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57 Cards in this Set

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Stress
Is the physical or mental response to demands from the environment, the events that lead up to these demands, or the individual's perception of the demands- depending on which camp of stress researchers are using the term.
Three Areas of Stress Theories
1. Stimulus-oriented theories: environmental demands on the person
2. Interactionist: person's perception of the events
3. Response-oriented: body's response to stress
Stress and Aging
- with aging, less efficient responses to stressors
- they interact in a manner that produces lowered immune functioning
Response-Oriented Theory of Stress
Selye described it as the body's response to demand. (stressor) The more demands on a person, the stronger the stress response. (stress response)
Response-oriented Theory: General Adaptation Syndrome
Three stages:
1. Alarm reaction
-- shock phase:
-- Countershock Phase:
2. Resistance
3. Exhaustion
Alarm Phase
Alarm reaction (fight or flight):
-- shock phase: an initial, immediate effect of some noxious stimulus on the body's tissue, like a drop in body temp. or blood pressure to supply skeletal muscles and brain more oxygen. Endocrine glands are stimulated to produce hormones like cortisol and adrenaline. Body decreases energy supplied to organs. Natural fats and sugars are produced to supply extra energy.
-- Countershock Phase: some kind of physiological defenses are mounted, adrenal cortex enlarges and secretes higher level of hormones, and the body temperature and blood pressure move back toward normal levels. If the stressor continues, alarm reactions fade and are replaced by the second stage.
Resistance Phase
2. Resistance- the body strives to achieve normality, or homeostasis. Complicated sets of neural and hormonal interactions which attempts to limit the impact of the stressor. The shrinkage of the thymus gland (involved in immune responses).
Exhaustion Phase
3. Exhaustion- when some of the alarm-stages responses reappear. Reduced ability to adapt. Sometimes leading to physical illness or death, tissue death, and exhaustion.
Grandparents As Primary Caregivers: impact of stress on grandparent
Findings:
- Grandparents are significantly more likely to report limitations in areas
- Satisfaction with health significantly lowered
- 50% higher odds of having and ADL limitation
- twice as likely to report depressive symptoms
Impact of stress on an African-American grandparent
- all participants except 4 had a TS score of 91, considered a clinically significant level of stress
- tend to use social support and positive attitudes as major ways of coping with the stresses
- 40% indicated pyshcological stress levels high enough to warrant mental health intervention
- challenges were higher with children of emotional/behavioral problems
- less stress with years of caregiving service
- counseling, tutoring, and special education were beneficial in reducing stress
- problem-focused and emotional-focused coping were significantly elated to lower levels of stress
-- being married did NOT have a protective effect against stress
-- average stress level was highest for grandparents with higher incomes
- they experience high blood pressure and cerebrovascular disease (stroke)
Impact of stress on spouse care-givers of a person with Alzheimer's Disease
- AD, replaces the brain's circuitory with wounds of sticky plaque and expansions of dead, twisted neurons, possibly reaching a burde of a-beta burden, a down-ward spiral
- sense of control was associated with less psychological distress and reduced morbidity
- self-blame was a form of acceptance of their role
- impaired immune response to influenza virus vaccine
- anticipatory grief is there, but source of stress no longer there when the person dies
Stress and Immunity Article
- immune responses decline with age (shingles, wound infections, cancers)
- psychological functions (long-term immune dysregulation, wives at a greater risk than husbands, caregiving for family member with dementia, care-givers have poorer immune function, and accelerates aging)
- health implications (respiratory infections especially in caregivers, slow process of wound healing, surgical stress heightened
- aging interacts with stress and depression to enhance risks for morbidity and mortality among older adults
Stimulus- Oriented Theory
- environmental experiences produce stress
- Social Readjustment Rating Scale (SRRS)
Social Readjustment Rating Scale
- Holmes and Rahe's 43 life-changing events, any change positive or negative, requires adaptation
- after having 100 assigned points to them, experiences had in past 6-12 months, the total score predicts likelihood of becoming ill with a stress-induced illness
- expected/unexpected events: auto accident vs. terminal illness
- on time/off time: having a parent die in teens vs. 50's or 60's, terminated from work in 40's or 50's, marriage in 70's, divorce in 60's, having to leave school to work in the 20's
Chronic ongoing stressors vs. major life events
- stressors in prolonged years are chronic:
- caregiving/receiving
- widowhood
- adjustment to losses
- primary aging changes
- secondary aging changes
Stressful Events in 1st and 2nd half of life
1: begin/end school, live independently, housekeeping, first job, first romance, marriage, pregnancy, divorce, coming out, take out a mortgage
2: care for disabled, poor health, last child leaves, retirement, widowhood, death of a child/friends, birth of a grandchild, relocation
Interactionist Theories
- person's perception of an event, extent to which some experience exceeds a person's ability to adapt
- how the stimulus connects to the response based off of Lazarus & Folkman
- perception is critical to the event's interpretation as a hassle, uplift, challenge, benign, whether it is perceived as a threat
- appraisal process is composed of thinking about and evaluating one's resources for coping and this process affects how the stimulus will be reappraised
Primary Vs. Secondary Aging
-Primary aging are physical changes that happen to most people as they get older, they can be slowed down or even reversed, or covered up. It eventually happens to all of us even the healthiest.
