Terms for Revision

Question 1

Define Self-Determination Theory

Answer 1

Self-determination theory (SDT) is defined as a broad framework for the study of human motivation and personality. SDT provides a framework for the sources of motivation and a description of the respective roles of intrinsic and types of extrinsic motivation in cognitive and social development and in individual differences.

Question 2

What three basic psychological needs does Self-Determination Theory define?

Answer 2

SDT defines three basic psychological needs (ARC); autonomy, relatedness and competence.

Question 3

What happens when all three basic psychological needs are met?

Answer 3

When all these needs are met, it leads to increased interest, excitement and confidence which leads to overall better well-being, enhanced performance, heightened creativity and increased persistence.

Question 4

Define Autonomy

Answer 4

Autonomy is defined as the need to satisfy and explore interests. Optimal conditions to support development of autonomy include, non- controlling, directive or authoritarian environments (which stifle autonomy), i. e. environments that support involvement in problem-solving/decision making.

Question 5

Define Relatedness

Answer 5

Relatedness is defined as the need to feel attached and connected to others. Optimal conditions to support development of relatedness include, environments which nurture trust and interdependence and that recognise an individual’s feelings and perspectives.

Question 6

Define Competence

Answer 6

Competence is defined as the need to experience mastery and challenge. Optimal condition to support development of competence include, environments which provide opportunities for graded acquisition of skills and mastery, this is typically offered in environments which are nurturing and supportive of autonomy.

Question 7

Name the 6 types of motivation

Answer 7

1. Amotivation: Non-regulation
2. Extrinsic motivation: External Regulation
3. Extrinsic motivation: Introjected Regulation
4. Extrinsic motivation: Identified Regulation
5. Extrinsic motivation: Integrated Regulation
6. Intrinsic motivation: Intrinsic Regulation

Question 8

Describe Amotivation: Non-regulation

a) What is it
b) Contexts in which it occurs
c) Signs of this state

Answer 8

a) Lacking an intention to act
b) - An activity not being valued
- Lack of feelings of competence
- Belief that an activity will not result in a desired outcome
c) Behaviour: lack of persistence in activities/drops out
Language: why bother? It’s not worth doing. Too hard.

Question 9

Describe Extrinsic motivation: External Regulation

a) What is it
b) Contexts in which it occurs
c) Signs of this state

Answer 9

a) External controls/influence performance. These may be tangible (e.g. physical reward) or intangible (e.g. social approval, inducements). These may also include threats, penalties, deadlines, punishments.
b) - Reinforcement contingencies and external controls sustain behaviour
c) Language: reflects external control (e.g. I was made to do it. I will be allowed to this if I do that.

Question 10

Describe Extrinsic motivation: Introjected Regulation

a) What is it
b) Contexts in which it occurs
c) Signs of this state

Answer 10

a) Motivation for acting is dictated by a sense of obligation to others (which has been internalised). Feelings of self-esteem and ego are contingent on approval or disapproval (self or from others)
b) - Belief that an activity has little value
- External validation of performance is required
c) Behaviours: pressure self into performance, pride or self-disdain after others show approval/disapproval
Language: e.g. I could… I ought to… I should… I would.

Question 11

Describe Extrinsic motivation: Identified Regulation

a) What is it
b) Contexts in which it occurs
c) Signs of this state

Answer 11

a) Personal choice; engage with little external pressure/regulation. There is an internal disposition to act and a willingness to engage.
b) - Activity is seen as relevant and worth pursuing
- Low levels of external pressure/ control
c) Behaviours: likely to be self-initiated and maintained, likely to persist
Language: e.g. How can I? I can… I will.

Question 12

Describe Extrinsic motivation: Integrated Regulation

a) What is it
b) Contexts in which it occurs
c) Signs of this state

Answer 12

a) Integration of personal goals within the broader context (existing social values). The individual becomes part of an overall value system (full internalisation)
b) - Goals are important and relevant
- Person has intention to persist at an activity
c) Behaviours: puts in hard work to achieve goals, goal directed behaviour is integrated with other aspects of self
Language: similar to identified regulation; may make comments such as, ‘This is important to me; it will help me reach my long-term goal’.

Question 13

Describe Intrinsic motivation: Intrinsic Regulation

a) What is it
b) Contexts in which it occurs
c) Signs of this state

Answer 13

a) Fully internalised, self-determined participation in an activity
b) - occurs as three different types:
1. Motivation to know
2. Motivation to experience mastery/competence
3. Motivation to experience stimulation from sensory pleasure/through flow
c) Behaviour: self-initiated, self-directed, high levels of spontaneity/ excitement/ confidence/ persistence
Language: e.g. I want to do it again and again. I know what I need to do next.

Question 14

Define Self-concept

Answer 14

Self-concept is defined as a detailed set of ideas about how we perceive ourselves in relation to others and the environment. Self-concept is usually descriptive rather than evaluative.

Question 15

Define Self-esteem

Answer 15

Self-esteem is defined as how people evaluate themselves. It is the value the individual places on the attributes that contribute to his or her self-concept. Self-esteem is evaluative of the descriptive factors outlined in self-concept.

