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Aging:PromotingAwarenessandAdvocacyAging:PromotingAwarenessandAdvocacyDeanD.VonDras,Ph.D.DeanD.VonDras,Ph.D.HumanDevelopmentandPsychologyDepartmentsHumanDevelopmentandPsychologyDepartmentsUniversityofWisconsin-GreenBayUniversityofWisconsin-GreenBayvondrasduwgb.eduvondrasduwgb.edu.1 1.1Overview:n nRecognizingphysical/psychological/socialRecognizingphysical/psychological/socialinteractionsinteractionsn nRecognizingfunctionalchangesduetoageandRecognizingfunctionalchangesduetoageanddisabilitydisabilityn nPromotingawarenessandadvocacyPromotingawarenessandadvocacy.2 2Overview:.2.3 3PsychologicalPhysicalSocial.ObservablePhysicalChangeswithAge:SkinandfaceSkinandfacewrinkles,sagging,leatheringwrinkles,sagging,leathering HairHairthinningandgrayingthinningandgraying HeightHeightdecreasesdecreases WeightWeightincreasesduringmiddleadulthood,i.e.,increasesduringmiddleadulthood,i.e.,themiddle-agespread,andoftendecreasesinoldthemiddle-agespread,andoftendecreasesinoldage,especiallyinphysicallyfragileolderadultsage,especiallyinphysicallyfragileolderadults.4 4ObservablePhysicalChangeswDeclinesinSensory-PerceptualProcesseswithAge:n nVisionandHearingVisionandHearingn nTasteandSmellTasteandSmell n nSomethesis:Somethesis:Skin,Temperature,PainSkin,Temperature,Painn nProprioceptionProprioceptionsensationsgeneratedbythesensationsgeneratedbythebodythatletyouknowthelocationoflimbsinbodythatletyouknowthelocationoflimbsinspacespacen nKinesthesiaKinesthesiaonessenseoflocationwhileonessenseoflocationwhilemovingthroughspacemovingthroughspace.5 5DeclinesinSensory-PerceptualChangesinHearing:PresbycusisPresbycusisagerelatedhearingimpairmentagerelatedhearingimpairmentn nCausedbydeteriorationofmechanismsintheCausedbydeteriorationofmechanismsintheinnerear,long-termexposuretoloudnoises,innerear,long-termexposuretoloudnoises,certaindrugs,animproperdiet,orgeneticcertaindrugs,animproperdiet,orgeneticfactors.factors.6 6ChangesinHearing:.6DeclineinsensitivitytotonesandpitchesDeclineinsensitivitytotonesandpitchesdifferentfrequenciesdeclineatdifferentratesdifferentfrequenciesdeclineatdifferentrateswithadvancingage.withadvancingage.7 7.7FromOrdyetal.(1979),“Agedifferencesinthefunctionalandstructuralorganizationofthehearingsysteminman,”in,OrdyandBrizzee(Eds.),Sensory Systems and Communication in the Elderly.8 8FromOrdyetal.(1979),“AgeSpeechperceptionSpeechperceptionbecomesmoredifficultduebecomesmoredifficultduetothedeclineintoneandpitchsensitivity.tothedeclineintoneandpitchsensitivity.9 9.9Waystomakeyourspeechheard:n nTalkinalowerpitchbutdistinctvoiceTalkinalowerpitchbutdistinctvoicen nArticulateeverysyllable-speakclearlyArticulateeverysyllable-speakclearlyn nTalkfacetoface-“readmylips”Talkfacetoface-“readmylips”.1010Waystomakeyourspeechheard.1111.11.1212.12CausesofDisability:CongenitaloccurringatbirthCongenitaloccurringatbirth Accident/injuryAccident/injury Becauseofillness/diseaseBecauseofillness/disease