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PSY 447 study guide test 2 Questions With Complete Solutions Negativity Bias which is the tendency to form an initial impression that is negative and then cling to that even when further information proves more positive. (This is NOT limited to older adults!) This is a problem for many older adults (and more so their family members) when the older adult must involuntarily move to a new residence - typically, a care facility or a small apartment. Positivity bias the tendency to focus heavily on a person's positive attributes when forming a perception Social scripts (social knowledge) Social knowledge (p. 228) can also refer to social scripts. This is knowledge we have regarding how to behave in certain social contexts. It is often just "picked up" and not formally taught. Dispositional attribution assuming that another's behavior is due to personality factors, not situational ones Situational attribution
attribution to factors external to an actor, such as the task, other people, or luck Cognitive Style People differ in their approach to problem-solving (pp. 234-235, "Cognitive Style" Age based double standard Examples of stereotyping include the age-based double standard, whereby we attribute certain behaviors to age-based "failings" when they occur in older people and to other factors when they occur in younger people. Patronizing talk/ elder speak Why is moving important when it comes to social cognition? (Multiple ways! Examples!) older adults are at a disadvantage when the social context is cognitively demanding" (p. 228, top of 2nd column) and then notes that "conditions of time pressure and multiple distractions" are examples of a demanding social context. You can imagine an older adult moving (involuntarily) into an assisted living facility and finding the sheer numbers of people (and most likely all strangers, whether other residents or staff members), geographic layout (this hall to the dining room or that hall? And where is the activity room again?), schedule of activities (piano sing-along at 10:30 on Tuesdays and Fridays, but at 3:00 on Mondays and Thursdays), and meal times overwhelming. This
older person may come across as rude or prickly; his or her social cognition is too taxed by all the other demands to function at its usual level. They may make some poor social decisions (judgments) that have longer-term repercussions, perhaps lashing out at other residents or staff members who are only trying to provide assistance. Explain negativity bias re age relevance, the continuation of it, voluntariness, etc. the tendency to form an initial impression that is negative and then cling to that even when further information proves more positive. (This is NOT limited to older adults!) This is a problem for many older adults (and more so their family members) when the older adult must involuntarily move to a new residence - typically, a care facility or a small apartment. They don't like their room or apartment, they don't like the other residents, they don't like the food, they don't like the activities, they don't like the staff, they don't like the view, they don't like the this and the that and the everything. (They are a lot like teenagers who have been forced to move, which just goes to show that this is not necessarily an AGE thing.) What is happening here is partly a rebellion against being forced to move. No one likes being forced to do something they resent, so the initial reaction is understandable. However, the continuation of it becomes a problem. (Because no one likes to be around someone who does nothing but complain.) This somewhat points out the importance of the older person him- or herself choosing the care facility or
new home. At least then they are likely to be aware that there are some positive aspects. Older adults are at a disadvantage when the social context is ___. cognitively demanding
- Explain the above with regard to moving to a new residence. "conditions of time pressure and multiple distractions" are examples of a demanding social context. You can imagine an older adult moving (involuntarily) into an assisted living facility and finding the sheer numbers of people (and most likely all strangers, whether other residents or staff members), geographic layout (this hall to the dining room or that hall? And where is the activity room again?), schedule of activities (piano sing- along at 10:30 on Tuesdays and Fridays, but at 3:00 on Mondays and Thursdays), and meal times overwhelming. This older person may come across as rude or prickly; his or her social cognition is too taxed by all the other demands to function at its usual level. They may make some poor social decisions (judgments) that have longer-term repercussions, perhaps lashing out at other residents or staff members who are only trying to provide assistance.
- Who makes snap judgments? "we all make snap initial judgments ..."
- How do older people differ (re younger people) with regard to snap judgments? p 230 "older adults consistently hold to their initial judgments or conclusions ... more often than younger adults."
- Do older adults tend to focus more on dispositional attributions, situational attributions, both, or neither? Explain. top of page 231, middle-aged and older adults have life experiences that cause them to consider both dispositional and situational attributes when explaining behavior.
