers to the physical interpersonal, or social demands that environments put on people.
ex:
physical demands: walk up 3 stairs to you apartment
interpersonal demands: adjusting your behavior patterns to diff. people

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5
Q

Adaptation level:

A

Where behavior and affect are normal

press level is average for a particular level of competence

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6
Q

Zone of maximum performance potential

A

A slight increase in press improves performance

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7
Q

Zone of maximum comfort

A

Created by slight decreases in press

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8
Q

Lawton and Nahemow’s model suggests that behavior

  • Proactivity
  • Docility
A

depends on one’s competence level in an environment with a particular level of environmental press.

-Proactivity is choosing new behaviors to meet new desires or needs. (exert control over their lives)
-Docility is allowing the situation to dictate the options.
(little control over their lives)

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9
Q

Preventive and Corrective Proactivity (PCP) Model
Two types of proactive adaptations
Life stressors and

A

Life stressors and lack of good congruence in person–environment interactions result in poor life outcomes.

Two types of proactive adaptations:
Preventive adaptations—actions that avoid stressors and increase or build social resources. ex: making more friends
Corrective adaptations—actions taken in response to stressors and can be facilitated by internal and external resources. ex: changing diet after heart attack

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10
Q

Stress and Coping Framework

A

Interaction with the environment can produce stress (Lazarus, 1984).

-Adaptation depends on perception of environmental stress and the attempts to cope. (situations can be evaluated as Harmful, beneficial, or irrelevant )

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11
Q

If harmful, what is the coping mechanism and response? Outcome positive or negative?

A

if harmful people show a range of coping mechanisms to avoid harmful situations. coping outcomes can be either r positive negative depending on contextual factors

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12
Q

Schooler (1982):

A

the presence of social support systems affected the likelihood that particular situations would be defined as threatening.

ex: living alone=viewed more stressful
living nearby friends=less stressful, more supported

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13
Q

Everyday competence

A

is a person’s potential ability to perform a wide range of activities considered essential for independent living.

  • Broader than just ADL or IADL
  • Necessary determinate for whether an elderly person can take care of themselves
  • Behavior is expressed in a particular environmental context and researcher need to pay heed to cultural and contextual differences in everyday competence.
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14
Q

Willis has developed a model that incorporates all the key ideas discussed above.
Antecedents
Components
Mechanisms

Outcomes of everyday competence

A
  • Antecedents: involve individual and sociocultural factors
  • Components: involve intraindividual and contextual factors
  • Mechanisms: involve factors that moderate the way in which competence is expressed
  • Outcomes of everyday competence: psychological and physical well-being (future competence related to current competence)
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15
Q

ecology of aging

A

seeks to understand the dynamic relations between older adults and the environments they inhabit

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16
Q

Aging in Place

A
  • Balancing environment press and competence through selection and compensation
  • Being able to maintain independence
  • Feeling “at home”-> self-identity=attachment
  • Cluster housing=combing aging in place philosophies with supportive services
  • —-consists of a residential-like setting that provides a range of care
  • —-lower cost alternatives and emphasizes individual choice
17
Q

competence environmental press has two options

A

lower environmental press or increase competence develop new skills
or do both with home modification

18
Q

Home Modification & Examples (look for pictures of these examples online)

A

Helping people deal with tasks of daily living by modifying the environment

  • Hook for car keys near the door
  • Hand rails in bathrooms
  • Door handles that are easier to grasp
  • Widening doorways
  • Lowering countertops
  • Wheelchair ramps

-An emerging home modification is the accessory dwelling unit (ADU).=seperate dwelling next to families main dwelling to give some independence

19
Q

Adult Day Care
Designed to
Goal is to
three types

A
  • Designed to provide support, companionship, and certain services during the day
  • Goal is to delay placement in more formal care setting.

three types

  • Social services, meals, recreation, and minor health care
  • More intensive health care, therapy, for serious medical problems
  • Specialize care for dementia or developmental disabilities
20
Q

Congregate Housing

A

Apartment complex for older adults

  • Shared meals
  • Affordable

Differs from assisted living in level of services
Residents must be capable of independent living and
-not require continual medical care
-know where they are and oriented to time
-no evidence of disruptive behavior
-able to make independent decisions
-be able to follow specific service plans.

-provide only housing or housing + medical services

21
Q

Assisted Living

Has these essential attributes:

A

A supportive living arrangement for people who need assistance with personal care but are not physically or mentally impaired to require 24-hour care. (not meant to deal with high intensive nursing care, foster autonomy/indepencence

Has these essential attributes:

  • As much like a single family house as possible
  • Emphasizes personal control, choice, dignity, and autonomy
  • Should meet routine services and special needs
22
Q

Assisted Living

  • Utilize
  • Generally
  • ;ack of
A

-Utilize checklist to ensure the selected facility meets specific requirements of the individual

  • Generally smaller and cost less
  • Medicaid may subsidize if individual’s financial situation merits.
  • Government assistance is expected to be limited in the future.

