PSYX 233 1st EditionExam # 2 Study Guide Lectures: 1 - 12Chapter 5B = f(P,E) mean? - Kurt lewin- Defines person-environment interactionso B= the function of behavior  P=person E=environment Competence-Environmental Press Model.o Competence: upper limit of a person’s ability to function in 5 domains o Physical health o Sensory-perceptual skillso Motor skillso Cognitive skillso Ego strength - Environmental press: physical, interpersonal or social demands that environments puts on people o Reflects demands placed on a person How does the Competence-Environmental Press Model relate to stress and coping? - Environmental press (stressors) competence coping skills/mechanisms developed - Social support effects likelihood that a person defines a situation as threatening- Perceived aversivenesso Older adults adaption dependent on perceptions of environmental stress andattempts to cope with ito Appraisals Harmful Beneficial irrelevanto Problem focused: facing problems head on with a solution o Non-coping: escaping, avoiding -Competence-Environmental Press Model factors: ○ Adaptation level: area where press level is average for a particular level of competence- Behavior and affect are normal ○ Zone of maximum performance potential: increases in press improve performance○ Zone of maximum comfort: slight decreases in press people are able to live happily without worrying about environmental demands Responses to competence and press- Proactivity o Choosing new behaviors to meet new desires or needso Exerting control over life- Docility o Allowing a situation to dictate options o Little control Congruence Model: People with particular needs search for environments that meet them best  Limitations:o Restrictions on environmento Restrictions on freedom o Perceived freedom restrictions o Considerations:o P-E fit--> person environment fit  Individual differences Cultural considerations ○ Self-efficacy and the congruence model o Importance in ability to account for differences in competence between adults with cognition or related abilities o Everyday competence: person’s POTENTIAL ability to perform a wide range ofactivities considered essential for independent living (not actual ability to perform tasks)  Measured through:- ADLs- IADLs-o Future competence:  Related to current competenceWhat are the main living and assistive options for older adults who have lower Competence or higher environmental press?  Home modificationo Accessibility Installing hand rails, easy open door knobs, lowering countertops, wheelchair ramps etc. o Assistive technology  Ipad Aging in placeo Selection & compensation to cope Eating canned/microwavable food instead of cooking from scratch  Use of an assistive device i.e. cane/walkerHow is a feeling of responsibility and choice important for aging well, especially in intensive careenvironments such as nursing homes?  Importance of choice & efficacy o Allows the individual to feel like the have control over the his/her own life decisionso Langer & Rodin: Research shows that residents who have higher perceived personal control show improved well being and activity levels and can live longer  Motivation o More successful aging when individual feels sense of usefulness/purposeo Hopelessness + helplessness  depression, lower quality of life  Decision making capacity:o Death with Dignity: Timeline:- Oral request of doc.- 15 day waiting period- 2nd oral request- Written request- 48 hr. waiting period for prescription- Allowable to pick up prescription  Pros:- Can empower- Self efficacy - Ends suffering Cons:- Other options- Questionably ethical o Patient-Self Determination Act: law that mandates that all facilities that receive Medicaid/Medicare funds must comply with 5 requirements regarding advance care planning (advance directives: AD) Requirements: - 1. Providing info at time of admission about rights to make medical treatment decisions and form AD - 2. Maintaining written procedures/policies regarding AD- 3. Documenting the completion of AD in persons medical chart- 4. Complying with state law regarding implementation of AD- 5. Providing staff/community education about AD Ethical issues:- Resident comprehensiono Cognitively impaired individuals cannot understand Nursing homes Types: Skilled nursing care: 24 hour care with skilled medical and health services Intermediate care: 24 hour care including a less intense level of medical and health service from nurses Special care units: staff receive special training with dementia; provide physical design elements for residents with functional limitations Considerations: o Competence/environmental press: B= f (P,E)- As competence declines environment must provide more support to optimize behavior  Skilled vs. intermediate careo Congruence model: PE fit o Autonomy Responsibility Personal choiceo Person centered care: Promoting well-being of residents by increasing level of perceived personal control + respect Creating the best, individualized, supportive environment o Individual Specific:  Level of training  Insurance  Care plan Describe the traits of individuals most commonly residing in nursing homes.  Demographics:o Whiteo Femaleo 75+o Recently admitted to hospitalo Widowed/divorcedo No children/family nearby o Some cog./physical Impairment o < 1 problems with IADL What is person-centered care?  Promoting resident’s well being through increasing perceived level of personal control and treating with respect Individualized careWhat are some services included in “care” at nursing homes?  Included: room/board, 24 hour health staff, routine visits, housekeeping, social events, transportation What is elder abuse and neglect? Types: o Physicalo Sexualo Emotional/psychologicalo Financial/material exploitation o Abandonmento Neglect o Self-neglect Susceptible: o Individuals with increased care demands  Cog/physical impaired  Offenders:o Family Care staffCan a nursing home become a “home?”  Home= place to live Defining home in relation to family & social relationships instead of a place with objects o Finding continuity from home to nursing home through engagement in activities or similarities in living arrangements What is elderspeak?  Infantilized, patronizing speecho Unwarranted use of 1st name, terms of endearment,