Aging: Promoting Awareness and Advocacy

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• Aging Promoting Awareness and Advocacy
• Dean D. VonDras, Ph.D.
• Human Development and Psychology Departments
• University of Wisconsin-Green Bay
• vondrasd_at_uwgb.edu

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• Overview
• Recognizing physical/psychological/social
  interactions
• Recognizing functional changes due to age and
  disability
• Promoting awareness and advocacy

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•   

Psychological
Physical
Social
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•  Observable Physical Changes with Age
•  Skin and face wrinkles, sagging, leathering
•  Hair thinning and graying
•  Height decreases
• Weight increases during middle adulthood,
  i.e., the middle-age spread, and often
  decreases in old age, especially in physically
  fragile older adults
•  

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• Declines in Sensory-Perceptual Processes with
  Age
• Vision and Hearing
• Taste and Smell 
• Somethesis Skin, Temperature, Pain
• Proprioception sensations generated by the body
  that let you know the location of limbs in space
• Kinesthesia ones sense of location while
  moving through space 

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• Changes in Hearing
• Presbycusis age related hearing impairment
• Caused by deterioration of mechanisms in the
  inner ear, long-term exposure to loud noises,
  certain drugs, an improper diet, or genetic
  factors. 

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• Decline in sensitivity to tones and pitches
  different frequencies decline at different rates
  with advancing age.
•  
•  

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From Ordy et al. (1979), Age differences in the
functional and structural organization of the
hearing system in man, in, Ordy and Brizzee
(Eds.), Sensory Systems and Communication in the
Elderly.
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• Speech perception becomes more difficult due to
  the decline in tone and pitch sensitivity.
•  

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• Ways to make your speech heard
• Talk in a lower pitch but distinct voice
• Articulate every syllable -- speak clearly
• Talk face to face -- read my lips

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• Causes of Disability
• Congenital occurring at birth
• Accident/injury
• Because of illness/disease
• Age-related

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• Keep in mind
• A disability may not be obvious to others.
• A disability is more likely to occur in old age.

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Most Prevalent ChronicConditions in Later-life

1. Arthritis
2. Hypertensive Disease
3. Heart Disease
4. Hearing Impairments
5. Musculoskeletal impairments
6. Chronic Sinusitis
7. Diabetes
8. Visual Impairments

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Most Feared Conditions in Later-life

1. Alzheimers Disease - Dementia
2. Stroke/Cancer
3. Physical disability that prevents independence
   and autonomy of normal life (e.g., Parkinsons
   Disease)
4. Heart Disease/Chronic Pulmonary Disorder
5. Deafness/Blindness      

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• Old age and disability impact upon
• Activities of daily life (ADLs)
• Instrumental activities of daily life (IADLs)
• Sense of self

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•  

Ideal Self
Real Self
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• Stereotype a social belief about a group of
  people.

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• Stereotypes linked with traits of older adults
• Negative Stereotypes -gt Traits
• Severely impaired -gt Slow-thinking, feeble,
  senile
• Despondent -gt Sad, hopeless, afraid, lonely
• Shrew/curmudgeon -gt Ill-tempered, stubborn,
  bitter
• Recluse -gt Quiet, timid, naive

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• Positive Stereotypes -gt Traits
• Golden-ager -gt Active, independent, happy
• Perfect grandparent -gt Loving, supportive, wise,
  kind
• J. Wayne Type -gt Patriotic, proud, religious

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• Loss Continuum Model (Pastalan, 1982)
• Views aging as a progressive series of losses
  that reduces ones social participation.

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Shrinking Environment with Loss

Greatest physical limitations--home
bound/residential care
Later life--with increasing physical decline
Later life--healthy
Young adulthood--Healthy
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• Person-Environment Interaction and Optimal
  Aging
• Kurt Lewins (1936) conceptualization
• B f (P, E)
• Behavior is the function of both the person and
  environment

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• Competence and Environmental Press Model (Lawton
  and Nahemow, 1973)
• Behavior is a result of a person of a particular
  competence in an environment of a specific press
  level.
• Behavior exists on a positive-negative continuum
  and is observable at the behavior and affect
  levels.

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• Competence the theoretical upper limit of a
  persons capacity to function.
• Environmental press the demands placed upon the
  person.
• Adaptation level where press is in balance for
  particular level of competence.