Question 16

Define Self-efficacy

Answer 16

Self-efficacy is defined as a belief in one’s ability to perform a given task successfully. Self-efficacy predicts the likelihood that someone will attempt a given behaviour and continue working at it, despite possible difficulties in new situations. Self-efficacy is not concerned with the actual skill itself, but with judgements about what one can do with the skills they have. Self-efficacy is one’s sense of competence and confidence regarding performance of a given task in a given domain.

Question 17

Describe the existential self including when this concept develops

Answer 17

The existential self regards the understanding of self as separate and distinct. It is contingent upon the interactions between infants and caregivers. The existential self develops in the first six months of life, and is established by 21-24 months of age, as children develop a sense of ‘me’.

Question 18

Describe the categorical self including when this concept develops

Answer 18

The categorical self regards the process of actively defining self (not just in opposition). The categorical self places the self in a range of categories based on comparison with others. The categorical self develops from about two years old. Factors such as size, gender, physical characteristics and abilities influence the categorical self.

Question 19

Name 2 strategies to improve low self-esteem

Answer 19

i. acknowledging and praising positive qualities

ii. challenging negative self-evaluations and negative core beliefs

Question 20

What are the key components of family?

Answer 20

The key components of family include structure, function, interactions and life cycle

Question 21

Describe the ‘structure’ component of family

Answer 21

Structure refers to the specific membership, beliefs, values and coping strategies that make a family unique.

Question 22

Describe the ‘function’ component of family

Answer 22

The function of a family refers to the tasks that families perform to meet the needs of the family members. Additionally, the function of the family dictates their reason for being together.

Question 23

Describe the ‘interaction’ component of family

Answer 23

The interactions of the family refer to the interrelationships between family members.

Question 24

Describe the ‘life cycle’ component of family

Answer 24

life cycle of a family refers to how the family changes over time as the experience normative (predictable events such as childbearing, children going to school, adolescence, becoming empty nesters and old age) and non-normative events (unpredictable events such as illness, disability and natural disasters).

Question 25

Define normative events

Answer 25

=Predictable events such as childbearing, children going to school, adolescence, becoming empty nesters and old age

Question 26

Define non-normative events

Answer 26

=Unpredictable events such as illness, disability and natural disasters

Question 27

Define and describe family structure

Answer 27

A family structure refers to the members in the family, and their role on the hierarchy. Additionally, it refers the beliefs, values and coping strategies that make a family unique.

Question 28

What is the difference between rituals and routines?

Answer 28

Rituals and routines help to construct meaning of family and build family relationships. They help to preserve a sense of family meaning, identity and cohesion within the family and link the members of the family together through shared meaning and a common identity. The key difference between routines and rituals are that routines give life order and rituals give life meaning.

Question 29

Why are rituals and routines important for a family?

Answer 29

Rituals and routines help to construct meaning of family and build family relationships. They help to preserve a sense of family meaning, identity and cohesion within the family and link the members of the family together through shared meaning and a common identity.

Question 30

How are culture and family related?

Answer 30

Cultural background is important in determining family beliefs and values. Additionally, family is an important context for developing cultural values and beliefs in a child.

Question 31

What purpose do family occupations provide?

Answer 31

Family occupations can provide cultural foundation, enabling participation in a variety of contexts, they can help shape sense of identity and emotional well-being, help establish routines and habits, support readiness of a child to learn and develop a readiness for a child to assume a place in their community.

Question 32

What factors may determine allocation of resources in a family?

Answer 32

• socioeconomic status of the family
• the employment status of each family member
• whether any of the family members require more resources due to illness or disability
• the age of the family members
• the independence of the family members
• the role of the family members within the hierarchy

Question 33

Give examples of subsystems within a family

Answer 33

Subsystems within a family include parents, siblings and extended family

Question 34

Define co-occupation

Answer 34

Co-occupation describes when two or more people mutually engage in occupation and can form the basis of many interaction in the family system.

Question 35

Give an example of co-occupation in infancy

Answer 35

An example of co-occupation in infancy can include a mother feeding an infant.

Question 36

Give an example of co-occupation in childhood

Answer 36

An example of co-occupation in childhood might include the parent and their child working together to complete the child’s school homework.

Question 37

Give an example of co-occupation in adolescence

Answer 37

An example of co-occupation in adolescents can include the parent driving with and teaching the child when they have their learners license.

Question 38

Give an example of co-occupation in adulthood

Answer 38

An example of co-occupation in adulthood might include visiting the parents weekly to have dinner together.

Question 39

What are the key physical changes that occur during middle adulthood?

Answer 39

• Physical signs of ageing
• declines in: smell, taste, touch, pain, temperature, muscle strength, coordination, reaction time
• declines in vision and hearing
• differences in male and female health behaviours
• death rates twice as high in men than women
• cause of death is typically disease rather than accident or violence

Question 40

What chronic health conditions begin to appear in middle adulthood?

Answer 40

• Asthma
• Bronchitis
• Diabetes
• Arthritis
• Impairments of sight and hearing
• Malfunction/disease of the circulatory, respiratory, digestive and genito-urinary system
• Mood disorders
• Rising complications with obesity

Question 41

What are the key features and changes that occur regarding sexuality in middle adulthood?

