Week 1 Flashcards
Is the percent of aging adults in developed countries higher or lower than those in developing countries?
Higher. Fastest growing areas include Australia, Latin America, and the Caribbean
Is there a general increase or decrease in the aging population in CA?
Increase
What age group in CA is the fastest growing?
85%
Is diversity increasing or decreasing?
Increasing. Whites are decreasing fast and hispanics are increasing fastest
Are older adults more or less healthy than they were 10 years ago?
Less healthy now. More sedentary, more chronic diseases. People living longer but their health is decreasing. But getting better at improving disability e.g., technology like vision improvements
What may account for decreases in disabling effects of certain diseases in older adults?
- Struggle with Arthritis, Diabetes, Cancer
- More time on computers
- Common wear and tear with aging
- BUT mental distress is improving
T/F: The majority of older adults (65+) take no medication
FALSE. The majority take 2-3 meds. Half take 2 or greater.
How can OTs help older adults who take a lot of meds?
- Medication management
- Lifestyle redesign (non pharm. solution)
- Discuss medication preference and create coals
In what disease is the U.S. doing relatively well at preventing deaths regarding compared to globally?
Stroke
T/F: Breast cancer mortality rates have increased greatly since 1990 in U.S.
False. Rates have decreased
Mortality rates due to Lung Cancer, Alzheimers, Diabetes, and COPD are relatively low in U.S.
False. They are high.
Prediction of future health of older adults?
- Better b/c technology?
- Worse because keep living longer, so more illness?
The study of aging (biological, sociological, physical, etc)
Gerontology
Age related pathological state of loss of physiological reserve that leads to physical impairments, functional limitations, and disability.
Frailty
What is the defining criteria for frailty?
Must meet 3/5:
- Loss of strength/weakness
- Fatigue/exhaustion
- Loss of 10 lbs within year
- Slow walking speed
- Low physical activity
Changes occurring in older adulthood that are different from pathological processes, but may interact reciprocally with illness and disease presentation
Age-related changes
Successful multidimensional aging process which includes physical, psychological, functional, social health components
Active Aging
Medical services for older people
Geriatrics
Approach to intervention focussed on maintaining health and avoiding disease rather than on treating disease after onset
Health Promotion
Length of time an individual has lived since birth
Chronological age/aging
Changes that occur in capabilities related to mental and cognitive functioning, self-esteem and self-efficacy, learning, memory, perception
Psychological age/aging
Decline and deterioration of functional properties at cellular, tissue, organ level
Biological age/aging
Individual’s changing roles and relationships in social structure (family and friends at work, organizations like church)
Social age/aging
55+
Senior
65+
Older adult
55-75
Young-old
76+
Old old
85+
Oldest old
80-89
Octagenarian
90-99
nonagenarian
70-79
septuagenerian
Over 110
supercentenarian
centenarian
100+
T/F: it is socially acceptable to use the term “elderly”
FALSE. Don’t say this.
Who lives longer generally, men or women?
Women. Boo-ya. Women more likely to live alone in later life, leads to isolation and loneliness and lower life satisfaction. Possible financial difficulties
T/F: Men report an increase in QOL and life satisfaction in a heterosexual relationship after wife passes.
False. Men report decrease QOL and life satisfaction after wife passes. Men lose the social circle that wife was in charge of
Generally, research has focussed more on women in aging.
False. Research less focussed on women. Researchers now required to include women as participants. Issues relating to women often ignored e.g., breast cancer, osteoporosis Early writing about aging ignored women or placed them under men, so less documented
Historical effects impacting a generation of people or older adults
Cohort effect. This influences behaviors and experiences of aging. Influences attitudes towards issues like social security benefits.
Cohort effects of today’s elder cohort (1901-1924)
Pio, post-polio, patriotic, watch their spending, vote, no waste, “greatest gen”
Individuals born in 1946-1964
Baby boomers
Born in 1965-1981
Generation X
Born in 1982-2004?
Generation Y/Millennials
Born 2005?-2015?
Generation Z/iGeneration
This public policy fights for rights for older adults. Provides support and restorative services.
Older Americans Act (OAA). Provide transport, adult daycare, caregiver support, nutrition services
Who often ends up taking over responsibilities of older adults?
Family members with $ to cover health care costs.
Why would there be intergenerational conflict between older and younger adults?
