Aging: Promoting Awareness and Aging: Promoting Awareness and AdvocacyAdvocacy

Dean D. VonDras, Ph.D.Dean D. VonDras, Ph.D.

Human Development and Psychology DepartmentsHuman Development and Psychology Departments

University of Wisconsin-Green BayUniversity of Wisconsin-Green Bay

vondrasd@uwgb.eduvondrasd@uwgb.edu

Overview:Overview:

Recognizing physical/psychological/social Recognizing physical/psychological/social interactionsinteractions

Recognizing functional changes due to Recognizing functional changes due to age and disabilityage and disability

Promoting awareness and advocacyPromoting awareness and advocacy

  

 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’

 

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 – one’s sense of location while moving through space 

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. 

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

  

Decline in Hearing Sensitivity

0

20

40

60

80

30 40 50 60 70 80

Age

Dec

ibel

1 khz

2 khz

4 khz

8 khz

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.

Speech perception – becomes more

difficult due to the decline in tone and pitch sensitivity.

 

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”

Percent of Decline in Physical and Cognitive Function: Modified from Spirduso (1995) and Weg (1983)

0

20

40

60

80

100

20 40 60 80Age Group

Pe

rce

nt

Maximum LungCapacityHeart Function

Nerve ConductionVelocitySpeed of CognitiveProcessingArm Cranking Power

0

10

20

30

40

50

60

Pe

rce

nt

65-69 70-74 75-79 80-84 85+Age Group

Percent of Adults with Disabilities (National Center for Health Statistics, 1999)

Causes of Disability:

Congenital – occurring at birth

Accident/injury

Because of illness/disease

Age-related

Keep in mind…

A disability may not be obvious to others.

A disability is more likely to occur in old age.

Most Prevalent ChronicConditions in Later-life

1. Arthritis2. Hypertensive Disease3. Heart Disease4. Hearing Impairments5. Musculoskeletal impairments6. Chronic Sinusitis7. Diabetes8. Visual Impairments

Most Feared Conditions in Later-life

1. Alzheimer’s Disease - Dementia2. Stroke/Cancer3. Physical disability that prevents

independence and autonomy of “normal” life (e.g., Parkinson’s Disease)

4. Heart Disease/Chronic Pulmonary Disorder

5. Deafness/Blindness      

Old age and disability impact upon…

Activities of daily life (ADLs) Instrumental activities of daily

life (IADLs) Sense of self

 

Stereotype – – a social belief about a group of people.

Stereotypes linked with traits of older adults:

Negative Stereotypes -> Traits

Severely impaired -> Slow-thinking, feeble, senile

Despondent -> Sad, hopeless, afraid, lonely

Shrew/curmudgeon -> Ill-tempered, stubborn, bitter

Recluse -> Quiet, timid, naive

Positive Stereotypes -> Traits

Golden-ager -> Active, independent, happy

Perfect grandparent -> Loving, supportive, wise, kind

J. Wayne Type -> Patriotic, proud, religious

Loss ContinuumLoss Continuum ModelModel (Pastalan, (Pastalan, 1982)1982)

Views aging as a progressive series of Views aging as a progressive series of losses that reduces one’s social losses that reduces one’s social participation.participation.

Person-Environment Interaction Person-Environment Interaction and Optimal Aging and Optimal Aging

Kurt Lewin’s (1936) conceptualization: Kurt Lewin’s (1936) conceptualization:

BB = = f f ((PP, E), E)

Behavior is the function of both the Behavior is the function of both the person and environmentperson and environment

Competence and Environmental Press Competence and Environmental Press ModelModel (Lawton and Nahemow, 1973) (Lawton and Nahemow, 1973)

Behavior is a result of a person of a Behavior is a result of a person of a particular competence in an environment particular competence in an environment of a specific press level.of a specific press level.

Behavior exists on a positive-negative Behavior exists on a positive-negative continuum and is observable at the continuum and is observable at the behavior and affect levels.behavior and affect levels.

CompetenceCompetence – the theoretical upper limit of – the theoretical upper limit of a person’s capacity to function.a person’s capacity to function.

Environmental pressEnvironmental press – the demands placed – the demands placed upon the person.upon the person.

Adaptation levelAdaptation level –where press is in balance –where press is in balance for particular level of competence.for particular level of competence.

Five Domains of Competence by Five Domains of Competence by Lawton and Nahemow:Lawton and Nahemow:

Biological healthBiological health Sensory-perceptual functioningSensory-perceptual functioning Motor skillsMotor skills Cognitive skillsCognitive skills Ego strengthEgo strength

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

Weak Environmental PressEnvironmental Press Strong

Low

C

om

pete

nce

Com

pete

nce

Hig

h

Negative affect and maladaptive behavior

Negative affect and maladaptive

behavior

Mar

ginal

Mar

ginalM

argin

al

Mar

gin

al

Adap

tation

leve

l

Adap

tation

leve

lM

axim

um p

erfo

rman

ce p

oten

tial

Max

imum

per

form

ance

pot

entia

l

Positive affect and adaptive behavior

B A

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

The competence-environmental press The competence-environmental press model is a useful lens of analysis for model is a useful lens of analysis for interventions in that it describes a interventions in that it describes a scaffolding processscaffolding process, where modification of , where modification of environment can increase adaptation. environment can increase adaptation.