- Secondary: changes that happen to some, and can be prevented and even cured in some cases. Factors of education, social, health practices, income, genetics, and cultural practices.
Pre-Clinical Disabliity
The transition between impairment and disability. Critical point or threshold below which the transition process can be interrrupted.
- Tasks are performed without modification but general activity level decreases (individual may be unaware of this process until sufficient accrual)
- Specific tasks are affected but still can be completed because the individual changes ways the tasks are performed.
Ageism on Disabliity
-Psychological factors: social support, feedback from others, -/+ outlook, acceptance of mental health counseling, sense of personal control, ageism, depression
-Socio-Cultural Factors: - stereotypes affect thinking, decision making, personal choices, self-care, recognition of accuring health conditions, seeking help
- having negative adaptation: having doubts of dizziness when standing up (due to old age, hesitates, gives up gardening)
- positive adaptation: physical therapy, etc.
Aging and Balance
-Sensory Systems
- Vestibular System
- Somatic-Sensory system
- diseases, lower extremity weaknesses, assistive devices, medications, chronic conditions, dementia, confidence, fear of falling
Sensory Sytems in Balance
Sensory Systems: vision provides information about where the body is in space, body's rate of movement, obstacles in path... age leads to impaired depth perception, problems with contrast sensitivity, major eye diseases
Vestibular Systems in Balance
- Five organs in the inner ear:
- 3 semi-circular canals, filled with fluid that moves in response to head movements and provides information about the turning of the head
- sacccule
- utricle: receptors in saccule and utricle provide static vertical information during standing (indication of a tilt)
- decrease in vestibular neurons at age 40, by 70 there is a 40% loss, they demonstrate worse sways
Somatic-Sensory Sytems in Balance
- Provides information regarding body contact and position.
- skin receptors grow less sensitive in age
- muscle and joint recpetors provide information about positions of these body areas.
Fries Article: Success and in compressing morbidity
- Compression of Morbidity paradigm: notes that most illness was chronic and occured later in life, and the burden could be reduced if the onset of the illness could be postponed if this greater than than increases in life expectancy, then lifetime morbidity will decrease
- life expectancy is increasing
- declining disablility trend, compression of morbidity
- good health risks with longterm reductions in lifetime disability (reductions in smoking cigs, better treatments, joint replacements, medical preventive measures)
- good education levels, access to medicare, and socio-economic status effect on disability
- health enhancement and health policies
Strength and Endurance in Eldest Years
-isotonic muscle strength increases
- multi-set increased more
- women decrease the risk for osteoperosis
- reduce the risk of falls
- lower rates of heart disease
-total amount of exercise is more important than intensity
- spare family as a burden and indepedence
Longevity Patterns
-CHD (coronary heart disease) leading killer in men and women, #1 killer for women in US, average age is lower for men than women, men have it more than women
- factors to CHD is smoking, smoke, tobacco
- smokers were more than men, with low education and socio-economic status
- women new more of the negative side effects than men
- male associated it to alcohol and women to coffee
- women live longer than men
- heritable component
- XX vs. XY linkage, freedom in xx linkage
- males have a higher neonatal death rate
- homicide, lung cancer, suicide, pulmonary diseases, accidents, cirhossis, and heart disease
Binge Drinking in Collge Students
- interracial finds
- whites had the most %
- kids who binge are more outgoing but more depressed
- primary health danger in college students
-everything negative involvement and low levels of those increased risks to binge drink
- belief, the #1 predictor of binge drinking
- commitment to GPA
- positive attachment and frequent drinking
- social bond theory predicts drinking
- parents need to do a better job teaching to decrease drinking
Learning
Acquiring or encoding new information through experience, observation, or practice.
