Phd Psychology Of Aging Past Paper PDF

PHHD – Psychology of Aging i Lecturer, Psychology Department School of Medicine Click to edit master title style Learning Outcomes You should be able to: 1. Identify the various forms of elder abuse and its hidden nature 2. Discuss age discrimination and stigma in healthcare 3. Outline and...

PHHD – Psychology of Aging i Lecturer, Psychology Department School of Medicine Click to edit master title style Learning Outcomes You should be able to: 1. Identify the various forms of elder abuse and its hidden nature 2. Discuss age discrimination and stigma in healthcare 3. Outline and explain Baltes theory of successful ageing 4. Identify caregiver burden & burnout BMF Case (OSTEO/HIP FRACTURE) – link to the psychology of aging "Lisa is an 80-year-old woman, living with her husband Joe who is 79. She has always enjoyed reasonably good health. She is due to see her GP (Dr. Sam Johnson) soon who has been sent the results of a DEXA scan (to assess bone mass) that she had recently" "Lisa's husband Joe’s condition deteriorates considerably and he needs almost constant supervision and eventually requires end of life care and planning, a more sustainable management plan is also required for Lisa’s own health care needs". Identify the various forms of elder abuse and its hidden nature  What is elder abuse? 1. Intentional actions that cause harm (or serious risk of harm) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder 2. Failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm  Frequency: 2%-10% of older adults Lachs & Pillemer: Lancet 2004; 364: 1263–72  What is elder abuse? The abuse of someone aged 65 or over - this happens in a relationship where there is an expectation of trust (e.g. family, health professionals) Can be a single of repeated act, or lack of action Causes harm, distress or violation of human rights  Experiencing mistreatment associated with 3- fold increase in likelihood of death in 3-year follow-up  Can lead to serious physical injuries and long- term psychological consequences. Types of elder abuse Recognise signs of elder abuse: 1. Emotional: seems depressed, confused, withdrawn 2. Social: Isolated from friends and/or family 3. Physical: Has unexplained bruises, injuries, burns, scars. Has bed sores, or other preventable conditions 4. Neglect: appears underfed, dirty, dehydrated, under/over medicalised, not receiving medical care 5. Financial: changes in banking/spending patterns https://www.youtube.com/watch?v=QAsk6g9OHvQ  Risk factors for elder abuse 1. Living in shared accommodation (e.g. nursing home  More opportunities for contact with HCPs 2. Dementia – Disruptive behaviours, frailty, cognitive impairment 3. Social isolation – Increased family stress, abuse hidden from public 4. Pathological state of perpetrators – Substance abuse, mental illness 5. Close relative of the abused Lachs & Pillemer Lancet 2004; 364: 1263–72 Discuss age discrimination and stigma in healthcare What is ageism? Showing prejudice, stereotyping or discrimination because of a person's age Stereotyped as passive, failing physically and cognitively, dependent on others 1 in 5 experience age discrimination in healthcare services https://www.kingsfund.org.uk/sites/default/files/AgeDisc.pdf Examples of ageism in healthcare Rationing medical care for older patients – (e.g. COVID- 19 treatments, access to surgery, etc.) Lack of access to screening services Assuming behaviour linked to cognitive impairment - not screened for mental health problems: Assuming behaviour linked to cognitive impairment Not offered lifestyle treatments Less than 1% are hospital in-patients: Do medical students have a skewed perspective on older adults – only see the sickest older patients? Examples of ageist language “Old” de rly ” “El “Bed- “ S en ior” blocker” “Having a to senior “Fa i l ur e “Senile” moment” thrive” Positive ageism Well-meaning  Patronising? “In your “70 is the golden new 50” years” “Look good for your age” “You can’t ung at teach an old “Yo dog new heart” tricks” Outline and explain Baltes theory of successful ageing Life expectancy at birth, total (years) - 2020 Source: United Nations Population Division. World Population Prospects: 2019 Revision Life expectancy at birth, 1960 vs 2020  1960 Min age (Mali)= 20 Max age (Sweden)= 73 2020  Min age (Mali)= 60 Max age (Japan)= 85 Age profile in Ireland (Source: Central Statistics