Answer 41

-Sexuality: Physical /emotional aspects
-Affected by numerous events related to family, work, and lifestyle
-Biological Changes
>Menopause=The cessation of menstruation
>Menopause is measured from 1 year after the last menstrual cycle
>Menopause occurs ~ 48-55 years
>Levels of oestrogen gradually decline
>increased risk of developing osteoporosis
>effects of menopause: decreased libido, mood swings, hot flushes, decreased concentration

Question 42

How does intelligence and cognition change in middle adulthood?

Answer 42

• Highest rate of productivity at this age.
• People tend to be more creative in 20‘s and 30’s as creativity requires flexibility in thought patterns
• Capable of analysis, and doing work which requires extensive knowledge
• Benefits of continued mental stimulation, mindfulness meditation and exercise
• Standard IQ tests show that performance on intelligence tests increases during adulthood, with different abilities peaking at different times

Question 43

What happens to memory in middle adulthood?

Answer 43

-Memory may begin to decrease towards the end of middle adulthood
-Factors influencing a decrease in memory functions include:
o Stress and anxiety
o Depression
o Lack of sleep/fatigue
o Too much alcohol
o Too many commitments
o Hormonal changes
o Medications

Question 44

What work related issues are relevant during middle adulthood?

Answer 44

• Work demands that are not matched with worker capacities may increasingly cause health problems and displacement from workforce
• Major commitment to paid work in order to continue functioning independently and be able to fulfil responsibilities
• Continuation of financial independence unless challenged by changes in employment/ family relationships/ family breakdown
• Major challenge: Life balance

Question 45

What factors influence leisure pursuits during middle adulthood?

Answer 45

• Often less time available but may develop hobbies with a view to expanding them on retirement (e.g. social activities, sport, travel)
• Work and leisure often interconnected

Question 46

Describe the Normative Crisis Model

Answer 46

• Human development involves an inbuilt plan in which an individual face a series of crises that need to be resolved
• Proposes there is a universal sequence of critical changes (crises) that people experience at different ages

Question 47

Describe the Timing of Events Model

Answer 47

• According to this model, affective development is not determined by age but by an individual’s response to specific life events (e.g. Getting a job, parenthood, divorce etc)
• Events are classified as normative (those we can anticipate - e.g. retirement) and non-normative (those we can’t - e.g. divorce)
• Events can be individual (e.g. pregnancy) or cultural (e.g. economic depression)

Question 48

Describe Erikson’s Stages: Generativity Versus Stagnation (Adulthood: 40 – 64 years):

Answer 48

Generativity
-Reaching out to others in ways that give to and guide the next generation
-Commitment extends beyond self
-Typically realized through child rearing
-Other family, work mentoring relationships also generative
Stagnation
-Place own comfort and security above challenge and sacrifice
-Self-centred, self-indulgent, self-absorbed
-Lack of involvement or concern with young people
-Little interest in work productivity, self-improvement

Question 49

Describe and list Peck’s expansion of Erikson’s theory

Answer 49

Peck expanded on Erikson’s theory and added four developments of middle age:
Wisdom vs. Physical Powers:
Knowledge and experience more that make up for declining physical powers and attractiveness
Socializing vs. Sexualizing:
Appreciation of people’s personalities and friendship, rather than sexual attraction. Thus, reaching a greater depth of understanding
Emotional flexibility vs. Emotional impoverishment:
People must be able to shift their emotional investments from one person to another and be able to adjust to changing physical limitations by changing activities.
Mental Flexibility vs. Mental Rigidity:
Being Flexible enables people to use their past experiences as provisional guides to new issues

Peck’s stages of psychological development expanded on Erikson’s theory which was regarded as ‘too narrow’.

Question 50

Describe the presence and impact of stress in middle adulthood

Answer 50

Stress & anxiety highest in middle adulthood:
-Competing demands
-High levels of responsibility
-Concern about ageing and increasing health concerns
Stress and anxiety:
-Increases the risk of depression
-Negatively impacts cognitive function
-Directly and indirectly impacts on health

Question 51

List the occupational roles most prominent in middle adulthood

Answer 51

• Son/daughter
• Brother/sister
• Parent
• Grandparent
• Caregiver
• Friend
• Colleague
• Student
• Worker
• Volunteer

Question 52

Describe the ‘sandwich generation’ and how it impacts those in middle adulthood

Answer 52

• Sandwich generation describes the role of middle-aged adults who are ‘sandwiched’ between the older and younger cohorts in the population
• Additionally, this term serves to describe the middle-aged adults who are currently serving in both the roles of parent to their own children and adult child of a parent
• Often faced with significant challenges and responsibilities – caring for children and elderly parents – facing their own impending retirement, health issues, and mortality
• Can take a toll on marriage and relationships-generally faced with increased burdens and stress.

Question 53

What relationship issues are pertinent in middle adulthood?