Memory
Body of information that is stored in and retrieved from teh neurological system.
Intelligence
Theoretical limit of a person's performance influenced by genetic and biological factors as well as environmental opportunities and constraints.
- Ability to learn form experience and to adapt to the surrounding environment.
- Visible indicator of the efficiency of various cognitive processes that work together to process info
- IQ is the general capacity
Most tests measure a subset:
- verbal comprehension: understand words, vocab. tests
- verbal fluency: retrieve words, writing down words as many as they can
-inductive reasoning: infer regularities, analogies
-spatial orientation: roatate objects, geometric tests
-number: apply numerical concepts, computation
Fluid Intelligence
- skills that are biologically determined
- skills that are independent of experience and learning
- involves processing info. that is not embedded in a context of exisisting info.
- ability to deal quickly with new situations and unfamiliar circumstances
- spatial orientation, figure out next letter in a string of letters
Crystallized Intelligence
-accumulated and stored knolwedge
-through life-long experiences, education, technical skills learned from a job
- tests for vocab., general knowledge, social judgement
Longitudinal vs. Cross sectional studies differ in understanding cognitive development
-beginning in mid-1950's researchers began to realize that many cross sectional studies resulted in biased information wehn looking at the effect of age on various processes
- cross-sectional studies tended to show declines in various tasks of learning, memory, and intelligence with aging due to Cohort Effect
- longitudinal studies showed slower rates of decline in mental abilities, stability well into the older years, and a great deal of variability among particular test
Nicotine's effects on cognitive development
- nicotine can increase perception, visual attention, attentiveness, arousal, short-term memory, long-term memory, ability to withhold inappropriate responses.
- can help people with AD
- cognitive development is possible still after dementia
-
Cognition and Exercise
- exercise helps to maintain cardiovascular fitness linked to mental maintenance
- medium to low activities less decline
- improves blood flow to brain
- preserve mental detioration, of growth of nerve cells
- women benefit more
- brain areas differ from people who exercise or don't
Attachment Theory
- Bowlby: not feeding or nurturing that begins attachment process through association, but rather the infant's instinctive drives to be safe and secure
- leads to special relationships with that person who provides safety and security
- when threats to safety diminsh, other behaviroal systems can occur like exploration, caregiving, sexual relationships
- Ainsworth: Strange Situations:- secure attachment= beocomes upset, comes back remains close, and then plays again
- insecure/avoidant= cries a little, indpendent, to explore room, avoids parents return
- anxious= clings to mother and is upset when she leaves, cries a lot, ambivalent when she returns
- when child experiences a parent as usually available, responsive and accepting=secure attachment
- when attachment figure fails to provide the child with the experiences necessary to foster a secure base, insecure attachment develops
- emotional bond that develops between adult romantic partners is similar to the emotional bond between infants and their caregivers
Cohabituation Partners
- age is negatively associated with it
- usually younger
- hihger levels of alcohol
- mostly socially isolated
- low levels of religiousity
- 45% lead to marriage
- mostly women unpartnered
- mostly to men and previously married
- more violence in comparison to married
- higher rates of separation and divorce
-
- most cohabitants break up
- incresing # of them become parents
-
Gay/Lesbian Relationships
- no difference in child adjustment or well-being
- lesbian mothers spend more time on house and child than fathers
- biological mothers more time on child though than social mother
- lesbian mothers are more emotionally involved than heterosexual mothers
- higher respect for childs autonomy
- no differences
- confusion about gender identity
- do not acquire a female and male role
- long-term relationships in lesbians
- levels of satisfaction the same as heterosexuals
Marital Status and Well-Being
- women marry at a younger age
- those with lower well being measures are less likely to marry
- widowhood with lower levels of morale
- older you are the lower your morale and social engagements
- increased age with poor psychological reasoning
- widowhood perceived health effected in short term, but actual health in long term
- the more resources a person has, the better the chances of forming a satisfying relationship
- those with satisfying marrieages had highest self-esteem
Advance Directives
To make our preferences known to health care providers and others who should be aware of them. If he/she is unable to communicate them.