- What is the #1 reason parents give for physically abusing their very young child? #1 reason why children under age 2 years or so are physically abused by their parent figures is because they are crying.
- What is the #1 reason parents give for physically abusing their 2-to-6-year-old child? The #1 reason for children about two to five or six years is they have wet or soiled their pants / bed.
- People who have strong beliefs about certain behaviors tend to make what THREE kinds of attributions? people who have strong beliefs about certain behaviors tend to make more rapid and negative and dispositional attributions than people who are less rigid.
- How are cohort differences and salience important when examining social cognition? (details!) 223-224 can be summed up by cohort differences and salience. The textbook says, "older adults may hold different beliefs than other age groups" (which is more about cohort than age); and "how strongly individuals hold these beliefs may vary as a function of how particular generations [cohorts] were socialized" (both on p. 223, 2nd column). The example of cohabitation (or as my grandmother said, "living in sin") is a much bigger problem for today's oldest adults than it will be for the oldest adults in 20 years (thus, a cohort effect, not an age effect).
- Social judgments are based on three main things - what are they? Be able to give examples of how they work. social judgments are a function of our life experiences, our personalities, and what is important to us NOW, and not just our age. (If you decided at age 16 that "old = bad," and at some point realize you are old, then you are going to run screaming from anything that makes you seem old/bad. But if you realized at age 20 or 25 that "old = interesting" or "old = lots of things" - well, then older age won't seem so frightening / terrible to you.)
- What are the several reasons that goals and motivations may change as people grow older?
- It is true that quite old, or quite frail, adults do carefully consider where to expend energy and hoard their resources (if they go to the bridge game this afternoon, they'd better have a lie-down in the late morning or they won't have the energy to concentrate and keep up with the conversation). But that is not typical of most people under age 75 or 80, many of whom are very clued-in, social-cognition-wise
- Priorities and values shift over time, and we find certain situations less interesting or worthy of attention.
- Maybe it's that many older adults have already achieved certain goals and are no longer interested in them. Maybe it's that over time some goals just become less important.
- What kinds of details are older adults more likely to recall? Why? As noted on page 234, older adults are more likely to both focus on and recall pleasant and positive details and events than unpleasant or negative ones. This is partly because as you get older, you realize how much energy is wasted on anger, resentment, bitterness, and other negative emotions.
- How do Thinking types differ from Feeling types? Myers-Briggs, this gets at the Thinking vs. Feeling ("How You Make Decisions") and the Judging vs. Perceiving ("Your Attitude Toward Life") aspects. Thinking types are drawn
toward facts, while Feeling types are drawn toward emotions - theirs and others'. Thinking types may choose a course of action that seems rude to others; Feeling types may do something that is against their own best interest to avoid hurting another person's feelings.
- How do Judging types differ from Perceiving types? Judging types prefer predictability and like to get decisions over with. Perceiving types like to keep their options open for as long as possible and enjoy novelty and variety. We have these preferences from very early ages, though we can learn to act like and appreciate the opposites.