E.g., arranging living environment designs E.g., arranging living environment designs to increase social interactionto increase social interaction

Ways to enhance a sense of competency:

Speak to a person, practice Buber’s “I and Thou”.

Be respectful—recognize independence and autonomy.

Recognize abilities and skills—wisdom. See development occurring despite

disability and infirmity. Respect cultural differences in reaction to

changes in life, e.g., death.

Promoting Awareness and Advocacy

Different instructional activities and levels of student engagement

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

Self-Discovery Activity:Self-Discovery Activity:

What are the Most Valuable Things in Your Life?What are the Most Valuable Things in Your Life?

List the 5 most valuable things in your life—and explain why List the 5 most valuable things in your life—and explain why they are important:they are important:

Now, choose one of the aspects you mentioned to give up. Now, choose one of the aspects you mentioned to give up. Which one would it be and why?Which one would it be and why?

Now choose two other of the aspects you noted above to give Now choose two other of the aspects you noted above to give up. Which would these be and why?up. Which would these be and why?

How might giving up these aspects of your life reflect the losses How might giving up these aspects of your life reflect the losses the elderly endure?the elderly endure?

How do you think How do you think youyou will cope and adapt, as you encounter will cope and adapt, as you encounter losses with age?losses with age?

Film Review Essay:Film Review Essay:

Review a film where the main characters are Review a film where the main characters are elderlyelderly

Then compose an essay discussing how Then compose an essay discussing how theories and research discussed in class theories and research discussed in class coincide with characterizations or themes coincide with characterizations or themes expressed in the film. expressed in the film.

Interview an Older Adult:Interview an Older Adult:

Conduct a semi-structured interview of an older Conduct a semi-structured interview of an older

adult and provide a case study discussing how adult and provide a case study discussing how your understanding of the person coincides your understanding of the person coincides with theories and research discussed in class. with theories and research discussed in class.

    Our learning goal is to find practical application Our learning goal is to find practical application

of theory and research to “real” lives and of theory and research to “real” lives and experiences, and further our understanding of experiences, and further our understanding of various aspects of adult development and various aspects of adult development and aging. aging.

Sensory-Perceptual Deficit Simulation:Sensory-Perceptual Deficit Simulation:

Materials: Materials:

Two cotton balls and about 2 feet of plastic wrapTwo cotton balls and about 2 feet of plastic wrap

Procedure: Procedure:

Gently place cotton balls in each ear canal – this will Gently place cotton balls in each ear canal – this will simulate changes in hearing that might occur in old age. simulate changes in hearing that might occur in old age.

Bunch up and then gently place the wrap across the Bunch up and then gently place the wrap across the bridge of your nose as if they were eye glasses – this will bridge of your nose as if they were eye glasses – this will simulate changes in the peripheral visual mechanisms simulate changes in the peripheral visual mechanisms that might occur with cataracts. that might occur with cataracts.

Web-based learning activities:Web-based learning activities:

Common Causes of Age-Related Vision Loss: Common Causes of Age-Related Vision Loss:

Lighthouse International: Visual deficit simulation Lighthouse International: Visual deficit simulation examplesexamples

http://www.lighthouse.org/patient/default.htmhttp://www.lighthouse.org/patient/default.htm

Noise-Induced Hearing Loss:Noise-Induced Hearing Loss:

Health and Safety Executive: Auditory deficit simulation Health and Safety Executive: Auditory deficit simulation examplesexamples(This site allows a download to your computer)(This site allows a download to your computer)

http://www.hse.gov.uk/noise/demonstration.htmhttp://www.hse.gov.uk/noise/demonstration.htm

An online version of the An online version of the Implicit Implicit Association TestAssociation Test (IAT, Greenwald et (IAT, Greenwald et al., 1998):al., 1998):

The IAT is found at the Internet web project sponsored by The IAT is found at the Internet web project sponsored by the Southern Poverty Law Center the Southern Poverty Law Center http://www.tolerance.org/http://www.tolerance.org/

Students’ Assignment:Students’ Assignment:

Visit the web site, read about the IAT, complete two online Visit the web site, read about the IAT, complete two online tests.tests.

Read tutorials on stereotypy and prejudice. Read tutorials on stereotypy and prejudice.

Write a brief reflection paper regarding this experience. Write a brief reflection paper regarding this experience.

A sample of students’ narrative A sample of students’ narrative responses:responses:

I learned that perhaps I had biases that I was not aware I learned that perhaps I had biases that I was not aware of … I felt that I had very positive attitudes toward older of … I felt that I had very positive attitudes toward older adults, but I was amazed to find out that I did indeed adults, but I was amazed to find out that I did indeed have biases! have biases!

I saw that even though you may not believe that you I saw that even though you may not believe that you have bias towards others, unconsciously you probably have bias towards others, unconsciously you probably do. Society has a huge influence over us. do. Society has a huge influence over us.

