Unit 3 - Chapter 5 of Text - Person-Environment Interactions

Question 1

Who was Kurt Lewin?

Answer 1

• German-American psychologist, known as one of the modern pioneers of social, organizational, and applied psychology in the United States
• Contributions - 3 lenses of analysis:
  1) Applied research
  2) Action research
  3) Group communication

Question 2

What does equation B = f(P,E) mean?

Answer 2

This equation defines the person-environment interaction and means that behaviour (B) is a function of both the person (P) and the environment (E)

• What this basically means is that behaviour is a combination of a person interacting with their environment

Question 3

What are some objective aspects of environment?

Answer 3

• Objective aspects of an environment are elements that are measurable, such as crime rate, quality of housing, density of housing etc.
• You may think people are nuts to live in a particular neighbourhood as the crime rate may be higher, but people come into an environment with personal choice and may not always choose an environment that makes sense from an objective standpoint.
• The example given in the book is about people who live in a high crime city such as New York … it would make more objective sense to live in a city with a lower crime rate, but some people really like New York and want to live there.

Question 4

Define psychosocial

Answer 4

• Relating to the interaction between social factors and individual behaviour.

Question 5

What is required to understand psychosocial aging? How can this be done?

Answer 5

• Understanding psychosocial aging requires seeing each indivual as a unique person rather than lumping all aging people together
• One way of making sure that we’re not just lumping all seniors together is to examine the person’s realtionship between themselves and their environment

Question 6

What is competence?

Answer 6

• The upper limit of a person’s ability to function in five domains:
  1) Physical health
  2) Sensory-perceptual skills
  3) Motor skills
  4) Cognitive skills
  5) Ego strength
• These factos are viewed as underlying all other abilities and reflect the biological and psychological forces

Question 7

What is environmental press?

Answer 7

• Environmental press refers to the physical, interpersonal, or social demands that environments put on people
• Physical demands might include having to walk up 3 flights of stairs to get to your apartment
• Interpersonal demands include having to adjust your behaviour patterns to different types of people
• Social demands include dealing with laws or customs that place certain expectations on people
• These aspects of the theory reflect biological psychological and social forces
• Competence and environmental press change as people move through the life span
• Competence-environmental press framework reflects life-cycle factors as well
• What you are capable of doing as a 4 year old differs from what you can do as a 25 year old, which differs from what you can do as an 80 year old
• The demands put upon you by the environment also change as you age

Question 8

Provide an outline of the competence and environmental press graph (5.1)

Answer 8

• Low to high competence is represented on the vertical axis and weak to strong environmental press is represented on the horizontal axis
• Points in the figure represent various combinations of the two
• The shaded areas show that adaptive behaviour and positive affect can result from many difference combination of competence and environmental press levels

Question 9

How is adaptation level defined?

Answer 9

• The area where press level is average for a particular level of competence; this is where behaviour and affect are normal
• Slight increases in press tend to improve performance
• This area on the figure is labeled the zone of maximum performance potential

Question 10

What is the zone of maximum performance potential?

Answer 10

• When press level is slightly higher, tending to improve performance

Question 11

What is the zone of maximum comfort?

Answer 11

• When press level is slightly lower, facilitating a high quality of life
• People are able to live happily without worrying about environmental demands
• Combinations of competence and environmental press that fall within either of these two zones result in adaptive behaviour and positive emotion, which translate into a higher quality of life

Question 12

Graph 5.1

Question 13

What is the competence-environmental press approach?

Answer 13

• An approach to understanding how people interact with their environments that uses biopsychosocial (a general model stating that biological, psychological (thoughts, emotions, behaviours), and social (socio-economical, socio-environmental, and cultural) factors, all play a role in how humans function in the context of disease or illness.
• Health is best understood in terms of a combination of biological, psychological, and social factors) into the person-environment relationship

Question 14

How do people deal with changes in their particular combinations of environmental press, such as adjusting to a new living situation, and competence, perhaps due to illness?

Answer 14

When people choose new behaviours to meet new desires or needs, they respond in 2 basic ways:

1) Proactivity
2) Docility

Question 15

What is proactivity?

Answer 15

When people choose new behaviours to meet new desires or needs, they exhibit proactivity and exert control over their lives.

Question 16

What is docility?