Age-relatedAge-related.1313CausesofDisability:.13KeepinmindKeepinmindAdisabilitymaynotbeobvioustoothers.Adisabilitymaynotbeobvioustoothers.Adisabilityismorelikelytooccurinoldage.Adisabilityismorelikelytooccurinoldage.1414.14MostPrevalentChronicConditionsinLater-life1.Arthritis2.HypertensiveDisease3.HeartDisease4.HearingImpairments5.Musculoskeletalimpairments6.ChronicSinusitis7.Diabetes8.VisualImpairments.1515MostPrevalentChronicConditiMostFearedConditionsinLater-life1.AlzheimersDisease-DementiaAlzheimersDisease-Dementia2.Stroke/CancerStroke/Cancer3.PhysicaldisabilitythatpreventsindependenceandPhysicaldisabilitythatpreventsindependenceandautonomyof“normal”life(e.g.,Parkinsonsautonomyof“normal”life(e.g.,ParkinsonsDisease)Disease)4.HeartDisease/ChronicPulmonaryDisorderHeartDisease/ChronicPulmonaryDisorder5.Deafness/BlindnessDeafness/Blindness.1616MostFearedConditionsinLateOldageanddisabilityimpactuponn nActivitiesofdailylife(ADLs)n nInstrumentalactivitiesofdailylife(IADLs)n nSenseofself.1717.17.1818IdealSelfRealSelf.18 StereotypeStereotypeasocialbeliefaboutagroupofasocialbeliefaboutagroupofpeople.people.1919.19Stereotypeslinkedwithtraitsofolderadults:Stereotypeslinkedwithtraitsofolderadults:NegativeStereotypes-TraitsNegativeStereotypes-Traits Severelyimpaired-Slow-thinking,feeble,senileSeverelyimpaired-Slow-thinking,feeble,senileDespondent-Sad,hopeless,afraid,lonelyDespondent-Sad,hopeless,afraid,lonelyShrew/curmudgeon-Ill-tempered,stubborn,Shrew/curmudgeon-Ill-tempered,stubborn,bitterbitterRecluse-Quiet,timid,naiveRecluse-Quiet,timid,naive.2020StereotypeslinkedwithtraitsPositiveStereotypes-TraitsPositiveStereotypes-TraitsGolden-ager-Active,independent,happyGolden-ager-Active,independent,happyPerfectgrandparent-Loving,supportive,wise,Perfectgrandparent-Loving,supportive,wise,kindkindJ.WayneType-Patriotic,proud,religiousJ.WayneType-Patriotic,proud,religious.2121PositiveStereotypes-TraiLossContinuumLossContinuum ModelModel(Pastalan,1982)(Pastalan,1982)ViewsagingasaprogressiveseriesoflossesViewsagingasaprogressiveseriesoflossesthatreducesonessocialparticipation.thatreducesonessocialparticipation.2222.22.2323Youngadulthood-HealthyLatePerson-EnvironmentInteractionandOptimalAgingKurtLewins(1936)conceptualization:KurtLewins(1936)conceptualization:B=f(P,E)n nBehavioristhefunctionofboththepersonandBehavioristhefunctionofboththepersonandenvironmentenvironment.2424Person-EnvironmentInteractionCompetenceandEnvironmentalPressModelCompetenceandEnvironmentalPressModel(LawtonandNahemow,1973)(LawtonandNahemow,1973)n nBehaviorisaresultofapersonofaparticularBehaviorisaresultofapersonofaparticularcompetenceinanenvironmentofaspecificcompetenceinanenvironmentofaspecificpresslevel.presslevel.n nBehaviorexistsonapositive-negativeBehaviorexistsonapositive-negativecontinuumandisobservableatthebehaviorcontinuumandisobservableatthebehaviorandaffectlevels.andaffectlevels.2525CompetenceandEnvironmentalPCompetenceCompetencethetheoreticalupperlimitofathetheoreticalupperlimitofapersonscapacitytofunction.personscapacitytofunction.EnvironmentalpressEnvironmentalpressthedemandsplaceduponthedemandsplacedupontheperson.theperson.AdaptationlevelAdaptationlevelwherepressisinbalanceforwherepressisinbalanceforparticularlevelofcompetence.particularlevelofcompetence.2626.26FiveDomainsofCompetencebyLawtonandNahemow:n nBiologicalhealthBiologicalhealthn nSensory-perceptualfunctioningSensory-perceptualfunctioningn nMotorskillsMotorskillsn nCognitiveskillsCognitiveskillsn nEgostrengthEgostrength.2727FiveDomainsofCompetencebyCompetence-EnvironmentPressModel(fromLawtonandNahemow,1973)Competence-EnvironmentPressModel(fromLawtonandNahemow,1973)WeakEnvironmentalPressEnvironmentalPressStrongLow