-Lack of regulations over quality of care
Sense of well-being is -higher with control over decisions and establishing stronger relationships.

23
Q

Types of Nursing Homes

A

nursing home is a type of long term care

There are four types of nursing homes:
-Intensive skilled- 24 hour care of residents needing constant or complicated medical procedures

  • Skilled nursing and rehabilitation-24 hr care under direct supervision of a physician, day to day services of nurse
  • intermediate care-24 h4 care, nurse supervision, less intense level, long term physical or emotional illness

Custodial care -all nonmusical services a facility provides, feeding assistance with ADLS.

The difference between the types of nursing homes is the number of health care works on staff.

24
Q

Who is Likely to Live in Nursing Homes?

A

Characteristics of People most likely to be placed in a nursing home
-Very old (typically over age 85)
-European American female
Financially disadvantaged
-Widowed or divorced
-Has lived in a nursing home for more than a year
-Has no children or siblings nearby
-The number of older adults of color in nursing homes is increasing

25
Q

Health issues and functional impairment in nursing home

A

-Average resident has significant mental and physical problems.
Main reason for placement (80%)
-One-third of residents have mobility, eating, or incontinence problems.
-30 to 40% show signs of clinical depression.
-Placement may be due to cost of care.

26
Q

Characteristics of Nursing Homes
Goal is to

Nursing home quality initiative

A

The competence-environmental press model
Goal is to find the optimal level of environmental support for people of low levels of competence.

Nursing home quality initiative
Quality of life for residents
Quality of care
Safety and other issues

27
Q

In selecting a nursing home relatives should keep the following in mind:

A
  • Level of skilled nursing care
  • Be mindful if facility is primarily Medicare or Medicaid
  • Is the director and upper staff fully licensed?
  • Is the care plan put in place by professionals?
  • Ask questions about staff educational levels and staff turnover.
28
Q

(considered best practice today)

A

Person-centered care planning -best nursing home

  • Based on promoting residents’ well-being through increasing their perceived level of personal control and treating them with respect
  • Focus on the individual
  • Involves a team who knows and cares
  • Residents show an improvement in well-being and activity level, live longer, and decrease in the need for certain medications and soft restraints with this approach.
29
Q

Special Care Units

A

-Supportive environment for people with moderate to severe dementia requires certain specialized design and intervention features.

  • Help people function at the highest level possible
  • Special training in working with persons with dementia
  • Design elements that take functional limitations into account (e.g., memory aids like color-coded halls)
  • Residents wear wrist or ankle bands that trigger alarms.
30
Q

Selecting the Right Special Care Units That Provide Research-Based Staff Training

A
  • Effective communication
  • Behavioral management techniques
  • Appropriate methods for assisting with personal health and hygiene
  • Appropriate methods for dealing with incontinence
  • Appropriate techniques for handling sexuality
  • Effective techniques for controlling wandering
  • Appropriate ways of supervising eating
  • Appropriate techniques and interventions to address memory failure and disorientation
  • Appropriate techniques for assisting with mobility
31
Q

Can a Nursing Home Be a “Home”?

-What can be done to foster the sense of “home”?

A
  • What can be done to foster the sense of “home”?
  • Being included in the decision and selection of a specific nursing home
  • Having prior knowledge of, and positive experience of a specific facility
  • Defining the home in terms of family and social relationships rather than place, objects, or total autonomy
  • Establish a continuity between home and nursing home
  • Reminiscing about home may facilitate adjustment
32
Q

How Not to Communicate with Residents
Patronizing speech
Infantilization or elderspeak

A

Patronizing speech
-inappropriate speech based on stereotypes of incompetence and dependence

Infantilization or elderspeak

  • Inappropriate use of first names
  • Terms of endearment— “Honey” “Sweetie”
  • Assumption of greater impairment than may be the case
  • Cajoling to demand compliance
33
Q

Decision-Making Capacity and Individual Choices

  • How well can nursing home residents make decisions regarding their care?
  • Assessing a person’s capacity to make medical decisions is
A
  • Cognitive impairment(hard form them to make decisions let family members decide)
  • Patient Self-Determination Act (PSDA)=
  • Provide written information at time of admission concerning their right to make treatment decisions

-Assessing a person’s capacity to make medical decisions is difficult and often done during times of crisis.
Living will
Patients normally give the decision to family members.

34
Q

New Directions for Nursing Homes

the Eden Alternative

A

the Eden Alternative

  • Starts from the premise that skilled care environments are habitats for people rather than facilities for the frail
  • Operates under 10 principles
  • protect dignity of each person
  • account for the bulk of suffering by different strategies
35
Q

New Directions for Nursing Homes

-green house project

A
  • Radical departure from the idea of large residential facilities
  • Encourages residents to participate in their care through helping with daily tasks
  • Personal dignity is maintained and quality of life is improved.
  • make it feel like home
36
Q

New Directions for Nursing Homes

The Pioneer Network

A
  • Similar values to Eden Alternative
  • Older persons are valuable to society
  • Treating all people with dignity