Answer 16

When people allow the situation to dictate the options they have, they demonstrate docility and have little control

Question 17

Give an example of proactivity and docility

Answer 17

• Let’s say that a senior is moved to a seniors’ residence … perhaps against their will or without their agreement. If they are proactive, they will get out and meet the other residents, participate in the activities, take meals in the common dining room, etc. If they behave in a docile fashion, they may sit in their room, refuse to meet other residents, won’t join in on the activities, etc.
• The theory says that proactive behaviour tends to come from those with high competence and docile behaviour comes from those with low competence

Question 18

What relationship is seen between a person’s competence and the degree to which environmental factors will influence them

Answer 18

• The less competent the person is, the greater the impact of environmental factors
• The most competent the person is, the less the impact of environmental factors

Question 19

What does the concept of proactivity and docility help us predict?

Answer 19

• It helps us understand how well people adapt to various care situations such as adult day care

Question 20

What is a general rule about competency and the impact of environmental factors?

Answer 20

• The less competnet the person is, the greater the impact of environmental factors.
• To the extent that people experience declines iin health, sensory processes, motor skills, cognitive skills, or ego strength, they are less able to cope with environmental

Question 21

Why is is important to examine issues of competence and environmental press?

Answer 21

• Because most older adults prefer to live at home, examining issues of competence and environmental press in that context is important
• Given the importance of creating residential alternatives and offering them to older adults with physical limitations, it is critical that we understand how the environment affects people’s day-to-day functioning in the home

Question 22

What is the congruence model?

Kahana’s Model

Answer 22

• Another way to consider how people and environments interact is to look for the best fit for a specific person in a particular environment.
• Kahana includes the ideas of competence and environmental press but applies them differently
• In Kahana’s view, people vary in their needs, and environments differ in their ability to satisfy them
• According to the congruence model, people with partiicular needs search for the environments that meet them best.
• To the extent that a match exists, the person feels content and satisfied; when a mismatch occurs, stress and discomfort result

Question 23

When is congruence between the person and the environment especially important?

Answer 23

• When personal or environmental options are limited
• Limitations can occur for 3 reasons:
  1) Environmental characteristics are restricted, as when public transportation is restricted
  2) Personal freedom is restricted as when she/he must eat at the same time, whether they want to or not
  3) A person’s beliefs that there is no way to get around despite a reliable bus system
• Restricted environments are places such as long-term care facilities such as nursing homes and hospitals

Question 24

What were 3 of Langer’s findings?

Answer 24

• Making residents feel competent and in control were key factors in promoting positive person-environment iinteractions in nursing homes
  1) The decision to place a person in a nursing home often is made by people other than the person involved
  2) The label “nursing home resident” may have strong negative connotations
  3) When the staff think they are demonstrating “tender loving care” by cutting up people’s meat, doing up their buttons, etc. they can inadvertently increase the resident’s level of incompetence and/or dependence

Question 25

What were Langer’s findings regarding environment and routine?

Answer 25

• The physical aspects of the envrionment may also reinforce the beilef of no control. If the environment is unfamiliar or is difficult to negotiate, mastering the environment increases feelings of control
• Routine is detrimental to well-being. If the environment is too predictable, there is little for people to think about
• Humans become mindless, we are unaware of what we do, we behave as if we were on automatic pilot. Residents quickly can’t remember what happened, even a short time ago
• The staff may end up viewing someone as incompetent when they’re not, they’re just not responding due to the boring routine

Question 26

What were Buschmann and Hollinger’s findings re: social support and touching?

Answer 26

• Providing affective social support through touching is an effective substitute for residents’ inability control their environment

Question 27

What is Lazarus and Folkman’s cognitive theory of stress and coping?

Answer 27

• People evaulate situations to assess their potential threat value
• Situations are evaulated as harmful, beneficial, or irrelevent
• When situations are veiwed as harmful or theatening, people establish a range of coping responses that they have at their dispostal for avoiding harm
• This is called a coping response
• Outcomes of coping may be positive or negative depending on many contextual factors

Question 28

What are Schooler’s 3 potential stressors on health and morale?

Answer 28

1) Environmental change
2) Residential mobility
3) Major life events

Question 29

According to Schooler, what are buffering or protective factors that aging people may use?

Answer 29

• Social support systems
• Schooler showed that the presence of social support systems affected the likelihood that particular situations would be defined as threatening

Question 30

What is everyday competence?

Answer 30

• A person’s potential ability to perform a wide range of activites considered essential for independet living.
• It is not the person’s actual ability to perform the task, it also involves a person’s physical, psychological and social functioning abilities

Question 31

How must we view behaviour?