Office, www.cso.ie) 1996 2031 85+ 1996 80-85 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 05-9 0-4 Men Women Strategies for a Healthy Adulthood and Old Age: Baltes’ Model of Successful Ageing What about people who age successfully and avoid negative outcomes? SOC model: Selection – an adaptive response where you focus on fewer aspects of functioning Optimisation – maximise ability in those aspects Compensation – use psychological and technical strategies to enhance function e.g. pianist – fewer pieces, more practice, contrasts in tempo Use of strategies associated with a range of outcomes including psychological well- being, self-management and QoL Identify caregiver burden & burnout  “The mornings are the worst Lisa & Joe doctor, if I could just get some help…..” “I can’t cope, I just can’t keep “I need some time to myself, going, Joe isn’t well” to get out walking” “I have to do everything for “I’m so stressed……I know I him…..he needs help getting should give the cigarettes out of bed, he needs help up but I’m just so stressed” getting dressed, he needs help washing himself, he needs help going to the toilet, and there’s nobody else there but me…..I’m just exhausted to be honest, doctor”.  Key Feature of Old Age: Caregivers Est. 15-20% of population More women than men (est. 59%- 79%) – 50% increase in men as primary caregivers between 1984-1994 – Women spend 50% more time than men Majority are 35-65 yrs; ave. 47 yrs Person providing care: adult child (41-44%); spouse if older, living in home One in five provide > 40 hrs/week of care Physical Effects of Caregiving Findings from a 2020 US national caregivers survey: 23% rate health as worse, 21% report fair or poor health 53% say their decline in health has affected their ability to provide care Most common aspects of health that have worsened because of caregiving: – 87% Energy & sleep – 70% Stress and/or panic attacks – 60% Pain or aching – 52% Depression – 41% Headaches – 38% Weight gain/loss Physical Effects of Caregiving Physical Effects of Caregiving Characteristics of Caregiver Burnout Clinical indications – Changes in appetite, headache, fatigue, difficulties concentrating, insomnia, > alcohol Increased stress & anxiety Circular thinking – Trapped in own perspectives Social isolation Depressive & affective symptoms – Loss of control, powerlessness, guilt, grief  “The mornings are the worst Does Lisa have doctor, if I could just get caregiver burnout? some help…..” “I can’t cope, I just can’t keep “I need some time to going, Joe isn’t well” myself, to get out walking” “I have to do everything for “I’m so stressed……I know I him…..he needs help getting should give the cigarettes out of bed, he needs help up but I’m just so getting dressed, he needs stressed” help washing himself, he needs help going to the toilet, and there’s nobody else there but me…..I’m just exhausted to be honest, doctor”. Why it matters Be aware of your stereotypes and prejudices in relation to aging Communication: adjust your consultation style; allow more time for information to be considered before asking questions Advise: help older patients understand that exercise can improve cognitive and physical functioning even in older age Why it matters Healthcare professionals need to be able to identify abnormal patterns of development and treat them appropriately to minimise disturbances to physical/psychological growth Being aware of people’s capabilities at different age’s also allows for optimal HCP-patient communication BMF – Health Psychology Assessment BMF Reflection Assignment (700-750 words) – Complete the VIA Strengths Questionnaire: www.viacharacter.org – You must complete the online character strengths questionnaire to complete this assignment. – Submission Deadline: Check the VLE for reflection documents. More information after the BMF character strengths lecture Required Reading: Alder B., et al.: Psychology and Sociology applied to Medicine. Pages 14-17. Morrison V. & Bennett B. An Introduction to Health Psychology.2012 (3rd Ed.).Pearson. England (pages 18 - 20) Recommended reading: Ageing in Ireland: www.ncaop.ie – factsheets Elder abuse: http://www.elderabuse.org.uk/Index.htm Small GW. What we need to know about age related memory loss. British Medical Journal 2002,324,1502-1505 Fialova et al. (2005) Potentially inappropriate medication use among elderly home care patients in Europe. JAMA, 293:1348-1358