- Why are older people (usually) so comfortable with their routines and living environment? However, as people age they generally do become more comfortable with their routines (after all, they created them!) and their living environment (they created that, too). This is why involuntary changes in either can be very upsetting and taxing to their energy and disposition. It is people who already have a "high need for closure" and who already tend to "make stereotyped judgments" (1stcolumn, p. 235) who reflect the more rigid stereotype we often attribute to older adults (conveniently forgetting the many older adults who do not fit that stereotype). Many older people do not want to make quick
decisions - they would much rather drag it out or, in some cases, have someone ELSE make the decision for them In what ways are some cultures more positive in their views of older adults? Why? However, many other cultures (Hispanic, Asian, Native American, African-American, etc.) hold much more positive views of older members of their societies, seeing them as leaders and deserving of respect and honor. This may be due to in part to the greater integration between older and younger members in those cultures, with older people continuing to be actively engaged in families (e.g., Hispanic grandmothers who care for their grandchildren and great-grandchildren), local institutions (e.g., older African-American women as leaders in black churches), and the economy (basket-makers and rug-weavers among the Navajo). What are examples of patronizing talk / Elderspeak? Another example of stereotyping is patronizing talk (also known as Elderspeak, Infantilizing, and patronizing speech, p. 221, 1st column). This mimics the way adults talk to young children and can include a higher pitch, a sing-song tone, the use of plural pronouns (as in "are we ready for our bath?" - are you climbing in the tub with them?), the use of demeaning phrases such as "well, well" and "now, now" (as in "Now, now, we don't want to make a mess, do we?"), and childish expressions such as "go potty" or "make wee-wee" instead of adult phrasing. It can also
include a LOUDER AND S L O W E R VOICE THAN USUAL, which may be appropriate if the other person has a hearing loss, but many older people can hear just fine (often thanks to hearing aids) and do not need the amplification. CHAPTER 5 !!! B = f(P,E) "Behavior is a function of both the Person and the Environment." Environmental press Environmental press is the demands your environment makes on you and therefore whatever you need to do to manage your environment, whether physical (a half-acre of lawn to mow or the need to do laundry in the basement), interpersonal (the patience required to answer the repeated questions of your spouse with Alzheimer's, over and over, all day long), or socio- cultural (learning to cook and do laundry or do home repairs, even though those tasks are not part of your cohort's or culture's gender roles). Ecology of Aging seeks to understand the dynamic relations between older adults and the environments they inhabit Congregate Housing an increasingly popular long-term care option- provides a variety of support services, including meals in a common dining
room, along with watchful oversight of residents with physical and mental disabilities PEI prevention and early intervention Aging in Place Proactive Agnes chose to be proactive. Agnes believed SHE could control her health, by taking certain steps. Agnes has an internal locus of control Assisted Living (ALFs) Competence Docile Agnes chose to be proactive. Ruth chose to be passive (or docile). Each made a CHOICE. This applies to many situations in life, from starting college to moving to a new city to retirement. Agnes believed SHE could control her health, by taking certain steps, while Ruth believed that her poor health was inevitable. Agnes has an internal locus of control while Ruth has an external one. Adult Daycare
Adult Day Care is like child day care, in that it is a group setting where a number of adults who need assistance can spend the day. How do older adults often wear rose-colored glasses when it comes to moving? What other age group tends to do this, too? Many older people focus on the positive aspects of their (current) environment and minimize the troublesome ones, which is why they stay in neighborhoods and houses that are becoming less safe (crime, stairs). If they do feel forced (by others) to move, they often focus on the negative aspects of their new environment rather than taking a more open-minded approach. (This also applies to teens and tweens whose families are moving. )
- Understanding psychosocial aging means focusing on __, rather than __. (p. 129) individual's needs // treating all older adults alike
- Who (ages) does environmental press affect? Environmental press applies to people of all ages - but it becomes more challenging as people get older, in part because it is psychologically frustrating to struggle to do something that used to be easily completed or that is totally foreign to what you are used to doing.
Be able to give / identify examples of physical, interpersonal, and social environmental press, regarding older age. whether physical (a half-acre of lawn to mow or the need to do laundry in the basement), interpersonal (the patience required to answer the repeated questions of your spouse with Alzheimer's, over and over, all day long), or socio-cultural (learning to cook and do laundry or do home repairs, even though those tasks are not part of your cohort's or culture's gender roles).
- What constitutes inappropriate environment press? What should the environment provide us? when the environment is too easy / bland / dull OR too challenging / hyped-up / complicated (etc.) we don't tend to perform well. In the first case, we become numb and sluggish and blah. In the second we become stressed and tense and anxious. What we all need, regardless of age, is an environment that provides us with appropriate challenges to either increase our capabilities or at least maintain them, but not so many challenges that we either fail in our attempts or learn to give up.