Younger adults may resent older adults for financial responsibilities. Not supported in research
Social Security
Government system that provides $ to retired people who are unemployed or disabled. Works to reduce poverty in older adults. The working population puts money into SS, but the working pop is shrinking while the aging population is increasing. Causing ratio to be off. Big challenge for policy makers.
T/F: better education and higher income is associated with longer and healthier life
True! Adverse SES is cumulative over lifespan. Wealthy and well educated, less likely to have cognitive decline in later life. More positive self-identities, greater subjective well-being, feel have access to caregivers
T/F: In general, income has no impact on health
False! Generally lower income leads to poorer health. May be because risky behavior taking, or lack of access to medical services/care. With higher educational levels and SES, financial means don’t decrease as much with age. Those who can afford supplemental health insurance less likely to develop disability b/c better access to care throughout life and maintain better health habits.
T/F: There is a strong link between housing and health
True.
Pros and cons of older adult living in rural location
Pros: less stress, less exposure to chemicals, intimate relationships and support system
Cons: lack of access, they introduce more money into the economy than they require in services. They provide services like watching grandkids or financially support adult children
Pros/cons of older adult living in suburban location
Pros: Greatest access to financial resources
Cons: Transportation can be difficult, fewer community resources. Some move to communities designed specifically for them, but may be isolating
Pros/Cons of older adult living in urban location
Pros: more ethnically diverse, lots of public transport (greatest access)
Cons: Cost expensive so financially strained
When older adult has 2 homes. He/she leaves during the winter when it gets cold and returns during Summer when warmer
Snowbirds
Older adult moves back to support system when retires
Reverse migration
T/F: Institutionalization increases at age of 55+
False, institutionalization (e.g., nursing home) increases at 85+. Alternative supported living arrangements are emerging e.g., assisted living
Predisposition to diseases like AD, osteoporosis, diabetes, HD
Genetics
T/F: environmental and social factors cannot alter expression of genes
False. Protective factors in behavior or environment or both may reduce signs of disorder even with biological characteristics
Where do we want to encourage older adults to age?
At home-aging in place! We want to help older adults stay in place so they can be more independent, drawing upon well-learned habits and focus on other fulfilling roles. Can get help from nearby family members if needed.
T/F: Personality can serve as a protective factor?
True! Personality influences outlook and behavior. Extraverts are likely to establish and maintain social networks, problem solvers are more prone to find access to care. Positive self-esteem and optimism can influence decision to get help
T/F: Personality traits often change as one ages
False. Personality traits are usually stable in life and influence how one ages
Positive self-esteem and optimism can affect one later in life how?
Positive self-esteem and optimism can influence one’s decision to get help
Current social attitudes on aging are…?
Mixed attitudes, ambivalence, confusion. Perception that elders shouldn’t participate in variety of activities.
Value of individual is often linked to ____?
Engagement in activities!
How can we change social attitudes about aging?
Education and personal experience
T/F: Older adults in U.S. spend their time very differently than those in UK
False. Pretty similar
Person unable to do what is necessary and meaningful in life due to external restrictions
Occupational Deprivation
For what reasons may older adults be vulnerable to occupational deprivation?
No transportation, access, opportunities for activity, limits in environment, residential care. Lack of opportunities to engage in occupation have negative consequences
What types of events/situations might trigger life transitions and role changes?
Retirement, having grandkids, death of significant other
Why might older adults experience retirement differently?
- If retire, won’t have meaningful occupation anymore
- retirement may be voluntary b/c changes in role e.g., caregiving or involuntary e.g., due to disease/illness
- Helping older adults est. routine when retire so they have a successful transition is important!
Who is more likely to become a widow, men or women?
Women experience widowhood more often. Generally live longer than men
Health repercussions related to widowhood?
Grief is a common reaction to death of spouse. Can lead to other health repercussions e.g., Depression, alcohol abuse
How is social participation affected by becoming a widow?
Can lead to lack of social participation. Social participation is a protective factor for health and health outcome. Widows have more informal social interactions than others. Generally, females have higher social participation.
How can we help clients who are widows?
Using narrative storytelling to help focus on other things besides loss. Help with social participation
Why may older adult relocate?
Process differs from relocations in earlier life.
- life events, transitions
- Move closer to family
- Move to place where get more services
Ecological model for late-life residential decisions
Shows different levels that impact relocation: individual characteristics, community-based services, informal support systems, physical environment, individual characteristics
Community-based e.g., if don’t have services, may impact decision to move to new place with services
T/F: late-life relocation is often a stress-free process that fosters growth for older adult
False. Stressful process, can lead to health issues, esp. if involuntary decision
Practice implications for late-life relocation?
