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Human Behavior in the Social Environment: A Multidimensional Perspective Unit 9 LATE ADULTHOOD Chapter 12 Late Adulthood No quiz this week. Let’s take a quick look at the directions for your final project. Final Project Due at the end of Unit 9. Project Objective: Illustrate your knowledge of the course material. Summarize and evaluate the influences of the environment on Luis’s behavior. Please review the rubric. Late Adulthood Developmental Themes Late Adulthood (65-death) Erikson’s theory: INTEGRITY versus DESPAIR Integrity is defined as the ability to integrate or satisfactorily blend one’s history and experience with the task of evaluating & accepting one’s life. The oldest old (85+) & minority elders are the fastest growing ages Leaving a legacy is an important goal for many in later life Late Adulthood Developmental Themes General Characteristics of older adults by subperiod Young-old (65-74) - The young-old typically remain active in the community & maintain strong ties with families & friends Middle-old (75-84) - More in this age group experience chronic disease (arthritis, cardiovascular, respiratory, circulatory) Old-old (85+) - A predominant number of this group is dependent, frail & experiencing more disabilities & chronic illnesses Source: Based on Hartford (1985). Late Adulthood Theories of Aging Continuity theory: emphasizes that people change less with aging than they stay the same. Adaptation to changes that occur with age is done using familiar strategies from the person’s past Activity theory: applies social role theory to late life. Older people experience greater subjective well-being when they continue to be active in many roles. Disengagement theory: disengagement occurs in late adulthood through the process of mutual withdrawal of the person and of society. Socioemotional selectivity: as people age, familiar and reliable relationships become more important. People regulate emotions and conserve energy by selecting with whom to invest their emotional energies. Which of the theories relates to Carmen Perez? Source: Based on Hartford (1985). Late Adulthood Biological Dimension Biophysical growth and development Health care and medications Sexuality Implications for practice: sexuality in late adulthood Biophysical strengths and hazards Chronic health problems Death and dying Advance directives for health care Implications for practice: End-of-life care Late Adulthood Psychological Dimension Cognitive Development & Information Processing Selective Optimism & CompensationFocuses on ways the older self is able to cope & maintain integrity despite declines in reserve capacities Late Adulthood Cognitive Development & Information Processing Fluid Intelligence -Abstract reasoning ability or “native intelligence” • Does this increase or decreases with age? Cystallized Intelligence - Accumulated information & verbal skills • Does this increase, decrease or remain stable with age? Late Adulthood Common Myths Associated with Mental Impairment Possibly Alzheimer’s or Dementia NORMAL Temporarily forgetting a colleague’s name Not being able to recall the name later Having a word on the tip of the tongue Substituting strange words for forgotten words Misplacing objects in moments of distraction Misplacing things in unusual places & having no memory of putting them there Forgetting for a moment where Getting lost on your own street you’re going Having trouble balancing the checkbook accurately Forgetting how to add or subtract numbers Temporarily forgetting the day of the week Not knowing what season or year it is, even after thinking about them Late Adulthood Attitudes & Emotions: Loss, Grief & Mourning Factors that may affect experience, behavior & adaptation in loss ENVIRONMENTAL OR EXTRINSIC FACTORS • • • • • Personal losses or gain Social forces Socioeconomic adversities Unwanted retirement Cultural devaluation of older persons Late Adulthood Attitudes & Emotions: Loss, Grief & Mourning Factors that may affect experience, behavior & adaptation in loss INTRINSIC FACTORS • • • • Nature of personality Physical diseases Age-specific changes Experience of bodily dissolution and approaching death Late Adulthood Loss, Grief & Mourning Four Tasks Essential to Mourning A Loss: 1. ACCEPT THE LOSS: Initially people deny the reality of death, so the first task is to accept that the loved one is gone & will not return • Often people display searching behaviors (seeing the loved one in a crowd or hearing their voice) 2. FEEL THE PAIN: Many ask after the death of loved one “When does the pain go away?” But pain cannot be avoided & if not dealt with at the time of death, it may resurface later • Bereaved individuals need to externalize the pain by talking about the death & the loved one • Group therapy can be helpful to facilitate this Late Adulthood Source: Worden, (2002). Loss, Grief & Mourning 3. ADJUST TO THE NEW ENVIRONMENT: External adjustments include dealing with practical realities & loss of social roles Internal adjustments may relate to the person’s identity as a child or a partner of the person who is deceased Spiritual adjustments, coming to some understanding of the meaning of the person’s life & the loss, need to be made. 4. FIND A WAY TO MAINTAIN CONNECTION WITH THE DECEASED Late Adulthood Source: Worden, (2002). Social Dimension Families & Groups Parent-Child Relationships Communities & Support Systems The Continuum of Care Social Strengths & Hazards Elder Abuse & Neglect Late Adulthood Parent-Child Relationships Increased