- In terms of an environmental press, how (SPECIFICALLY) can homes provide too much press for many older people, and how (SPECIFICALLY) can care facilities provide too little? My parents, as much as they loved where they lived in the condo, did not like walking on icy sidewalks or driving on icy
roads. They sometimes found themselves in the winter time unable to leave their condo for a day or two (and rather bored), for fear of falling or having a car accident. Icy sidewalks and roads for them are too much environmental press. Those environments do not offer us any challenges or interesting stimulation. Many care facilities (nursing homes, assisted living communities) are much like that.
- Understand internal locus of control and external locus of control. locus of control, which refers to where you locate control in your life People with an internal locus of control believe that they can control the things that happen to them, or at least how they react to them. People with an external locus of control believe that outside forces control their lives and there is little (or nothing) they can do to change that. Understand the Congruence Model and be able to give / identify examples of congruence related to older age (and of incongruence). The Congruence Model states that "people vary in their needs and environments differ in their ability to satisfy those needs;
thus, people with particular needs search for environments that meet them best." Congruence Model focuses on 1) three types of limitations - those that are about the environment (such as when no reliable public transportation is available), those that affect a person's freedom (such as what time they can eat or what kinds of meals they can have), and those that are within the person (such as fear of falling, prejudice, etc.) - as well as 2) individual differences (poverty vs. financial comfort, a shy vs. outgoing personality), and the importance of 3) competence (abilities, such as getting dressed, managing stairs, etc.). In addition, it focuses on people living in care facilities, though it can also apply to other situations. Older people may choose to live near bus lines or universities with Lifelong Learning classes or their grandchildren. They may decide to retire to the mountains or the ocean or a big city high- rise. All of us, all of our lives, make decisions about what environment best suits our temperaments and competencies. Feeling that you are "at home" means feeling a sense of belonging as well as having some control over your surroundings and daily life. This is where there can be a LOT of incongruence between institutional rules and personal preferences. We've looked at things like mealtimes and activities, but it can include less tangible things as well.
- What are examples of limitations and individual differences regarding care facilities? Older people who live in a care facility find that while there may be many positive aspects, there will likely also be some limitations - meals are served in specified "windows" (breakfast from 7-9, lunch from 11-1, dinner from 4:30-6:30 - if you want to sleep in and have breakfast at 10, you are out of luck). Your room is too small to fit your piano, and you feel uncomfortable playing the "public" one in the activity room. (Especially because most of the day that room is being used for activities.) Some 80-year-olds want to live in an active living environment with lots of people and things to do. Others prefer a more intimate setting, with lots of quiet time for reading, reflection, or individual endeavors such as painting or wood-working. Institutions such as care facilities need to take into account the individual differences in their residents. Some will want their door closed at all times (for more peace and quiet), others will want theirs open as an invitation for others to come in.
- What is the Platinum Rule and why is it better than the Golden Rule? There is a saying, known as the Golden Rule that states, "Do unto others as you would have them do unto you" - but that assumes that other people have the same preferences you have. A better saying, known as the Platinum Rule, states "Do unto others as they would like to be done to."
- Why is the personal freedom issue a bigger deal for someone in a care facility? No matter how much a care facility might try to be like a person's home, there will still be limitations in what they can do. It isn't like the 80-year-old in the nursing home can't handle institutional requirements / rules - it's just that in the past, they weren't part of her HOME. We are supposed to be able to make our own rules in our own home.
- In most cases, who selects a care facility? the decision to place a person in a nursing home is often made by other people (usually family members). This is a topic I want to stress (and we will look at it again) - the vast majority of older people do not make ANY plans for what they want to do.
- What are ways nursing home staff can send messages that their residents are not competent? Having a sense of competence is important to most people. This is where living in a care facility can create limitations. Unfortunately, in many care facilities, resident competence is not valued as much as it should be and the staff may (because of time pressures) provide assistance that is not really needed. It takes longer to let Aunt Frances dress herself as much as possible so the staff puts her clothes on for her. After a while, Aunt Frances gives up trying to get herself dressed and waits passively for help. (On the other hand, you can see WHY the staff person feels the need to move Aunt Frances along. It would
help if nursing homes had larger staffs, but then costs would go up.) the staff may be the kind who speak to elders in what is called "Elderspeak," which is like "baby-talk" - "Are we ready for our dinner, Sweetie?" said in a sing-song voice. Very disrespectful. The staff may also refer to the residents as "patients," which implies someone who is ILL. Most people in care facilities are not ILL. They need assistance with ADLs, but they may be extremely healthy. The correct term to use is "resident."