CompetenceCompetenceHighNegativeaffectandmaladaptivebehaviorNegativeaffectandmaladaptivebehaviorMarginalMarginalMarginalMarginalAdaptationlevelAdaptationlevelMaximumperformancepotentialMaximumperformancepotentialPositiveaffectandadaptivebehaviorBA.2828Competence-EnvironmentPressMn nThelessthecompetenceleveloftheperson,Thelessthecompetenceleveloftheperson,thegreatertheimpactofenvironmentalfactorsthegreatertheimpactofenvironmentalfactors.2929.29n nThecompetence-environmentalpressmodelisThecompetence-environmentalpressmodelisausefullensofanalysisforinterventionsinthatausefullensofanalysisforinterventionsinthatitdescribesaitdescribesascaffolding processscaffolding process,where,wheremodificationofenvironmentcanincreasemodificationofenvironmentcanincreaseadaptation.adaptation.E.g.,arranginglivingenvironmentdesignstoE.g.,arranginglivingenvironmentdesignstoincreasesocialinteractionincreasesocialinteraction.3030.30Waystoenhanceasenseofcompetency:n nSpeaktoaperson,practiceBubers“IandThou”.Speaktoaperson,practiceBubers“IandThou”.n nBerespectfulrecognizeindependenceandBerespectfulrecognizeindependenceandautonomy.autonomy.n nRecognizeabilitiesandskillswisdom.Recognizeabilitiesandskillswisdom.n nSeedevelopmentoccurringdespitedisabilityandSeedevelopmentoccurringdespitedisabilityandinfirmity.infirmity.n nRespectculturaldifferencesinreactiontoRespectculturaldifferencesinreactiontochangesinlife,e.g.,death.changesinlife,e.g.,death.3131WaystoenhanceasenseofcomPromotingAwarenessandAdvocacyn nDifferentinstructionalactivitiesandlevelsofDifferentinstructionalactivitiesandlevelsofstudentengagementstudentengagement.3232PromotingAwarenessandAdvocaLevelsofstudentengagement:Listeningandreflecting“Takingitinortuningout”Listeningandreflecting“Takingitinortuningout”Tellingaboutpersonalobservationsorexperiences“ThisTellingaboutpersonalobservationsorexperiences“Thisiswhathappenedtome”iswhathappenedtome”SimulationexperiencesSimulationexperiences findingoutforyourselffindingoutforyourself Discussingdifferentperspectivesexploringcontrasts,Discussingdifferentperspectivesexploringcontrasts,findingsimilaritiesfindingsimilarities ProblemsolvingIidentifyingproblemsProblemsolvingIidentifyingproblems ProblemsolvingIIgeneratingandtestingsolutionsProblemsolvingIIgeneratingandtestingsolutions.3333Levelsofstudentengagement:.Self-DiscoveryActivity:Self-DiscoveryActivity:WhataretheMostValuableThingsinYourLife?WhataretheMostValuableThingsinYourLife?n nListthe5mostvaluablethingsinyourlifeandexplainwhytheyareListthe5mostvaluablethingsinyourlifeandexplainwhytheyareimportant:important:n nNow,chooseoneoftheaspectsyoumentionedtogiveup.WhichoneNow,chooseoneoftheaspectsyoumentionedtogiveup.Whichonewoulditbeandwhy?woulditbeandwhy?n nNowchoosetwootheroftheaspectsyounotedabovetogiveup.Nowchoosetwootheroftheaspectsyounotedabovetogiveup.Whichwouldthesebeandwhy?Whichwouldthesebeandwhy?n nHowmightgivinguptheseaspectsofyourlifereflectthelossestheHowmightgivinguptheseaspectsofyourlifereflectthelossestheelderlyendure?elderlyendure?n nHowdoyouthinkHowdoyouthinkyouyouwillcopeandadapt,asyouencounterlosseswithwillcopeandadapt,asyouencounterlosseswithage?age?.3434Self-DiscoveryActivity:.34FilmReviewEssay:FilmReviewEssay:n nReviewafilmwherethemaincharactersareelderlyReviewafilmwherethemaincharactersareelderlyn