- living will: enables individuals to provide instructions about the kind of medical care they wish to receive if they become incapacitated or unable to make decisions
- health care proxy: durable power of attorney for health care, possible to appoint another person to make decisions about medical treatment, known as a surrogate
- complete it by state laws
- DNR
Ethical and Legal Issues pertaining to death and dying
- wills and insurance
- physician assisted suicide: provides with means to bring death
- defining death
- death certificates
- autopsies
- life insurance
Assisted Suicide in Oregon
- physicians find it difficult to do
- reluctant, average of 2
- usually not present when given the dosage
- elderly people consider it an option
- doctors who discussed end of life decsions, had lower usage of PAS
- ones who did not give pain medication did not give PAS
Housing Care and long-term Options hospice care
- people prefer to die at home
- older in nursing homes, younger in hospital
-Hospice care: provides dying people an alternative to endless medication treatment designed to cure their disease
-Palliative Care: pain should be alleviated and comfort maximized, but a minimum of invasive or life-prolonging measures shoudl be undertaken
Long-Term Care
wide range of supports for people with chronic illness
Independent Housing
older people more likely to live in housing free of mortgage, however, elders have bad homes and upkeeping them
NORC
naturally occurring retirement communities: apartment houses in neighborhoods with easy access
Assisted Living
24 hour care with persons that have no ADL's, small homes, or big living units, include housekeeping, meals, contracts
Adult Family homes/ foster care
owners licensed to take care of 5-6 people, not professionals but have training,
Congregate Housing
-independent living in separate apartments
- share activities with other
- rental, buy
- offer communal services
- skilled nursing care
Continuing Care Retirement Communities
- on a campus
- living accomodations depend on the needs of the person, and availability
- communal dining
- personal nurses
- education/ activities
- transportation through campus
- health care services
- pay monthly fee
Nursing Home
- for people with 24hour care
- needs of chronically ill,
- mandated ratio of staff to patients
Life Satisfaction
- only hope was a predictor of it in young
- capacity for loving relationships was for middle age
- hope, capacity for living, citizenship was a predictor for older adults
- men scored higher on self contorl than young men
- older have fewer constraints, and benefit from this
- transitions on time/expected are easier to adjust to
- incomes related to wellness
- age positively related to this
- midlife time of actiivty
- inner clock governs events
Social Support
- affect, affirmation, and aid received from others
- perception of his or her social contacts and emotional support is more strongly related to physical and emotional health than are most objective measures
- adults with adequate social support have lower risk of disease, death, and depression than do adults with weaker social networks or less supportive relationships
- beneficial effect of it is even clearer when a person is under high stress (buffering effect)
- women with multiple roles suffer greater effects of stress when they don't have adequate social support
- it reduces the negative impact of stressful experiences among the elderly
- it bolsters feelings of control and self-worth and that this is especially true if the stress is occurring in some ares of your life that threatens an important role
Social Networks
- receive support and give it well
- giving side seems to be more heavily weighted than the receiving side, may increase stress
- negative social interactions involve anger, dislike, criticism, or undermining when negative feelings come from those who are central to a person's social convoy, have a negative effect on adult's overall feelings of well-being
- later years of adult hood is a reduction of the amount of support given
Retirement
- fewer people are employed beyond 65, now no age requirement for retirement
- longer life expectancies affecting policy makers
- damage older people's health
- demand for skill rises
- bigger contribution to the economy
- to work beyond normal retirement age
- keep them fit
- social security problems
- public pensions
Langer article
- Field experimetn to assess the effects of enhanced personal responsibility and choice on a group of nursing home residents. Freedom to make choices vs. those who were not. picking a plant vs. given a plant, choosing movie date and not being able to
- pretest had no results
- responsibility were happier
- responsibility ones were more active and alertness
- nurses said that the experimental group showed increases in the proportion of time spent visiting with patients, visiting people outside the nursing home, and talking to staff, less time watching the staff
- movie attendance higher in R group
- jelly bean guess more from R group
- giving them the right to make decisions provides the non negative effects of aging