- In what ways can care facilities be dull and boring? In what ways can they be more interesting? Too often, care facilities are drab, with little landscaping, and boring views of other buildings. Too often, care facilities make virtually no demands on their residents, and life becomes a dull routine of breakfast at 8:30, chair exercises from 10 to 11, lunch at 12:30, a nap from 1:30 to 3, singing or crafts from 3:30 to 4:30, dinner at 5:30, a movie from 7 to 9, and bed at 9:30 - day after day after day after day .... You can see why residents of nursing homes are ALWAYS happy to see a visitor - especially if the visitor brings something interesting to do or talk about or is a baby or small child . Explain my version of the PCP model. (Now, Attitudes / LOC, Quality of Life)
- We're going to combine A and B and E and call it NOW. NOW is whatever your current situation is, given time and place and past experiences / decisions (of yours or others that affect you). Right NOW, you live in a community with excellent (or lousy) public transportation, you have excellent (or mediocre) health insurance, your income is adequate because you invested well during your working years (or you lack retirement
- We are also going to combine C and D. These include our ATTITUDES - optimism (or pessimism), openness to new experiences (or fear of the unknown) - as well as our LOCUS OF CONTROL (choices we make) - eat healthily, exercise, move to a home that does not have stairs, take advantage of the internet to stay in touch with far-flung family members and friends.
- All of the above (1 and 2) combine to create the person's QUALITY OF LIFE, which includes your moods (happy, sad, lonely, regretful, excited, contented or longing for more, etc.), the enjoyment (or not) you get from your activities, and the value you place on how you spend your time and the people you interact with (too much time spent doing nothing, too much time interacting with medical people, not enough time with grandchildren, etc.). Thus, N + A + LOC = QOL
- The focus must be on the interaction between ___ and ___, not on ___. (p. 133) "the focus must be on the INTERACTION between the person AND the environment, NOT on one OR the other"!
- The text says that "even seemingly small changes in a person's environment can result in major changes in behavior." What are examples of these?
- Why is it overall better for older people to "age in place" as long as possible? Aging in Place. This is the goal for most older people and of most organizations that serve them. The longer a person can continue to live in his or her own home, the happier and more independent they tend to be and the less money they (and taxpayers) spend The philosophy of aging in place says that it is usually better to make some modifications to the current home environment than to uproot the older person and force them to adapt to an entirely new environment
- What are ways to modify and / or simplify a person's environment / behavior for a better fit? Common modifications include implementing the fall prevention strategies (grab bars and "hand holds," etc.), hiring out some work (lawn care, heavy housework), and simplifying
other things (such as making some food items in bulk and then microwaving them for later meals, rather than having to cook every day). They may also include bigger changes - converting a 1st-floor office to a bedroom with a small bathroom; adding ramps to the front and back porches; installing an elevator, taking out the standard bathtub and putting in a one-level snail shower that will accommodate a wheelchair. (This all relates to the SOC model, as you may have noted.)
- What about the person's home makes it hard (especially for women) to leave? Most people, and especially women from the older cohorts, find their home truly is a "source of identity." It may be where they raised their children and where they hold thousands of precious memories If they move, they will likely have to rid themselves of many of those items, as well as lose the daily joy of walking through the place they created to be "theirs."