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• Five Domains of Competence by Lawton and Nahemow
• Biological health
• Sensory-perceptual functioning
• Motor skills
• Cognitive skills
• Ego strength

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Positive affect and adaptive behavior
Negative affect and maladaptive behavior
Marginal
Marginal
Adaptation level
Maximum performance potential
Low Competence High
Negative affect and maladaptive behavior
B
A
Weak Environmental Press Strong

• Competence-Environment Press Model (from Lawton
  and Nahemow, 1973)

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• The less the competence level of the person, the
  greater the impact of environmental factors

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• The competence-environmental press model is a
  useful lens of analysis for interventions in that
  it describes a scaffolding process, where
  modification of environment can increase
  adaptation.
• E.g., arranging living environment designs to
  increase social interaction

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• Ways to enhance a sense of competency
• Speak to a person, practice Bubers I and Thou.
• Be respectfulrecognize independence and
  autonomy.
• Recognize abilities and skillswisdom.
• See development occurring despite disability and
  infirmity.
• Respect cultural differences in reaction to
  changes in life, e.g., death.

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• Promoting Awareness and Advocacy
• Different instructional activities and levels of
  student engagement

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• Levels of student engagement
• Listening and reflecting Taking it in or
  tuning out
• Telling about personal observations or
  experiences This is what happened to me
• Simulation experiences finding out for yourself
• Discussing different perspectives exploring
  contrasts, finding similarities
• Problem solving I identifying problems
• Problem solving II generating and testing
  solutions

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• Self-Discovery Activity
• What are the Most Valuable Things in Your Life?
• List the 5 most valuable things in your lifeand
  explain why they are important
• Now, choose one of the aspects you mentioned to
  give up. Which one would it be and why?
• Now choose two other of the aspects you noted
  above to give up. Which would these be and why?
• How might giving up these aspects of your life
  reflect the losses the elderly endure?
• How do you think you will cope and adapt, as you
  encounter losses with age?

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• Film Review Essay
• Review a film where the main characters are
  elderly
• Then compose an essay discussing how theories and
  research discussed in class coincide with
  characterizations or themes expressed in the
  film.

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• Interview an Older Adult
• Conduct a semi-structured interview of an older
  adult and provide a case study discussing how
  your understanding of the person coincides with
  theories and research discussed in class.
•  
• Our learning goal is to find practical
  application of theory and research to real
  lives and experiences, and further our
  understanding of various aspects of adult
  development and aging.

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• Sensory-Perceptual Deficit Simulation
• Materials
• Two cotton balls and about 2 feet of plastic wrap
• Procedure
• Gently place cotton balls in each ear canal
  this will simulate changes in hearing that might
  occur in old age.
• Bunch up and then gently place the wrap across
  the bridge of your nose as if they were eye
  glasses this will simulate changes in the
  peripheral visual mechanisms that might occur
  with cataracts.

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• Web-based learning activities
• Common Causes of Age-Related Vision Loss
• Lighthouse International Visual deficit
  simulation exampleshttp//www.lighthouse.org/pat
  ient/default.htm
• Noise-Induced Hearing Loss
• Health and Safety Executive Auditory deficit
  simulation examples(This site allows a download
  to your computer)http//www.hse.gov.uk/noise/dem
  onstration.htm

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• An online version of the Implicit Association
  Test (IAT, Greenwald et al., 1998)
• The IAT is found at the Internet web project
  sponsored by the Southern Poverty Law Center
  http//www.tolerance.org/
• Students Assignment
• Visit the web site, read about the IAT, complete
  two online tests.
• Read tutorials on stereotypy and prejudice.
• Write a brief reflection paper regarding this
  experience.

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• A sample of students narrative responses
• I learned that perhaps I had biases that I was
  not aware of I felt that I had very positive
  attitudes toward older adults, but I was amazed
  to find out that I did indeed have biases!
• I saw that even though you may not believe that
  you have bias towards others, unconsciously you
  probably do. Society has a huge influence over
  us.
• I really did not learn very much from this
  activity. I feel this was more of a hand
  eye-coordination exercise than an attitudes test.
  If you really want to see how people have
  attitudes towards others then you need to ask
  them questions and do follow-up studies.
• I learned that there are a lot of different ways
  to be biased against others.