I really did not learn very much from this activity. I feel I really did not learn very much from this activity. I feel this was more of a hand eye-coordination exercise than this was more of a hand eye-coordination exercise than an attitudes test. If you really want to see how people an attitudes test. If you really want to see how people have attitudes towards others then you need to ask them have attitudes towards others then you need to ask them questions and do follow-up studies.questions and do follow-up studies.

I learned that there are a lot of different ways to be I learned that there are a lot of different ways to be biased against others.biased against others.

Pretest Posttest4

4.5

5

5.5

6

Self-Rating of Bias in

Social Perceptions

Pretest-Posttest Self-Ratings of Bias in Social Perceptions

ExperiencePrejudice - Low

ExperiencePrejudice - High

Classroom advocacy assignment:Classroom advocacy assignment:

Identify an issue or problem, e.g., rising health costs, Identify an issue or problem, e.g., rising health costs, adapting to environmental press, etc.adapting to environmental press, etc.

Assign small groups a unique “case” to discuss and have Assign small groups a unique “case” to discuss and have them identify important concerns and possible solutions them identify important concerns and possible solutions for the individual(s) represented in the case. for the individual(s) represented in the case.

Cases may include the following individuals:Cases may include the following individuals:

- cognitively impaired elderly- cognitively impaired elderly- institutionalized elderly- institutionalized elderly- chronically ill elderly- chronically ill elderly- economically disadvantaged elderly- economically disadvantaged elderly- mentally ill elderly- mentally ill elderly- family caregivers of older adults- family caregivers of older adults- widowed elderly- widowed elderly- new immigrant elderly- new immigrant elderly- older adults from different ethnic backgrounds- older adults from different ethnic backgrounds

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 < .05, ** p < .01. a 0 = advocacy is for self or student perspective; 1 = advocacy is for unique group of older or disabled adults

Means, Standard Deviations, and Spearman Correlations of Survey Measures with Advocacy Perspective (N = 74)

“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 book’s view or the teacher’s.”

“It helped me understand the issues better.”

Sampling of Student Narrative Responses Discussing What is Learned When Serving as an Advocate is a Required Aspect of Discussion

Overall…Overall…

The advocacy role takes the student The advocacy role takes the student beyond their usual realm of thinking and beyond their usual realm of thinking and experience, enhancing depth-of-learning. experience, enhancing depth-of-learning.

The activity stimulates a wide variety of The activity stimulates a wide variety of learning behaviors, e.g., interactive learning behaviors, e.g., interactive inquiry, critical analysis, empathic inquiry, critical analysis, empathic understanding, etc.understanding, etc.

Things an advocate can provide informally:

Moral support

Sense of belonging

Self-esteem

Recognition of competency and mastery

Practical aid

Safe environment

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 another’s shoes”

Sympathy – feeling sorry another person.

Empathy ≠ Sympathy

Avoid patronizing speech – remarks that reflect stereotypes of incompetence and dependence.

Avoid infantalization – e.g., using terms of endearment, using simple language, etc.

Bernie’s TravelsBernie’s Travels

1.1. Attended McBride HS -- all-conference and all-district Attended McBride HS -- all-conference and all-district as a senior.as a senior.

2. Attended UMSL – 3-year starter, 52. Attended UMSL – 3-year starter, 5thth in career scoring, in career scoring, senior co-captain and MVP in 1971-72.senior co-captain and MVP in 1971-72.

3. Assistant coach at McCluer North HS 1972-1974.3. Assistant coach at McCluer North HS 1972-1974.4. Head coach at McCluer High 1974-1975 – Class 4A 4. Head coach at McCluer High 1974-1975 – Class 4A

State Champions.State Champions.5. Returns to UMSL as Asst. Coach, 1975-1977.5. Returns to UMSL as Asst. Coach, 1975-1977.6. Head Coach Jefferson College, 1977-1985 – 182-69 6. Head Coach Jefferson College, 1977-1985 – 182-69

record, eight 20-win seasons, Region 16 East finals 5 record, eight 20-win seasons, Region 16 East finals 5 times.times.

7. Moves to Murray State (Ky.) 1985-1989 as recruiting 7. Moves to Murray State (Ky.) 1985-1989 as recruiting coordinator—1988 NCAA tournament, 1989 NIT.coordinator—1988 NCAA tournament, 1989 NIT.

8. Southwest Missouri State Assistant Coach, 1989-8. Southwest Missouri State Assistant Coach, 1989-1992.1992.

9. SMS Head Coach 1992-1995 – 48-37 record, NIT.9. SMS Head Coach 1992-1995 – 48-37 record, NIT.10. Assistant Coach New Mexico State -- 199610. Assistant Coach New Mexico State -- 199611. Head Coach at Kirkwood High in St. Louis -- 199711. Head Coach at Kirkwood High in St. Louis -- 199712. Head Coach at University of Missouri-St. Louis -- 12. Head Coach at University of Missouri-St. Louis --

19991999

“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)