It is important for older adult to have a sense of control, so include them in the decision making process early on. Talk and plan together. Ask clients what their expectations are, reason for moving, what they need to do to prepare
Social process of recognizing and promoting people’s abilities to meet their own needs, solve their own problems, and mobilize the necessary resources to feel in control of life
Empowerment
T/F: Older adults are one of the most empowered groups
False! Older adults are one of the most DISempowered groups
Care model vs. Empowerment model
In empowerment model, the client has a say in what he/she wants, needs, and expects
Contributing factors to disempowerment
- Poverty: poor housing, discriminatory services
- View “older adults” as all the same
- Service providers have idea that aging population is rising
- Negative stereotypes of older adults
Role of OT in assisting with life and role transitions and empowerment of older adults?
- Define what occupation is, have them reflect on activities, help maintain routine and balance in life so they’re stable and maintain occupations
- discuss how aging will affect occupations
- make sure they understand how to maintain occupations and what they can expect as they get older
- help with cognitive and physical function which minimizes disease and disability
T/F: definition of old age is not static. It changes over the years
True! Changing definitions of aging and different perceptions of aging process contribute to confusion about expected roles and activities in older adults
Who is more likely to live in poverty-older women or men?
Older women are more likely than older men to live in poverty
Impact of gender on economic circumstances in aging
- Until recently, old age for women defined by loss of procreation and for men by loss of work
- Women poorly prepared for old age, didn’t have $ or societal support
- Men retained some prestige via moral leadership
- But women had continuation of roles via ongoing responsibilities in household and grand parenting activities
Old age is most often referred to the age of ____?
65+
T/F: homelessness has increased over time
True.
T/F: wealthier homes lead to more successful aging
True. Mobile homes can be problematic-distance from family support, homes depreciate in value
Widowhood in men vs. women
- Older men face social isolation b/c difficulty reestablishing social ties
- Men face greater decline in life satisfaction after death of spouse
- Men who get spouse later in life have increase in life satisfaction
Who experiences poverty at higher rates, older men or women?
Women, especially widowed. Current cohort tended not to work outside the home. Social security may be only income
Who experiences greater disability in later life, men or women?
Women live longer, so experience greater disability in later life. More likely to develop AD, bone fractions, other conditions that affect QOL and ability to function. Less understanding of health conditions in older women b/c more research done using male groups.
Lower SES is associated with…
Increased risky health behaviors, poor health literacy, poorer follow through with health promotion and screening. Associated with risk of onset of disability.
Ratio of those in the workforce to those (children and retired) who are depending on taxes that workers pay to provide their support
Dependency ratio. Recent concern b/c in U.S., increasing proportion of elders relative to working age.
T/F: elders tend to not be very politically active and liberal about social services
False. Tend to be politically active and conservative about social issues
Three goals to live lives with sense of satisfaction and well-being
- Avoiding disease and disability
- Maintaining high cognitive and physical functioning
- Staying involved with life and living
According to Clark, what is the first step in Lifestyle Redesign?
The first step in a Lifestyle Redesign Program is to clearly define what is meaning by occupation
According to Clark, what is “occupation”?
Occupation refers to the “chunks” of activity that we engage in during our everyday lives
According to Clark, for participants to begin to redesign their lives, they must…
Participants must first step back, reflect, and shape or reshape their thinking about their everyday activities
In this model, the goals are for the occupational therapist to describe occupation (using foundational occupational science concepts) and make explicit the relationship of occupation to health while encouraging clients to apply the concepts to their own lives (using occupational self-analysis).
Lifestyle Redesign
This concept in Clark’s module allows for constancy in the body in the face of environmental fluctuations
Homeostasis. When we are in a state of homeostasis, we tend to feel a sense of general well-being
According to Clark, _________ is necessary for homeostasis
Routine is necessary for homeostasis
This mechanism dictates our sleep cycle, hormonal balance, and body temperature in accordance with a 24-hour day
Circadian Rhythm. To achieve overall health, important to stay in sync with body’s circadian rhythm.
T/F: According to Clark, an unpredictable routine is more likely to help us maintain homeostasis
False. Flo says when we maintain a regular daily routine with a healthy balance of different types of occupations, we are more likely to achieve homeostasis.