Answer 53

• Marriage and Divorce: Increasing divorce rate
• Relationships with maturing children: letting go of control of these children
• Relationships with siblings: loosing contact due to busy lives
• Relationships with parents: facing parents ageing
• Friendships: loosing contact due to busy lives

Question 54

Describe the model of occupational (work-related) stress?

Answer 54

• Occupational (work-related) stress is recognised globally as a major challenge to workers’ health, and the health of an organisation
• Describes the physical, mental and emotional reactions of workers who perceive that their work demands exceed their abilities and/or resources to do the work
• It occurs when workers perceive they are not coping in situations where it is important to them that they cope

Question 55

List some possible health effects of occupational (work-related) stress

Answer 55

•Short-term exposure not likely to lead to harm: can improve performance
•Long term-Can Impact On:
-Physical 
-Mental
-Emotional
-Behavioural
-+ Longer term conditions

Question 56

List some possible diminished occupational performance effects of occupational (work-related) stress

Answer 56

• Job satisfaction, morale and cohesion may decline
• Absenteeism and sickness
• Increase staff turnover
• Accidents and injuries increase
• Conflict increase/Relationships decline
• Client satisfaction reduced
• Increase health care expenditure and workers compensation claims
• Productivity and efficiency reduced

Question 57

What is workability

Answer 57

• Workability is a comprehensive approach to understanding and managing wellbeing in the workplace
• Focus is on increased work participation and prolonging working life:enabling people with disability or ill health to remain in employment, and keeping people healthy and productive
• Workability is built on a balance between a person’s resources/capacities and work demands.

Question 58

List Robert Atchley’s 6 phases of retirement

Answer 58

Phase 1: Pre-retirement
Phase 2: Retirement
a)Honeymoon
b)Immediate Retirement Routine
c)Rest & Relaxation
Phase 3: Disenchantment
Phase 4: Reorientation- ‘taking stock’ and being more realistic
Phase 5: Retirement Routine
Phase 6: Termination of Retirement (when retirement role no longer relevant-possibly due to ill health/disability)

Question 59

Describe Robert Atchley’s Phase 1: Pre-retirement

Answer 59

The phase prior to the actual retirement experience usually involves both disengagement from the workplace and planning for what retirement will entail.

Question 60

Describe Robert Atchley’s Phase 2: Retirement

a)Honeymoon

Answer 60

When a person “retires” and there- fore, no longer participates in paid employment, they frequently take one of three possible paths.
a) Honeymoon
The “honeymoon” path is characterised by feeling and acting as if one is on vacation indefinitely. Men and women become very busy doing many of the leisure activities they never had time for previously, especially travel.

Question 61

Describe Robert Atchley’s Phase 2: Retirement

b)Immediate Retirement Routine

Answer 61

b) Immediate Retirement Routine
The “immediate retirement routine” path is adopted by those who already had a full and active schedule in addition to their employment. These individuals easily establish comfortable, yet busy schedules soon after retirement.

Question 62

Describe Robert Atchley’s Phase 2: Retirement

c)Rest & Relaxation

Answer 62

c) Rest & Relaxation
The “rest and relaxation” path is described as a period of very low activity as compared to the “honey- moon” path. Persons who have had very busy careers with limited time to themselves frequently choose to do very little in their early retirement years. Frequently, however, activity levels do increase after a few years of rest and relaxation.

Question 63

Describe Robert Atchley’s Phase 3: Disenchantment

Answer 63

For some people, adjusting to retirement is not an easy experience. Following the honeymoon period or a time of continued rest and relaxation, there may be a period of disappointment or uncertainty. A person may miss the feelings of productivity they experienced when working. Disenchantment with retirement can also occur if there is a significant disruption in the retirement experience, such as the death of a spouse or an undesired move.

Question 64

Describe Robert Atchley’s Phase 4: Reorientation- ‘taking stock’ and being more realistic

Answer 64

After a period of rest and relaxation or feelings of disenchantment, it is com- mon for people to “take inventory” of their retirement experience and outline ways that will improve their retirement role. Becoming more involved in community activities, taking up a new hobby or relocating to a more affordable setting may contribute to this “second chance” at retirement. A common goal of reorientation is to design a retirement lifestyle that is satisfying and enjoyable.

Question 65

Describe Robert Atchley’s Phase 5: Retirement Routine

Answer 65

Mastering a comfortable and rewarding retirement routine is the ultimate goal of retirement. Some adults are able to do this soon after they leave employment, while others take longer, only finding their way after years of extended leisure or a period of disenchantment. Once a fulfilling and comfortable retirement routine has been found, this phase of retirement can last for many years.

Question 66

Describe Robert Atchley’s Phase 6: Termination of Retirement (when retirement role no longer relevant-possibly due to ill health/disability)

Answer 66

Eventually the retirement role becomes less relevant in the lives of older adults. When a person can no longer live independently due to disability or illness, the role of disabled elder becomes the primary focus of his or her life.

Question 67

Which of Erikson’s stages is focal during young adulthood? What are they key issues which are to be resolved during this stage?