nThencomposeanessaydiscussinghowtheoriesandThencomposeanessaydiscussinghowtheoriesandresearchdiscussedinclasscoincidewithresearchdiscussedinclasscoincidewithcharacterizationsorthemesexpressedinthefilm.characterizationsorthemesexpressedinthefilm.3535FilmReviewEssay:.35InterviewanOlderAdult:InterviewanOlderAdult:n nConductasemi-structuredinterviewofanolderadultConductasemi-structuredinterviewofanolderadultandprovideacasestudydiscussinghowyourandprovideacasestudydiscussinghowyourunderstandingofthepersoncoincideswiththeoriesunderstandingofthepersoncoincideswiththeoriesandresearchdiscussedinclass.andresearchdiscussedinclass.n nOurlearninggoalistofindpracticalapplicationofOurlearninggoalistofindpracticalapplicationoftheoryandresearchto“real”livesandexperiences,theoryandresearchto“real”livesandexperiences,andfurtherourunderstandingofvariousaspectsofandfurtherourunderstandingofvariousaspectsofadultdevelopmentandaging.adultdevelopmentandaging.3636InterviewanOlderAdult:.36Sensory-PerceptualDeficitSimulation:Sensory-PerceptualDeficitSimulation:Materials:Materials:n nTwocottonballsandabout2feetofplasticwrapTwocottonballsandabout2feetofplasticwrapProcedure:Procedure:n nGentlyplacecottonballsineachearcanalthiswillsimulateGentlyplacecottonballsineachearcanalthiswillsimulatechangesinhearingthatmightoccurinoldage.changesinhearingthatmightoccurinoldage.n nBunchupandthengentlyplacethewrapacrossthebridgeofBunchupandthengentlyplacethewrapacrossthebridgeofyournoseasiftheywereeyeglassesthiswillsimulatechangesyournoseasiftheywereeyeglassesthiswillsimulatechangesintheperipheralvisualmechanismsthatmightoccurwithintheperipheralvisualmechanismsthatmightoccurwithcataracts.cataracts.3737Sensory-PerceptualDeficitSimWeb-basedlearningactivities:Web-basedlearningactivities:CommonCausesofAge-RelatedVisionLoss:CommonCausesofAge-RelatedVisionLoss:n nLighthouseInternational:VisualdeficitsimulationexamplesLighthouseInternational:Visualdeficitsimulationexampleshttp:/www.lighthouse.org/patient/default.htmhttp:/www.lighthouse.org/patient/default.htm Noise-InducedHearingLoss:Noise-InducedHearingLoss:n nHealthandSafetyExecutive:AuditorydeficitsimulationexamplesHealthandSafetyExecutive:Auditorydeficitsimulationexamples(Thissiteallowsadownloadtoyourcomputer)(Thissiteallowsadownloadtoyourcomputer)http:/www.hse.gov.uk/noise/demonstration.htmhttp:/www.hse.gov.uk/noise/demonstration.htm.3838Web-basedlearningactivities:AnonlineversionoftheAnonlineversionoftheImplicit Association Implicit Association TestTest(IAT,Greenwaldetal.,1998):(IAT,Greenwaldetal.,1998):TheIATisfoundattheInternetwebprojectsponsoredbytheTheIATisfoundattheInternetwebprojectsponsoredbytheSouthernPovertyLawCenterSouthernPovertyLawCenterhttp:/www.tolerance.org/http:/www.tolerance.org/StudentsAssignment:StudentsAssignment:Visitthewebsite,readabouttheIAT,completetwoonlinetests.Visitthewebsite,readabouttheIAT,completetwoonlinetests.Readtutorialsonstereotypyandprejudice.Readtutorialsonstereotypyandprejudice.Writeabriefreflectionpaperregardingthisexperience.Writeabriefreflectionpaperregardingthisexperience.3939AnonlineversionoftheImpliAsampleofstudentsnarrativeresponses:Asampleofstudentsnarrativeresponses:vvIlearnedthatperhapsIhadbiasesthatIwasnotawareofIIlearnedthatperhapsIhadbiasesthatIwasnotawareofIfeltthatIhadverypositiveattitudestowardolderadults,butIfeltthatIhadverypositiveattitudestowardolderadults,butIwasamazedtofindoutthatIdidindeedhavebiases!wasamazedtofindoutthatIdidindeedhavebiases!vvIsawthateventhoughyoumaynotbelievethatyouhavebiasIsawthateventhoughyoumaynotbelievethatyouhavebiastowardsothers,unconsciouslyyouprobablydo.Societyhasatowardsothers,unconsciouslyyouprobablydo.Societyhasahugeinfluenceoverus.hugeinfluenceoverus.vvIreallydidnotlearnverymuchfromthisactivity.IfeelthiswasIreallydidnotlearnverymuchfromthisactivity.Ifeelthiswasmoreofahandeye-coordinationexercisethananattitudestest.moreofahandeye-coordinationexercisethananattitudestest.IfyoureallywanttoseehowpeoplehaveattitudestowardsIfyoureallywanttoseehowpeoplehaveattitudestowardsothersthenyouneedtoaskthemquestionsanddofollow-upothersthenyouneedtoaskthemquestionsanddofollow-upstudies.studies.vvIlearnedthattherearealotofdifferentwaystobebiasedIlearnedthattherearealotofdifferentwaystobebiasedagainstothers.againstothers.4040Asampleofstudentsnarrativ.4141.41Classroomadvocacyassignment:Classroomadvocacyassignment:Identifyanissueorproblem,e.g.,risinghealthcosts,adaptingtoIdentifyanissueorproblem,e.g.,risinghealthcosts,adaptingtoenvironmentalpress,etc.environmentalpress,etc.Assignsmallgroupsaunique“case”todiscussandhavethemAssignsmallgroupsaunique“case”todiscussandhavethemidentifyimportantconcernsandpossiblesolutionsfortheidentifyimportantconcernsandpossiblesolutionsfortheindividual(s)representedinthecase.individual(s)representedinthecase.Casesmayincludethefollowingindividuals:Casesmayincludethefollowingindividuals:-cognitivelyimpairedelderly-cognitivelyimpairedelderly-institutionalizedelderly-institutionalizedelderly-chronicallyillelderly-chronicallyillelderly-economicallydisadvantagedelderly-economicallydisadvantagedelderly-mentallyillelderly-mentallyillelderly-familycaregiversofolderadults-familycaregiversofolderadults-widowedelderly-widowedelderly-newimmigrantelderly-newimmigrantelderly-olderadultsfromdifferentethnicbackgrounds-olderadultsfromdifferentethnicbackgrounds.4242Classroomadvocacyassignment:Scale/ItemScale/ItemMean(SD)Mean(SD)Advocacy Perspective Advocacy Perspective a aDiscussion Activity:Discussion Activity:IncreasedinsightIncreasedinsight7.32(1.49)7.32(1.49).23*.23*CreatednewawarenessCreatednewawareness7.20(1.55)7.20(1.55).25*.25*EnhancedunderstandingEnhancedunderstanding7.49(1.57)7.49(1.57).17.17GainedknowledgeGainedknowledge7.27(1.57)7.27(1.57).16.16OveralldiscussionscoreOveralldiscussionscore49.90(9.98)49.90(9.98).24*.24*Position of Advocate:Position of Advocate:HelpedrealizeimportantconcernsHelpedrealizeimportantconcerns6.97(1.76)6.97(1.76).33*.33*HelpedfindinsightintoproblemsHelpedfindinsightintoproblems6.91(1.85)6.91(1.85).22*.22*HelpedunderstandingissuesHelpedunderstandingissues7.07(1.95)7.07(1.95).26*.26*Overallperspective-takingscoreOverallperspective-takingscore49.14(10.42)49.14(10.42).30*.30*p.05,*p.01.a0=advocacyisforselforstudentperspective;1=advocacyisforuniquegroupofolderordisabledadultsMeans,StandardDeviations,andSpearmanCorrelationsofSurveyMeasureswithAdvocacyPerspective(N=74).4343Scale/ItemMean(SD)AdvocacyPe“Fromthenewperspective,insightisgained,anddifferentcomprehensionofthesamequestions.”“Fromthenewperspective,insightisgained,anddifferentcomprehensionofthesamequestions.”“ThinkingofhowIwanttobetreatedat90+.”“ThinkingofhowIwanttobetreatedat90+.”“Thinkingoutsidethebox.”“Thinkingoutsidethebox.”