Answer 31

• Behaviour must be viewed in its environmental context
• Cultural context must be considered as well

Question 32

Outline Willis’ model of everyday competence

Answer 32

• Wills distinguised between
  1) Antecedents (a thing or event that existed before or logically precedes another). This includes both individual (health, cognition) and sociocultural (cultural sterotypes, social policy, health care policy)
  2) Components - which components are most important or exert the ,most influence depends on the overall conditions under which the person lives
  3) Mechanisms - factors that moderate the way in which competence is actually expressed - whether one believes that he or she is in control of the situation influences
  4) Outcomes of everyday competence - Psychological and physical well-being, which are two of the major components of successful aging

Question 33

What predictions can be made regarding the decline in older adults’ ability to handle everyday problems?

Answer 33

• Health outcomes of one episode of everyday competence are the antecedents of the next, illustrating how future competence is related to current competence
• Decline in older adults’ ability to handle everyday problems predicts mortality

Question 34

What are the basic components of the congruence model?

Answer 34

• People with particular needs search for the environments that meet them best

Question 35

What are the major types of nursing homes?

Answer 35

• Largest number of older residents of long-term care facilities
• Governed by provincial and federal regulations
• Two types of nursing homes:
  1) Skilled nursing care - 24 hour service, skilled medical care and other health services, usually from nurses
  2) Intermediate nursing care - 24 hour services, including nursing supervision, but at less intense level
• Major difference is the types and numbers of health care workers

Question 36

Who is most likely to live in a nursing home?

Answer 36

• Over 85
• European American
• Female
• Recently admitted to a hospital, lives in a retirement home rather than being a homeowner
• Is cognitively impaired
• Has problems with instrumental activities of daily living
• Widowed, divorced, or single
• No children or siblings nearby

Question 37

What are the key characteristics of nursing homes?

Answer 37

• One way of evaluation them is by applying the competence-environmental press model
• Find the best level of environmental support for people with low levels of competence
• Factors to consider - quality of life for the residents, quality of food, are residents well groomed, rooms neat and clean, comfortable furniture, quality of care, safety, outdoor areas
• Skilled nursing care if patient requires is
• Ensure it is properly licenced
• Is there a resident care plan?
• What is the educational level of the staff?

Question 38

What is the person-centered planning approach to nursing home policies?

Answer 38

• Promoting residents’ well-being through increasing their perceived level of personal control
• Allowing things such as residents decorating their own rooms, choosing what they want to eat from a buffet, choosing whether they want a shower or a bath
• Not using a “one size fits all” approach
• Residents who have higher perceived control over their lives show significant improvement in well-being, activity level and live longer
• Use fewer drugs for residents such as sleeping pills and antidepressants
• Lower level of incontinence

Question 39

What are special care units?

Answer 39

• Secure facilities for those with dimentia or cognitive impairment
• These units require specialized design - the best have physical design elements that take functional limits into account
• Design so that residents can’t leave the building, or alarm systems so if they cross a barrier, the alarm rings
• Residents bring items from home to remind them of their past
• Have private dining areas so they don’t mix with the other residents

Question 40

How should the staff of special handling units be trained?

Answer 40

• Appropriate and effective communication techniques
• Behavioural management techniques
• Techniques to help with personal care that leaves the resident with as much dignity as possible
• Appropriate handling of incontinence
• Appropriate handling of sex
• Effective techniques for controlling wandering
• Appropriate ways to handle feeding
• Appropriate techniques and interventions to address memory failure and disorientation
• Techniques for handling mobility issues

Question 41

How can a nursing home be a home?

Answer 41

• The environment has plenty of reminders that it is an institution and not a house
• Circumstances that foster people feeling that they are at home includ having some say in where they’re going, having prior knowledge and a positive experience with a particular facility, defining home as relationships with friends and family versus belongings or buildings, being able to create some sort of continuity between home and the facility

Question 42

How should people communicate with nursing home residents?

Answer 42

• The

Question 43

How is decision making capacity assessed?

Question 44

What are some new directions for nursing homes?

Question 45

How does one “age in place”?

Question 46

What process do people go through to make the best living arrangement decision?

Question 47

What modifications are typically done in a person’s current home to provide a more supportive environment?

Question 48

What services are provided in adult day care?

Question 49

What is congregate housing?

Question 50

What are the characteristics of assisted living facilities?