Answer 67

Erikson’s Stages: Intimacy Versus Isolation (Early Adulthood: 20 – 39 years):

• Key outcome: ‘Intimacy’ or the ability to share with and care about another person and commit to them without fear of losing oneself in the process
• Erickson said it involves “a fusing of identities”
• Intimacy can occur between friends, family members, and with partner
• Learn what commitment requires
• Relationships with family members and good friends deepen and become more solid as one learns what it means to love
• Successful completion can lead to comfortable relationships and a sense of commitment, safety, and care within a relationship

Question 68

Describe Crystallised intelligence

Answer 68

• Tasks that have been specially learned & therefore more dependent on education & cultural background. That is, task-specific intelligence
• Knowledge and skill become more specialised as you get older.

Question 69

Describe Fluid Intelligence

Answer 69

• the process of perceiving relations, forming concepts, reasoning & abstracting
• tested with novel problems
• relatively free of culture and education, tends to peak in late teens and then decline from young adulthood.

Question 70

What are the differences between adolescence and early adulthood related to cognition?

Answer 70

-Early adulthood generally considered period in which individuals approach peak of cognitive development and intellectual efficiency.
-Cognitive theorists suggest: Differences between adult and adolescent thinking
o Adolescents more dualistic in nature
o Adult: give up absolute truth in favour of considering a problem in the context in which it is presented
o Moving from where a single answer exists to where a single answer rarely exists

Question 71

Which stages of cognitive development are present during early adulthood and what are their key features?

Answer 71

Schaie and Willis’s stages which are present in early adulthood might include the achieving stage, responsible stage and the executive stage. Transition across Schaie and Willis’s stages is not dependent on age but on the opportunities that people had to develop skills.
Achieving stage: During the achieving stage, people use their previously acquired knowledge and apply it practically in the real world. During this stage, people do best on tasks that are relevant to the life goals that they’ve set for themselves.
Responsible stage: This stage occurs when a person establishes a family and is now responsible for a spouse or children. Early adulthood is mostly associated with the responsible and achieving stages in early adulthood, but some also move to the executive stage.
Executive stage: During this stage, people broaden their focus from the personal domain to the community or societal level. Reaching this stage requires both opportunity and intrinsic ability.

Question 72

How is moral development in young adulthood different to that of adolescence? What stage should be attained?

Answer 72

Kohlberg proposed that moral development is advanced in young adulthood through encountering conflicting values away from home and sustaining responsibility for welfare of other people (e.g. parenting, caring for clients). During early adulthood, Kohlberg’s stage of Postconventional morality, which includes stage 5 and 6, can be reached. At this stage, morality centres on abstract and carefully considered principles. People in this stage rely on self-chosen ethical principles rather than correct rules.
Stage 5:
-Personal values may dictate individual understanding of right or wrong. However, there must still be procedural rules governing them.

Stage 6:

• Adherence to own rules based on personal ethical principles
• Not all individuals advance to this stage

Question 73

What are the key transitions that occur during young adulthood?

Answer 73

At this age, people transition into more independence and have the opportunity to pursue personal goals without the intensity of supervision and the structure of previous life stages. During this stage of transition, people establish self-concept and personal direction which is essential for career selection, partner selection and assumption of community responsibility. During early adulthood, a person’s opportunities and privileges are dependent upon abilities rather than a significant event (as it is in adolescence). The transition into early adulthood is a process rather than an event and everyone’s experience is different depending on whether the change or transition is expected or not.

Question 74

Identify a risky behaviour that young adults might participate in. For your chosen behaviour discuss strategies for reducing the problem/risk.

Answer 74

One risky behaviour that young adults might be involved with is texting while driving. In the past, scare-tactics have been used in TV commercials in an attempt to prevent young adults from engaging in this risky behaviour. However, with the recent rise of streaming services, it is unlikely that young adults are viewing live TV or these commercials. A more appropriate strategy for reducing the risk of texting while driving might involving similar techniques, but on more accessible platforms for young adults such as social media or streaming services.

Question 75

Discuss what occupational and other roles might be gained and lost due to a period of hospitalisation in early adulthood.

Answer 75

Gained:

• The role of a patient
• Occupations might include, taking medication, going to rehab, new/altered self-care routines, etc.

Lost:

• Freedom and flexibility to engage in leisure occupations (e.g. playing sports, socialising, etc.)
• May lose the role of caregiver for children
• Productivity occupations – work (e.g. full-time job)
• Productivity occupations – non-paid work (e.g. study, volunteering, housework, parenting)

Question 76

What do “Programmed” and “Wear and Tear” theories say about the process of ageing?

Answer 76

Programmed:

• There are limitations to cell division
• There are genes which cause deterioration
• Aging is inherent, genetically programmed in the organism and not simply a result of environmental factors or disease

Wear and tear:

• Body systems wear out through usage
• Chemical waste products accumulate
• Decreased cell replacement
• Environmental disease factors
• The idea that effect of aging is caused by damage done to cells and body systems over time

Question 77

What are the key age-related physical changes in late adulthood?

