高血压英文ppt精品课件agingpromoting awareness and

Aging: Promoting Awareness and Advocacy Dean D. VonDras, Ph.D. Human Development and Psychology Departments University of Wisconsin-Green Bay 1 Overview: n Recognizing physical/psychological/social interactions n Recognizing functional changes due to age and disability n Promoting awareness and advocacy 2 3 Observable Physical Changes with Age: n Skin and face wrinkles, sagging, leathering n Hair thinning and graying n Height decreases n Weight increases during middle adulthood, i.e., the middle-age spread, and often decreases in old age, especially in physically fragile older adults 4 Declines in Sensory-Perceptual Processes with Age: n Vision and Hearing n Taste and Smell n Somethesis: Skin, Temperature, Pain n Proprioception sensations generated by the body that let you know the location of limbs in space n Kinesthesia ones sense of location while moving through space 5 Changes in Hearing: Presbycusis age related hearing impairment n Caused by deterioration of mechanisms in the inner ear, long-term exposure to loud noises, certain drugs, an improper diet, or genetic factors. 6 Decline in sensitivity to tones and pitches different frequencies decline at different rates with advancing age. 7 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. 8 Speech perception becomes more difficult due to the decline in tone and pitch sensitivity. 9 Ways to make your speech heard: n Talk in a lower pitch but distinct voice n Articulate every syllable - speak clearly n Talk face to face - “read my lips” 10 11 12 Causes of Disability: n Congenital occurring at birth n Accident/injury n Because of illness/disease n Age-related 13 Keep in mind A disability may not be obvious to others. A disability is more likely to occur in old age. 14 Most Prevalent Chronic Conditions in Later-life n Arthritis n Hypertensive Disease n Heart Disease n Hearing Impairments n Musculoskeletal impairments n Chronic Sinusitis n Diabetes n Visual Impairments 15 Most Feared Conditions in Later-life n Alzheimers Disease - Dementia n Stroke/Cancer n Physical disability that prevents independence and autonomy of “normal” life (e.g., Parkinsons Disease) n Heart Disease/Chronic Pulmonary Disorder n Deafness/Blindness 16 Old age and disability impact upon Activities of daily life (ADLs) Instrumental activities of daily life (IADLs) Sense of self 17 18 Stereotype a social belief about a group of people. 19 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 20 Positive Stereotypes - Traits Golden-ager - Active, independent, happy Perfect grandparent - Loving, supportive, wise, kind J. Wayne Type - Patriotic, proud, religious 21 Loss Continuum Model (Pastalan, 1982) Views aging as a progressive series of losses that reduces ones social participation. 22 23 Person-Environment Interaction and Optimal Aging Kurt Lewins (1936) conceptualization: B = f (P, E) n Behavior is the function of both the person and environment 24 Competence and Environmental Press Model (Lawton and Nahemow, 1973) n Behavior is a result of a person of a particular competence in an environment of a specific press level. n Behavior exists on a positive-negative continuum and is observable at the behavior and affect levels. 25 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. 26 Five Domains of Competence by Lawton and Nahemow: n Biological health n Sensory-perceptual functioning n Motor skills n Cognitive skills n Ego strength 27 Competence-Environment Press Model (from Lawton and Nahemow, 1973) Weak Environmental Press Strong Low Competence High Negative affect and maladaptive behavior Negative affect and maladaptive behavior Marginal Marginal Adaptation level Maximum performance potential Positive affect and adaptive behavior B A 28 n The less the competence level of the person, the greater the impact of environmental factors 29 n 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 30 Ways to enhance a sense of competency: n Speak to a person, practice Bubers “I and Thou”. n Be respectfulrecognize independence and autonomy. n Recognize abilities and skillswisdom. n See development occurring despite disability and infirmity. n Respect cultural differences in reaction to changes in life, e.g., death. 31 Promoting Awareness and Advocacy n Different instructional activities and levels of student engagement 32 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 33 Self-Discovery Activity: What are the Most Valuable Things in Your Life? n List the 5 most valuable things in your lifeand explain why they are important: n Now, choose one of the aspects you mentioned to give up. Which one would it be and why? n Now choose two other of the aspects you noted above to give up. Which would these be and why? n How might giving up these aspects of your life reflect the losses the elderly endure? n How do you think you will cope and adapt, as you encounter losses with age? 34 Film Review Essay: n Review a film where the main characters are elderly n Then compose an essay discussing how theories and research discussed in class coincide with characterizations or themes expressed in the film. 35 Interview an Older Adult: n 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. n 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. 36 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. 37 Web-based learning activities: Common Causes of Age-Related Vision Loss: n Lighthouse International: Visual deficit simulation examples /patient/default.htm Noise-Induced Hearing Loss: n Health and Safety Executive: Auditory deficit simulation examples (This site allows a download to your computer) .uk/noise/demonstration.htm 38 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 / 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. 39 A sample of students narrative responses: v 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! v 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. v 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. v I learned that there are a lot of different ways to be biased against others. 40 41 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 42 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) 43 “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 dont 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.” Sampling of Student Narrative Responses Discussing What is Learned When Serving as an Advocate is a Required Aspect of Discussion 44 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. 45 Things an advocate can provide informally: n Moral support n Sense of belonging n Self-esteem n Recognition of competency and mastery n Practical aid n Safe environment 46 47 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” 48 Sympathy feeling sorry another person. Empathy Sympathy 49 Avoid patronizing speech remarks that reflect stereotypes of incompeten