health & longevity have complicated parentchild relationships, & there is considerable ambivalence about giving/receiving help & the changing roles Caregiving is a broad term that may describe: • • • • Hands-on assistance with activities of daily living Helping to hire & manage professional caregivers Making decisions about care for a parent who needs help Overseeing the care a parent receives in a nursing home Contributors to Resilience in Family Caregivers Distancing from the care situation, physically & emotionally Regular physical exercise Keeping up personal hobbies Having at least one close confidant for emotional support Personal religious beliefs A philosophy of duty toward the parent Sense of humor Source: Adapted from Ross, Holliman & Dixon (2003). Late Adulthood Communities & Support Systems: The Continuum of Care Long-term care- Medical & social interventions for those who have chronic illnesses or impairments that are geared toward helping a patient live as satisfactorily as possible in an appropriate, least restrictive setting Senior living options: Independent living senior apartments Low-income-housing tax credit properties Board & care homes or adult foster homes Freestanding assisted-living facilities Continuing care retirement communities Nursing homes Late Adulthood Elder Abuse & Neglect Elder abuse includes any mistreatment of older adults, whether it is abuse or neglect, intentional or unintentional Physical Abuse, including Sexual Abuse Emotional Abuse Financial Exploitation Self-Neglect occurs when an independent older person is incapable of necessary self-care resulting in being malnourished, dehydrated, dirty, ill or living in a cluttered, unsafe environment Self-Neglect usually relates to dementia or psychiatric illness of an elder who lacks involved family nearby Late Adulthood Risk Factors & Signs of Elder Abuse & Neglect Presence of family member’s mental illness, or drug or alcohol abuse Stressful life events for the family, such as financial loss, death, divorce Cognitive impairment of the older person (more likely to be neglected) Physical impairment/dependence on others for physical needs (more likely to be abused Late Adulthood Risk Factors & Signs of Elder Abuse & Neglect Older person’s social isolation Poor hygiene & nutritional status; obvious lack of care The older person appears hypervigilant or nervous The caregiver displays hostility & impatience toward the elder Late Adulthood Causes of Elder Abuse & Neglect Caregiver Stress- Refers to situations in which the caregiver becomes overwhelmed by the demands of the dependent elder Caregiver may perpetrate abuse in a moment of anger/stress or may neglect the person’s needs Caregiver stress only accounts for a very small amount of abuse cases Wolf (2000) cites multiple risk factors that cause elder abuse, including the earlier relationship of the victim & abuser, the abuser’s mental state & the lack of appropriate alternative services or caregivers Caregiver Impairment- Refers to a caregiver’s mental illness, personality disorder, or substance abuse & may involve more serious acts that are perpetrated repeatedly Ecological Model of Elder Abuse Views elder abuse as multidimensional & linked to other social problems Late Adulthood Developmental Considerations for Assessment in Late Adulthood ROUTINE OBSERVATIONS • Examples: Chronic health conditions; functioning in activities of daily living; medications used & their side effects; Opportunities to exercise; Mental status: memory, judgment ; social and community opportunities ; family support or conflicts Late Adulthood Developmental Considerations for Assessment in Late Adulthood STRENGTHS & LANDMARKS OF DEVELOPMENT • Examples: Maintaining interests & activities to capability; interest in remaining as independent as possible; interest in sexual expression & companionship; desire to leave a legacy; desire to maintain family & friendship connections; may take comfort in religious beliefs or spirituality Late Adulthood Developmental Considerations for Assessment in Late Adulthood DEVELOPMENTAL ISSUES (NOT PROBLEMS) EXAMPLES: Physical vulnerability due to senescence of bodily systems; cognitive processing speed decreases; short-term storage & recall memory decreases; strengthening of religious beliefs (sometimes); selective about appropriate activities & interests; may need to give up drive; may need supportive end of life care Late Adulthood Developmental Considerations for Assessment in Late Adulthood DEVELOPMENTAL OBSERVATIONS REQUIRING ATTENTION EXAMPLES: Little affect; lack of interest or enjoyment; talks of being worthless or being a burden; social isolation; slurred speech or otherwise not alert; walking unsteadily but without cane or walker; possible alcohol misuse; repeats same questions, gets lost, obvious memory loss; signs of physical neglect- dirty, unkempt, bedsores; signs of nutritional deficiency- too thin, little food in the house, etc. Late Adulthood Your final project is due at the end of Unit 9. For Unit 10, please read the article titled, From Tragedy to Triumph: Counselor as Companion on the Hero’s Journey. I encourage you to post to the discussion board in Unit 10. Thank you for a great term! Jordyn Amaya Garner Late Adulthood A fond farewell… You have all been wonderful. Thank you so much for your hard work and your thoughtful contributions. I have learned a lot myself from your insight and experiences and I am so glad to have had you all in my class. I hope to see you again in the future. Best, best wishes to you all! Late Adulthood