Answer 77

• Decreased vision (cataracts, glaucoma or age-related macular degeneration)
• Loss of hearing (presbycusis)
• Decreased efficiency of the heart leading to increased blood pressure
• Skin – skin tears, bruises and wrinkles
• Hair thins
• Decreased flexibility/mobility
• Cartilage – increased degenerative joint change
• Increased risk of vertebral compression fractures
• Reflexes – slower, may cause incontinence
• Digestive system maintained
• Sleep patterns – may need less sleep
• Problems with dental health are common and ay lead to malnutrition
• Deterioration of quality of movements and changes in cognitive and sensory systems put elderly at increased risk of falls

Question 78

How is intelligence and memory affected in late adulthood?

Answer 78

Intelligence:

• Decline in Fluid Intelligence
• Maintain or increase in Crystallised Intelligence

Memory:
-Short term memory (20 seconds) is maintained in old age
-Long term memory (long term storage):
o Newly learned (declines)
o Distant past (maintained)
-Age-associated memory impairment (AAMI)
o Clinical state that involved complaints of memory impairment with everyday activities
o Very modest loss of memory function in healthy people aged 50 and older
-Benign senescent forgetfulness (BSF)
o Term associated with healthy individuals who experience brief transitory episodes of cognitive decline
o It is attributed to inattentiveness and distractions than to the actual aging process
o BSF is not severe enough to interfere with daily activities

Factors effecting memory:
-Registration
o Impact of sensory loss with hearing and vision
-Encoding and storage loss of efficiency
o Extra time needed to perceive and actively rehearse the information and relate it to past knowledge and complete information storage
-Retrieval
o Extra time needed for process of locating and producing the encoded information for use

Question 79

What are the early and advanced symptoms of dementia?

Answer 79

Most common early symptoms:

• Progressive and frequent memory loss
• Confusion
• Personality changes and behaviour changes
• Apathy and withdrawal
• Loss of ability to perform everyday tasks

Advanced symptoms:

• Hallucinations
• Delusions
• Suspicious – lose/hides/accuses
• Demanding
• Aggression
• Apathetic, withdrawn
• Disinhibited behaviour
• Incontinence
• Mobility compromised
• Can lose verbal communication
• Gradual progress, ending in death

Question 80

What are the two theories of socio-emotional development in late adulthood?

Answer 80

Disengagement:

• Aging is characterised by ‘mutual withdrawal’
• The older person voluntarily reduces activities and commitments
• Society encourages segregation

Activity theory:

• The more active older people remain, the more successfully they will age
• Greater loss of roles leads to decrease life satisfaction

Question 81

What is ageism? List some agist assumptions

Answer 81

=Prejudice against older people

Ageist assumptions:

• Older people are all the same
• Older people are like children
• Physical and mental decline is an inevitable consequence of ageing
• Older people do not have the same social needs as other age groups
• Older people do not communicate as well as younger people
• Older people do not have diverse sexual needs
• It is normal for older people to be withdrawn or sedentary

Question 82

What are the mental health issues in late adulthood?

Answer 82

Mental health issues in late adulthood:

• Higher incidence of depression in institutional care
• Higher suicide rate in older old
• Often don’t receive sufficient care for mental health

Question 83

How do disengagement theory and activity theory relate to participation by older adults?

Answer 83

Disengagement theory:

• Aging is characterised by ‘mutual withdrawal’
• The older person voluntary reduces activities and their commitments
• Society encourages segregation

Activity theory:

• The more active older people remain, the more successfully they will age
• Greater loss of roles leads to decrease in life satisfaction

Question 84

What does ego integrity vs despair mean? How does Peck’s psychological developments expand on Erikson’s crisis?

Answer 84

Ego integrity vs despair:

• Ego integrity = an acceptance of oneself, one’s parents and one’s life
• Older adults must develop an acceptance of their lives and impending death
• If not, they may be overwhelmed by lack of time to start anew and unable to accept death = despair
• The ultimate goal is ego integrity

Peck’s psychological developments:
-3 psychological developments critical to successful old age:
o Ego-differentiation vs work role preoccupation
• Redefinition of worth beyond work role, maintain vitality and sense of self
o Body transcendence vs body preoccupation
• Accept that they are no longer as physically able, and concentrate on what still functions well
o Ego transcendence vs ego preoccupation
• Elderly need to deal with the reality of eventual death, and recognise that their contributions through life will is meaningful even after they have died

Question 85

What is the social environment like in late adulthood?

Answer 85

Social environment:

• Similar to middle adulthood
• Only major change is that after retirement, many people see their social network shrink as they have less casual contact with people
• This is particularly true for married couples who rely heavily on each other after retirement
• Widowers tend to rebuild new friendships and social networks while people who are divorced or never remarried tend to maintain the same friendship patterns that they had in middle adulthood

Relationships:

• Marriage – married longer due to increased lifespan
• Divorce – unusual in 60-70 age group
• Death of a partner – male/female difference
• Remarriage – more common
• Never married – social isolation
• Partners – important source of emotional economic and practical support
• Sexuality – not asexual/issues around sexuality in aged-care
• Sibling bonds – maintain strength of family relationships. Good source of support in late adulthood
• Friendship – protective factor, gender differences, local communities are important networks. People become increasingly isolate if unable to access friendships and networks on a regular basis
• Grandparents – often important role

Question 86

What are the different types of elder abuse, why are the elderly vulnerable, who are the perpetrators and what are the effects?

