FAD4936 Exam 3 Study Guide Chapters 11 14 Chapter 11 The Oldest Old and Caregiving Additional Notes Statistics involving Oldest Old o Now 11 5 of people are 85 between 3 8 and 4 4 million o Future projected 23 85 approx 14 7 million Young Old 65 74 Old Old 75 84 Oldest Old 85 Life Satisfaction Sense of well being experienced and identified by the individual not something recorded by measure external to the individual o Satisfaction in later life seems to depend on person s ability to master environment effectively and feel a sense of accomplishment o Between 80 90 years one starts to admit that they are old A clear awareness that the spirit is willing but the body is unable to cooperate emerges 1 Caregiving distress indicates the negative stresses of caregiving Problems in caregiving include o Strain of responsibility for direct personal care of elder o Caregiver s own personal health problems o Role strain from demands of other work and need for leisure o Inter sibling problems and other strained family relationships o Arranging outside help and coping with finances 2 Coping response to the demands of a stressful situations Coping techniques vary from person to person Coping situations vary from coping with stressors from caregiving to person w Alzheimer s coping w their disease 3 Formal Outside support and Informal caregiving spousal adult children Informal Caregiving groups exc o Three generation is becoming more common as this type of caregiving is the preference o Comes from relationships that exists naturally in a person s life family friends church o Stress and expense of caregiving can cause relationship between caregiver and care recipient can become intense and complex o Most commonly carried out by a spouse followed by a daughter Formal Caregiving o comes from professionals hospitals nursing homes o Staff are paraprofessionals or professionals that are paid for caregiving 4 Weakened family support fewer offspring are available to offer support while more people are living into the old old category more people need help not enough children to help them Factors contributing to WFS o Demography including fewer offspring and longevity o Women s changing roles o Changing intergenerational relationships adult children more likely to live far away basis for help is more for psychological reasons than economic reasons Greatest predictor of whether or not person will enter a nursing home is if women are present 5 Robust aging successful aging and the maintaining of good mental and physical status Those that that fit with this category report greater social contact better health and vision and have experienced fewer life events in the past three years 6 Physical health of the aged group 75 84 and those 85 The 75 84 age group is by far healthier and happier than depicted by stereotypes Physical losses begin to take their toll after 85 Those who don t suffer from severe impairments can exhibit a broad range of healthfulness and well being People in their 90s are often very healthy and robust 7 Instrumental Activities of Daily Living IADL Personal Activities of Daily Living PADLs or ADLs IADLs Shopping housework money management meal preparation PADLs ADLs bathing eating dressing getting in and out of bed walking to get things Less than half of 85 need help with ADLs and about 60 need help with IADLs 8 Intergenerational norms standard expected behaviors of one generation towards another Women are more likely expected to help than men because women seem more acceptable to provide personal care Men and women also view and handle caregiving differently Canadian study shows that most people think that emotional support should and could be provided by adult children Some believed that they should provide physical assistance and a majority believed they should help out financially Conclusions are that children feel strong moral obligation to provide care for disabled parents Most adult children take care of their parents through a sense of responsibility they feel towards them 9 Psycho social interventions usually intended for caregiver Individual Counseling Family Counseling Support groups usually available in larger communities at mental health clinics Educational Groups Social Worker Visits Problem solving groups for caregiver and patient 10 Paraprofessional caregivers include Nurses aids personal care attendants chore workers who are paid to assist professionals in caring for elder in a nursing home doctor s office hospice exc 11 Respite care Provides alternative care for a short time about 2 weeks Alleviates stress for the caregiver Improves functioning of the dependent elder 12 Modified nuclear family describes the typical American situation There is a great deal of family interaction like visiting and exchanging gifts services but there is no extended family household Most elders live in separate households but they are not cut off from their families Chapter 12 Special Problems 1 Theoretical Explanations of elder abuse See table 12 3 on page 329 Psychological Model Relationship of violent behavior to aggressive personality traits at the most sever end of physical aggression large proportions of elder abusers have histories of mental illness and or substance abuse Situational Model Abuse as a problem of caregiving high levels of stress and burden of caregiving increase mistreatment and neglect of the frail elder Symbolic Interaction Model Each person approaches in interaction with personal definitions and expectations if behaviors match the roles expected the interaction continues otherwise conflict arises The caregiver s subjective sense of stress related to the dependency tasks creates stress not the tasks themselves Social Exchange Theory When each individual contributes equally a fair exchange results when one party is unable to reciprocate the exchange is seen as being unfair Unequal distribution of power in caregiving situations can result in abuse Feminist Theory Identifies violence as a tactic of entitlement and power that is deeply gendered rather than a conflict tactic that is personal and gender neutral Is more successful at explaining wife abuse rather than child or elder abuse Ecological Model Focuses on behavior within the social context and on the accommodation between the person and the environment Political Economy Model Elder abuse arises from the way older people are marginalized in society These experiences are a product of the division of labor and structure