- What kinds of non-gloomy housing decisions (to move) do older adults often make? The place they chose has many awesome amenities (240 acres, work-out facility, lifelong learning classes, lovely restaurant) and living choices - they chose an independent house with garage, but could later move to an independent apartment, the assisted living part of the CCRC, the nursing home, or the
memory care section. Stay put, or move to the beach? Stay relatively put, but downsize to a smaller home? Stay put, or move to where the grandchildren are growing up? Except half the grandchildren are in Houston and the other half are split
- What makes moving in one's older years more stressful? That move was extremely wrenching. My mom was at first happy about being near more family, but mostly she could not remember what was going on and soon the happiness gave way to anger. My dad had to say a more-or-less permanent goodbye to the city he lived in his entire life, as well as his weekly running group, the high school friends who still got together monthly for lunch, the other high school friends who still got together monthly for dinner, the cousins he grew up with, etc. (It was slightly helpful that the day before they left, the high in Dayton, Ohio was 12 degrees.) A big factor in how wrenching a decision to move is lies in its voluntariness Other people must move because of finances, or they must choose a particular place because of financial limitations. They do not want to move, but they can't afford to stay where they are. Taxes may have gone up, heating bills for a large house may
have gone up, etc. They may downsize to a more affordable condo or to a cheaper part of town or region of the country.
. As noted, it is best if the older individual is involved in the decision-making, but why does that often not happen? (Multiple reasons, including for #12 above.) If you choose to move (the move is voluntary), it is usually for positive reasons. My parents CHOSE to sell their house, buy the two condos, sell the Sun City condo, sell the Ohio condo, and move again to a community they also chose. But then they (or at least my dad) was pretty much forced to make the move to Phoenix, due to the need for more help. You can argue that he "chose" it, but the situation was untenable in Ohio and he was essentially backed into a corner. but that is often not the case, when the individual in question is recovering from hip surgery or a serious stroke.
- What are the three types of adult day care? social (which provides meals, recreation and some health-related services), medical/health (which provides social activities as well as more intensive health and therapeutic services) and specialized (which provide services only to specific care recipients,
- Understand MediCAID vs. MediCARE. How do they apply to nursing home care?
Medicaid is health insurance offered to people who are at a certain level of poverty. This can vary from state to state. Medicaid recipients are children, teenagers, young adults, middle-aged adults, and older adults. The defining issue for Medicaid is POVERTY. Medicare is health insurance offered to those 65 and over. Your income does not matter. Millionaires have Medicare coverage. The defining issue for Medicare is AGE. Medicaid usually will pay for at least some adult day care expenses. Medicare typically does not. Medicare also does NOT pay for long-term nursing home care. (It will pay for short-term rehab, for up to 100 days.) Thus, if an older person needs to move permanently to a nursing home, they have to pay for it out of pocket (with their own cash, savings, proceeds from the sale of their home, etc.). However, if their income is low enough (again, this varies by state), they can be eligible for Medicaid coverage, because Medicaid DOES pay for nursing home care. Thus, older adults are also motivated to "spend down" their assets, in order to qualify for Medicaid. (There are government regulations to prevent this from happening too quickly, as it is the taxpayers who then pick up the tab. Some nursing homes do not take Medicaid recipients, because the reimbursement rate from Medicaid is less than most charge. Others do take Medicaid recipients, but only if they have first
"bought in" to the retirement community (as my parents did), by providing a fairly large sum of money up-front or, as with my sister-in-law's mother, paid extremely high fees until their money does run out. These infusions of cash then guarantee the person the same standard of care, no matter how long the person lives
- How can care facilities be "culturally appropriate"? having culturally appropriate surroundings is always better. This refers to food (kosher for Jewish attendees?), activities (loteria and telenovelas for Hispanic members?), music (southern Gospel for African-Americans from the south?), the language staff members speak, and so on. These are also true of nursing homes and other care environments
- How do congregate housing and ALFs differ? Congregate housing just means that a lot of people live in the same basic place - if you live in an apartment building, you live in congregate housing. However, some congregate housing is specifically for older adults Assisted Living Facilities (known as ALFs) provide assistance with ADLs and basic medical care (such as making sure medications are taken as prescribed). They also provide housekeeping services and usually two to three meals a day.
- What three attributes should an ALF provide to its residents?