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• Classroom advocacy assignment
• Identify an issue or problem, e.g., rising health
  costs, adapting to environmental press, etc.
• Assign small groups a unique case to discuss
  and have them identify important concerns and
  possible solutions for the individual(s)
  represented in the case.
• Cases may include the following individuals
• - cognitively impaired elderly
• - institutionalized elderly
• - chronically ill elderly
• - economically disadvantaged elderly
• - mentally ill elderly
• - family caregivers of older adults
• - widowed elderly
• - new immigrant elderly
• - older adults from different ethnic backgrounds

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Means, Standard Deviations, and Spearman
Correlations of Survey Measures with Advocacy
Perspective (N 74)
Scale/Item Mean (SD) Advocacy Perspective a
Discussion Activity
Increased insight 7.32 (1.49) .23
Created new awareness 7.20 (1.55) .25
Enhanced understanding 7.49 (1.57) .17
Gained knowledge 7.27 (1.57) .16
Overall discussion score 49.90 (9.98) .24

Position of Advocate
Helped realize important concerns 6.97 (1.76) .33
Helped find insight into problems 6.91 (1.85) .22
Helped understanding issues 7.07 (1.95) .26
Overall perspective-taking score 49.14 (10.42) .30
p lt .05, p lt .01. a 0 advocacy is for
self or student perspective 1 advocacy is for
unique group of older or disabled adults
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Sampling of Student Narrative Responses
Discussing What is Learned When Serving as an
Advocate is a Required Aspect of Discussion
From the new perspective, insight is gained, and different comprehension of the same questions.
Thinking of how I want to be treated at 90.
Thinking outside the box.
I learn by hearing all the sides of the debate. It is never one sided there are many opinions and voices to be heard.
Get to see different views from different positions. This just allows for a more open perspective in daily life.
We were able as young people to debate what we may want, even if it could potentially affect the elderly.
Many people have different ways of looking at the same topic. Small group discussion allowed us to look at our topic through different vantage points. Also, giving us a unique group helps us think of various people affected by the topic.
Mentally ill elderly probably don't know a lot about what is happening so the more we can help them and their families the less confused they will be.
Have to consider the perspective, develop an argument, find credibility or resources to back it up defend your view.
You learn many more ways to look at a critical subject and not just the books view or the teachers.
It helped me understand the issues better.
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• Overall
• The advocacy role takes the student beyond their
  usual realm of thinking and experience, enhancing
  depth-of-learning.
• The activity stimulates a wide variety of
  learning behaviors, e.g., interactive inquiry,
  critical analysis, empathic understanding, etc.

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• Things an advocate can provide informally
• Moral support
• Sense of belonging
• Self-esteem
• Recognition of competency and mastery
• Practical aid
• Safe environment

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• Acting with Empathy
• Empathy recognizing and understanding the
  state of mind, beliefs, desires and emotions of
  another person without interjecting your own.
• Putting yourself in anothers shoes

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• Sympathy feeling sorry another person.
• Empathy ? Sympathy

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• Avoid patronizing speech remarks that reflect
  stereotypes of incompetence and dependence.
• Avoid infantalization e.g., using terms of
  endearment, using simple language, etc.

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• Bernies Travels
• 1. Attended McBride HS -- all-conference and
  all-district as a senior.
• 2. Attended UMSL 3-year starter, 5th in career
  scoring, senior co-captain and MVP in 1971-72.
• 3. Assistant coach at McCluer North HS
  1972-1974.
• 4. Head coach at McCluer High 1974-1975 Class
  4A State Champions.
• 5. Returns to UMSL as Asst. Coach, 1975-1977.
• 6. Head Coach Jefferson College, 1977-1985
  182-69 record, eight 20-win seasons, Region 16
  East finals 5 times.
• 7. Moves to Murray State (Ky.) 1985-1989 as
  recruiting coordinator1988 NCAA tournament, 1989
  NIT.
• 8. Southwest Missouri State Assistant Coach,
  1989-1992.
• 9. SMS Head Coach 1992-1995 48-37 record, NIT.
• 10. Assistant Coach New Mexico State -- 1996
• 11. Head Coach at Kirkwood High in St. Louis --
  1997
• 12. Head Coach at University of Missouri-St.
  Louis -- 1999

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We need to meet all kinds of people so that we
can find ourselves. Young people need older
people just as older people need young people in
order to become more themselves and more human.
That humanizing process will teach us that there
is a child behind the mask of each older face,
just as there is already an older person behind
the mask of each young face. Leo. E.
Missinne (1990)