Answer 86

Different types of elder abuse:

• Physical
• Emotional and psychological
• Sexual
• Financial/exploitation
• Abandonment
• Neglect

Why are elderly vulnerable?

• They are less physically able
• They can be isolated and are therefore more desperate for social interaction

Who are the perpetrators?
-Anyone in a position of trust, control or authority 
-This can include:
o	Spouse 
o	Partner
o	Relative 
o	Friend
o	Neighbour 
o	Volunteer worker
o	Paid worker 

What are the effects?
Physical effects:
-Welts, wounds and injuries (e.g. bruises, lacerations, dental problems, head injuries, broken bones, pressure sores)
-Persistent physical pain and soreness
-Nutrition and hydration issues
-Sleep disturbances
-Increased susceptibility to new illnesses (including sexually transmitted diseases)
-Exacerbation of pre-existing health conditions
-Increased risk of premature death

Psychological effects:
-Established psychological effects of elder maltreatment include higher levels of distress and depression
-Other potential psychological consequences that need further scientific study are:
o Increased risk for developing fear/anxiety reactions
o Learned helplessness
-Post-traumatic stress syndrome

Question 87

What is successful ageing and what factors are involved in it?

Answer 87

What is successful aging?

• Individuals 65-74 report less sadness compared to 20-24-year old’s
• Increased ability to regulate emotions
• Acceptance of life
• Experience of pride and contentment
• More able to recognise and draw on strengths

Strategies for successful aging:
-Selection
o People identify goals, prioritise them and determine their degree of commitment
-Optimisation
o Maximise performance to facilitate success. May involve learning new skills
-Compensation
o Adapting to limitations that interfere with goals. May use assistive technologies, or adapt way in which task is done
-Fits well with occupational therapy theory
-Facilitates successful ageing by:
o Helping to optimise function,
o Improving people’s engagement in work, leisure, self-care
o Encouraging the pursuit of meaning

Question 88

What are 5 potential negative outcomes of hospitalization?

Answer 88

Negative outcomes of hospitalization:

• Delirium
• Deconditioning
• Significant decline in ADLs
• Requiring higher level of care at discharge
• Readmission to hospital within 28 days

Question 89

What are 4 things that are associated with higher levels of care at discharge from hospital?

Answer 89

Higher levels of care at discharge:

• Short term memory loss
• Dependence in toilet use
• Dependence in hygiene
• Use of community services prior to admission

Question 90

What are 6 strategies that can be employed to attempt to reduce the negative outcomes of hospitalization in adults?

Answer 90

• Multidisciplinary focus with discharge planning commencing soon after admission
• Collaboration with family and client
• Opportunities for clients to have choice over and participate in usual occupations
  a. Restore and maximize ability to carry out ADL
  b. Maximize social interaction
• Exercise interventions to prevent deconditioning
• Construct daily routines and maintain personal social interactions
• Reduce hostile aspects of hospital environment
• Distance to toilet, lighting, noise level, ensure continuity of care
• Discharge only after client has sufficient balance, endurance and mobility to remain safely at home

Question 91

What are the types of loss that people experience?

Answer 91

Roles

• Unemployment, retrenchment, retirement
• Loss of role, status

Health

• Loss of health, amputation, loss of hearing/sight
• Disability and loss of independence (important to help the person optimize choice and control)
• Loss of youth, body image

Cultural
-Loss of homeland, culture, language

Question 92

List and describe Kubler Ross’s five stages of grief?

Answer 92

Denial: Not acknowledging the situation. A person in this stage might say, “This can’t be happening to me.”
Anger: Denial gives way to anger, resentment, rage and envy. Someone in this stage might say, “Why me? It’s not fair.”
Bargaining: Asking and hoping that some other option could be offered. Someone in this stage might say, “I’ll do anything if…” or “I wish I had done this…”
Depression: This is not clinical depression but a stage of intense sadness. Someone in this stage might say, “I’m so sad, why bother with anything?”
Acceptance: Having a sense of peace, acceptance of a situation. Someone in this stage might say, “It’s going to be okay.”
Finding meaning: This stage involves finding positive outcomes after the loss. This transforms grief into a more peaceful and hopeful experience.

Question 93

What are the four tasks of mourning?

Answer 93

Four tasks of mourning:

• Acceptance of reality of the loss
• Work through the pain
• Adjust to the environment when someone or something is no longer there
• Reinvesting in other relationships/attachments

Question 94

What is the term of the study of death and dying?

Answer 94

Thanatology

Question 95

Define the terms bereavement, mourning and grief?

Answer 95

Bereavement: Being deprived of a close relation or friend through their death.
Mourning: Expression of sorrow for someone’s death.
Grief: The physical, emotional, somatic, cognitive and spiritual response to actual or threatened loss of a person, thing or place to which we are emotionally attached

Question 96

What are the views of death during the stages of childhood?