“Ilearnbyhearingallthesidesofthedebate.Itisneveronesidedtherearemanyopinionsand“Ilearnbyhearingallthesidesofthedebate.Itisneveronesidedtherearemanyopinionsandvoicestobeheard.”voicestobeheard.”“Gettoseedifferentviewsfromdifferentpositions.Thisjustallowsforamoreopenperspectivein“Gettoseedifferentviewsfromdifferentpositions.Thisjustallowsforamoreopenperspectiveindailylife.”dailylife.”“Wewereableasyoungpeopletodebatewhatwemaywant,evenifitcouldpotentiallyaffectthe“Wewereableasyoungpeopletodebatewhatwemaywant,evenifitcouldpotentiallyaffecttheelderly.”elderly.”“Manypeoplehavedifferentwaysoflookingatthesametopic.Smallgroupdiscussionallowedusto“Manypeoplehavedifferentwaysoflookingatthesametopic.Smallgroupdiscussionallowedustolookatourtopicthroughdifferentvantagepoints.Also,givingusauniquegrouphelpsusthinkoflookatourtopicthroughdifferentvantagepoints.Also,givingusauniquegrouphelpsusthinkofvariouspeopleaffectedbythetopic.”variouspeopleaffectedbythetopic.”“Mentallyillelderlyprobablydontknowalotaboutwhatishappeningsothemorewecanhelpthem“Mentallyillelderlyprobablydontknowalotaboutwhatishappeningsothemorewecanhelpthemandtheirfamiliesthelessconfusedtheywillbe.”andtheirfamiliesthelessconfusedtheywillbe.”“Havetoconsidertheperspective,developanargument,findcredibilityorresourcestobackitup“Havetoconsidertheperspective,developanargument,findcredibilityorresourcestobackitupdefendyourview.”defendyourview.”“Youlearnmanymorewaystolookatacriticalsubjectandnotjustthebooksviewortheteachers.”“Youlearnmanymorewaystolookatacriticalsubjectandnotjustthebooksviewortheteachers.”“Ithelpedmeunderstandtheissuesbetter.”“Ithelpedmeunderstandtheissuesbetter.”SamplingofStudentNarrativeResponsesDiscussingWhatisLearnedWhenServingasanAdvocateisaRequiredAspectofDiscussion.4444“Fromthenewperspective,iOverallOverallTheadvocacyroletakesthestudentbeyondTheadvocacyroletakesthestudentbeyondtheirusualrealmofthinkingandexperience,theirusualrealmofthinkingandexperience,enhancingdepth-of-learning.enhancingdepth-of-learning.TheactivitystimulatesawidevarietyofTheactivitystimulatesawidevarietyoflearningbehaviors,e.g.,interactiveinquiry,learningbehaviors,e.g.,interactiveinquiry,criticalanalysis,empathicunderstanding,etc.criticalanalysis,empathicunderstanding,etc.4545.45Thingsanadvocatecanprovideinformally:Thingsanadvocatecanprovideinformally:n nMoralsupportMoralsupportn nSenseofbelongingSenseofbelongingn nSelf-esteemSelf-esteemn nRecognitionofcompetencyandmasteryRecognitionofcompetencyandmasteryn nPracticalaidPracticalaidn nSafeenvironmentSafeenvironment.4646Thingsanadvocatecanprovide.4747.47ActingwithEmpathy:ActingwithEmpathy:EmpathyEmpathyrecognizingandunderstandingtherecognizingandunderstandingthestateofmind,beliefs,desiresandemotionsofstateofmind,beliefs,desiresandemotionsofanotherpersonwithoutinterjectingyourown.anotherpersonwithoutinterjectingyourown.“Puttingyourselfinanothersshoes”“Puttingyourselfinanothersshoes”.4848ActingwithEmpathy:.48SympathySympathyfeelingsorryanotherperson.feelingsorryanotherperson.EmpathySympathyEmpathySympathy.4949.49AvoidAvoidpatronizing speechpatronizing speechremarksthatremarksthatreflectstereotypesofincompetenceandreflectstereotypesofincompetenceanddependence.dependence.AvoidAvoidinfantalizationinfantalizatione.g.,usingtermsofe.g.,usingtermsofendearment,usingsimplelanguage,etc.endearment,usingsimplelanguage,etc.5050Avoidpatr
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