Answer 96

Infant:

• May display signs of distress
• Unable to give meaning to the distress
• Absorbs emotions of the others around her/him

2 years old:

• Unable to conceptualise permanence of death
• Death is a temporary state
• If verbal, may ask for dead parent

5-7 years old:

• Begin to understand death
• Irreversible and universal

5-9 years old:

• Death is final
• The dead stay dead
• Some children at this level of mental development picture death in the form of a person: usually a clown, cloaked person or skeletal figure

10+ years old:

• Death is not only final, but it is also inevitable, universal and personal
• Everybody dies, whether mouse or elephant, stranger or parent

Question 97

How is grief manifested in childhood under three-year old’s and 3-5-year old’s?

Answer 97

Under 3 years old:

• Regression
• Sadness
• Fearfulness
• Loss of appetite
• Failure to thrive
• Sleep disturbance
• Social withdrawal
• Developmental delay
• Irritability
• Excessive crying
• Increased dependency
• Loss of speech

3-5 years old:

• Constipation
• Soiling
• Bed-wetting
• Anger and temper tantrums
• Out of control behaviour
• Nightmares
• Crying spells

Question 98

How is death viewed differently in early vs middle vs late adulthood?

Answer 98

Early adulthood:

• Often experience death of someone for the 1st time – e.g. parents/grandparents
• Increasing understanding of own mortality
• May lead to reviewing life/taking stock
• More likely to become involved in caring for bereaved
• Focus of concern: family well-being and self

Middle adulthood:

• Increased awareness of mortality
• Vulnerability
• Focus of concern: family well-being and self

Late adulthood:

• More experience of other’s having died (sometimes too much)
• Potentially more acceptance of mortality/less fear
• Ego integrity/despair

Question 99

What are 5 determinants of intensity and duration of the grief response?

Answer 99

Determinants of intensity and duration of grief response:

• Who the person was/ nature of the attachment?
• Mode of death
• Historical antecedents
• Personality of the bereaved
• Ethnic and religious background

Question 100

Compare the differences between grief and depression?

Answer 100

Grief:

• Variability of moods and feelings
• Capable of external expression
• Wants solitude but responds to warmth
• Sporadic pleasure, retain sense of humour
• Experienced in waves
• Diminishes in intensity over time
• Healthy self-image

Depression:

• Moods and feelings are low, more static
• Absence of externally directed anger, internally directed
• Fear of being alone or are unresponsive to others
• No pleasure, sense of humour
• Consistent sense of depletion
• Sense of worthlessness and disturbed self-image

Question 101

What is anticipatory and morbid grief?

Answer 101

Anticipatory grief: Grief before death has occurred, when you know the loss is going to happen
Morbid grief: Morbid grief is when a person holds on to the grief for long periods of time, giving it a lot of attention. they can become so invested in their grief that they are unable to function.

Question 102

What are the three types of complicated grief? Describe them.

Answer 102

Disenfranchised grief: Grief that can’t be easily openly acknowledged, publicly mourned or socially supported because the relationship with the person is not recognised, the loss is not recognised, and the griever is not recognised. An example of a relationship which is not recognised might be a same-sex relationship, or an affair. An example where the loss or the griever is not recognised might be the loss of a pet.
Psycho-social losses: Chronic sorrow (see below) and loss of self.
Greif related to violent death: Death due to natural disasters, death in wartime, murder and suicide. In many of these situations (particularly natural disasters and war), the grief is shared by a large number of people. In these situations, people have less opportunity to grieve and to support each other.

Question 103

What is chronic sorrow and by whom is it displayed?

Answer 103

Chronic sorrow is reoccurring and unresolved sorrow or grief. This occurs when the griever is continually confronted by their loss. One example of this is when an experiences grief for their child with disabilities. Grief is present because their hopes and dreams for the baby are gone, and the parent continues to recognise everything they are unable to do as the child ages.

Question 104

Describe the mechanisms for reconstructing meaning for the bereaved.

Answer 104

Making sense of the death:

• This usually involves seeing the loss as predictable, as part of a natural order
• It often involves finding reasons for what happened – does an illness/accident make sense?
• This often leads us to consider the meaning of life – Why did this occur? Why did this happen to me?
• The most difficult losses are those that fail to make sense

Finding benefit in the experience:

• Involves finding benefits, positive value or significance to the loss
• The capacity to fins benefits strengthens adjustment to the loss over time

Undergoing identity change:

• Amidst the pain and anguish of loss we can also experience positive changes
• We construct of ourselves
• Changes might include becoming more resilient, more independent or more confident, learning new skills, taking on new roles, developing a new appreciation or life and those still living, experiencing spiritual growth, and increase empathy for others

Question 105

Identify approaches to intervention that may be used when working with people who experience loss of grief.

Answer 105

Approach to intervention:

• Establish a relationship with the person experience loss
• Be comfortable with their expression of grief
• Listen
• Normalize grief reaction
• Understand that strong emotions can bring growth
• Companion them in rebuilding their life

Question 106

Name specific interventions that can be used with people experiencing grief or loss.

Answer 106

Specific interventions:

• Grief counselling
• Cognitive behaviour therapy
• Re-engagement in life roles/goals
• Stress management/relaxation
• Acceptance and commitment therapy
• Life review and reminiscing